09-0754 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-0 000 000 0754`==,,
Property Address:
-=: 9 70_DESERT STREAM DR
APN:
604-321-001-1 -23935
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
5000
Tavl
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
1,4—
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.
Li�e:��nt,.ct
10-C20i Licens No.: 856936
or:
OWNEh-BUILDER DECLARATION
I hereby affirm under penalty of perjury t at 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 contractors) 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:
LQPERMiIT
Owner:
SAPIDA TEDDY
79370 DESERT STREAM D
LA QUINTA, CA 92253
Contractor:
TELFORDJONES, INC
25920 IRIS AVE, S
MORENO VALLEY, CA 925
(951)486-0337
Lic. No.: 856936
NPI
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/09
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 STATE FUND Policy Number 238-0005911
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 sho come s j ct the workers' compensation provisions of Section
/] 0 of the L bor de, I s fo hwi h om/pily withlose provisions.
plicant: aw
WARNING: FAILURE TO SECURE WO E ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL NALTIES 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 st to laws relating to building donstructio d ereby authorize representatives
of this u y t enter upon t above-mentioned proper pectin pur o S.
,Dgte: S' ature (Applicant or Ager tl:
Application Number . . . . 09-00000754
Permit . .
. MECHANICAL
Additional desc .
Permit.Fee
31.50
Plan Check Fee
7.88
Issue Date . .
.
Valuation
0
Expiration Date
1/09/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 16.5000 EA MECH B/C
>3-15HP/>100K-500KBTU
16.50
-------------------------------------------------------------------------
Special Notes and
Comments
---
CHANGE OUT HVAC CONDESER :13 SEER, 5
TON. 2007 CODES.
-------------------------=--------------------------------------------------
Other Fees . ...
. . . . . . BLDG
STDS ADMIN (SB1473)
1.00
Fee summary.
Charged Paid
--------------------
Credited
--------------------
Due
-----------------
Permit Fee Total
31.50
.00 .00
31.50
Plan Check Total
7.88
.00 .00
7.88
Other Fee Total
1.00
.00 .00
1.00
Grand Total
40.38
.00 .00
40.38
LQPRRA11T
—o JtAKs-hUMt,1MFKUVLMI:NI JONES
Certificate of Comflance Prescriptive Method - WAC-oniv Ahwation CF -IR -ALT
Project rift.
1:5
Date:
0 CalCERTS 2005
ant-ApencV, Use Only: r. x.1.1
Project ARMS:
Climate Zone:
tindin
V
Documentation Author:
Telephone.I!-,"
iD01 .. . ...... ..
Company Name*
Field, Chult 09, V
IMPORTANT' This CF -1 R -ALT fat r Is only for use when an HVAC -only alteration Is made to an existing home
Use one form for each system befitq altered. This issyStem # ' -of-. ffstems altered In this house.
thatannl3g- CherK only 111nea that aRnly.
Scope of Alterations,
1 13
An Air Handby Is to be Installed or rer liated, Ovll swll!!g to be determined. Continue to nerd line.
2 E3
A Furnace Heat &Whanger is to be it or replaced. Duct sedrig to 0o determined. Continue tDriviilio.
3 ;<
An outdoor conderinina unit is to be nsWed or replocacl. Duct Sealing &War TXV(RCA) to be datermineti. Continue to nod line:'
4 0
A'coonna or heating c6ilis to to insfii1led or. Telacad. Duct Seefing andforTXV(RCA) to be daWmined. Continue to nod line.
6 0
More than 40 fed of now or replaciernmedurt are to be installed in tmnandillonedspece. Duct mallngtobedetermined.
0 Chea hem if the allb c lua system is also to be new or Mlaced. Continue to neid IIna.
6 0
If n;; of lines 1-5 are dw-W. nMha -Duct Sealing nor T)CV(RCA) we niquired, GotoSection S.
Section I -Duct Swlinq (Only if any of Lines 1. 2. 3, 4 or are checked. Sid pifLine 6ischecked. 1-
7 C3 This s tarn Is In Climate Zone 1, 3. 4, 'S .6 7, or 8. No duet aiding is ulied. Go to Section 2.
SW Wit scam has less than 401W cf. du= in unconditioned space, N*duct wWinglsraciuitartGotos6dtmZ
9 C3 his system was previously asaled and tasted, and WM awtifted by a HERS Ww
No di.01. sadina Is MuIred. Attach pmorioug CF -4R form. Go to Seetion 2.
10 E3 is duct system Is sealed or Insulated with asbestos, No duct sawing Is rmulrad. Go to Section 2.
Note: If the entire duct aVatern is to xi, new or replaced, Lines 11-14 do not apply.
11 0
In Climate Zones 2.12 end I& An 0.11: AFUE fumace win be InsUlled In lieu c1duct imllma and TXVI
11 e . appi cam
12 13
.'
In Climals Zones 10, 13 wW I&- An SEER 14 MUER 12 cmdansawill be inatalled with TXV(Rr.A) .
AND added duct Insulation (R-4 wrap en ffidatIng ducts, R-8 new ducts) In lieu of duct seang. Go to Section 7-
13 13
In Climate Zonas g, 10, 11, 13,14, or 15',;An SEER 14a=F-ER 112cdndensarwin be tulelledwIth rA%1FZN
AND a 0.02 AFIJF- ftirnaca will be Intel 16i In lieu of duct eading. Go to Section 2-
14 0
In Climate Zones 2, 9,-11, 12,14 or 16 An SEER 14 Aye EER 12condenser wIll bainstalled with TXV(RCA)
D an 0.82 AFLIE fdmwA will be Inst fled with Increased duct Insulation In fleii or duct mWirm. Go to Secoon 2.-
15 0
None of lint T -i 4 above are chocked, Duct Searing im Required. Continue.
Section 2 -TXV(RCA ) (Only It Lines 3 or 4 are checked, othenwlse of to Section 3)
16 0
e am barn i e d Je a cV a unR. NoTWINGNiammited. GoloSection 2l,
17 0
ThIB ayntem Is 16 Climate Zone a and a 14 SEER air conditioner ar 0.82AFUE fiirnaco is being Inslaired.
NcTXV(RCA J1s required. Gotg5e0ion's.
18 0
This syptarn la In CAlmats, Zone 1. 3, 4. 5. 8. 0r 7. No TXY(RCM Is Mglured. Go to Section S.
19 M
TN% gyslarn Is In ClImft Zone W and sine 14 Is not chein-kad. NoTW(RONIsr"ulmd. GotDSadcn3.
20 E3
This system Is In Climate Zone 16 and Ift"14 Is checked and not line 16. TXV(RCA)Isre. quIred. GootoSection 3.
21 Q
is system is in ClimiAB Zone 2 or 8-15 and line 11,18 or 17 is nil checked. TXV(RCA) to required. Go to Sedan 3.
Sect)0 3 - HERS Rater verification
22 13
If IIAG 15 is checked. HERS vorificatloy. Is required for Duct Sealing.
23 D
if line 12,1$,14.20 or21 are ehaokikl.ind noi fine 16 or 17, HERS verification (a requirod for �(RCA)�.
24 0
If fine 12,13 or 14 ate checked. HERS F torl'I'llcatlain io required for 12 EER
Section 4 - Equlomeet EffirJendes
25 [3 If Grlas 11.12. 13, 14 or 17 are ched(ed-I upgraded equipment.91111clencles are required. List In S;Nw— C
Section 5- Duct R -Values 4,
26 C3
Llf—mom then 40 *at 0fdUVt.ISbean RInst 9W2Lr—m—faced , duct R-yalusmusA meet or missed Pse laftal) regulIamenta.
27 0 111
leria than 40 feet of duct Is Wnj In-sia led or replaced, duct Rwalue must mem or we. veal P-42
Section 6 - see next pEge
VC131011 W -W -Vo
This form can only be used on projecti beh"
ig verified by CaICERTS certified raters.
0
Page I ' ot2
WWW.Calcerts.com
SEARS_HDME .,IMPROtlEMENT" • 4. `JURE•&
x:A Vb/.1;:IPl:L.uuy :UtS °[d haft"titYH:OtiStiti�SB`31:• -
nArtt 'ir-,min of (`_nrnnfimni-a Drwsr.rietive MAthod . HVAC-oniv Alteration CF -IR -ALT
Project Tine:
spb'
s
Gate:
O0
CaICERTS 2005
IMPORTANT: This CF -1 R-AL•"'fomt Ie onty for use when an HV myaIle tion is made to an eid8ting home
Use one form for each an beingattend. This is system ,# of systems altered in thle,house,
Section 6 - Minimum Requirements for Egilpment to be InstalledWered.
OMMved equipment meet match Vpot-odtbn and mast a mesad e►Iiden*s/R-YMM.
28. Congoumilon: asola Xewlgn C Pae cageWIL
20 dtw,
QGaa brace, AFU L ERmtpump FAU ❑ r** FAU (30ther
30 t7
31 �.
fl
ndena lQliaatpkmP SE PF: FF3i32
e adl ONO tlMOM m t7 ronin
33 ❑
Lenolh ft R•uelra
Alt mandato mt FBures a to an altered con onent. See MF -1R - ALT form.
Compliance Statement: -
This certificate of compliance fists the building features and specifications needed to complywith Tithe 24, Parts 1 and 6 of the
Calllbrla Code of Regulations, and the adrilnistrative regulations to implement them. This ceNBcate has been signed by the
Individual with overall project responsibility—The undersigned recognizes that compliance using duct seaflrig, verification of refrigerant
charge, and TXV require Installer testing an 1,cartliicatlon and verification by an approved HERS rater.
Home Owner or Authorized Anent Documentation Author
Name:
Name:
Company Name:
Address:
-7 q;7 o
CitylStatelZp:
Address:
Out rsG� Cit `
Phone:
WO S
CitylState/21p:
Phone:
Signature.
Signature,
Enforcement Agen"OdInn De artment ."
Notes/Comments:
Name: ..I
Title;
Department:
Phone #.
Fax #;
Signature or stamp:
Required fomms;
CF-iR-ALT: by anyone. Required at tirne of R0m111-appllcatlon. Copies to home owner, enforcement agency, HERS rater.
CF-6R-AL7: by Installing contractor. Requiret to close permit Copies to home owner, enforcement agency, HERS rater, .
CF -4R -ALT: by HERS rater. Required to closa.permft. Copies to home owner. erttarcement agency, Installer, The CF -4R forms for a
sarnele-group shall not be released until all tea ting Ind verWicatlon is Com leted.end essed for he ent)Le rou .
version 03-1046 Page 2 of 2
This form can only be used on projects being verified by CotCERTS certified raters, www.caleerts.com
s
--- 0
Bin #
City of La Quinta
Building ar Safety Dlvlsion
P.O. Box 1504, 78-495 Ca11e Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pemtit #
q
Project Address: 93
�f/ �W G�/ crlirzaw;
Owner's Name: 7 e,6b i sapl q
A. P. Number.
Address: 793 76 AUaT SMa? 1? Ak.
Legal Description:
City, ST, zip: h? 0YX174, OG) 92253
Contractor: �
Telephone: � , !�•�` �'.yf"
Project Description: LJ/_/6q/) 1f
/� 'l
Address: 2592 0 A40/1 Rye. 0134 -Y0
City, ST, Zip: %77 Wb Ydle Cit . 92551
(ALMA)s • 13 .sem i51-PA)
Telephone: - 033
19,�i y ,
�;•"�" fis•�rr:
State Lie. # : �5W q3. City Lic. C.'1020 70
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: ,h. way,.
moi• <tr
State Lie. # t`%>-'' "
....�,,�?�`.� y,� >
Name of Contact Person: )1/U Te1�� .
Construction Type: Occupancy:
Project" (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Estimated Value of Project: ✓moi r .
APPLICAmr: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
F Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21! Review, ready for correctionstissae .
Electrical
Plumbing
Subcontactor List
Called Contact Person
Grant Deed
Plans pinked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Reyier+, ready for eorrectlonsrissue
Developer Impact Fee
Planning Approval
Called C:untaet Person
A.LP.P.
Pub. Wks. Appr
Date of p,':rmit issue
School Fees
Total Permit Fees