10-0386 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: X1:0-000003.86 Owner:
Property Address: 80531 PEBBLE BEACH DONALD & DANA MEACHAM
APN: 775-131-024- - - 80531 PEBBLE BEACH
Application description: MECHANICAL LA QUINTA, CA 92253 O
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 415
_ Contractor: .
Applicant: Architect or Engineer: CALIFORNIA EXPRESS ENT INCL
9245 DOWDY DR SUITE 201
SAN DIEGO, CA 9,2126
_ � � (858)'693:-4079 •
LiC. No.: 912239 -
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/03/10
W 2 2010
WYOF LAQUINTA.
FWANiMiE +SEPT
LQPERMIT
------------_-----------
' LICENSEDCONTRACTOft'S'DECLARATION
WORKER'S COMPENSATION DECLARATION -
I hereby affirmunder penalty of perjury that )-am�licensed under provisions of Chapter 9 (commencing with -
I hereby affirm under penalty of perjury one of the following declarations: .:.
Section 7000) of Division 3 of the Business and Professionals Code and my License is in full force and effect. -
I have and",will maintain a certificate of consent to self=insure for workers' compensation,. as, provided
License Class: B C36 C20 License No.' 912239' -
.. for by Section 3700 of the Labor Code, for:the performance of the work for which this permit is
ontractor: _
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
OWNER -BUILDER: DECLARATION -
insurance carrier arB policy numbePare:
hereby affirm under penalty of perjury that I am ezemptdfrom the' Contractor's_ State License Law.for the.
Carrier ENDURANCE .IM 'Policy Number WEN0032455-.02
following -reason (Sec. 7031..5, Business,and Professions Code: Any.cityorcounty.that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I.shall not employ -any.
construct, alter, improve, demolish,•or repair any structure,: prior to its issuance, also.requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
- permit.to file a signed statement that he or she is licensed .pursuantto.the provisions of the Contractor's State
and agree that, it I should bee me_subject to the workers' co pa sation provisions of Section
License Law (Chapter 9lcommencing with Section 7000) of Division of the Business and Professions Code)br
3700 of the Lab Code, I comp with thos'/d[tp�rovisions. -
that:he or she is exempt therefromand the basis for the allegedexemption. Any violation -of Section 7031.5 by
(�onhwnh
any applicant for "a per subjects the:applicantto a civil penalty:of not more than five hundred dollars I$500).:
te: g-•)-'�G plicant:
(_ 1 I', as owner.of-the property, or my employees with wages as their sole compensation, will rho the- .work, and
the structure*is not intended or offered for.sale (Sec. 7044, Business. and Professions Code:The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS,UNLAWFUL, AND SHALL
Contractors`State License Law does not apply.to-`an owner -of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIES AND, CIVIL FINES UP TO ONE HUNDRED THOUSAND
and.who does the work himself or herself through his.or hei'own:emplpyees, provided that the
DOLLARS ($100,000). IN-ADDITION-TOTHE COST OF COMPENSATION, DAMAGES AS PROVIDED'FOR IN
imp' "ments'are not intended or offered for sale.. If,.however, the buddmg-,or improvement is sold. within
SECTION'3706 OF THE LABOR CODE; INTEREST, AND ATTORNEY'S FEES. -
one year of completion, the owner-ouilder will have th_e burden of proving that he or.she;did not build or
- -
improve for the purpose of sale.). -
_
'APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property; am exclusjvely contracting with licensed contractors to construct the project (Sec.
- IMPORTANT Application is hereby made to the' Director of. Building and Safety fora permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply.to an owner of
conditions and restrictions set forth on this application. '
property who builds oi:improves thereon, and who contracts for the projects with a contractors) licensed
1. Each person upon whosebehalf this application is made, -each person at whose: request and for
pursuant to the Contractors'. State License Law!).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ I I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to,. and shall defend,'indemnify and hold harmless the City
- of La Ouinta, its officers, agents and employees for any act or omission related to theworkbeing
performed under or following issuance of this permit.
-
Date: Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation. '
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work -for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to buildingc struction, and hereb authorize representatives
of this county to enter upon the above-mentioned property r' spection purposes
Lender's Name: '
FTo Sililiffiature (Applicant or Agent):
Lender's Address:
LQPERMIT
Application Number . . . . . 10-00000386
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 31.50 Plan Check Fee
7.88
Issue Date . . . . Valuation . . . .
0
Expiration Date 10/30/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1:•00.. 16.5000 EA MECH B/C >3-15HP/>1.00K-500KBTU
16.50
Special Notes and Comments
TNSTAII-`NEW' 13" SEER "CONDENSING -UNIT:
2007 CODES."
-------------------_------------------------------------------
Other Fees BLDG STDS.ADMIN (S B1473)
1.00
Fee summary Charged. Paid Credited
Due
' Permit.Fee Total 31.50 .00.. .00
31.50
Plan•Check Total 7.88. .00 0'0
7:_88
Other Fee Total' '1..00 "' 00 .00
1:.00
Grand Total 40'.38 00 .00
40.38.
LQPERMIT
05/03/2010 11:07 18586958592
,
PAGE 02/04
2v00000
«ago. ' |Pemoa
11 Packaged Unit
REM VERIFICATION SUMMARY Li below are lbur HVAC albmtinn O*k the installer &6 ;ii WOW is ;;;;. dom Itid
inspection and a copy 06 to tho
installer, The
OF ohdftftttd'LV,4R'fb (nb 6atid filled &'u 'Q Illed out. arid
- All HVAC Equipment repinced CF -60 gr—m—r,'k�W.04,
a Condenser Coil ad /or CF -6R fortm:
• hidoor Coil and /or
C3 I Duct systoms with Im than 40 lindu ftt in unconditioned spade, or
'
�
�
For Split SYgems: Duct 6, jCM;; Pir CCA 350 CFwtnn, FWD, TmAll, ms'-andlemer HSPP Or -PSM
for
ng more than 40
OM
Mp
L 4 r
X11-2.0 -HERS,ond(kr;splitsysicw)W.CH.25.UR.S
cm W%52W—I-Wy
2008 Residential Compliance Forms - Afarch 7010
o
05/03/2010 11:07 18586958592 PAGE 01/04
Qin #
City p La Quinta
Building &'Safety Division
Box 1504; 78-49S:Ca11e Tampico
La Quinta; CA 92253 (760):1777.;7012
Bt1il4ing.Permit Appfication andTracking Sheet
Permit #P.O.
411
Project Address:
Owner's Namc;WED' �•
A. P. Number:
Address::��
Legal Description:
Contacor: r RVk. EARM
Addross: L 45
NJppf
City,.$T, 7,V Q; ��
y^
0. 9�
Project Description: L�
City, ST, Zip C
EU
p
M. R 9
Telephone: • F� '3 7
<" 3 s�ai6
State Lic,.fi :
City Lic. #:
,Arch., Engr,, Designer: .
Address:
T, Zip:
Telephone: C:
LStaYto'1___!1
ii �L": ilFi li �p r {
f , tS `�rFf
Construe Typc Occupancy:
aic.
Projcct•type (circle one):: -Add' Alter
Demo
Name of Conte&. Pcrson: .
$q: Fe:
9 Stories:
H Units;
Telephone # o£ Contact Person:
E9tiniated Vlue of Prpject : /00
APPWCANT: DO IVOT:WRITE�BELOW THIS Mi.,
4.
Submittal
Rtq'd
Pecid
TRAC1QNl:
PERMT.FEES
Plan Sets
111nn Check submitted
.Item
Amount
Stractoral Cates.
Reviewed, ready -for corrections
Pian CherJc Deonsit
Trnss.C.0m.
CAlled Contact Person .
Plan Check 110ance,
ritle 24 Calcs.
Plans picked tip
Consdtnctlnn
Flood plain plan
Plans resabmllted
Mechanical:
Grading plan
ztrQ Review, ready for corrcctionslissuc
Ejectrlcn)
Snbcontoctor List
Called Contact Person
Plumbing
.Grant Deed
Plans picked up
S.ivf:I:
H.O.A. Approval
Plans m ubmitted, -
Grading
IN kI0U3E:-
ew, ready for coi rcctions/issue
-Developer Impact Tec
PlanningApproval
Called ContaetPeraon
:AJXX.
Pub. Wks: Appr
Date of permitWuc
school Fees
T&A'Permit Tees . .