08-1129 (MECH)P.O. BOX 1504..
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 0T8-.0.0.0� 0-11-29�
Property Address:
78645 SAGUARO DR
APN:'
646-313-014-114 -0000'00-
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY RES.
Application valuation:
4000
Applicant:
Architect or Engineer:
LICENS D CONTRACTOR' EC ATION
I hereby affirm under penalty of perjury that I Ii nsed under pr io of Ch pter 9 (commencing with
.Section 7000) of Division 3 of tqe Busines d P fes ,an my Lice a is in full force and effect.
Licensee Class: C20 Li n •964 6
Date / r�' Eontractor— . -
9�.'Oti'f
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 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) 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.).
I _ 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 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,QPERAI IT -
Owner:
MELODY FLEMING
78-645 SAGUARO
LA QUINTA, CA
(
92253
Contractor:
J & J INCORPORATED
P.O. BOX 966
PALM DESERT, CA 92260
(760)346-4477
Lic. No.: 596456
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/02/08
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the fallowing 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 ENDURANCE' REINS P icy Number WEN100280802.
I certify that, in the performance h work for.whi- per issued, I shall not employ any
person in any manner so.a o eq me sub1 - o th orkers' compensation laws of California,
and agree that, if I shou_I me subject a kers' compens tion provisions of Section
377000 of. the labor Co I f- rthwith mpl ith those provis ns.
Date: Z y0APP_IicF an�� t: 7'
6�
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 actoromission 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 ssati n of work for 1 n will subject
permit to cancellation.
I certify that I have read this application and state that the above forma is torr e 0 co all
city and county ordinances and state laws relating to buildi s iuct' , and he a ori a representatives
of this -county to enter upon the above-mentioned prope fo pec purpose
Dale: i" 2- 44ignature-(Applicant or Agent) Aol
r
LQPERU4IT
Application Number . . . . . 08-00001129
Permit . . . . . . MECHANICAL
Additional desc . .
Permit Fee 33.00
Plan Check Fee
6100
Issue. Date . . . .
Valuation . . .
.
0
Expiration Date 12/29/08
Qty Unit Charge Per -
Extension
BASE
FEE
15.00
1.00. 9.0000 EA MECH
FURNACE <=10, 0K
9.0.:.,
0
1.00 9.0000 EA MECH_;B/C
<=3HP/100K.BTU
9.0,0.
Spe.cial.Notes and Comments
REPLACE EXISTING HVAC SYSTEMS 13
SEER
HEATING.AND COOLING SYSTEM.
Fee summary: Charged
---------- - - - - ------ - - - - ----
Paid Credited
-- - - - - ------ - - - - ---
Due
--- - - - - - -
Permit Fee Total . 33.00
..00 00
33.00
Plan`Check Total: 6.00
.00 .00
6.00
Grand Total 39.00
.00 .00
3.9.00
Bit, #
City of . LaQ uinta
Building ?I Safety Division
P.O.. Box 1504, 78-495 Calle Tampico
U (uinta, CA 92253 - (760) 777-701.2
Building Permit Application and Tracking Sheet
Permit #
/J '1
�5(S"
Project Address: 79two
5!a
Owner's Name: AV6.0 . -
A. P. Number:
Address: 5 J
Legal Description:
City; ST, Zip: `A Qul,, 2 g -z_0
Contractor:
Telephone:
Address: to�P v
City, ST, Zip:
Projecf Description: P
Telephone: ,•..
.State Lic. #: CityLic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
"Construction Type: Occupancy:
State Lic. #:
� Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: _
Sq. Ft.:
F#stortes:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO: NOT_ WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRACEING
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 Calcs.
Plans picked up'
Construction
Flood plain plan
Plans resubmitted .
Mechanical
Grading plan
god Review, ready for-corrections/issue
Electrical
Subcontactor List
Called ContacuPerson
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A.-Approval
Plans resubmitted
Grading
IN HOUSE:-
3rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.[.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE: RESIDENTIAL PaLre 1 of 1 CF -IRA
Project Title P Gy L v
DateBuilding
Permit #
Project Address
Duct systems that are documented to have been previously scaled as confirmed through field
gnostic testing in accordance with procedures in the Residential ACM Manual.
verification and jLa
2
'78-- Rb
Existing ducts stems that are extended, which are constructed, insulated or scaled with asbestos.
3
1 G
1 Ducts stems with: less than 40 linear feet of ducts in unconditioned spare.
IPIon Check/ Date
1,A q -2-Z'6-3
I
i
Documentation Author
Telephone
Field Check/ Date
Compliance Method (Prescriptive — HVAC and/or Duct
Climate Zone
Enforcement Agency Use Only
System Alteration - b 1.52 (b) l C, D and E)
EXCEPTIONS
If ny of the following three exceptions are ✓, the ducts stem is exempt from sealed ducts.
#
Minimum
( Ef fi iencvHsiP
Exceptions
I
fl
Duct systems that are documented to have been previously scaled as confirmed through field
gnostic testing in accordance with procedures in the Residential ACM Manual.
verification and jLa
2
C
Existing ducts stems that are extended, which are constructed, insulated or scaled with asbestos.
3
1 G
1 Ducts stems with: less than 40 linear feet of ducts in unconditioned spare.
HVAC SXSTE.MS
Heating Equipment Type
and Capacity
boiler. [ ) heat
Minimum
( Ef fi iencvHsiP
Distribution. Type
and Location (ducts,
attic, etc.)
Configuration
Duct or Piping 7 hermostat Type (split or
R -Value pnckagc)
i-' Z r
go 611'
C
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
CF -4R pages 3 of 8
EER as indicated in Table 8-3 of Residential Compliance Manual (climate zones 2 and 9-16 only) (installer testing
and certification and HERS Rater field verification required.)
CF -6R pages 5 and 6 of 12
CF -4R pages 3 and 4 of 8
G EER
CF -6R page 8 of 12
CF -4R pages 5 of 8
Cooling Equipment Type N'linimum
(A, heat Efficiency Duct Location
and Capacity IC
pump, cvap. coating) (SEEP or (attic etc,)
LF.R)
Duct R -Value Thermostat Type
Configuration
(split or
package)
-&<4 JE 4&W74l X77VO-
i-' Z r
TXV (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field verification required.)
C
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
CF -4R pages 3 of 8
EER as indicated in Table 8-3 of Residential Compliance Manual (climate zones 2 and 9-16 only) (installer testing
and certification and HERS Rater field verification required.)
CF -6R pages 5 and 6 of 12
CF -4R pages 3 and 4 of 8
SEALED DUCTS REFRIGERANT CHARGE V AND EER
The prescriptive requirement for either a refrigerant charge or a. TXV does apply to packaged units.
Before the permit can be finalized, a signed CF -4R must be provided to the building department for any of
the following ✓ compliance requirements:
✓
I Compliance Requirement's
HERS Rater Forms (if applicab(e)
Sealed Ducts (climate Zones 2 and 9-16) (Installer testing and certification and HERS rater field verification required.)
C
TXV (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field verification required.)
C
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
CF -4R pages 3 of 8
EER as indicated in Table 8-3 of Residential Compliance Manual (climate zones 2 and 9-16 only) (installer testing
and certification and HERS Rater field verification required.)
SPECIAL FEATURES REOUIRING HERS RATER VERIFICATION
A ✓ Indicates which compliance requirements are part of this project and need HERS rater verification.
Compliance Requirements
Installer Forma (if applicable)
HERS Rater Forms (if applicab(e)
Duct Sealing
CF -6R page 4 of 12
CF -4R page 1 of 8
Q Thermostatic Expansion Valve (TXV)
CF -6R pages 5 and 6 of 12
CF -4R pages 3 of 8
Q Refrigerant Charge
CF -6R pages 5 and 6 of 12
CF -4R pages 3 and 4 of 8
G EER
CF -6R page 8 of 12
CF -4R pages 5 of 8
ti