10-0332 (MECH)i- -
P.O. BOX 1504
78-495 CALLE TAMPICO
LA`QUINTA', CALIFORNIA 92253
Application Number: 10-00000332 `
Property Address: 78150 CALLE TAMPICO
APN: 770 -0.20 -024 -1 7000000 -
Application description: MECHANICAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 4825
Applicant: n
V
Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SMITH FAMILY TRUST
78150 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor:
PALM DESERT AIR COND
42081 BEACON HILL
PALM DESERT, CA 92211
(760)346-0677
Lic. No.: 374937
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: A/19/10
CO INC
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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 Business 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
r License Class: C20 l ense No.: _374937
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is r
issued.
Co ctor:—�
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I.hereby affirmunder penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier SOUTHERN INS Policy Number WSIO03802-01
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit'to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
- and agree that, if I should become subject to the workers' compensation provisions of Section
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
3700 of the Lab r Code, I shall forthwith c ly with those provisions.
:.
9 �'
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 155001.:
ate: �A icani -
(_ 1 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,. provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.I.
Lender's Name:
Lender's Address:
LQPERMIT
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 construction, an reby authorize representatives
of this county to enter upon the above-mentioned property for inspection pur s.
�9 (O Signatt (Applicant or Agerft?--f
'Application Number 10-O'D000332
Permit MECHANICAL
-Additional desc .
Permit Fee . . . . 31.50
Plan Check Fee
7.88
Issue Date . . . .
Valuation . . .
0
Expiration Date 10/16/10
Qty. Unit Charge Per
Extension
BASE
FEE
15.00
1.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
16.50
Special Notes and Comments
REPLACE;( ONE'5 TON HEAT PUMP CONDENSER,
13 SEER. 2007-CODES.
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Other Fees . . . . . BLDG
STDS ADMIN (SB1473)
-
1.00
Fee summary Charged
----
Paid Credited
Due
----------------- ----------
Permit Fee Total 31.50
.00 .00
31.50
Plan Check Total 7.88
,00 .00
7.88
-Other Fee Total 1.00
.00 .00
1.00
Grand Total 40.38.
.00 .00
40.38
LQPERMIT
Certificate of Combliance PrescriDtive Method — HVAC Only - Alteration
I
Y
i�
CF -1 R-PDAC,,,,
Project Title:
Date:
SMITH FAMILY TRUST
04/19/2010
'EnfoicementAgencyv Only t
Project Address:
Climate Zone:
Building Permit No 1 ,
78-150 CALLE TAMPICO
15
$'t
Documentation Author:,
Telephone Number:
Plan Check Date.
KARL BROWN
760-346-0677
Company Name:
Field Check Date
PALM DESERT AIR CONDITIONING & HEATING CO.;`
IMPORTANT: This CF --1 R-PDAC form is only for use when an HVAC only alteration is made on an existing home. Use one
form for each system being altered. This is system number 1 of 1 systems being altered in this house.
Section 1 - HVAC System: ,
1 Configuration: O Split System O Package Unit
2 O An Air Handler is to be installed or replaced.
3 O A Furnace with a Heat Exchanger is to be installed or replaced. AFUE:
4 O An Outdoor Condensing Unit is to be installed or replaced.
4a 0 Air Conditioning SEER: EER:
4b 0 Heat Pump SEER: 13 EER: 0 HSPF: 0
5 0 A Cooling or Heating Coil is to be installed or replaced. 0 Air Conditioning 0 Heat Pump
6 0 More than 40 feet of new or replacement duct work are to be installed in -unconditioned space.
6a 0 Entire duct system was replaced.
7 0 No items in this section are checked; go to section 6.
Section 2 — Duct Sealing Exceptions:
8 0 This system was previously sealed and tested, and was certified by a HERS rater. Attach previous CF -4R form.
9 0 This system is in Climate Zone 1,'3, 4, 5, 6, 7 or 8.
10 0 This system is sealed or insulated with asbestos.
11 0 This system has less than 40 feet of ducts in unconditioned space.
12 0 This system is in Climate Zone 10, 13 or 15: An SEER 14 AND EER12 or greater condenser will be installed with
TXV (RCA) verification AND added'duct insulation (R-4 wrap on existing ducts or R-8 on new ducts).
13 0 This system is in Climate Zone 10, 13 or 15: An SEER 14 AND EER12 or greater condenser will be installed with
TXV (RCA) verification AND a 92% or greater furnace will be installed.
14 O No items in this section are checked, duct sealing is required. 'Continue.
Section 3 — TXV (RCA) Verification: (Only if lines 4 or 5 are checked, otherwise go to sectionA.)
15 0 This system is a package unit. No TXV (RCA) verification is required.
16 0 No items in this section are checked, TXV (RCA) verification is required. Continue.
Section 4 — HERS Rater Verification:
17 0 If line 14 is checked, HERS verification is required for duct sealing.
18 0 If lines 12, 13 or 16 are checked AND line 15 is not checked, HERS verification is required for TXV (RCA).
Section 5 — Equipment Efficiencies:
19 0 If lines12 or 13 are checked, upgraded equipment efficiencies are required in section 1.
Section 6 — Duct R -Values:
20 0 If more than 40 feet of duct work is being installed or replaced, duct R -value must meet or exceed Package D
requirements.
21 0 If less than 40 feet of duct work is being installed or replaced, duct R -value must meet or exceed R4.2.
Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with
Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This
certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance
using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an
approved.HERS rater.
Document r gna
Document Author A—daiess
12-081 Beacon Hill, Palm Desert, CA 92211
Bin #
City 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 # ��f
v
Project Address: 78-150 CALLE TAMPICO
Owner's Name: SMITH FAMILY TRUST
A. P. Number:
Address: 78-150 CALLE TAMPICO
Legal Description:
Contractor: Palm Desert Air Conditioning. &Heating Company
City, ST, Zip: LA QUINTA, CA 92253
'Telephone: 925-837-4956:;xt:<>� �'�>�<:?><�';'•°">:?:'ra'<"t>°">:?
Address: 42081 Beacon Hill
Project Description:
city, ST, Zip: Palm Desert, CA 92211
REPLACE ONE 1 5.0 TON HEAT
Telephone: 760 346-0677
- -
P M P NDE N
U CO SER. ,r2:00 �k
State Lic. # : 374937
City Lic. #•: 100886�S'-TAN
DARDS-j
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: le one:
P
Construction n T
o e: Occupancy:
Type: P cY:
State Lic. #:
Project type (circle. one): New Add'n Alter Repair Demo
Name of Contact Person: KARL BROWN
Sq. Ft.: __7_#
Stories:
# Units:
Telephone # of Contact Person: (760) 346-0677
Estimated Value of Project: 4,825
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' 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:-
Yd 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