09-0749 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'yl 4 4 Q"
n
Applicant: or En
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 end Profession s Code, and my License is in full force and effect.
License Class: C20 icens o.: 794315
late:? "� �" Q ��Contractor:�_/I P11FT
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ I 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.I.
Lender's Name: _
Lender's Address:
LQPERAIIT
Owner:
PFEIFFER PATRICIA
79145 DIANE DR
LA QUINTA, CA 922,
Contractor:
DOVE AIR INC
69749 RISUENO ROAD
CATHEDRAL CITY, CA 92234
(760)327-1890
Lic. No.: 794315
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
O
Date: 7/10/09
ME
-----------------------------------------------
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 ecome subject to the workers' compensation laws of California,
and agree that, if Ishould be me subject the workers' compensation provisions of Section
3700 of the Labor Code, all forth wi omply with those provisions.
Date:_ 7-P- —, Applicant: --,
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 ofworkfor 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 c� nstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned propertyr hspectian puv oses.
�[e:.7 ' 1 /'P 1i I Signature -(Applicant or Agent):
�09-00000749
Application Number:
Property Address:
79145 DIANE—DR
APN:
604-361-030-78 -278,99 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1365
T4'yl 4 4 Q"
n
Applicant: or En
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 end Profession s Code, and my License is in full force and effect.
License Class: C20 icens o.: 794315
late:? "� �" Q ��Contractor:�_/I P11FT
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ I 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.I.
Lender's Name: _
Lender's Address:
LQPERAIIT
Owner:
PFEIFFER PATRICIA
79145 DIANE DR
LA QUINTA, CA 922,
Contractor:
DOVE AIR INC
69749 RISUENO ROAD
CATHEDRAL CITY, CA 92234
(760)327-1890
Lic. No.: 794315
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
O
Date: 7/10/09
ME
-----------------------------------------------
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 ecome subject to the workers' compensation laws of California,
and agree that, if Ishould be me subject the workers' compensation provisions of Section
3700 of the Labor Code, all forth wi omply with those provisions.
Date:_ 7-P- —, Applicant: --,
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 ofworkfor 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 c� nstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned propertyr hspectian puv oses.
�[e:.7 ' 1 /'P 1i I Signature -(Applicant or Agent):
Application Number . . . . . 09-00000749
Permit . .
. MECHANICAL
Additional desc .
.
Permit Fee . . .
. 24.00
Plan Check Fee
6.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date .
. 1/06/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
----------------------------------------------------------------------------
Special Notes and
Comments
i AC CHANGE OUT 3 TON CONDENSOR ADD
TXV
METERING DEVICE 13
SEER / ATTIC.
----------------------------------------------------------------------------
Other Fees . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged
----------
Paid Credited
--------------------
Due
-----------------
Permit Fee Total
----------
24.00
.00 .00
24.00
Plan Check Total
6.00
.00 .00
6.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
31.00
.00 .00
31.00
LQPERA11T
CERTMCATE OF • COMFMiANCET: RESZDENTM L (Page 2 M) CF -IR.,
Project Title Date' T
FENESTRATION PRODUCTS .—U-FACi'ORANO SHGC '
+� ❑ FE14ES'TRATION'MAMMUM ALLOWED AREA WORKSHEETWS-4R—must be included -for New Construction,
Additions and Alterations.
Fenestration
.#�I�rpelPos.
(Front, Loft,
Rear, Right,
Skylight)
Orien- '
talion,
N. S W'
Arra
R2
" ,
U-fador2 .
U=favor'
SouroO SHW
.
SHdC
SourcQ5
Exterior.
ShadinglOverhangs�' �.
-41' box if WS -3R is
included
E3
❑..
1) Skylights anow included,in West ' g fenestratibn area if the skylights arc tilted to the west or ' in tory direction
when the pitch is less than 1:12. See'§ l51(f)3C and in Section 3.23 orbic Residential -Manual
2): Patter 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) . Eater values in this column from NFRCor from Standards Defauh Table 1168 or. adjusted SHGC from WS -3R
. ..5) Indicate source either from NFR.0 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.
7) See Section 3.2.4. is the Residential Manual:
HVAC SYSTEMS
ReatingEquipment
Type and Capacity
lkat pmp, boas coc-
Minimum.
Efficiency.
AFiIEorM .
Distribution.,.
Type and,Location
ducts art; r,ebr.
Dud or Piping Thermostat Configuration
R-Valde iter
Cooling Equipment • Minimum
'type and Capacity Efficiency Duct.Lwation Dud
LA/rfitat rA eva . li SfiER'orR atti etc. R -Value
Thermostat Configuration
liter
G NtL'°
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) C&M
Project Title Date
SEALED DUCTS and TXVs for. Alternative Measures)
A signed CF -4R Form must be provided.to the building department for each home for which the following. are
rerniired. .
OR
E3 [Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-C: Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
El seated as confirmed through field verification and diagnostic testing in accordance with'procedures in the
Residential ACM Manual and duct systems with more than 40, linear feet iit unconditioned
aces shall meet the r uirements of Section BO m and.duct insulation Ke
quirements of Package D.
WATRIZ HFATYNG RVSTF.Mq
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
Sealed Ducts all climate zones Installer testing and certification and HERS rater fieldrverification required.
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
External
Insulation
R -Value
TXVs, readily accessible (climate zones -2 and 8715 only)
(Installer testing and certification and HERS Rater field verification required.)
❑
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
❑ Refrigerant Charge (climate zones2 and -8-15 only) (Installer testing and certification and HERS Rater field ,
verification required.)
Manual. No water heatin calculations are required, and the system complies automatically.
OR
E3 [Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-C: Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
El seated as confirmed through field verification and diagnostic testing in accordance with'procedures in the
Residential ACM Manual and duct systems with more than 40, linear feet iit unconditioned
aces shall meet the r uirements of Section BO m and.duct insulation Ke
quirements of Package D.
WATRIZ HFATYNG RVSTF.Mq
Svstemc cervine sinele dwelline.units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
❑
dwelling unit. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is
Tank
External
Insulation
R -Value
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heatin calculations are required, and the system complies automatically.
Check box. if system does not meet criteria of "Standard" system, and does not comply with the Pieapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
❑
Check box to verify that a time control is required for a reciiculating.system.pump for a system serving multiple
units
Svstemc cervine sinele dwelline.units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Rated
Input'
(kW or
stung(gallons)
Energy
Tank Factor ort
Capacity . Thermal
Efficiency.Loss
Standby
%o
Tank
External
Insulation
R -Value
Tank
External
insulation
R -Value
Svstem serving multiple dwelling units
Water Heater
Type
Distribution
Type
Number
in System
Rated
i
input'
w or.
13"(gallons)
Tank.
Capacity .
Energy
Factor or
Thermal
Efficiency
Standby'
Loss (0/o),
Tank
External
insulation
R -Value
1. For small gas storage water heaters (rated inputs of less than or equal to 75,000 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 ;
.Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
Pipe Insulation (kitchen lines >_ 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/a
inches or greater in diameter shall be thermally insulated as specified by Section 150 0 2 A or 150 0) 2 B.
Residential Compliance Forms
March 2005
• .- .:rte. fir. .•
A -
CERTIFICATE OFCOMPLIANCE::RF SXDEN'TIA.Z. (Pagel of 4) Cz+'-1R
Project Title Date —
Projea Addre Bww�g eetinit
Documentation Author ' ..Telephone
. Plan t�oek J Date .
• • '. . •• - ,FiddQ�ock/Date.
Cornplia=6Method (Prmmptive) CliaaiatcZone ': ta�taasnau�teciwyUst0 y
<13 Aliernative Compona�t Package Mttliodc (check one). �C _ D D (AlternatiYe) .
Package C and Padne, D choices require HERS ratac Pad verification and/or dwgnostiotesting (soe CP -I R.page 3j• •.
Foi Package DAhttnativc see'Appendk-S Tabic'151-C FobbW= 7-14
GENERAL INFORMAT70N ..
Total Conditioned .FloorAwA (CPA) ' ft2 ' Avgrap–Od"ling Hdibt: - ft
MaximcrmAllowed West.FacingFeu OohodictsPei ThbleIna &r5i-C'--'(S°.4XCFA)�_ti�•
Maximum Allowcd•ToW Fcncstration Products Pa Tabk ISI$ or ISI -C._..: (Z0-/ X CFA)_ ft
✓ 0 BWldingType:.(checkoneormore) SlWcFamany• Muitifaojy Addition Alteration.
(if adding fenestration t311.out WS-4}t,:Fe ieshadop Maximum Allowed Area.Waimbeet and sec Section 83Z .
' for Additions and $3.3 for Alterations.) '
Number of Stod= • ' . Number of Dwe lidg Units:
door Construction 1 'p ' _ . SWRaised Floor (circle orae of both)
Front Qrieatation:'' Notch /South /Fast/ West/.All Urientatiotas.(mput fivat orientation in degrocs from Thee
North and circle -one).
. } ✓ CI• ADIAI!IT BARRIER (ceauh-e3. in climate zones 2.4.3-15)
O_ PAOUE SPEACIDS INCLUDING OPAQUE DOORS
Componcat Assembly U-
T'pe (W2% Frame factor (for )oiat . Roof ftdiiant
Roof, Floor,' TYPO. Cavity Continuous: wood, nidal Appendix i3atrier L,ocation/Coanantnts .
•Slab.Edge; (�Kdod Insulation Insulation frame and mass IV Installed atti
_:Doors orM- Value RValue, as3bmblies a Reference .XesorNo ( i�ac. '
1) See Joint Appendix•IV in Scction. IV.2„. IV3 and IVA; which is the basis for the U -factor criterion. U -factors can not
exceed prescriptivevalue to show equivalence to R -values:.
Residential Compliancp. Forms March 2005
y' CEItTTRZCATE OF CONZPLIANCE: RESIDENTIAL. (Page 4 of 4) CT'=1R
.tjaVia }h.XS'WJ' , .
i
j Project Title - - - -
JJ Date
} i SPECIAL FEATURES NOT REOUIRING HERS VERIFICATION (add extra sheets ifnecessary)
Indicate whittr special features are part of this project, .The list below only,tets special features relevant to -the
prescriptive method.
<
Feature,
R wired Form's ita 1itable
Description
i
Metal Framed -Walls
C171R•
<
Feature,
R wired Form's ita 1itable
Description
11
Metal Framed -Walls
C171R•
❑
Radiant Barriers
CF -1R
❑
Exterior Shades
WS -4R
❑
Cool Roof.
MA; Attach CRRC Label. to . .
Forms.
❑
Dedicated Hydronic heating
Performance CalcuMoh
ern
R ' wired• Attach .R+gn to Forms. ,
O
Combined Hydronle System
Pgfbrmanee Calculation
BAWire&Att" Run to Forms. .
❑
Gas Cooling
Performanoa Cokulatioir '
Reguhed:
U
Buried Ducts
N% • Indicate on buildi l& phw.
IGitchcri'Pipe Insulation
See Section 5.62 Distribution
Systems in Residential -Manual.
Multiple Water Heaters Per
Seo Table -13'or use
❑
Dwelling -Unit
Performance Calculation and
'attach
-Run to Forms.
❑
Central Water Heating System
Performance Calculation and
8ervin Multiple Dwel "
attach Run to Forms.
❑
14ori NAECA Large Water
Cg:1R
Heater
See Table S-13 or nae•
❑
Indirect Watet Heater
Performance. C`akuiation and
attach Run to Forms
See Table 5-13 or use -
0
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms
See Table 543 of use
❑
' Solar. Water Heating System
Performance Calculation and
attach.Run to Forms
❑
Wood Stove Boiler
-.Performance Calculation and •
attach Run to Forms
SPECIAL FEATURES REOU LWG HERS RATER VERIFITION CA .
(add extra sheets if necessar0 indicate to -the HERS Rater which credits are part of this project and need
LG! .:G/ GVUO I:VlY O: LL L'MA La �,LL1[1La nuliciluc�r 5a1'F•y _ -
MOU U a t V V a
sln
aty- O f a QuInta
Buildln� 8L Safety DWI=
P.O. Box 1 t04, A-495 Calle Tampico
La Qulnta, CA 92253 - (760)• 777-7012
Building Permit Application and Tracking. Sheet .
Permit
-Project Address: _ 5
Ovim'sNw. e
A. P. Numbs:
Address: "l 14 S
Legal Vescriptiow
Contractor: ID Ov T A ZL T-1-ic,Tdcphone:
City, ST, Zip: ek cn 21, 53
Address; 1
Ymjeet Description: C `\c vk-j t O v/ r
City, ST, Zip: C - o LZ 3 43
} v✓\ p
Telephone: — t.8l 0
V S C'6 -
E
State Lle #: G City Lic. #s 0
Arch., Engr., Designer:
Arch.,
Address.
City, SC, Lip:
Tcleplivtu:
;tate Lie. #: /
Name of Contact Peraron: C Gy I! r0
Telephone it ofConlact Person: '
tronstriapdon'Type: Occupancy:
Project rM(eircle one): New Add'n • Alter .Repair Demo
Sq. F•: #Stories: # units:
Estimated Value of Project:. u
APPLICANT: DO,';NOT VVWE BELOW THIS WIVE
6
-.Slubmittal
R 'd
Ree1d
TRAC�CIIHG.. PERMPf•FEES
Plan Sets
Pian Creek submitipd
Item Amount
struct"Acal s..
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Coulter Peraon
Platt Check Ballace
Cautntetion
Energy Coles.
Plans picked up
Flood plain, plan .
Plansrranbmitted
MeebAweaI
Grading.plan
v Renew, ready for eorrectioaslissne
Electrical
Sabcoutactor List
Called Contact Person
Plrmbing
Grant Deed
Pisa$ picked up
S KL
11.0.A. Approval
r
, i'lans esubipiUed
Grading
IN HOUSE:-
J1 tevlew, ready for correetioustissne
Developer Iriupact Fee
rimming Approval
Called Contact Person
A.Id'.P.
Pub. Mi. ApprDate
of permit Issue
School Fees
....._ .. ...:
Total Peratit Fees