10-0781 (MECH)P.O. BOX 1504
78-495 CALLE.TAMPICO
LA QUINTA, CALIFORNIA
92253
Application Number:
0`0.0,0007'81
Property Address:
43619 -PARMA CT
APN:
609-542-'006-18 -28457
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
5258
Applicant:
A.
Architect Or Engineer:
T,
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that,l am licensed under provisions. of Chapter 9 (commencing with
'Section 7000) of Division 3 of the Business -and Profe sio Code,.and my License is in full,force:and effect.
License' lass: C20 -C43 censeNo.:.276586
te� ontractor:
OWNER-BUILDERDECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the -Contractor's Stete 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 ofcompletion, 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 1 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
Owner:
STAN FORD
43-619 PARMA COURT
LA QUINTA., CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
7153
Contractor:
DESERT AIR CONDITIONING, INC.
590 WILLIAMS•ROAD
PALM SPRINGS, CA 92264
(760)323-3383
Lic. N6.: 276586
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
issueda
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
insurancecarrier and policy number are:
Carrier INS CO OF WEST Policy Number WSD2163974,02
_ 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 the workers' compensation provisions.of Section
/7 37700 of the Labor Cy I sh'tfor wit c ly wnh those provisions.
WARNING: FAI URl E.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 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 stateJaws relating to building cons yr ti , and here thorize representatives
of this unty to enter upon the ve-menti16 d prop or i tia rposes.
7d_ sign re (Applicant or Agent):
/10
Application Number 10=00000781
Permit MECHANICAL
Additional desc .
Permit Fee . . . . 30.50 Plan Check Fee
7.63
Issue Date . . . . Valuation . . .
. 0
Expiration•Date 2/16/11
Qty Unit Charge. Per
Extension
BASE.FEE
15.00
1..00• 9 -. 0000. EA MECH' B/C.. <=3HP/10OK ,BTU
9...0.0_:... ..
1 ..00; 6,,,50100 EA ' MECH OTHER'MECH' EQUIPMENT
6.50
„•- _
Special Notes and Comments .
REPLACE `5 TON CONDENSER & COIL, LIKE FOR.,
r. LIKE,2007 CODES..
Other -Fees BLDG STDS ADMIN; (SB14"73)-
.1.00
Fee summary Charged Paid.. Credited
Due
Permit •=.Fee. -Total 30.50 00 . 00
3.0.5,0
Plan -.-C_ beck•.=Total 7.63 00 .00
7.63
' Other 'Fee Total 1::.00 : = .0000..
1..00
Grand Total 3.-9:13 00 .00
39•.13.
LQPERMIT
I Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC 9
ate Zones 10 to 15
Sit ddres :
Enforcement Agency:'
Date:
Per it #
Conditioned Floor
Equipment T et
List Minimum Efficienc i
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
❑ace
❑ AFUE
❑COP
Over 40 R of ducts added or
❑Setback
n r Coil
❑SEER
❑ HSPF
replaced in unconditioned space
Served by system
(lfnoralready
be
EWCondensing Unit
❑ EER
❑ Resistance
❑ R 6 (C7 10-13)
sf
present, must
installed)
❑ Other
❑ R 8 (CZ 14-15)
1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -1 R-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor typical residential systems.
PIERS VERIFICA'T'ION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final
inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was -in fact the work completed by the
installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
sin Be innin October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for, final ins ection.
1. HVAC Changeout
Required Forms:
e All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25-14ERS
CF -4R forms: MECH- 21 and fors lit systems) MECH-25
e Condenser Coil and /or
a Condor Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
o Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ I. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:
® Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-IIF.•,RS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement Required Forms:
u Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forms:
a Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-PIERS CF -4.R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible IDesigner's'Declaration Statement)
I certify that this Certificate of Compliance documentation is accurate and complete.
u I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Parts I and 6 of the California Code of Regulations
The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets,
calculations, plans ands ecifications submitted to the enforcement pency for approval with the permit application.
Name:Signature:
--==Jam;----�--- - -
-
Company -t_% Date:
46- 9
�GJ
Address (] �• / ' , License:
O�%1 6 ` g 94City/State/Zip:
?I�T , _.Mz C"nt& 4 g Phone: 0.
623- 33L3_J
U
2008 Residential Compliance Forms March 2010
Bin #
City 0f La Quinta
Building 9 Safety IN ,
P.O. Box 1504, 78-495 Calle Tampico
La Quinta; •CA- 92253 - (760) 777-7012
Building Permit Application and ;Tracking Sheet -
Permit #
Lo
ZI Project Address: n C .JP"'•
Owner's Name:
A. P. Number:
Address: .6 cl)rAA
Legal Description:
'City, ST, Zip:R
Contractor: Desert Air Conditioning Inc.
Telephone:
41,.,{•ilii:::Ciiiij}:.cii:<ai;wl'F'r.�if •••
Address: 590 W i l l i am S Rd
Project Description:
City, ST, Zip: Palme-04G
e,
Telephone: (760) 323-3383v
::;r<s<<%'>s>":;•:::"% <h:
v:l:::.G::.::.:.S.:nv.:
� Co• �/ , 6.Q �C G
State Lie. #: 2765.86
City Lie: #: 3 6 3
Arch., Engr., Designer.
Address:
City, ST, Zip:
>....::<.:;;.:<.;;:.«.;•...a•:.,,vs::,.:;
Telephone: <:<>:;;:;;>:..i>ll:::.: �:s.<.<�::s::.,...:<..:
Construction Type: Occupancy:
Lie. #: >'< <:<^r>'v.::,«.<::>:r::, `_,`z<::;s::i;::.?I•l»; zl:l:«:.::.:.::»;.:::::.
air Demo type circle one): New Add'n Alter RepState
.
Name of Contact Person: A C ��%,' �Q 4 ij ; k
Sq. Ft.:
#Stories:
tits:
Telephone # of Contact Person:( 7 6 0) : 3 2 3— 3 3 8 3
^ e#
Estimated Value of Project: 5, d' `5 ' 00
APPLICANT: DO NOT WRITE'BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIONG
PERMIT FEES
Pian Sets
Plan.Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person.
Pian Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2a1 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked,up
S.MJ.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees