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08-0470 (MECH)Applicant: Architect or Engineer: ��U��-fit ,/1� �� • ' . �/ V �--�. LICENSED CONTRACTOR'S DECLARATION 4s BUILDING & SAFETY DEPARTMENT U - 7 - 09F T 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 Clas 'B- 10-C20- c No.: 856936 . Date //Q9or Contract OWNER -BUILDER DECLARATION I hereby affirm under penalty of 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 — Y 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' StateLicenseLaw does not apply to an owner of property who builds or improves thereon, and whodoesthe work himself or herself through his or her own employees, provided that the - .1 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 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 1 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 theperformance of the work for which this permit is issued ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPFRMIT Owner: ANNE CHICOINE 51855 AVENIDA VALEJO LA QUINTA, CA 92253-7603 (999)000-0494 Contractor: TELEFORDJONES, 25920'IRIS AVE, MORENO VALLEY, (951)486-0337 Lic. No.: 85693 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/18/08 \/ WORK ER'S'COM PENSATION 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 STATE FUND Policy Number 238-0005911.. 1 certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subje to the workers' compensation laws'oi California, and agree that, if 1 should became subje kers' compensation provisions of Section 00 of the or o y�aflth t ply ith those provisions. DA licntWARNING: FAILURE OSECURE WOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO T AL 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 fora 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 ands at the above infn is corr t. I agree to comply with all city and county ordinances and sta�elw relating to- 'Iding c sa ere authorize representatives o6this co ty t enter upon the abentioned gropepos / O8_• Dat Signature IApntor Ag ' P O. BOX 1504... n • , t" 78-495 CALLE TAMPICO LA QUINTA,CALIFORNIA 92253 Application Number: 08-00000470 �D�" G'�' Property Address: " "`` AVENIDA VALLEJO APN:> — 773-171-021-9 -000000-` Application description: MECHANICAL Property Zoning:' COVE. RESIDENTIAL Application valuation: 1270 Applicant: Architect or Engineer: ��U��-fit ,/1� �� • ' . �/ V �--�. LICENSED CONTRACTOR'S DECLARATION 4s BUILDING & SAFETY DEPARTMENT U - 7 - 09F T 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 Clas 'B- 10-C20- c No.: 856936 . Date //Q9or Contract OWNER -BUILDER DECLARATION I hereby affirm under penalty of 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 — Y 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' StateLicenseLaw does not apply to an owner of property who builds or improves thereon, and whodoesthe work himself or herself through his or her own employees, provided that the - .1 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 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 1 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 theperformance of the work for which this permit is issued ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPFRMIT Owner: ANNE CHICOINE 51855 AVENIDA VALEJO LA QUINTA, CA 92253-7603 (999)000-0494 Contractor: TELEFORDJONES, 25920'IRIS AVE, MORENO VALLEY, (951)486-0337 Lic. No.: 85693 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/18/08 \/ WORK ER'S'COM PENSATION 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 STATE FUND Policy Number 238-0005911.. 1 certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subje to the workers' compensation laws'oi California, and agree that, if 1 should became subje kers' compensation provisions of Section 00 of the or o y�aflth t ply ith those provisions. DA licntWARNING: FAILURE OSECURE WOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO T AL 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 fora 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 ands at the above infn is corr t. I agree to comply with all city and county ordinances and sta�elw relating to- 'Iding c sa ere authorize representatives o6this co ty t enter upon the abentioned gropepos / O8_• Dat Signature IApntor Ag :Application. Number 08700000470 Permit MECHANICAL Additional desc -.. - - - - Permit•.Fee` 33.00 Plan Check Fee•. 8:25 Issue•.Date Valuation 0 Expiration Date 9/14/08 Qty Unit Charge Per 'Extension BASE FEE 15.00• • 1.00 9.0000' EA MECH'FURNACE <=100K 9.00 1,.'00 . `9.0000 EA MECH -B/C <=3HP/100K'BTU. 9.00 ---------------------------------------------------------------------------------- - Special Notes and Comments REPLACE EXISTING AC/FURNACE HVAC CHANGE OUT AC-3TON.UNIT 14 SEER FURNACE< 100 -BTU- 80°s' EFR Fee summary Charged Paid Credited Due ----------- ---- ---------- - Permit Fee -Total' ,33.00 Permit -------- ----------- ----- - .00 .00 33.00 * Plan .Check Total 8.25 .00 .00 8.25'.," Grand.Total 41.25 .00 .00 .141.25 . LQPERD4IT CERTIFICATE O] (Page 1 of 4 CF -1R Project Title Date Project Ad Ss'Building Permit /I Documentation Author . Telepho' np� Plan Check /Date Field Check / Date Compliance Method (Prescriptive)Climate Zone Enforcement Agency Use.Only �.❑ Alternative. Component Package Method: (check one) C DD (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 Total Conditioned Floor Area (CFA) ft Average Ceiling Height: $ Maximum Allowed West Facing Fenestration Products Per Table .151-B or 151-0 -- (5% X CFA) Maximum Allowed Total Fenestration Products Per Table 151-B or 151-C _ (20% X CFA) ❑ 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: 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).. V ❑ 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 ood r etal Cavity. Insulation R -Value Assembly U- factor (for Continuous. wood, metal Insulation fame and mass —R -Value assemblies i Joint Appendix IV. Reference Roof Radiant. Barrier. Installed Yes or No Location/Comments (attic, garage, taical, etc. ,-' 1) See Jointfddix Section IV.2, IV.3 and IVA, which is the basis for the U -factor criterion. U -factors can not --�- F&tea. =aruv�. vauc.w snuw equivaienceto.x-values: . CERTIFICATE OF COMPLIANCE: RESIDENTIAL. -Page 2 of 4) CF -IR Project Title Date FENESTRATION PRODUCTS — U -FACTOR AND SHGC �. ❑ FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS4R —must be included for New Construction, Additions and Alterations. Fenestration #/Type/Pos: Exterior (Front,. Left, Orien- Shading/Overhangs 6.7 Rear, Right, tation, Area U -factor SHGC v/ box if WS -3R is Skylight) N, S E, Wt ft U-factor2 Source' SHGC° Sources included. a a ❑. 1) Skylights are now included in West facing fenestration area if the skylights are tilted to the westor tilted in any direction when the pitch is less than 1:12. See § 151(f)3C and in Section 3.23 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 116A; 4) Entervalues 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, See Section 32A in.the Residential Manual. HVAC SYSTEMS . . Heating Equipment MinimumMWThe, ,Type and Capacity Efficiency,iping Thermostat Configuration furnace' beat boiler etc. AF YE or HSPue a lit or ' ck e Cooling Equipment Minimum Type and Capacity' Efficiency Duct Location Duct Thermostat Configuration . A/C h uei cva .coolin SEERorEER attic M. R -Value e s litor ack e Residential Compliance Forms March 2005 .h. CERTIFICATE COMPLIANCE: Rum 3 of 4) CF- Nrqject Title Date SEALEDDUCTS and TXVs (or Alternative Measures) A signed CF -411 Form must be provided to the building department for each home for which the following. are . required. Sealed Ducts (all climate zones) (Installer testing and certification and HERS rater field verification requ ne TX1Vs,.readj1y accessible (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field verification required.). kefiigerant Charge (climate zones 2 and % only).(Installer testing and certification and HERS Rater field OR 'Alternative to Sealed Ducts and Refiigerant.Charge rlxvs.(SeP Package D Alternative Package Features for PrOiect Climate. Zone in the RM ppendix B Table 151 tq, Footnotes 7-14. 'OR TIFlor additions and alterations, duct systemsthat e not documented. to have been previously sealed as confirmed through field verification Residential on and diagnostic. testing in accordance with procedures th esidential ACM Manual and duct systems With. more than 40 linear feet in unconditioned - ced n e es s .s shall meet the requirements of Section 150(m) trid duct insulation nuirements of package D. WATER HEATING SYSTEMS Check box if system meets criteria of a"Standard" system. standard system is one gas-fired water beater per 0- dwelling unit If the water heater is a storage type, not all50'gallons is the maximum capacity and recirculation system is Check bo�m system t f0d ion in m g 'L " he w dwelling allowed. w when u g. st� not 0 Check box when using Preapp,oved Alternative water ng table, Table 54 in.Chapter 5 in the Residential Manual. No water heating calculationsare Manual. 1299ked, and tphl s' stem Check ox I Sys m do yste complies automatically. t m _ Iv wa El Check box 11 system does not meet criteria Of 'Standdrd- system, and does not comply with the Preapproved Al e at e ter Heating table. In this case. the -Performance Method must be used and lit submittal. must be included in the W E Check t f Check box to verify that time con is required for'a recirculating 03 it system units pump for a system serving multiple Systems serving single dwellinLy.. units Rated lr Inpue Tana or o Distribution Number W Energy T' a e in. stem (kor Ca k r �ctor c Standbyr ln� Water J=on B R -Value System serving mu le dwe in li its Rated Energy Tank Water r Distribution Inpuf Tank Factor' or External Number Thermal Standbys (k;W.or Capacity Insulation e in .'stem BW&r allohs) Efficiency Loss -R-Value 1. .Fors all gas storage -water heaters rs inputs of less than or equal to 15,000 Btu,/hr), electric resistance, and heat pump water heaters, list Energy Factor. For large gas storage Water heaters (rated input of greater than 75,000 - BhOir), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water beaters, list Rated Inputand Thermal Efficiencies. Pipe Insulation (kitchen lines 2:3/4 inches) All hot water.pipes from the heating source.to the kitchen ftfures thata're inches or greater in. diameter shall be thermally insulated as specified by Section 156 (j) 2 A or 150 (j) 2 B. Residential Compliance Forms, March 2005 b ix CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 4) CF -IR Project Title Date SPECIAL FEATURES NOT REOUIRING HERS VERIFICATION (add extra sheets if necessary) Indicate which special features are partof this project. The list below only represents.special features relevant to the rescri tive method. ❑ Feature Metal Framed Walls Required Forms if a ' livable Descri tion CF -1R. ❑ Radiant Barriers CF -1R . ❑ Exterior Shades WS -4R ❑ Cool Roof. N/A; Attach CRRC Label to ` Forms. Dedicated Hydronic Heating \ Performance Calculation stem R -ked- Attach Run to Forms. ❑ . Combined Hydronic System,Performance Calculation . R uired-.Attach Run to Forms. . ❑ Gas Cooling Performance Calculation ❑ Buried Ducts Required. N/A; Indicate on build'in tans. ❑ Kitchen Pipe Insulation See Section 5.6.2 Distribution stems in Residential Manual. Multiple Water Heaters Per. See Table 5-13 or use Dwelling Unit Performance Calculation and attach Run to Forms. Central Water Heating System Performance Calculation and Servin Multi le Dwellin s . attach Run to Forms. ❑ Non-NAECA Large Water Heater CF -IR - ❑ Indirect Water Heater See Table 5-13 or use Performance Calculation and attach Run to Forms, ❑ Instantaneous Gas Water Heater See Table 5-13. or use Performance Calculation and attach Run to Forms ❑ Solar Water Heating System See Table 5-13 or use Performance Calculation and attach. Run to Forms ❑ Wood Stove Boiler ,Performance Calculation and attach Run to Forms SPECIAL FEATURES REOUEMG HERS RATER VERIFICATION . _(add extra sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need verification. 'Feature . R uired Forms(if 'a livable Descri tion uct Sealin CF -6R part 4 of 12 Refrigerant Charge CF -6R part 5 of 12 ❑ Thermostatic Expansion Valve CF -61Z part. 6 of 12 Residential Compliance Forms , March 2005 . Bin # Crty of 1� Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Per 't # Project Addressl !`, � Owner's Name: �j(/�{/� orQ A. P. Number: Address: �G Legal Description: City,ST Zi Contractor: .,* h Telephone: one. 9 Address: UG�3 Project Description: City, ST, Zip.1gaeeA— J2 Telephone: hone• s �a State Lic. # : City Lic. Arch., Engr., Designer: x� Address: City., ST, Zip: Telephone: e one: �> State ic. #: Name of Contact Person: Con 0 structi n Type: Occupancy: P cu anc P Y• Project Pe (circle one): New Add'n n Alte r Repair.air Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: 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 Calm Plans picked up, Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2pd 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:- hd 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