10-0713 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00000713
Property Address:
79335 TORONJA
APN:
772=340-038-
Application description:
MECHANICAL
Property Zoning:
LOW-DENSITY RESIDENTIAL
Application valuation:
18000
c&tit 4 4v Q"
Applicant: Architect or Engineer:
PLP
Cie
-7 ---------- � - - :. .
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 th Business an rofessionals Code, and my License is in full force and effect.
License.Class- C20 /�. Ien 'No.: 686310
1
ate: ract : .
'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 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and .00
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(sl licensed
pursuant to the Contractors' State License Law.).
1 _ 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•QPERMIT
Owner:
DAVIS IRIS
79335.TORONJA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/02/10
. Ifv LA
GENERAL AIR CONDITION AI S 0 J 2010
31170 RESERVE DRIVE
THOUSAND PALMS, CA 9 1276 CITVrFLAQ(?4TA
(760) 343-7488 [ ('111 k 111E:¢r', i.
Lic. No.: 686310
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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. t v
Qy. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
�T Code, for the performance of the work for which this permit is issued.. My workers' compensation ,
insurance carrier and policy number are:
Carrier PREFERRED EMPL Policy Number WKN1295355
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,�oc
ould bec a subject to t e o kers' compensation provisions of Section
700 of the Lade, I shat f hwifh com ly th Tose provisions.
ate: plicant' \
WARNING: FAILURE TO SECURE WO ERS' 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 bu' ng constr ct( n, and hereby uthorize representatives
of thi out t e r upon the above-mentioned prop r1� or inspe do rlpoos s. /�.Cre-.v"
' ure (Applicant or Agent): 1 v — -
Application Number .
. . . . 10-00000713
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
51.00 Plan Check Fee
8.25
Issue Date . . . .
Valuation
0
Expiration Date
1/29/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 9.0000
EA MECH FURNACE <=100K
18.00
2.00 9.0000
EA MECH B/C <=3HP/100K BTU
18.00
Special Notes and Comments
HVAC"CHANGE-OUT 3 & 4
TON COMPLETE
SYSTEMS. 2007 CODES.
----------------=---------------------------------------------------
Other Fees . . . .. .
. . BLDG STDS ADMIN (SB1473)
--------
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total
51.00. .00 .00
51.00
.Plan Check Total
8.25 ".00 00
8.25
Other Fee -Total
1.00 .00 .00
1.00
Grand Total
60.25 .00 .00
60.25
LQPERMIT
2
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Ad re .
Enforcem t Agenc .
Date:
�- L
Permit
0 3
onditioned Floor
E ui ment Type'
List Minimum Efficienc Z
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
hd K `mace
❑ AFUE
❑ COP
Over 40 ft of ducts added or
replaced in unconditioned space
Served b system
ack
r Coil
�ondensing
❑SEER
❑ HSPF
pY
Y
(Ijnotalready
Unit
❑ EER
❑ Resistance
❑ R 6 (CZ 10-13)
❑ R 8 (CZ 14-15)
sf
present, must be
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed,• if more than one system, use another CF -IR- LT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor typical residential systems.
HERS VERIFICATION SL74AIARY 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 d- 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
install . he inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
si d. Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC 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
CF -6R forms: MECH-21-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• 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:
❑ 1. 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 ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: 'MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF -4R forms: MECH 20-, and (for split systems)IvIECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percents 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:
• 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:
• Includes adding or replacing more than 40
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 < 15 percent
❑ EXCEPTION: Existing ducts stems 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 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 andspecifications submitted to the enforcement agency for approval with the ppw4jt licatio .
Name:
Signature:
Company:
e: /
Address: 1 ^ �n �
\
License:
City/State/Zip: 'h 15 G ol A 1?6O
Phone: -7 nT)
Vill n
•C[W of La Quin t.a
"Building 81• Safety Divislon
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and. Tracking Sheet
Permit #
Project Address: C4J
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: Q
Address: % �eC��J�
_ ':z'.':> ';'
�
Tele hone: .<arb {a• ,'^„':<.”
Project Description:
City, ST, Zip:
Telephone:Z 7�. 'f�<
:;%J, rel}>niil'.:.j rJ •v ti'+J �'} •:{hS Ay::�
State Lic. # : City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
•{r'rJi�'j:iY �in:;r`�'yL'_rx.;>:hi {tt�?:;>�:�5:;%yY{
. i:••v'i:s s<:`` s Ys :%l.>ii:-#%'r:>:{
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State Lic. L+. nSJ•.�;f•>SJ$Q:SJsyi:t'vS3�Jj\:??{v'�'.�•k'l,
•J>'lr:S!:SSif'.•S�f,.i:v`.:: %i::.:::::::hY. ....fnS-.: J
_
Construction Type: Occupancy:
f
Project type (circle one): New Add'n Alter Repair Demo.
Name of Contact. Person:
Sq. Ft.:
J # Sto 'es:
# Units:
Telephone # of Contact Person: �j U
Estimated Value of Project:
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd'
Recd
TRACMG
PERMIT FEES
Plan Sets
2.
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.
I.Plans
picked up
-
Construction
Flood plain pian
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctionsAssue
Electrical
Subcontactor List
Called Contact Person
Plumbing .
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
UN HOUSE:-
Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I.P,P,
Pub. Wks. Appr
Date of permit issue
Schodl.Fees .
Total Permit Fees