06-1172 (MECH)ceity/ 4
P.O. BOX 1504F• �^� VOICE 760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT.,
Date: � 3/22/06
Application Number: 06-00001172 Owner: ,
Property Address: 54063 -SOUTHERN HILLS KIRSHNER MERVYN/DARLENE'
APN: 775-101-037- - - 54063 SOUTHERN'HILLS
Application description: MECHANICAL LA QUINTA, CA .92253. _ _
Property Zoning: LOW .DENSITY RESIDENTIAL
Application valuation: 18000. - -�
Contractor: MAR 22 Zoot!
Applicant: " Architect or Engineer: POLAR= BARR AIR 'COND, INC P�F�
41921 'BEACON HILL SUITE C f.OFLAouiNTA
PALM DESERT, _ CA 922.60 F1 CE�E�
(760)346-5529
Lic. No.: 722201
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 Busin s 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.
Lic se Class: C20 .: Li nse No.: 722201 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is '
issued.
Date: ontractor: c`� ►l 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 affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND ' Policy Number 0000460014226 t
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 tabecome subject to the workers' compensation lawsofCalifornia_ -
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 sho ecome 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 3700 of he Labor Cod I hall forthwith co ply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by� //,t �
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) r : #DateApplicant:
(_ 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 havetheburden of proving that he or she did not build or
improve for the purpose -of sale.f. APPLICANT ACKNOWLEDGEMENT
(_ ) I, as owner of the property; am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to:the.Director of Building and Safety for a permit subject to the -
' 7044, Business and Professions Code: The Contractors' State License Lawdoesnot apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed 1 : Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - - whose benefit work is performed under or pursuant to any permit issued as a result'of this application,
• (_ ) I am exempt under. Sec. , B.&P.C. for this reason 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.
Date: - Owner: - 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
• • - - - CONSTRUCTION LENDING AGENCY - . permit to cancellation.
I heieby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C:1. - city and county ordinances and state laws relating to buildi g onstruction, and hereby authorize representatives
• •
of this to enter upon the above-mentioned propfor inspection purposes.
Lender's Name: - 2 .�-t/,•'l�// !• .
ate: 3 ZZ ignature (Applicant or Agent):
Lender's Address:
LQPERMIT
J
:.Application Number_ 06-00001172
Permit" MECHANICAL
Add itional_ desc
--
-
ermit Fee 86.00
_
Plan Check Fee .
- L-21.5'0. -
- Iss.ue,'Date
• Valuation:;
0 '
Expiration Date 9,/18/06
" Qty Unit Charge Per
Extension
'BASE
FEE . ,
15.0.0 ..
.2 .00 - 9:0000 EP, MECH -FURNACE.
<=100K
18.00
" 1.00 , - . 11.0000 .EA MECH:'FURNACE
>100K,
•11.00
I.00- 9.0000 BP, MECH
B/C <=3HP/100K BTU
9.00
2:00'; •' '. <16. 5000 'EA•: MECH
B/C" >3-15HP/>I00K-50OKBTU -"
" --= - 33;00 •--
Special Notes and -Comments
REPLACE EXISITING HVHC SYSTEM-
-Pee summary Charged
Paid- Credited
Due
_,
Permit Fee.Total 86.0,0
00 :00
86..00
Plan Check Total", 21.50
:00 .00.
21:5.0"
Grand Total- 107.50
..00 .60
107.50
LQPERMTT
Bin #
City of La Quints
y
Building U 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:
Owner's Name: /n 9A fS q ,fen—
fe2A.
A.P. Number:
Address: 5�40 6 3 Sao ttfc—r—" Gf,' it S
Legal Description:City,
ST, Zip: L L'/aG�
Contractor: -9,+• a -a- +l L , r,- C_
Telephone: 6 • 6-4q 8.7 6-2—
Address: %Z,
Project Description:
City, ST, Zip:, -PA-L," VESff-2T ('/3 lC)
aoc-� a -S �n n QCT/R�� �7c,�T�n E>lIiAC.
Telephone: -7(_C) [f �$'zq
h
_ f
C v, e vl t I
State Lid. # : Z4D- ap /
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Constru.ction. Type:- Occupancy:
Project type (circle one): New Add'n Alter, Repair. Demo
State Lic. #:
Name of Contact Person: •A2�m
Sq. Ft.:
# Stories:
its:.
Telephone # of Contact Person: 760 :346 IS—T-Xe,
Estimated Value of Project:W /'8606°- '
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACMG
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
Energy Cal cs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2°" Review, ready for corrections<ssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
.Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:
''" 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
40IjDE ti
CERTIFICATK OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF 44,
Project Title Date
S`rtbfo 3 moo 7 rrc� ni G�: /�S L A Qy. n T a Cp
Project Ad Building Permit #,
-r6 07 !'sesSi�S-�� 760 -34 b G iq
Documentation Author Telephone Plan Chemo / Date
/ S Field Check / Date
Compliance Method (Prescriptive) Climate Zone
Enforcement Agmen, Use oniY
✓ O -Alternative Component Package Method: (check one) C D D (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
TotaIr Conditioned Floor Area (CFA) ft2 Average Ceiling Height: ft ,
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C ---- (5% X CFA) ft
Maximum Allowed T. otal Tenestration -Products-Per Table -15-1=B or -15-1 =_.: (20% X CFA) ft
✓ O Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Construction Type: r Slab/Raised Floor (circle one or both)
-Front -Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RADIANT BARRIER (required in climate zones 2,4,8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Assembly U-,
factor (for
Cavity Continuous wood, metal'
Insulation Insulation frame and mass
R -Value R -Value assemblies)'
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
t) gee joint Appenaix i v to bectton Iv.z, tv.s ana Iv.4, which is the basis for the U -Tactor criterion. U -tactors can not
exceed prescriptive value to show equivalence to R -values.
CERTIFICATE OF COMPLIANCE: RESIDENTIAL
-, (Page, 2 of 4) • CF -1R .
M Les h n/e Z_
Project Title Date
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓ ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS -4R —must be included for New'Construction,
Additions and Alterations.
1
Fenestration
#/Type/Pos. i
(Front, Left, Orien- -
Rear, Right, tation, Area U -factor
Skylighn N, S, E, W' (ft') 0 -factor' Source'
Exterior
Shading/Overhangs6•'
SHGC ✓ box if WS -3R is
SHGC° Sources included
Distribution
Type and Location Duct or Piping Thermostat Configuration
ducts attic etc. R -Value Type slit or package)
13
Imo%
FL'SA .A•T7,L 2-'i•2
r
[
of IY a 1
14
13
1) Skylights are now included to west-tacmg tenestratton area it the skylights are tilted to the west or tilted in any direction
when the pitch is less than 1:12. See §151(fl3C and in Section 3.2.3 of the Residential Manual
2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table I I6A,.
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R:
5) Indicate source either from NFRC or Table 116B.
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices.
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS.
Heating Equipment
Type and Capacity
fumace heat pump,boiler, etc.
Minimum
Efficiency
AFUEor.HSPF
Distribution
Type and Location Duct or Piping Thermostat Configuration
ducts attic etc. R -Value Type slit or package)
✓r.1AcE
Imo%
FL'SA .A•T7,L 2-'i•2
r
[
of IY a 1
14
Cooling Equipment Minimum
Type and Capacity Efficiency
A/C heat pump,eva . cooling) SEER or.EER
Duct Location
attic etc.
Duct Thermostat Configuration
R -Value Type (split or package)
q • L 1,
r
[
of IY a 1
14
Residential Compliance Forms March 2005 -
G
s r`°" CERTIF,I/CATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
In rSkrneY" :3-z2-616
Project Title Date
SEALED DUCTS and TXVs (or -Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
required.
OR
❑ IAlternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 15.1=C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WA I EK HEA 1]IN h JY J YEMS
V/
\
Check box if system meets criteria of a "Standard- system. Standard system is one gas-fired water beater per
❑
❑
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.);
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential
❑
TXVs, readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verification required.)
❑
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
❑
Alternative Water Heating table- In this case, the Performance Method must be used and must be included in the
OR
❑ IAlternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Project Climate Zone in the RM Appendix B Table 15.1=C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WA I EK HEA 1]IN h JY J YEMS
nvsrems serving smme awemng unim
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard- system. Standard system is one gas-fired water beater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss %
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 54 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Tank
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table- In this case, the Performance Method must be used and must be included in the
Water Heater
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for. a system serving multiple
Capacity
units • .
nvsrems serving smme awemng unim
wNiem servmv muame awennnu unim
Water Heater .
Type
Distribution
Type
Number
in System
Rated
Tank
Capacity
tons
Energy
Standby
Loss %
Tank
Input'
Tank
Factor' orExternal
—R
Water Heater
Distribution
Number
(kw or
Capacity
Thermal
Standby'
Insulation
Type/Fuel Type
Type
in System
Bw/hr)
(gaeons
Efficiency
Loss "/o
R -Value
wNiem servmv muame awennnu unim
Water Heater .
Type
Distribution
Type
Number
in System
Rated
Input'
(kw or
Bh to
Tank
Capacity
tons
Energy
Factor' or
Thermal
Efficiency
Standby
Loss %
Tank
External
Insulation
-Value
—R
r. rui suiai gas sturage water neaters krarea mputs.or less tnan or equal to 75,000 Btu/hr), electric resistance, and beat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water '
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines _> 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are '/4 .
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
CERTIFICATE' OF COMPLIANCE: RESIDENTIAL (Page 4 of 4)
Project Title Date
SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if necessary)
Indicate which special features are part of this project. The list below only represents special features relevant, to the
prescriptive method.
� Feature " Required Forms if applicable) Descri tion '
❑. Metal Framed Walls CF -1R -
❑ Radian
SPECIAL FEATURES REOUHUNG HERS RATER VERIFICATION
(add extra sheets if necessard) Indicate to the HERS Rater whichcredits are part of this project and need
verification. - ; - a
Feature
Required Forms if a 6licable . Description
CV Duct Sealing
CF -6R part 4 of 12
❑ Refri' Brant Char a
CF -6R part 5 of 12
Thermostatic Expansion Valve
. CF -6R part 6 of 12 .
t Barriers
CF -1R
❑ _
Exterior Shades
WS -4R
❑
Roof
N/A; Attach CRRC Label to
.Cool
Forms.
0
Dedicated Hydronic Heating
Performance Calculation
System
Required; Attach Run to Forms.
,
❑
Combined Hydronic System
Performance Calculation
,
Required; Attach Run to Forms.
❑
Gas Cooling
Performance Calculation
Required.
❑
Buried Ducts
N/A; Indicate on building plans.
❑
Kitchen Pipe Insulation,
See Section 5.6.2 Distribution
-
Systems in Residential Manual.
Multiple, Water Heaters Per .
See Table 5-13 or use
;
.❑
Dwelling Unit `
Performance Calculation and • .
attach Run to Forms..
ij
Central Water Heating Systema
Performance Calculation and
t
�Serving Multiple Dwellings
attach Run to Forms.
❑
Non-NAECA Large Water -
CF -IR
Heater
V '
See Table 5-13 or use
>-
❑
'Indirect Water Heater
Performance Calculation and
attach Run to.Forms
„
See Table 5=13 or use
❑
Instantaneous• Gas Water Heater.
Performance Calculation and
,
attach Run to Forms
See Table 5-13 or use
❑;
Solar Water Heating System '
Performance Calculation and
-
'
attach Run to Forms
❑
Wood Stove Boiler.
-Performance Calculation and
attach Run to Forms
�... ,
SPECIAL FEATURES REOUHUNG HERS RATER VERIFICATION
(add extra sheets if necessard) Indicate to the HERS Rater whichcredits are part of this project and need
verification. - ; - a
Feature
Required Forms if a 6licable . Description
CV Duct Sealing
CF -6R part 4 of 12
❑ Refri' Brant Char a
CF -6R part 5 of 12
Thermostatic Expansion Valve
. CF -6R part 6 of 12 .