06-1005 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tiht 4 4v Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
06-00061005
Owner:
Property Address:
80560 PEBBLE BEACH
M/M CARPENTER
APN:
775-131-075- - -
6
80560 PEBBLE BEACH
Application description:
MECHANICAL
D
LA QUINTA, CA 92253
.Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1500
MAR 1 c� 2�o6
--
Contractor:
Applicant:
Architect or Enginee
off V11111%
PALOMA AIR CONDITIONING
P.O. BOX 3510
PALM DESERT, -A 92261
(760)'347-1212
Lic. No.: 619091
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, and my License is in full force and effect.
\� License Class`. C20 License No.: 619091
I'! Date: _ Contractor: ��co %4 4,
"a 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
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 7600) 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, wilt 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 thafthe
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 _ 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/13/06
WORKER'S COMPENSATION DECLARATION'
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 insurince,,as required by Section 3.700 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 0000133-2005
F certify that, in the performance of the work for which this permit is issued,.) 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 workers' compensation provisions of Section
3�)t700 of the Labor Code, �I shall forthwith comply with those provisions.
—3: /43
Date: ^��ppican P- g4g�& i�i K
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 authorize representatives
of this county to erlter upon the above-mentioned property for inspection purposes.
Application Number . . '. . . 06-00001005
Permit . . . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 19.50
Plan Check Fee
4.88
` Issue Date . . . .
Valuation . . .
.
0
Expiration Date . . 9/09/06
4 Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 4.5000 EA MECH
VENT INST/ DUCT ALT
4.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE EXISTING DUCTS.
Fee summary Charged
-------------------------------------
Paid Credited
----------
Due
Permit Fee Total 19.50
----------
.00 .00
19.50
Plan Check Total 4.88
.00 .00
4.88
Grand Total 24.38
.00 .00
24.38
LQPERMIT
Bin #
city of La Quinta 4.
Building U Safety Division
P.O. Boz 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit:# S
0
Project Address:'
Owner's Name:
A. P. Number:
Address: d /
Legal Description:
Contractor: I
City, ST, Zip:
Telephone:
Address:
Project Description:.
City, ST, Zip: C) LI
Q
Telephone:
State Lic. # : G l 9 Q V
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
t� J'
tet. J" •.
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd •
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
'Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up.
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2°" Review, ready for correctionsrssue
Electrical '
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked Up
S.M.I.
H.O.A. Approval
Plans, resubmitted
Grading' ,
IN HOUSE:-
''" Review, ready for correctionshsssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
INSTALLATION CERTIFICATE. (Page 4 of 12) CF -6R
Site Address ' Permit Number
fJ
INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE
INSTALLER COMPL NCE STATEMENT \.
The building was: ✓ Tested at Final ✓ Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION' STAGE:
�' Remove at least one supply and one return register; arid verify that the spaces between the register boot and the interior
finishing wall are properly. sealed.
❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect' the connection points
between the air handler and the. supply and 'return plenums to verify that the connection points are properly sealed.
14 Inspect all joints to ensure that no cloth backed rubber, adhesive duct tape is used
New Distribution system is fully ducted (i.e., does not use building cavities 'as' -plenums or platforms returns in lieu of
ducts).
z ,y
✓ DUCT LEAKAGE REDUCTI,ON u.
lr . r-1 I . ..r....N......_d .4; . 0;, f—f; o ni nir dicihudnn cuclornc aro nvnilnhlo.in RAI l/. Annandir RC4. 3
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
r
�.;
1
Enter Tested Leakage Flow in' CFM:
y
Fan Flow: Calculated (Nominal: ✓ 0 Cooling ✓ ❑ Heating) or ✓ ❑ Measured
„�
2
If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(kBiu/hr) x Heating
6 I QV
Capacity in Thousands of Btu/hr, enter total,calculated or measured fan flow in CFM here:
3
Pass if Leakage Percentage. 6% for Final or':5 4% at'Rough-in:
❑ Pass O Fail
100 x Line # 1 / ine # 2)11
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out
4
Enter Tested Leakage Flow in CFM, from Pre -Test of Existing Duct System Prior -to Duct
0
System Alteration and/or Equipment Change -Out..
f�,R
art
~..
Enter Tested Leakage Flow in CFM from -Final Test of New Duct System or Altered.Duct
1
5
System for Duct System Alteration and/or Equipment Chan e -Out.
y
Enter Reduction in Leakage for Altered Duct System
6
Line # 4). Minus Line # 5 —(Only if Applicable)
h
7
Enter Tested Leakage Flow in CFM, to.Outside (Only if Applicable)
✓ ✓
Entire New Duct System - Pass. if Leakage Percentage S 6% for Final
❑pass ❑Fail
8
100 x Lirie # 5 / 4 , Line #2)11
TEST OR VERIFICATION STANDARDS: For`'Altered Duct System and/or HVAC Equipment Change
✓ ✓
Out Use one of the following four..Test:or:Verification.Standards:for com 'lianc
9
Pass if Leakage Percentage:5 15% [100 x [T 1' Line # 5) / ��d ine # 2)]]
4,6
Pass ❑ Fail
10
'Pass if Leakage to Outside Percentage. 5.10% [100 x (__(Line # 7) / (Line # 2)]]
❑ Pass 0 Fail
Pass if Leakage Reduction Percentage zi 60% [100 x L (Line # 6) / (Line # 4)]]
❑ pass ❑ Fail
11
and Verification by Smoke Test and Visual Inspection..
12
Pass if Sealing of all Accessible Leaks,and`Verification•by- Smoke Test and„Visual_Inspection)..
❑ Pass 0 .Fail
Pass 'LOne,of;Liries:# 9 through # 12 pass
ass ❑ Fail
✓A, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for
compliance credit. I, the undersigned, also certify that the.newly installed or retrofit Air -Distribution System Ducts, Plenums and
Fans comply with Mandatory requirements.specified in Section 150 (m) of the 2005 Building Energy Efficiency standards.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature:
Date: .Z ` ..
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms September 2005
CERTIFICATE OF FIELD VERIFICATION & DIAGNOS}TIC TESTING (Page 1 of 8) CF -4R
r'
Projec Address 2J1 Builder Name
Builder Contact Telephone Plan Number
HERS ater Telephone Sample,Group Number
/ lZ
ifyin-g�Signature ,y Dat" Sample House Number
Firm:y .�� + 451pa4/�je S / ` HERS Provider: /� � S
Street Address: ���f� �J7 6)✓-_ City/State/Zip: C�,�i �1IJy� l Cl.
Copies to: Builder, HERS Provider and Building Department
HERS RATER COMPLIANCE STATEMENT
The house was: ✓ ❑ Tested ✓ 'X Approved as part of sample,testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies
with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that
the new distribution system is fully ducted and correct tape is used before a CF -4R may be released"on every tested building.
The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample
and tested buildings.
The installer has provided a copy of CF -6R (Installation Certificate).
New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of
ducts).
New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in
combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.
✓ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Procedures for field verification and diagnostic testing of air distribution systems are aa'ailable in RACM, Appendix RC4.3.
Duct Diagnostic Leakage Testing Results ;;Z, ,7/ /Ih
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
;�
wlf�R
Values
#
I
Enter Tested Leakage Flow in CFM:
n�a tY
2
Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓440easured
/
Enter Total Fan Flow in CFM:
x
b
✓ ✓
3
Pass if Leakage Percentage 5 6% [ 100 x [_(Line # 1) / (Line # 2)]]
❑ Pass ❑ Fail
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out
-.;
4
Enter Tested Leakage. Flow in CFM from CF --6R: Pre -Test of Existing Duct System Prior to
Duct System Alteration
and/or Equipment Change -Out.
5
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System
g Y Y
for Duct System Alteration and/or 'Equipment Change -Out.
%�
% �%0-111,t{s
7, � y i
Enter Reduction in Leakage for Altered Duct System
6
[ (Line # 4) Minus (Line # 5)] - (Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
8
Entire New Duct System - Pass if Leakage Percentage <_ 6%
..
❑ Pass ❑ Fail
100 x Line # 5 / Line # 2
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Chan
a -Out
✓ ✓
Use one of the following four Test or Verification. Standards for com liance:
9
Pass if Leakage Percentage 5'15%0 [100 x (Line # 5,) /AM/0 (Line # 2)]]
�%v
��
❑ Pass ❑ Fail
10
Pass if Leakage to Outside Percentage 5 10% [100 x F (Line # 7) / (Line # 2)]]
❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage >- 60% [100 x [ (Line # 6) / ' (Line # l)]]
11
and Verification b Smoke Test and Visual Inspection
❑Pass ❑Fail
F
Pass if Sealin of all Accessible Leaks and Verification b Smoke Test and Visual Ins ection
i
❑ Pass ❑ Fail
Pass if One 0; Lines # 9 through # 12 pass
' ' '`
Rh
;5�Pass ❑ Fail
Residential Compliance Forms March 2005
- ' -- & 14RIN 10 VS
T. F
R
A M
0 VY:- 'i*.
INSTALLER
MPLIANCE STATEMENT FOR DUCT LEAKAGE
INSTALLER COMP9ANCE STATEMENT
The building was: v" Wested at Final / �rTeited'at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE:
Remove at ' least one supply and one return register, and verify that the spaces between the register boot and the interior
finishing wall are properly.sealed.
0 If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used
New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of
ducts).
VDUCT LEAKAGE REDUCTION.
Prbceduresforfieldverification and diagnostic testing of air distribution systents are available in RACM, Append& RC4.3
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
I
Enter Tested Leakage Flow in CFM:
Fan Flow: Calculated (Nominal: ,' 0 Cooling V 0 Heating) or V 0 Measured'.
2
If Fan Flow is Calculated as 400 cfm/t'on x number of tons,or as 21.7 cfiri/(�Btu/hr) x Heating
Capacity in Thousands of Btu/hr, enter total calculated or rneasvred fan flow in CFM here:
3
Pass if Leakage Percentage:!� 6% for Final or 4% at Rough -in:
0 Pass 0 Fail
[100 x [—(Line# 1)/,_.(Line#2)11
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out
gas-=,
4
Enter Testdd-Leakage Flow in CFM from Pre -Test of Existing Duct System Pr.ior-to Duct
System Alteration and/or Equipment Change -.Out.
Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct
5
Duct System Alteration and/or Equipment Change -Out.
Enter Reduction in..Leakage -foe Altered Duct System
6
[ _(Line # 4) Minus --L—(Line # 5A — (Only if Applicable)'
7
Enter tested Leakage Flow in CFM,to Outside (Only if Applicable) Y..
V/
Entire New Duct System - Pass if Leakage Percentage :� 6% for Final
0 Pass 0 Fail
8
[100 x [_(Lin . e # 5) Line # 2)11
TEST OR VERIFICATION STANDARDS: For Altered D . uct System an&or HVAC Equipment Change
V/ V
Out Use one of the following four Test or Verification Standards for comuliansie:
9
Pass if . Le . akage Percentage 15%. [100 x ine # 5) 11 t1rine # 2)]]
P�ass C3. Fail
10
Pass if Leaka (Line # 1) /
ge to -Outside Percentage:5.10% [100 x [ _ (Line . # 2)]]
0 Pass 0 Fail
Pass. if Leakage Reduction Percentage �-> 60% [100 x [ (Line # 6) / — (Line # 4)]]
0 Pas*s'' 0' Fail
and Verification by Smoke Test and Visual � Inspection
1.2
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
.0Pass - Fail
Pass.if Oneof Lines# 9 through# 12 pass
P"Pass 0 Fail
the undersigned, verify that the above diagnostic. test results w*ere performed in conformance with the requirements for
compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air- Distribution System Ducts, Plenums and
Fans comply with Mandatory requirements specified in Section 150 (m) of the'2005 -Building Energy Efficiency standards.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature:
Date:
/ 711
Copies to:.BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms September 2005
CERTIFICATE OF FIELD VERIFICATIO/N�& DIAGNOSTIC TESS'TING (Page 1 of 8) D CF -4R
�0'S�
Pit'--ecl Address Builder Name
Ycvm4^ 317 -I2 -i7 -
Builder Contact Telephone
HERS
Pftifying Signature /
Firm: ��_ + h&5p ww� 5
Street Address: -Na,9 4A�a,y- _
(Y-17 /
Telephone
Plan Number
Sample Group Number
It Sample House Number
HERS Provider: /C�'
City/State/Zip: Z-4 LF14n
Copies to: Builder, HERS Provider and Building Department
HERS RATER COMPLIANCE STATEMENT
The house was: ✓ ❑ Tested ✓ X Approved as part of sample testing, but was not tested
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies
with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must check and verify that
the new distribution system is fully ducted and correct tape is used before a CF -4R may be released on every tested building.
The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample
and tested buildings.
The installer has provided a copy of CF -6R (Installation Certificate).
New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of
ducts).
New systems where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in
combination with cloth backed, rubber adhesive duct tape to seal leaks at.duct connections.
✓ MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT
Procedures for field verification and diagnostic testing of air distribution systems are ailable in R4CM, Appendix RC4.3.
Duct Diagnostic Leakage Testing Results �/ /) y, )
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
1
Enter Tested Leakage Flow in CFM:191.
2
Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓42aAeasured
/
Enter Total Fan Flow in CFM:
6
✓ ✓
3
Pass if Leakage Percentage 5 6% [ 100 x [_(Line # 1) / (Line # 2)]]
❑ Pass ❑ Fail
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out;
^ '
4
Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to
., ! /
Duct System Alteration and/or Equipment Change -Out.
psi
M."
5
Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System".
%�
for Duct System Alteration and/or Equipment Chan a -Out.
�,.,.
Enter Reduction in Leakage for Altered Duct Systemwea.
6
(Line # 4) Minus (Line # 5)] - (Only if Applicable)7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
8
Entire New Duct System - Pass if Leakage Percentage <_ 6%
100 x Line # 5 / Line # 2
❑ Pass ❑ Fail
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Chan
a -Out
✓ Vol
Use one of the following four Test or Verification Standards for compliance
9
Pass if Leakage Percentage<_ 15% [100 x (Line # 5) /l t0 /169 (Line # 2)]]
L1,��y
41
❑ Pass ❑ Fail
10
Pass if Leakage to Outside Percentage:5 10% [100 x r(Line.# 7) / (Line # 2)]]
❑'Pass ❑ Fail
Pass if Leakage Reduction Percentage >_ 60% [100 x r (Line # 6) / (Line # 1)]]
11
and Verification b Smoke Test and Visual Inspection
❑Pass 13 Fail
12
Pass iealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection
13 Pass ❑ Fail
Pass if One of Lines # 9 through # 12 pass3
`s.,t'3
Pass ❑ Fail
Residential Compliance Forms March 2005