06-2596 (MECH)P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Q" Tlit(f
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002596 Owner:
Property Address: 53220 AVENIDA RUBIO DANIELLE FURMAN
APN: 774-043-011-14 -000000- 53220 AVENIDA RUBIO
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 6000
Contractor:
Applicant: Architect or Engineer: TELEFORDJONES, INC.
25920 IRIS AVE, STE 13A-400
MORENO VALLEY, CA -92551
(951)486-0337
Lic. No.: 856936
Er
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, nd my License is in full force and effect.
License Class: B -C10 -C20- Licens,, o.: 856936
Date: /� �6 Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
(to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
GA any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
I.QPF.RMTT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
X
Date: 7/06/06
JUL 07 2006
CITY OF LA QUINTA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section.3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 046-0014249
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the work rs' compensation provisions of Section
37000 of the Labor Code, I shall forthwith comply those provisions.
Date: 7-6 V 6Applicant:
WARNING: FAILURE TO SECU E WORKERS' C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the .
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of -this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby uthorize representatives
of this county -06 Signature
upon the above-mentioned property for inspection purposes.
Date: 71 V 6 Signature (Applicant or Agent):
Application Number . . . . . 06-00002596
Permit . . MECHANICAL
Additional desc .
Permit Fee - 33.00 Plan Check Fee 3.75
Issue Date . . . Valuation . . . . 0
Expiration Date 1/02/07
Qty Unit Charge Per Extension
BASE FEE 15.00.
1.00 9.0000 EA MECH FURNACE <=100K 9.00
1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE FAU/CONDENSER/COIL. INSPECTOR
TO FIELD VERIFY THAT THERE IS LESS THAN
40' OF DUCT IN UNCONDITIONED SPACE PER
CF -AR ALT -IF MORE THAN 40' DUCT TESTING
IS REQUIRED.
t► Fee summary Charged
e+
[•
LQPERMIT
Permit Fee Total 33.00
Plan Check -Total 3.75
Grand Total 36.75
Paid Credited Due
---------- ---------- ----------
.00 .00 33.00
.00 .00 3.75
.00 .00 36.75
Bin #
Permit #
nq�l�
Project Address; 53Z ZG
A. P. Number:
Contractor: V
Address: ;?C)
City, ST, Zip:
Telephone:
State Lic. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lia #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Cnlcs.
Truss Cales.
Mtle 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
n
City of La Quinta
Building ar Safety Division
P.O. Box 1504, 78495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Lia M
X� 0,37
APPLICANT: DO NOT W
Rec'4d TRA
Plan Check submitted
Reviewed, ready for carr
Called Contact Person
Plans picked up
Plans resubmitted
2"" Review, ready for cora
Called Contact Person
Pians picked u— p —�
Plans resubmitted
34 Review, ready for cora
Called Contact Person
Date of permit issue
Owner's Noma:% ![ C �N�
Address: ?&)
City, ST, Zip: ' �a /�-
Qv<�r ZZ5
Telephone: �
Project Description: Q
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Demo
Sq. FL: # Stories: #Units
Estimated Value of Project:
RITE BELOW THIS LINE
"ICING PERMIT FEES
Item
Amount
actions
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
ectiorWissue
Electrical
Plumbing
S.M.I.
Grading
etlons/lssue
Developer Impact Fee
A.LP.P.
Total Permit Fees
06/04/2001 08:06 FAX 8585869098 SEARS SAN DIE60 JONES IaOO4/005
06-19-2006 20:11 PAGE16
CerthIcate of Connoltanca Prascrinthm Nlathnd . 14Vec-nnhr At atrwtfnn (73MR.Al T
PtviecfT e: Date: ® CaICERTS 2006
Prof Climate Zona:
oaammnte r, Tet one:
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Company ams;
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IMPORTANT This CF -IR -ALT forth Is only for US$ whom an HVA my elperatlon Is made to an eddsting home
Use for eech e a bei altered This Is s # o s aitera0.ln this haus
Cheek all lines that anniv. Chacic only Ila= -j of atldly,
Scope of Altweeona:
1 ❑
rMr Nandlkw b b be Irtetelied er aced. Ours aealktq to be deteenIned. bantlnue to nad blc,
2 fitt�
Furnace Neat err to b ba a Duct awfi to be determined. Continue to nod I(rNL
.3 ,8[
outdoor — Plaraing unit b tao be Irtamllad crraotvm& Duet 8eaAnn ardkr TXV(ACA) to ba datermined. Cangma to nerd. Um
4
0000n a heath cell b b be instslied or Duct Sarlht w dlor TxV to ba dotertnlnod. uo Wno,
5 ❑
(hen 40 bet of wN er ra0mement duct aro to be instsaed in unamdl5ooed'space. Dud sedit to be detawbad. -
Chdok here if On tsdlm duct to dery to be nay or aced. 9AWK2 to am Im
6
If Itnee 1-5 ars ehedwd nellher Duct &WIM nor TXV are Mgtfmd Go b Sedlm S.
ON 1 2 �.
7 O la In ClImete Zane 1 3.4. e 7 a e. No duct ct gad, t90 to 8edkn 2
section1dud
8 §� h. less titan4o feet ofd In unparx Honed No duct seat is aired. Go to Section 2.9
17 system wu PnNotz* tronled and teetadendwata*V§adbyqNFRSrefs. t
ud to ulmd. Attach mwiows CF4R ftm. Go to Be10
EI slam h or insulated weh esbedn No duct r to tired. Go to Section $.
Note
if the atre dud sYsten is to be new or ere aced Lines 11-14 do not a
11 C
Ciera 2cr= Z-12 end 1& An d• AFUE Axnace win be Irtstellad In Rau dduct eedl and YW If
12Q
n ClhnfdePo+®10. 13 and 15: An SEER 14 AWEER 12 oaldenew will bakglWttl wim TXV("
D asded d= IMtrl Wm duets R-0 roc duds)In lieu of duct . Onto 6,,", 2-
13 O
n rxmate Zotec 9, 40, 11,1$, 14. or 18: An SEER 14 AM EER 12 oottdauer wW be inataued with TXV(RCA)
P a 0.92 AIIIE f (masa wIY ba meted in Ilau of dicot mw Ga to Section 2.
14 (3
Cheat Zane 2, 9,11,12, 14 al' 1 e: An SEER 14 Aka (!ER 12 t mwentrer will bo ktetailed wNh TXV(RCA)
an 0.62 AFUE Omani vAl be btablled wllh Incromw duct tnsulatlan In Rau of duct sedW. 0010 Bandon 2.
15 13
oma Yhae,714abovearedrectWd Duct Swing laRequired, Condrtue.
Section 2 - Oni nes 3 or 4 are d1 ; otherwiae Clot to Section 3
16 O '
s bei &2!2!&URr-A is Owulmd, fb to SeWnrt 3.
17 p
0,*9m to In C3lmefe Zona B ung a 14 6199K sir ow4gorw or 0.42 AFUE t m&a Is being tm"Rd.
Now Is rmvw. do to sw5err
18 ❑
syclan lain Glmde Zone 1 4 a o or 7. No tt s
19 �
1, lite 74tH 16 and 6+e 1 is mol dteciatd. N T7(V red. to 3.
20
hla Ia In CYmafa Zcm to (I 14 b &Ackod 'and nat llna te. 7XV("JoyaquTred. Go to 9eouon a
21 Thle oystem Is In C6t"mb 2 or 6.15 and Grta 11,19 or 17 Is not checked. TXV (R Is requtnd. Go to SeWon d,
8t don 3 - HERS Rater veriflcetl
22 C), INilne 15 is HERS wYMicaeon tp required for Duct saalln ,
23 3e tune 12 19 14, 20 a 21 we dwdmd not line 19 or 17 NERe wrinattlon b requlrad for TX PM&
24 One 12 13 or 14 We checked, HERS veMtkatlon ct mquhd for 1Z UR.
Section 4 --Fqulomgnt Efficlandes
25 ❑ Of 5te9 11. 1& 13,14 or 17 are checked, upgraded equlpmeet efficienelea are required. Lbt In !!sedan 9.
Section 5- Duct R Values
26 pIt
mora that 40 feet ofd Inctauod or ryplaqW, duet R -value mud m or used Package 0 requirernwft.
270 If
lee! then 40 tat of duct la being ImWled at Wmed, duot RwWue must n►MI or atanad R-4,2
Baden 6 - see n®d me
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TMs form ran only be used oh prtslects being verified try CaICERTS certified raters. www.ealowts.00m
06/04/2001 08:06 FAX 8585869098 SEARS SAN DIEGO JONES 1a005/005
05-19-2906 20:12 ` ; PAGE19
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