11-0045 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: x"11-00000045
Property Address: 52685-AVENIDA-VALLEJO
APN: 773-292-020-8 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 3800
Architect or Engineer:
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,jttd my License is in full force and effect.
License Class: C20 ansa I.o.: U4471
ate/'_/Z` �e tractor:'
- OWNER -BUILDER DECLARATION
1 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
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.).
(_) 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:
LQPERMIT
Owner:
CITY OF LA QUINTA REDEVELOP.
78495 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor: 11
SPEEDY AIR CONDITIONING
54685 AVENIDA HERRERA
LA QUINTA, CA 92253
(760)567-0133
Lic. No.:.834471
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/11/11
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 I should become subject o the wkers' compensation provisions of Section
3700 of the LaborCod , I shall forthwi om llGfivit Rhos provisions.
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 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 construc�tion, and hereby authorize representatives
of this county to enter upon the above-mentioned property for insp tion purposes.
D e�Znature (Applicant or Agent):
Application Number 11-00000045
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . 40.50
Plan Check Fee
10.13
Issue Date . . . .
Valuation . . . .
0
Expiration Date 7/10/11
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
WITH AIR HANDLER, CONDENSER &
THERMOSTAT. 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 .00
10.13
Other Fee Total 1.00
.00 .00
1.00
Grand Total 51.63
.00 .00
51.63
LQPERMIT
JOB INVOICE
Speed! Ac .& ideating
54685 Avenida Herrera
La Quinta, Ca 92253
Lic # 834471
CITY OF LA QUINT,A
BUILDING AND SAFETY
SOLD TO:
eaw,
ADDRESS,T
2 l.�.5—
ATTENTION
DATE ORDERED
ORDS AKEN BY _
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TERMS
WORK ORDERED
2'
DATE ORDERED
DATE COMPLETED
CUSTOMER
APPROVAL SIGNATURE
AUTHORIZED SIGNATURE
A-2817-3817 / T-3866
TOTALLABOR
TOTAL MATERIALS
TOTAL MISCELLANEOUS
SUBTOTAL
TAX
GRAND TOTAL
MATERIAL j UNIT;, AMOUNT
";DESCRIPTION OE WORK ..
w, r� 1 i►�
' ` ter• /L -�
MISCELLANEOUS CHARGES
bill
LABORHRS.RATER
AMOUNT
IAOM�
.TOTAL
-
LABOR ---
WORK ORDERED
2'
DATE ORDERED
DATE COMPLETED
CUSTOMER
APPROVAL SIGNATURE
AUTHORIZED SIGNATURE
A-2817-3817 / T-3866
TOTALLABOR
TOTAL MATERIALS
TOTAL MISCELLANEOUS
SUBTOTAL
TAX
GRAND TOTAL
]OB INVOICE-
Speedy
NVOICE Speedy Ac .tic HeatingLBUILD
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c 54685 Avenida Herrera
I La Quinta, Ca 92253 _
OTIfiLic # 834471 NG AND SA ETY
DATE ORDERED
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DATE ORDERED
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JOB PHONE
STA TING DATE
TERMS.
:MATERIAL``?"UNIT; Is?,
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DATE COMPLETED
CUSTOMER
APPROVAL SIGNATURE
AUTHORIZED SIGNATURE _
A -2817-3817/T-3866
r.
TOTALLABOR
• TOTAL MATERIALS
TOTAL MISCELLANEOUS
SUBTOTAL
TAX
GRAND TOTA
Simplified Orescriptive Certificatef CompliAut:e: 2008 R idea A rertlons CF -IR -ALT -HVAC
Climate Zones 111 to 15
52.44'5 Av EIV i t) A i% LLE 50
Cayarremar�
nate:
:
-45.
Equ i meet Type' List Minimum Efficien =
Duct insulation requirement
Conditioned Floor
O Packaged Unit
0 Furngoe O AFUE 0 COP
Over 40 ft of ducts added or
0 Setback
Wjadoor Coil 13SEER_MC9 O HSPF�0
replaced In unconditioned space
Served by system
(1f na already
® CdndErising Unit O EER 0 Resistance
016 (CZ /0-13)
sf
P—K MW he
O Other
D R 8 (CZ 14-15)
tnttalted)
1. Equipment Type: Choose theequipmr'ru tiedlg rhstadled. if more than one system, use another CF- I R -ALT -HVAC or each system
2• M&latrrntE1WQ1a1Wttr8,9kfittdrs: 11SWR. 78%AFUE, 7. WSPFfortyplcalrrsdenpalsystems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Opflons. installer d den what work is being done and
Ons. E*, �S the HERS Item that lIM.be conducted. A gf
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 #
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: C )
h
T phone:
one:
Address:
Project Description: L
City, ST, Zip:
2 Z5�3
Telephone 7 S —D 3
7
State Lic. # : �`'�L�'7�
City Lic. #•:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
e one
P
Occu
Panc n tri n fYP Y
a #
St to Ltc.
ProJe ct type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: LO f'
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Perso ��% ��
Estimated Value of Project: 00. Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
. Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN.HOUSE:-
1rd 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
1' '4' -_ w
_wT-1- _i rt - - , , -�V, , - I , �% - , 3-
it t
v4 r
5 580 Avenida Ca6anza'...
2 WORK. ORDER
La Quinta CA, 92253'
Amount Paid
564490 ID
(160) ef#
(760) 771-9310. Fax A/C.
C./R
Lic# 857679. Air,Cbifidltioning & Heating Co
Phone Phone
DATE Auth# Caller Name & Phone
Tech #1w.-�" Inits. Code Reason for Call:
H'Reg )Prem
perational Nan -Operational Diagnosis:'-,
Maintenance Program offered
)ticker on Equipment/Stat
'
Corid., FAUCoil, Package, Corrip
Make
Mod # Quote -
Set. # Authorized• Work Performed: V4(1
Filter size40
Press.Lo Hi OAT
Amp.pomp,_', Cond-Fan
Cond, FAU, Coil, Package., Comp.
Make
I Mod
Set.
Filter size
Press10 Hi OAT
Amp.Como Cond.Fan'.
Cond., FAU,'Coil, Package, Comp
Make. Disclaimers
Mod
7:
Ser. #
Filter size
Press.Lo Hi OAT
Amo.CompCond.Fan
TUNEUP CHECKLIST
Filter ),Stat.. QTY PARTIP.O.#.
Drain (.),In.fan motor
O Elect. )Out tan motor
ITEM
O Amps Belts
Refrigerant Pulley
) Oil Leaks : (.)Compressor
) Air Flow ) Temp drop
O Pres. Conti. O Contactor
Wheel
TOTAL
O Blower )'Control
Winter Only
.'It is, understood that the obligation to pay for goods and services described herein is secured
Sumers Safety
by the equipment and parts on the default (non-payment) of the buyer. Labor performed by
Pilot O HT exchanger
ALOCO warranted for 1 year except for electrical work, refrigerant leaks, roof leaks or unless
Gas Valve alve )Thermocouple
authorized differently in writing by ALDC6.ALDbO is not responsible for any mold delec-
PAYMENT DUE
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
IMMEDIATELY
ant l6aks may occur in systems, therefore, making it difficult to detect them. Line isolations.
RETURN TOP COPY
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