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12-1110 (MECH)'K. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00001110 Property Address: 78705 AVENIDA LA FONDA APN: 770-171-005-148 -000000- Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4500 Tavl 4 4 Qum& BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: RAMIREZ ANTONIO S 78705 AVENIDA LA FONDA LA QUINTA, CA 92253 Contractor: Applicant: Architect or Engineer: PALOMA AIR CONDITIONING P.O. BOX 3501 PALM DESERT, CA 92261 (760)347-1212 Lic. No.: 619091 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/24/12 I I CITY OF LA 01.110A F I N A N 0 F 1F—Wf i V - - ---------------------------- ------------------------------------------------------------------ Co— LICENSED CONTRACTOR' ECLARATION I hereby affirm unde p aIty of perjury that I am licensed un visions of Chapter 9 (commencing with Section 7000) of wisp3 of the Business and Professio s ode, and my License is in full force and effect. Lic se Class• License No.: 619091 XDte: b/}j1 ntractor: ` 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.). (_) 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.). (_ 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 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 COMPANION PROPT Policy Number CPCA15666 I certify that, in theVerrmance of the work for which this permit is issued, I shall not employ any person in a aso as to become subject to the work ' mpensation laws of California, and ag at, iuld become subject to the compensation provisions of Section (..jjjj RO f the Labor Code, I shall forthwith co with those provisions. ate: 1 plicant: WARNING: FAILU E 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 i sued as result of this application becomes null and void if work is not commenced within 180 ay4.irtfm date of issuance of such permit, or cessation of rk`for 180 days will subject permit to c cellation. I certify that I havad is application and state that the above inf ation is correct. I agree to comply with all C ity and county igd ances and state laws relating to building c ruction, and hereby authorize representatives of thi nxt nter up the above-mentioned pro rty inspection purposes. te: gnature (Applicant o r> gent): Application Number . . . 12-00001110 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/23/13 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 HVAC CHANGE -OUT: REPLACE PACKAGE UNIT. 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 form Vyps in fbrmsi (no �h and qF.-..'04 All hVAC rep�aqaA ed Cohdensi InLo­r C F rp, bce * NU_ I I '�.7 i- U, ducts ­ A A ARequt 4w 0. new eWf new du a For For; ack 1AV"'Awo i ,Includes repladrl�or}I/ts�a�lin� rail' clu"m6g­1 ticilot ou and/ordoor r I r Ir . L equip t e qp pt changed. 6anOed. For SplitSystems DucEleakage For Packaged , F Vfil, :94ct leakage :­., 0-41:N'dwjDkdnj4y, 401feit I' .Includes iaddirwo-orteplacing mpff linearq i; of duct in u*ficowioltlo For splits PmAr p4r. q, [3: EXCEMON: �Existing qct4yp Contrip4or-11R.O.cmip WOO 'Autk I certify, atAhlice=.6-7 �Pii, 1 am-ellgl le tAndO,D1vWdn 3 f theCompllan'- t at the energy features an requltem ntsof-mde 24, Parts1i an g featur.e_*-identified Ont1 - �!. forms,rksheeti, calculations, We Name; He anParedes I' r,prnponY: . PALOMNAIWCONUL - 110jl I'Address: 6ABOX-3501: rc-ity/,State/,Zip*. PALWDESERT/ CA, Reg 1 212- 0049163jk-0ob0006-41 2000, ReSi ential COW104cc Fi to o>�'Cotnplance� WOO 0 V f, gear k - q mak, s tri 'D 17; A W-- L,�CA6T a1 V ItiorfeciflOcir ThgErn r- IrOnt �r m4m2i .1 Oa E c 'k .0� J&S'eWOR t It A - %*R 6 04 rr-'.z 1�0.� by Sys a t air presp4 iist be 13A 8 Ea HSp sf t, [3 Re�ls tance ,:bc1ng!1nstq11ed;'1f more!thollop-1 sym m, uj!#wqt 1R-AUTHYAC-1�r e#�Wsystgm ;gp%, 78ol. A"j C4 e 3; 4�� tyol I t Id n als ted .b�lowja�e UR , alterpy iyoppons; ",jnstajj!� decides done'' below lare �HVA c!5 ns.'Eapch-Optlo' I jjt's'jjh-O 5ERS' m, sure '�that Inps, be '�O sh011 or ve. o this �q, it A the - p. ner j i spq, I copylgiy5n to ..91.1"prpf Pe Pe y. the Installer. tha vcl�_ cip r 4 6n g1s 'r CF -411 0 CO -29 d f are filled .! XR out *a 9 4k 7: final Int -pa, n F 0 L 0 �d 0 1. Tns*._MECHr04, MECtH-21.H 1� 371. 7Tfs:H ,MEC r2j� 4M: -ms.:, EC T04,H_ii2kkks. �kmmc) M N W It -21 .ms: MECI,H T 4GA, MAH ill. 45 Oorc6nt !to hayelbeenlprGv�ously:�gal d pd & c rifirm through F ERS -verification,. r 4b linear. feet in.uncondit�oned �Spi'e, o t A r .1 .......... ................ ........ XX . . . . . . . t unit CF6111�,form3s' :CA. L(4 - M m •H-2 '-HERS, and #orsi5lit systems ME, �45"HERS ME CH: iorn2e 'CFf4Rj',f4r'm I : ' 1 for pjjj stefns� -ME H�Zp On. systems Cyi�,,p on `-.65-percont; RC, CA Z 3001tfm TM < 6 percent Required Formad orm I an 4,0ISF ECHr ; MVH-Z�-HERS Q I r se611�0Mit';ps.be$tos. ;taterhent)f* Il d c m jete. 1i Codg qccq , t resp n101jlty for the deoq .1den, tiled on %hl$: 11cate of ie de g, Ident1fi, pd on this Certificate of Colippil4rice con forimn -to e 1I2 0 . C2 jLO /06 ;Ca;C,E,RTS, Inc. 1IJ,Iy 2010 Permit # `\NP \I� JC Project Address: A. P. Number: 17 -- . Contractor: �% /� r Q pu l Project ro J t}pe (circle one): Ne- Add'n Alter Repair Demo Address: Stories: # Units: City. ST, Zip: Telephone: �C State Lic. # Arch., Engr., Designer: Address: . PERMIT FEES City, ST, Zip: Telephone: Item Amount State Lic. #: Name of Contact Person: Plan Check Deposit Telephone # of Contact Person: tl Submittal Plan Sets Structural Cates. Truss Calcs. Title 24 C21eS. Flood plain plan Grading plan Subcontactor List Grant Deed ILO.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees CitY Of La Quinta Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit APPlication and Tracking Sheet CQ -r-n.c- F,,,,wn—'s Name: 1 ST, Zip: C Project Description: C C-- Lic. #: - a�l/70- U -f-- ( 0�- Construction TvP e: _ Occupancy: Project ro J t}pe (circle one): Ne- Add'n Alter Repair Demo Stories: # Units: © 0 © /� 7 Estimated Value of Project: ^© �— APPLICANT: DO NOT WRITE BELOW THIS LINE 'd Recd TRACKING PERMIT FEES Plan Check submitted Item Amount Reviewed, readv for corrections Plan Check Deposit Called Contac) Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2'' Review, ready for co rrections/issue Electrical Called Contact Person Plumbing Plans picked up SAI.1. Plans resubmitted Grading '" Review, ready for corrections/issue Developer Impact Fee Called Contact Person +—f A.I.P. P. Date or permit issue Total Permit Fees