08-0257 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
tApplication Number: 08-00000257 I
Property Address: 78285 CLOUD VIEW WY
APN: 770-032-021-60 -28019
Application description: MECHANICAL
Property Zoning: MEDIUM DENSITY RES
Application valuation: 4000
Applicant:
f
Architect or Engineer:
Ok
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that 1 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: C20Jy� License No.: 596456
LDate~ i/� Contractor: V
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).:
1 _) 1, 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.).
(_) 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: 2/05/08
Owner:
POWELL RESIDENCE
78-285 CLOUD VIEW WY
LA QUINTA, CA 92253
Contractor: ZOOp
J & J INCORPORATED PFFEB 05 0
P.O. BOX 966
PALM DESERT, CA 9226
(760)346-4477
Lic. No.: 596456
-----------------------------------------------
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 VIRGINIA Policy Number
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 workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date:— Applicant:7ri �J l\r
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 ($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 fromdate 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 t7ntat upon the above-mentioned property for inspection purposes.
♦T� \.I T
Date: Signature (Applicant or Agent): f J
Application Number 08-00000257
t+� Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date
Valuation . .
. .
0
Expiration Date 8/03/08
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
B/C <=3HP/100K BTU
9.00
------=---------------------------------------------------------------------
Special Notes and Comments
RETRO FIT NEW 3 TON 14 SEER SYSTEM.
Fee summary Charged
Paid Credited
Due
-------------------------------------
Permit Fee Total 33.00
----------
.00 .00
----------
33.00
Plan Check Total 8.25
.00 .00
8.25
Grand Total 41.25
.00 .00
41.25
LQPERMIT
CERTIFICATE OF COMPLIANCE: RESIDENTIAL Pa e 1 of 1 CF-1RA
Project Titl Da
®Cis C�_��,�E>> " yC � �-�c�✓C.�--
uiWrrAR .Permit # .
Project Address n
17R i Y_ _ Ri b1l/
n
y� rU- ave" C�l(iv cl ll-Obc iZL
Plan Check/ Date
I
Documentation Author
Telephone Field Check/ Date
-- 3-4
3& `6
Compliance Method (Prescriptive — HVAC and/or Duct
Climate Zone Enforcement Agency Use Only ,
System Alteration - § 152 (b) 1 C. D and E)
i
�.
EXCEPTIONS
Ifanv of the followine three exeeetinnR are ✓- the duct wgtern is exemnt froth sealed dvctc
#
J
Exceptions
1
n
Duct systems that are documented to have been previously scaled as confirmed through field
verification and ALqnostic testing in accordance with procedures in the Residential ACM Manual.
Z
1 C
Existing ducts stems that are extended, which are constructed, insulated or scaled with asbestos.
3
Ducts stems with less than 40 linear feet of ducts in unconditioned s ace..
HVAC SXSTEIMS
Heating Equipment Type
and Capacity (furnace, heat
pump, boiler, etc.)
Minimum
Efficiencv
(AFUF. or HSPF)
Distribution Type
and Location (ducts.
attic, etc.)
Duct or piping
R -Value
Configuration
Thermostat Type (split or
package)
Z
Coolin Equipment T Minimum
>?Type
and Capacity (A/C, heat Efficiency Duct Location
pump, evap. cooling) (SEER or (attic, etc,)
E. ER
Configuration
Duct R -Value Thermostat T
Type (split or
package)
Z
SEALED DUCTS, REFRIGERANT CHARGE (TXVI 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,
✓ Compliance Requirements
led 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.) I
rRefrigerant Charge (climate zones 2 and 8-.15 only) (Installer testing and certification and HERS Rater field
verification required.)
FFR 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 vcrificatiori uired.
SPECIAL FEATURES REOUIRING HERS RATER VERIFICATION
A ✓ indicates which compliance requirements are part of this project and need HERS rater verification.
Compliance
Duct Sealing
ermostatic
Rcfrigcrant C
EER
U
tr
n Valve (TXV)
Installer Forms (if applicu
CF -6R page 4 of 12
CF -6R pages 5 and 6 of 12
CF -6R pages S and 6 of 12
CF -6R page 8 of 12
HERS Rater Forins (if
CF -4R page 1 of 8
CF -4R pages 3 of 8
CF -4R pages 3 and 4 of 8
CF -4R pages 5 of 8
Bin #
City of La Quinta
Building g Safety Division
P.O. Box 1504,78-495 Calle Tampico
La Quinta, CA 92253.- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
o'
Project Address:'
Owner's Name: 0AA40L49'
A. P. Number:
Address O -, T C Q
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address: T S –�ja S Vjet4g AV,0 Ly
Project Description:
City, ST, Zip: —CA — .ZZ0
S
Telephone: U �— C�
1 `a a
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:;
State Lic. #:
"` �' ;
Construction Type: Occupancy: 3
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
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Show Price
List
l
Service Order No.: GROB0207-1436r
Proposal Date: February 7 2008 -
Service Rep: Glen Ruschei 1
Technician: Greci dunn �`
Quality Verification Services
CA State License No.: 835016 A Division of Synergy Companies
Address: 90 Business Park Dr., Perris CA 92571
Phone: 951 656-2800
Fax: 951 656-2600
Toll Free: 1-888-988-9829
Web: www.synergycompanies.org
E-mail: Glen@synergycompanies.org
Other:
Work Performed (location of work to be performed)
Name: PATRICIA DOWEL
Address: 7 LOUDVIEW WAY City: LA QUINTA
State: CA zip: 92253
Telephone: Fax: Cell:
E-mail:
Owner Information
Name: PATRICIA POWEL
Address: 78258 CLOUDVIEW WAY city: LA QUINTA
State: C4 zip: 92253
Telephone: Fax: Cell:
E-mail:
Billing Information
Name: PATRICIA POWEL
Address: 78258 CLOUDVIEW WAY City: LA QUINTA
State: CA zip: 92253
Telephone: Fax: Cell:
E-mail:
HVAC Contractor Information
Name: ROOM TEMP
Address: P.0 BOX 966 City: PALM DESERT
License Number:
Contact person: NOEL
State: CA zIP: 92261
Telephone: 760 346-4477 Fax: 760 347-8036 Cell: 760 717-0336 E-mail:
Scope of Work
Work to be Performed Qtv
COST REBATE TOTAL
Building Permit Filing Fee
Duct Seal - Pre Test 1
$350.00 $350.00
Dud Seal & Post Test 1
$250.00 $250.00
Natural Gas Appliance Test NGA
AC Test In
AC Test Out
Sub Total
$600.00 $600.00
Total ue and Paya5le
#600.00
r, Paid with
Check #
Paid with Credit Card #
< Visa r MasterCard
Isecurity
Expiration date month/year):
(
CUSTOMER X
VS2 X
DATE:
17
DATE: U
NOTE: QVS2 warrants only those items which are specifically denoted in the scope of the work. Any additional work, including additional trips, would be a change to contract
and must be agreed upon by both parties. Any ducts that are unrepairable or warrant replacement, and any ducting that is inaccessible are not covered in this agreement. QV52
does not guarantee the % level of duct efficiency that can be obtained.
Service Order No.: GRO80207-1436
Summary Date: February 7, 2008
Servlce Rep: Glen Rusche
Technician: t Greg dunn
CA State license No.: 835016
Address: 90 Business Park Dr., Perris CA 92571
\\\ Phone: 951 656-2800
i Fax: 951 656-2600
Y.+ ,' j==; Toll Free: 1-888-988-9829
j Web: www.synergycompanies.org
Quality Verification Services
A DWislon of Synergy Companies E-mail: Glen@synergycompanies.org
Other:
Work Performed (location of work to be mfmmed)
Name: PATRICIA POWEL
Address: 78258 CLOUDVIEW WAY
City: LA QUINTA State: CA
ZIP: 92253
Telephone: ( Fax:
Cell: E-mail:
Scope of Work
Work to be Performed
Qty
Building Permit Filing Fee
Dud Seal - Pre Test
Dud Seal
Dud Seal - Post Test
1
Natural Gas Appliance Test NGA
AC Test In
AC Test Out
Service Technician Completion Summary
Was there any problems on the job? Yes
if Yes ex Iain:
• No
Did you perform any additional work? Qyes
If so what did you do?
• No
Did you complete everything on the work order?
Did -you collect payment from the home owner?
E)Yes ONo
Yes • No
Tons kBTU Test In
Technical Summary
Wo
Test Out Target amTime Doing Hers Rateresibie Duct seal required? Machine #
Ducts
Test ID
System # 1: 3.0 258
171 180 50.00 110.00 No
3186
177
System # 2:
System # 3:
Service Technician Completion Summary - comments section
found one leak in attic rip in duct conection to vent, sealed around fumace and around return.