09-0846 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: i09-00000846
Property Address: if 54540 AVENIDA JUAREZ
APN: 774-263-002-23 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 3865
Applicant:
T4ht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RASH DENNIS G
54540 AVENIDA JUAREZ
LA QUINTA; CA 92253
(
VOICE
(760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/04/09
Contractor:
PREFERRED PLUMBING HTG A/
P.O. BOX 5120 2 �'
PALM SPRINGS, CA 92263
(760)322-3173
LiC. No.: 457554
------------------------------------------------------------------------------------------------—
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I 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 Busing 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: C10 C16 C2 Li n e : 457554 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/ �, issued.
`r Date: " CJ 'Contractor: �� _ 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
-,_QYNER-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 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 of 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
.r 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 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
insurance carrier and policy number are:
Carrier DELOS INS CO Policy Number + 02DKRM12002143
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 wo a rs' compensation provisions of Section
/ 3700 of the Labor Co shall forthw' mpl ' t tho a provision _,%.
t "Date: ` 7 D --Applicant:
WARNING: FAILURE TO SECURE WORKER OMPE SA ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENH D 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 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. gree to comply with all
city and county ordinances and state laws relating to building struction, and hereb au ori a representatives
of this county to enter upon the above-mentioned property f __Pt
ion rpos
7Date; U Signature (Applicant or Agent): ------
Application Number .
. . . . .09-00000846
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation . .
. 0
Expiration Date
1/31/10
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
REPLACE EXISTING HEAT
PUMP & AIR
HANDLER
SYSTEM 13 SEER.
----------------------------------------------------------------------------
Other Fees . . . . .
. BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
---------------------------
----------
Paid Credited
----------
Due
Permit Fee Total
33.00
----------
.00 .00
33.00
Plan Check Total
8.25
.00 .00
8.25
Other Fee Total
1.00
.00 .00
1.00
Grand Total
42.25
.00 .00
42.25
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 1) CF -IR -A
Project Title
Uiw►QIS eAS-4
Date
S ,L(/o %
Building Permit #
Project Address
<5
2
Documentation Author
Telephone
Plan Check / Date
❑
High EER
Field Check/Date
Compliance Method (Prescriptive — HVAC and/
Climate Zone
Enforcement Agency Use Only
or Duct System Alteration - § 152(b)IC, D, and E)
HVAC SYSTEMS
Heating Equipment Type
and Capacity (furnace, heat
pump, boiler, etc.
Minimum Distribution Type Duct or Piping Thermostat Type Configuration
Efficiency and Location (ducts, Insulation (setback) (split or package)
(AFUE or HSPF) attic, etc. R Value
AQ e—
KJ 1,4�Tu
❑
<5
2
❑
Cooling Equipment Type Minimum
and Capacity (A/C, heat Efficiency
pump, evap coolin (SEER or EER)
Duct Location Duct Insulation
(attic, etc.) R -Value
Thermostat Type Configuration
(setback) (split or package)
AT oo QM lu
❑
<5
2
❑
Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos?
3
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
SEALED DUCTS, REFRIGERANT CHARGE (TXV) AND EER
Before the permit can be finalized, a signed CF -611 Form and CF -4R Form must be provided to the building department for any of the
followine comnliance requirements that are ✓ :
✓ Com liance Requirements
Sealed Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
TXV (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑ Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑ ALTERNTAVE to Duct Testing: High EER as indicated in Table 8-3 of the Residential Compliance Manual (SEE Table 8-3 for
additional requirements and available Compliance tions) - Installer testing and HERS Rater field verification required
' The prescriptive requirement for either a refrigerant charge or a TXV does not apply to packaged units.
EXCEPTIONS
If anv of the followine three exceptions are V. the duct system is exempt from sealed ducts
#
✓
Exceptions
l
❑
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
❑
Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos?
3
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
Duct alterations are exempt from duct sealing ONLY if they meet Exception 2 above.
SPECIAL FEATURES REQUIRING HERS RATING VERIFICATION
A ✓ indicates which compliance requirements are art of this project and need HERS rater verification.
✓ Compliance Requirements
Installer Forms (ifapplicable)
HERS Rater Forms (tfapplicable)
❑ Duct Sealing
CF -6R pages 3 and 4 of 12
CF -4R page 1 of 8
Er Thermostatic Expansion Valve (TXV)
CF -6R pages 3 and 5 of 12
CF -4R page 3 of 8
Refrigerant Charge
CF -.6R pages 3, 5 and 6 of 12
CF -4R pages 3 and 4 of 8
High EER
CF -6R pages 3 and 8 of 12
CF -411 page 5 of 8
*July 2008
B`" #
City of La QU'inta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P
Project Address:'
Owner's Name: UEA) t� 16 42AS j4
A. P. Number:
Address: 5'41'540
Legal Description:
City, ST, Zip: C 9 S�
Preferred Air Conditioning dba,-e
Contractor: pre f erred Plumbing. He a t i n &A'i
Telephone: -*,
Y. _
Address: -P0 Box 5120
Project Description: - ri.S-r i N
City, ST,Zip:palm Springs, CA' -92263
AT— P S!4 W1 V4
Telephone: ( 760 ) 322=3173
---
State Lie. # : 45755-4 City Lic. #:
Arch., Dig., Designer:
U 4Ge FOIL LA "
eo o t3 0 i
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.:
# 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
BeniAmount
Structural Cales.
Reviewed, ready for corrections
Pla Check Deposit
Truss Cafes.
Called Contact Person
Pla Check Balance
Energy Calcs.
Plans picked up
Con truction
Flood plain plan
Plans. resubmitted
Mee ianical
Grading.plan'
2"" Review, ready for correctionslissue
Ele rical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
7n° Review, ready for corrections/issue
Dev toper Impact Fee
Planning Approval
Called Contact Person
A.I..P.
Pub. Wks. Appr
Date of permit issue
School Fees
"
Tot 1 Permit Fees
M