0009-085 (RER)LICENSED CONTRACTOR 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
Professio ipls Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
. 280103 BMC f1 _1/2(
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
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.
Q ),.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 & policy no. are:
Carrier STATE FUNDPolicy No. 046-00-0008198
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 Isshould become
subject to the workers' compensationprovisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: 4- , ., Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
,
Signature (Owner/Agent) - "-Date
BUILDING PERMIT PERMIT#
r
VALUATION LOT 0".AMJ
DATE TRACT
(�
-1�1 i fiQ $484(KI.00
JOB SITE
ADDRESS 49_675 CO'k1Cmi A D ' vv
APN
OWNER
CONTRACTOR/DESIGNER/EN INEER
FIM Ii.OZAL
GEWITE CVA SMIJU11014INC
49.675 COACRE LA
2121 F_ TAHQii%CL CA14YON 02
LXQ1JIA1rA CA 92253
PALMSPIZ114GS CA 92262
(760),323-9445 CBLO 1001.
USE OF PERMIT
It4�C'�1'..LA3�iEOLiS
.
ILEMOVFJRP'PLACE ALL FENFSTPLATION/RVEA.CE
(I)DA,TFIROOM(I) AUNDRYRCIOM/Ft6: OCA E.AX' UN[TIRAiSE ROOFibPew
PATIO COVER PZIR..APPROVFD PLANS ONLY
"LUATION 48,000:00 LS
ESI11*4X. KD COST OF CONSrTRAYCHON
49,000.€ 0
PLAN CHECK FEE 101-000-439-318 $260.98
CONST RUC71ON FEE. 101-000.418-000 $401.30
MECHANICAL. FEB 101.000-4.21-000 545,00
ELECTRICAL FEE 9,01 -000.4.20-000 $.30,00
PLUMBINO FEE 10f-000=419«000 $45.00
" ? STR.ONQ MOTIO114 IEE • REED 10V060-243 -000 $4.90
SEP 18 2000
"ITY OF LA WIWI,
MM I OTAL CONSIFMIOt3 MD PLAN C,`19MI
5187.28
r a
M93 PRE -PAW F�C�.�3
$0,00
TOTAL PERMf FEES DUE NOW
5767.28
tf
RECEIPT
DATE
BY
DATEtIN4ED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs ��Ol �Zj (9-
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
_ _
O.K to Wrap
F.A.U.
_ _� _ _
Framing
Compressor
Insulation [) — —
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_
Final-' �_(�
Final
POOLS - SPAS
BLOCKWAL� A PROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PIN. Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines �_ ��—� ��–
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final(`
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voftage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
. TSI-NNOS mam]EowNEFI-s Assacm'A=XdN Na - T
................................................................................
P. 0. Box 1271 La Quinta CA 92253
760/564-2177 FAX 760/564-4882
September 6, 2000
Planning Department
CITY OF LA QUINTA
P. 0. Box 1504
La Quinta CA 92253
RE: Remodel of Kozel Residence
49675 Coachella Drive
Gentlemen:
A review of the plans submitted by Gemette Construction for remodel of
residence referenced above meet all the criteria setforth in the Association
CC&Rs.
If you have any questions, please contact the office.
Yours truly,
�o%
Ann
Tuttle
Association Manager
h'�/ b,i:IUUIO US: 4G i''JUV62 f'_ -4_"'D
Description / Application
• All models design certified by ETL and ETLc
testing laboratories to be in compliance with
United States and Canadian Safety Standards.
• Completely assembled, factory tested furnace, for
heating or combination heating / Fooling application.
• For utility room, closet, alcove, basement or attic
application.
• All models can be common ventedwith a water
heater using 5-1 vent.
• Capable of multiple position installation - upflow,
downflow or horizontal (ieft side anti right side
application),
• This product must not be ncrizontelly vented without
the use of optional equipment SVS -80, Sidewall
Venting Slower.
Construction
• Heavy gauge, reinforced, wrap-around Insulated,
steel cabinet with durable baked enamel finish.
• Aluminized steel heat exchanger cells featuring our
"weld free" manufacturing process.,
• Aluminized steel in -shot burners.
• Right hand or left hand connection for gas
and electric service.
SS -166
&)'T 15 o Lbs
Multi -Position
Induced Draft
Gas Furnace
GMP Series
fiAICIENC I
innna rum �aihatlon eMd.nm• A/Le AAtING
nas.ceca C (R rIFIE O
°� ama
4
79M • sJli N1a N�
Standard Equipment
• Energy saving PSC, multi -speed, direct drive
blower inotors.
• Quiet operating, sound isolated blower assembly.
• 40va transformer for heating and air conditioning
control service.
• Combination redundant gas valve and regulator.
• Integrated furnace control with diagnostics.
• Slower door safety switch.
• Energy saving hot surface ignition system.
• Alternate bottom, left or right side return air
connection provision.
• Quiet operating vent motor.
• Easily removable base plate.
• Multiple flame roll-out switches.
• Outlet"air limit switch.
• Pressure switch for proof of air.
• Complies with California LoNox Standards.
Optional Equipment
• L.P, conversion kit (LPM-01)
• Combustible floor base for downflow configuration
(Sam).
• Sidewall Venting Blower (SVS -80) for horizontal
venting.
Goodman Manufacturing Company. L.P.
1501 Seamist Houston,Texas 77008 OMP Series 4J98
r��lno/tbbe 08:42 19096275425
1 ,
PERFORMANCE RATINGS
BERGMAN COMPANIES
Model No.
NAT GAS
Input'+
8TUH
Heating Capacity
STUN
DOE" I
AFUE
Temp, Rise
Range
GMP050-3
6 000
36 000•
. t2.8
5
GMP075.3
75.000
60,000
80.0
35.65
(3MP075-4
75,000
60,000
80.0
26.65
GMP100.3
100,000
60,un
80-0
45-75
ramPloo-1001000
8070
86.0
35-65
GMP100-5
100,00
0,000
80.0
35 65
GMP 125.4
125000
80,0
45-75
GMF125j
GMP160.5
1 125100
1 140,000
100.000
112,OOQ•
80.0
$0.0
4 •75
35-65
PAGE 02
' For altitudes above 2,400 feet
reduce input rating 4% for each
1,000 feet above sea level,
- DOE AFUE is based upon
Isolated Combustion System
Ocs).
+L.P, 20m/cell NORMAL INPUT
BEFORE PURCHASING THIS APPLIAW,,E, READ IMPORTANT ENERGY COST AND EFFICIENCY
INFORMATION AVAILABLE FROM YOUR RETAILER.
SPECIFICATION DATA
Electrical Charact ri tics 11 X1160Gas Service Connection 1/2" FPT
BLOWPR Vent Filter- ElecteicalShipModel Motor DIa. I Width pia. Size In FLA Max wt.
MP MP Speeds Metal
050.3 1/3 4 _l0 6 4 14 XF5 5,2 15 114
075-3 113 4 10 6 4 14 X 25 5.2 15 124
075.4 112 3 r'!0 8 4 _1 _x_ 2 7.8 15 136,
1 1/3 4 90 8 4 16 X 25 5.2 15 146
100.4 1 10 8 4 16.9257.8 15 146
100.5 314 3 11 10 4 20 X 25 8,2 15 0-156
12 3 X10 10 4 25 7.8
125-5 314 3 _^I 1 10 4 20 X 25 5.2 15 165
150-5 3T4 3 _10 8(Z A""" 24 X 25 9.6 15 --176
•" Filter dimensions for bottom application. A models require 18" x 25" filters) for side air instal ations, Permanent air
filters recommended. Both sides or bottom inlet(s) must be used for appiicationa over 1800 C.f.m.
""GMP150;5'requires 5" diameter vent in downflow configuration.
DIMENSIONS
Ve
I I d, l� I III I 5 afiti ': f9
CL
vd. 2f
J 1
'I ,215rr i
1
lie -,
Clearances for Combustible Material (all models)
Sides
Rear
To Front' - Vent
V
0"
VertIrioriz LjLi%jler I B-1
•" 8° 3" I i," 1"
MODEL
A
± ®
C
DOWNFLOW
COMBUSTIBLE
FLOOR BASE KIT
080.3&0753
14,0
, 122.5
. t2.8
SHM1a
& -
07 -4 1 8,4
17.5
I .0
a 6.0
S8M'7
100-5 8 125-4 & -51
1s.5
19.5
SBM21 i
150.5
24.523.0
'23.0
§3M24
4- vent connector only
'Accessibility clearance shall take preCadence where greater
Specifications and Performance Data are Subject to Change Without Notice -
2
a]
U3, U31 ZeeU U8.:42 19696275425 IERI_-VAN COMPANIES
�v,o:sF
HORIZONTAL BUTT -UIP
C � . EVAPORATOR COIL
ST
Description / application
• Compact horizontal design for attic or crawl space
applications
e No transition required
Cabinet Construction
- No rust galvanized stucco fnish,
- Insulated cabinet,
• Removable access panel.
PAGE 63
�1
rn
Standard Equipment
- Copper tube aluminum i`in coil.
- No rust high temperaLre thermoplastic drain pan.
- Primary and secondary drain connections
- Check flowrator for heat pump or cooling unit
operation..
Goodman Manufacturing Co., L.P.
SS -255D 1501 Seamist-Houston, Texas 77008 H8 SERFS 8/97
03/05/2000 08:42 19099275425
LIQUID L
SUCTION LINE
SECONDARY DP
BERGMAN COMPANIES
COI,
AIN PAN
PAGE 04
m
SPECIFICATION �'""'
CASE COIL/FURNACE APPLICATION OPTION
HS COIL
COIL SIZE
14" FURNACC 17" FURNACE
17" FURNACE
21" FURNACE
21" FURNACE
f
GMP05w GMP100,3
GMPM-4
GMP125-4
GMP100-5
GMP075-
Gmplo -4
GMPN104-4
OMP125-5
OMPNO40-3 i
GMPNOSO-4
GMPNO60-3
H8-30
14"
X i X
-
-
H8-36
17-1/2"
X +� X
X
X
-
HBO 21 ° - _ X X — X
H9-61 21" X X X
Due to the rating miWmateh of various coils with outdoor units it isoimportant to match the furnace air flow for the total system capacity. Refer to Furnace °
Specification sheets for air flow charts.