11-0551 (MECH).y
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000551'x:=�
Property Address:51421 CALLE-KALIMA
APN: 770-166-021-10 -000000-
Application description: MECHANICAL
Property Zoning: MEDIUM DENSITY RES
Application valuation: 6000
T419� 4 4 Qum&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CROWLEY THOMAS J
51421 CALLE KALIMA
LA QUINTA, CA 92253
Contractor: /O
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5%26/11
Applicant: Architect or Engineer: TELFORDJONES, INC.
25920 IRIS AVE, STE 13A-4 0 pAl,'§i�
MORENO VALLEY, CA 925511!
I� (951)486-0337
Lic. No.. 856936
-
--------------------------------------------
---------------------------------------------�
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, and my License is in full force and effect.
Licen�:B-ClO-C20- LicenseNo.: 856936
ate:ractor:
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).:
(_) 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 contractorls) 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.).
Lender's Name:
Lender's Address:
LQPERMIT
D
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
f� 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 0059112009
_ 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 beco a subject to the workers' compensation provisions of Section
,i � X700 of the Labor Code, I s Irthwith c9mply -wit1h those Provisions.
ate: pFrr/ JLLplicant: II it Ut✓P_/
WARNING: FA URE 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 cons u tion, and hereby authorize representatives
of h' coun y t enter upon the above-mentioned property for in a purpos
(2
Bate: gnature (Applicant or Agent):
Application Number . . . . . 11-00000551
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50
Plan Check Fee
10.13
Issue Date . . . .
Valuation . .
0
Expiration Date 11/22/11
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
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Special Notes and Comments
REPLACE PACKAGE HEAT PUMP UNIT 78
°s
AFUE, 13 SEER. 2010 CODES.
------------------------7---------------------------------------------------
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
LOPERMIT
lir - find Prescrlptive certifi®tr of.CotnpGande: 2008 Res/dO�Gal NV7+c sucarr+csanr
:timate Zpnra 10- 15 '
sibe to zones
srs: EN oreernent Agency: Data: Permit #:
Ci of La uittta May 26, 2011
51421 Calle Kalima La Quinta, CA 92253 fY Q
Duct Insulation Conditioned Floor Thermostat
requirement Area
Equipment Typol ��=t Mlnlmum Efficienclr2 eq
Q FFurnkaace Unit ® AFUE -9. ERHSPF—_Zj_
P [� Setbacktalready
� R 6 (CZ .0-13) Served by system if not already present, must be
J Indoor CDII 0 SEER 1 [J R 8 (CZ 14 -is) a sf installed)
lgj Condensing Unit QEERslst❑ Other1, Equlpmart 7I✓1►e: hoose She equipmnp rnstelled; If more than one syst@/rb use another = R ALT MV C for each system.
2. Mla/mum Equiprrrant rfrcj wife': 13 SEER, 78% AFUE. 7.71IFPr Mr typical residential eYstems.
HgRS VERIFICAYTO SUMMARY Listed below are R HVAC alteration options. a inctauer decides what Work s being done
and picks one of the appropriate options. Each Option lists the HERS measures that must be condVCted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was In fact the work com leted by the Installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R
forms o hand filled CF-4Rs allowed) are filled out and signed.aeglnning October 1, ZoLa, a repistered copy of the GF -1R
and C(n6R shsll also be on site for final inspection.
1. MVAC changeout Required worms:
.
All HVA'` Equipment CP- forms: MECH-aT MECH-�I-HERS an (for split systems) MECH-25- RS
replaced CF -411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coit and /or CF -611 Corms; MECH-04, Ml~C1-1-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coll and /or CP -411 forms: mecH-21 and (for split systems) MECH-25
. Furnace
.... c.•r.+ R.rc4nmce purr leakage < 15 wcent; RC, CCA <_ 300 CFM/ton (Mlnlmum r ow AlRequirement), TMAH
Exempted Rom duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
Cl 2. Duct systems with less than 40 linear feet in unconditioned space, or
3. Existing duct systetnA are conatructed, Insulated or sealed with esbeAos R erdltC
❑ 4. The_systern,will not be Ducted (ie,.,Puctles MlnllSpltt yK$tern , , 5etr Xe fml_1�a efllp Cjt�rge)
20 Na; vAc System Kequis� FCii'rttd:
. Cut lm-&fChengtout with: 9° ;
MECtI-04 �-A41' HERS' iir)'d or split sy$i ma) MECH -�=PIERS, and MECH-25-HERS
new dijEfS`: (all new . ' FSE forrpd:: ( J' - zs
ducClitg=,;and all new_ f _ IrFMECH '^ '�� tf— a„�ir CUA m MECH-az. ilii MEC,M ..'sr
equID
For Split Systams.- uuct I4akage a=6 perzt3iit; f
For PacKeged Unite: Duct leakage < 6 percent
3. Nerw Ducts ,Kh/or wltylout
. Indudes replacing or installing all new oucunl
and/or outdoor condensing unit and/or indoor
coil and/or furnace, No or some equipment
changed,
vor spilt Syms: Duct leakage < 6 percent;
For Packaged units: Duct leakage < 6 percent
4. New Ducting over 40 feet
I 1 da dAin or re lacing mora than 40
i or PSPP..yi_.
CF -6R Forms: MECH-04, MECH-20-HERS, and (for input systems) MECH-25-H
CF -4R forma: MECH-20 and (for split systems) MECH-25
linear feet of duct in unconditioned space JCF•411 forms: MECH-21
For split system or packaged units: Duet leakage a 15 percent
G EXCEPTION' Existing duct systems constructed, insulated or sealed with asbestos.
Contractor Document -on Author's /Responsible baa gner's Dettaratton Statement)
K certify that this Certificatc at compliance documentatipn is accurate and complete.
. I am eligible under Division 3 of the California ousiness and vrofesslons Code to occeDt responsibility For the design identified on this Certificate of
Compliance,
. 1 certify that the energy feaWres and performance opecificatioAs for the de6lgn identified on this CerClflCatc of Compiianoa conform to tris
requirements of Title 24, Part$ I and 6 of the CaQfo nia Code of Regulatienc_
.'tile design features identified on this certificate of Compliance are consistent with the Information documented on other aDDllphle compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with tee permit application.
Name: Ken Telford 519naturc: Ken Telford
Company: TELFORDIONES INC pate: May 26, 2011
Address: 25920 IRIS AVESTE 13A 400 License: 8 6936
City/natate%ZiD: MORENO VAL EY / CA/ 92551 Pone:. (951) 486-0337
Reg: 211-A0025356A-00000000-0000 Ragistratior Date/Time: 2011/05/26 01104:3c Im" provider: Ca10ERTr, Xnc.Jul0
1009 Residential Coamlianoe Forms
TO /Tal -4WHri 0YSE6tiLe9L 0:ZZ 1113Z/5Z/9e
Bin #
. 0 of La 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
Permit #
Project Address: 2�
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:--4�1t�, 92ZJ
Contractor:
SOy. o�
Address:
Telephone:
Project Description:
City, ST, Zip: a
Telephone:
3
l
,�, .,• r � ,::::..,c:
City Lic. 0
State Lic. # :
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:`''" .
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: (0000.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
I
2'' 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:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date or permit issue
School Fees
Total Permit Fees