10-0634 (MECH)i P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00000634
Property Address:
78040 CORONADOS CIR
APN:
646-220-007- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4000
c&lq� aF�(P4"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Li ense No.: 878533
Date: -7-1 Yl� ontractor:
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, 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 1, 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—) 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: 7/14/10
Owner:
ULSH JANICE
78040 CORONADOS CIRCLE
LA QUINTA, CA 92253 FFD
Contractor: U JUL 1 j 2010
DIAL ONE'S ONE HOUR A/C & HTG
2 712 E. LA CADENA DRIVE OXY OF 1 g FLAQ gUiNT�
RIVERSIDE, CA 92507 FINANCE PT.
(951)276-9744
Lic. No.: 878533
-----------------------------------------------
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 INS CO OF WEST Policy Number WSD500334900
_ 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 Ishould oma subject to the work6s' compensation provisions of Section
3700 of the Labor Code, all forth it omply with those provisions.
Date '7t pplicant:
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 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 co r coon, and ereby authorize representatives
oft Acounty to enter on the above-mentioned property for ' s coon urp
Jy ignature (Applicant or Agent):
Application Number . . . . . 10-00000634
Permit. . . MECHANICAL
Additional desc .
Permit Fee . . . . 24.00
Plan Check Fee
6.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 1/10/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
---------------
9.00
-------------------------------------
Special Notes and Comments
------------------------
REPLACE 5 TON A/C CONDENSER AND
DISCONNECT ADJACENT BOX AT SAME
LOCATION. 2007 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total 24.00
.00 .00
24.00
Plan Check Total 6.00
.00 .00
6.00
Other Fee Total 1.00
.00 .00
1.00
Grand Total 31.00
.00 .00
31.00
LQPERMIT
Silo lifted Prescriptive Ceriffieate of Com lianec 2008Residentia! AVACANeradons CR-lRr-ALT HVAC
Climate Zones 10 to 13
S&eAddnsr:
tAr-jo (AmfudT2
:.
Dwe:
lrtrrtbL
• in 34
fitionedFloes
rnt Type' list Minim Efficiency'
Duct insulation requirement
Area
Thennosiat
0 packaged Unit
D:Ftanece a AFUE
AFU
a OP
C
Over 40 fl of ducts added or
0 Setback
O indoor Coil • �
9EElkirCondertsing
0 PF
replaced in unconditioned space
S system
WRO akvo*
Unit O EER
O Resistance
O R 6 (CZ 10-13)
sr
panes mw be
0 Other
O R 8 (LZ 14-15)�dIeD
1, Equ4mw J 9)pc Gwase the equipment being installed jfaeore tion one system, ase another CF -1 R-ALT-HVACjar each syat m
Z Alla( num Egalpawd Eirmeactes: 13 SEED 78%AFUE Z7HSPFfar typisvl reshfentld ssarems
HERS VERIFICATION SUMMARY Listed below arc four HVAC alteration Options. The installer decides what work is being done and
pias one of the appropriate Options. Each Option lista the HERS measures that mast be conducted. A Copy of the forma stall be left an site for final
inspection and a copy given to the homeowner. At Baal, the Inspector verities 0ut.the work listed an thio form was in fact the work emapleted by the
installer. The intim also verifies that each appnpiate CF -6R and registered CF -411 farms (nu, bend filled CF4Rs allowed) are filled out and
simrA Boduslae October 1. 2010. a registered cow or the CF -IR and CF -613 shall else belt an site for final insnectinoL
I Ell. HVAC Cbanaeout I Required Forms: 1
• All HVAC Equipment replaced j _..._. -.-..� - - ......_-- -- ,._. ,.... o, ,._...r .......... ............
CF -4R faatit MECH- 21 and (far split sterns) MECH-25
• Condenser Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and kir CF -4R fame: MECH- 21 andsP • ar fsplit systems) MECH-25
(
For Split Systems: Duct leakage < 15 peraemt; RC, CCA Z 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted bora duct leakage testing 111
0 1. Duct system was dommewed to have been previously sealed and confirmed through HERS verifeauion, or
0 2. Dud systems with cess than 40 linear feet in unconditioned space, or
0 3. Exisft duct systems are atrtstructed, insulated or sealed with asbestos
0 2. New HVAC Svstem I Repaired Forms:
t • Cut in or Changma with new I CF -6R forms: MLCH MECH-20-H RSERS
,and (for split systems) MECH-22-H, and MEM -2541M f
ducts (ail new ducting g�(all CF4R forme MECH 20-. and (far split systems)MECH-22, and MECH 25 t
'For Split Systeme: Duct leakage < 6 perces RC, CCA >_ 350 CFMAon, FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 Percent
I E3 3. New Ducts with Replacement I Required Forms:
• Includes replacing or installing ail oew,ducft CF-61tforms: MECH-O4, MECH-20-HERS„mtd (for split systems) ME04-2S-HERS
and/or outdoor condensing unit amv.4 jtidoor CF4R forma: MECM20 and (for split systems) MECH-25
coil wWw fiatmm Na all mWoment chs=4
For Split System. Duct leakage < 6 pe n=4 RC, CCA >_ 300 CFMhoa, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forms:
• Includes adding or replacing mon to 40 CF -6R forms: 1dECH-04, MMH2l HERS CF -4R fors: MECH-21
linear feet of duct in unconditioned soace.
For split system or packaged units: Dud leakage < 15 percent
0 EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Cenificate of Compliance documentation is arcurWe and complete
• ]am clique under Divisiun 3 of the California puniness ori Pruremims Codo to accept noponsibility far the deign idled on this CerWage of Campiinum
• 1 certify that the t:rtergy fattens and performance specifications for the design identified un this Catirmate of Compliance coofmm to the mW iromattta ofTide 24,
Parts I tad 6 of the f- ifoniu Code of Regulafxms.
• The design ksaurea ideaulied on this Cenifuate o(Camptiance are consistent with the iarmumlion dacumemed on mires a0kabfe complk=fam14 wudMheW,
Cornpany:
2008 Residential Comp/iance Forms Alarch 2010
Bin #
Qty of La Quinta
Building 8r 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:^7 0
Owner'slVariib�,,,�
A. P. Number:
Address: �re n
Legal Description:
City, ST, Zip:
Contractoru.-aJ?S
Telephone: — '
r.>
Address:
Project Description:
City, ST, Zip: WSk: �.
l,e e? e-40 17—
7Telephone:
Telephone:_ ``"': <y 1
—
State Lic. # : -3 City Lie. #: 7
Arch., Engr., Designer:
A.
Address:
City.,, ST, Zip:
Telephone:
, ... ,
..� :.ProJect
Construction Type: S Occupancy:
State Lip. #:
(circle one): New Add'n After Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: —
Estimated Value of Project: d�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
P q'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan t�hetk submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called oact Person
Plan Check Balance
Title 24 CalcL
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctiousrssue
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 correctionsfissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees