11-0165 (MECH)Y.U. BOX 15U4
• 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
11-00000165'
77330-CALLE SONORA
'173 -212 -011 -
MECHANICAL
COVE RESIDENTIAL
3800
Architect or Engineer:
.1 /Pr
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
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 License No.: 834471
atey'C-r- ontraaor.='� 1 i^
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.).
(_ 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: L 1
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: `2/15/11
Owner:
LA QUINTA REDEVELOPMENT.AGENCY
78495 CALLE TAMPICO e- ---D
LA QUINTA, CA 92253 y
FEB C 2611
Contractor:
SPEEDY AIR` CONDITIONI CIlY0 LA
4UlAITA
54685 AVENIDA HERRERA F!iVAAio:E-QUIN
EPT
LA QUINTA, CA 92253
•(760)567-0133
Lic. No.: 834471
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 EXEMPT Policy Number EXEMPT
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 1 should become subject to the workers )compensation provisions of Section
3700 of the Labor Code, 1 all forthwith cc ply wit !Ih_ose pro ''Sion.
aF7 te: plicant* c�
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 isnot 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 thatthe above information incorrect. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives.
of this ounty to enter upon the above-mentioned property for i t;pection purposes.
te� nature (Applicant or Agent)
T v
Application Number . . 11-00000165
Permit MECHANICAL
Additional desc .
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation
0
Expiration bate 8/14,/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00• 9.0000 EA MECH FURNACE <=100K
9.00
..1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
Special Notes and Comments
INSTALL NEW 4 TON HEAT PUMP SPLIT
SYSTEM. SEE ATTACHED APPROVED ESTIMATE.
2010 CODES.
-----------------_----------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 40.50 .00 .00
40.50
Plan Check Total 10.13 .00 0.0
10.13.
Other Fee Total 1.00 00 .00
1.00
Grand Total 51.63 .00' .00
51.63
LQPERMIT
.4oI-(85i-SS( .qS-o'
BID MEMO
JOB
BID #
c
ADDRESS
S, -'a oefla/
DATE
FIRM
-PREPARED
ADDRESS
APPROV
Y
TYPE OF
WORK
PHONE
r
{ WORWINCLUDED , AMOUNT OF BID
/JAPO PEW, AN
.
l
54685 •. Herrera
92253
ACKNOWLEDGEMENT
TAX
OF ADDENDA:
DELIVERY EXCLUDED
INCLUDED
RECEIVED BY:
D8120 BID MEMO
.d.— MAOF IN I)SA
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address
7 330 CjQ.C,LC_
En orcemauAgenry: �
Date:
Permh#:
�i- s
E ui ment T t
List Minimum Efficiency
Duct insulation requirement
Conditioned Floor
. Area
Thermostat
❑Packaged Unit
❑ FurnaceO
AFUE '❑ COP
Over 40 It of ducts added or
O Setback
0. door Coil
OSEER/ % ❑ HSPF=
reply in unconditioned space
Served by system
afnot already
Condensing Unit
O EER O Resistance
13R 6 (CZ 10-13)
sf
present be
O Other
❑ R 8 (CZ 14_15)
installed)
I. Equipment Type: Choose the equipment being installed; ifmore than one system, use another CF- IR-ALT-IfVACfor each system.
2. Minimum Equipment Effcieneles: 13 SEER, 78%AFUE, 7.7HSPFfor typica I residential systems.
HERS VERIFICATION 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 -411 forms (no hand filled CF411s allowed) are filled out and
signed.- Bnim October 1, 2010 a registered copy of the CF -111 and CF -6R shall also be on site for final Inspectfom
1. HVAC Changeout
Required Forms:
• All. H VAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
• Indoor Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
CF4R forms: MECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempled from duct leakage testing if
O 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
O 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 Changpout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting
ng az�t 1 all
new equipment) CF4R forms: MECH 20-, and (for split systems)MECH-22,.and MECH 25
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
113. New Ducts with Replacement •
Required Forms:
• Includes replacing or installing all new ducting
CF -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF4R 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
O 4. New Ducting over 40 feet
R uired Forms:
• Includes adding replacing more than
t
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < l5 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• 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 cenify 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. tans
and specifications submitted to the enforcement agency for approval with the perTnit application.
Name: � r
`
-- - —
Company: �. �,
Date:
Address:
License: `
T
City/Statc/Zip:
2008 Residential Compliance Forms March 2010
Bin #
Qty Of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: e'I _ '5 6 moi. (l
Owner's Name: Q FIDA..
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
C
lephone'za`r�e>
Project Description:
Address:
City, ST, Zip:
Telephone:
h;a. ..s;�ja..:�<a>+✓��`3:°'`>`.
State Lic. # :._ 3 , City Lic. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:
.z f7•`0.�vL ,
Telephone: k�... �< .�, w<. � �.::<s. M..� ,.
P . �°cF
State Lic. #:x :k ? �` <}}r < }o-
Name of Contact Person:
Construction Type: Occupancy:
Pro's type circle one New Add'.n Alter Repair Demo
Sq. Ft.: -V# Stories: #Units:
Telephone # of Contact Person: 5(p — b ��3
Estimated Value of Project: 3 8000
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Pian Check Balance
Title 24 Cake.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I..
H.O.A. Approval
Plans resubmitted
Grading
tN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
i .i 4 w•,d '"Y '1 � .4 < �' t i �i 4 ;Sr � 1. � � 0�
•.y .r j .f � .F�i (�. r�'�(. rr'�• ... � 'S r,,,.:�rl �,� `, 5.� ,r ...t ��..4� ` .`i'y G fi�r r.'
52580 Avenida Carranza
La Quinta CA, 92253
(760) 5649963
(760)771-9310 Fax
'Lic# 857079
AILD
Air Conditioning & Heating Co
Phone Phone
DATE Auth# Caller Name & Phone
Tech' # Inits. Code
( )Reg ( )Prem
( ) Operational ( ) Non-Operationat
( ) Maintenance Program offered
(
).Sticker on Equipment/Stat
Cond., FAU, Coil, Package, Comp
Make
•Mod # .
Ser: #
Filler size
Press.l_o Hi OAT
Amp.Comp Cond.Fan
Cond., FAU, Coil, Package, Comp
,Make
Mod #
Ser. #
Filter size
Press.l_o Hi OAT
Amp.Comp Cond.Fan
Cond—FAU, Coil, Package, Comp
WORK ORDER.
.Amount Paid
CkAr/ C.C./Ref#
Reason for Call: / o
Diagnosis:
Quote
Authorized Work Performed:
�r
Make Disclaimers
Mod #
Ser. #
Filter size
Press.Lo Hi OAT .
Amp.Comp Cond.Fan
MNEUP CHECKLIST
( )Filter
O Stat
i) train
{) In..fan.motor
(•) Elect.
{) Out fan motor
{ ) Amps
O Bens
( ) Refrigerant
() Pulley
( ) Oil Leaks
() Compressor
( ) Air Flow
O Temp drop
{ ) Pres: Contr.
O Contactor
( ) Blower Wheel ( ) Control
Winter Only
( ) Bumers ( ) Safety
{ ) Pilot O HT exchanger .
( ) Gas Valve (J Thermocouple
PAYMENT DUE
IMMEDIATELY
RETURN TOP COPY
QTY I PARTIP.O. it ITEM
..-e;
TOTAL 1122
It is understood that the obligation to pay for goods and services described herein is secured
by the equipment and parts on the default (non-payment) of the buyer. Labor performed by
ALDCO warranted for 1 year except for electrical work, refrigerant leaks, roof leaks or unless -
authorized differently in writing by ALDCO. ALDCO is not responsible for any mold detec-
tion and/or infestation whether pre-existing or subsequent to service. Material, parts and
equipment warranted by manufacturer's or suppliers written warranty only. Multiple refriger-
ant leaks may occur in systems, therefore, making it difficult to detect them. Line isolations,
if requested and contracted, are performed to help find these leaks. All work and charges on
this work order are on a flat rate (lump sum) basis unless specifically noted otherwise.
CUSTOMER SIGNATURE DATE