09-0828 (MECH)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number. x_09-00000828 Owner:
Property Address: 80675 WEISKOPF PARKER RESIDENCE
APN: 762-160-003- - - 80675 WEISKOPF
Application description: MECHANICAL LA QUINTA, CA 92247
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4000
Contractor:
Applicant:Archit ct or Engineer: CR FRIEND LD TOLLEY A/C
/l
�0 � P.O. BOX12100
PALM DESERT,
CA 92255
(760)346-0434
Lic. No.: 872703
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under pro ' ter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals e, and my Licens is in full force and effect.
License Class: C20 2ese No.: 872703
D.�o' 09Contr _r.
OWNER -BUILDER EC RATION
I hereby affirm under penalty of perjury that I am exempt from the ntractor'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 _ 1 1, 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 ) 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
VOICE (760) 777-7012
FAX (760) 777 -7011 -
INSPECTIONS (760) 777-7153
Date: 7/30/09
WORKER'S COMPENSATION DECLARATION
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 TRUCK INS EXCH Policy Number A01109591
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 w com ation laws of California,
and agree that, if I should become subject t of is' compensatio' revisions of Section
_ a 3700 of the La or Code, 1 shall forthw' comp ,with those provision
Date ..pelican .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL A S UP TO ONE HUNDRED THOUSAND
'DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPE ATION, 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 a o comply wit all
city and county ordinances and state laws relating to building construction, and orize representativ
of this county to enter upon the above-mentioned property for ins 'on pu ses.
Date: ,�jd'�*2gnature (Applicant or Age
Application Number . . . . . 09-00000828
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date.
Valuation . . .
. 0
Expiration Date 1/26/10
Qty. Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00
------------------------------------------------------
Special Notes and Comments
---------------------
REPLACE A/C UNIT 14 SEER AND FURNACE 80
AFUE 2007 CODES (2)TON UNIT.
-------7--------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
---------------------------
Paid Credited
Due
----------
Permit Fee Total 33.00
--------------------
.00 .00.
33.00
Plan Check Total 8.25
.00 .00
8.25
Other Fee Total 1.00
.00 .00
1.00
Grand Total 42.25
.00 .00
42.25
LQPERMIT
P.1
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page I of I CF -IRA
Project Title `�
,Ahic— l �
ate
�,7-
Building Permit #
Project Address
Exceptions
Plan Check/ Date
Documentation Author
Telephone
- ?
Field Check/ Date
4'
7
2
Compliance Method (Prescriptive — HNfAC and/or Duct
Climate Zone
nforcemeot Agency Use Only
System Alteration - § 152 (b) 1 C, D and E)
1 Ducts stems with less than 40 linear feet of ducts in unconditioned space.
EXCEPTIONS
1_ n _ .L - ✓ rt-- A—t c Nom io AvPmnt irnm fPAIt-li (111CM
Ll
allY v,
14,16 wr,v...u&I—
Configuration
Thermostat Type (split or
package)
FVJ
Exceptions
Duct systems that are documented to have been previously sealed as confirmed through field
I
0
verification and dia nostic testing in accordance with procedures in the Residential ACM Manual.
2
0
Existing ducts stems that are extended, which are constructed, insulated or sealed with asbestos.
3
1 0
1 Ducts stems with less than 40 linear feet of ducts in unconditioned space.
Heating Equipment Type
and Capacity (furnace, heat
pump, boiler, etc.)
Minimum
Efficiency
(AFUE or HSPF)
Distribution Type
and Location (ducts, Duct or Piping
attic, etc.) R -Value
Configuration
Thermostat Type (split or
package)
CMinimum Configuration
Cooling Equipment Type
Efficiency Duct Location Duct R -Value Thermostat Type (split or
and Capacity (A/C, heat attic, etc.
pump, evap. cooling) lSeco or ( ) package)
SEALED DUCTS, REFRIGERANT CHARGE TX AND EER
The prescriptive requirement for either a refrigerant charge or a TXV does apply to packaged units.
Before the permit can be finalized, a signed CF -4R must be provided to the building department for any of
the following ✓ compliance requirements:
✓ Compliance Requirements
Sealcd Ducts (climate zones 2 and 9-16) (installer testing and certification and HERS rater field verification required.)
TXV (climate zones 2 and 8-15 only) (installer testing and certification and HERS Rater field verification required.)
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.'
0 EER as indicated in Table 8-3 of Residential Compliance Manual (climate zones 2 and 9-16 only) (Installer testing
and certification and HERS Rater field verification re uired.)
SPECIAL FEATURES RE UIRING HERS RATER VERIFICATION
A ✓ indicates which compliance requirements are part of this project and need HERS rater verification.
✓ Compliance Requirements Installer Forms (if applicable) HERS Rater Forms (if applicable)
Duct Sealing
CF -611 page 4 of 12 CFAR page I of 8
Thermostatic Expansion Valve (TXV) CF -6R pages 5 and 6 of 12 CF -411 pages 3 of 8
CF -6R pages 5 and 6 of 12 CF -4R pages 3 and '4 of 8
0 Refrigerant Charge .
0 EER
CF -6R page 8 of 12 CF -4R pages S of 8
tin '#
Qty of La Quint'a
Building &r Safety Division
P.O. Box 1504, 78-495 -Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
q4d
Project Address: dt, 6211
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
......
hone: ....... ..
Telep. X— t..
Project Description:
Address: Oa
City, ST, Zip:7
Telephone:
9-1-2217L�J --7-7-,-)
A
State Lic. #
City Lic.
Arch., Engr., Designer:
J
Address:
City., ST, Zip:
Telephone:
............. ....... X:
. . . . . . . . . . .
Construction Type: Occupancy:
Project type (circle one): Ne<A.dd'n' Alter Repair Demo
State Lic. #:
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:Estimated
Value of Project: ez-zl,
APPLICANT: DO NOT WRITE. BELOW THIS LINE
N
Submittal
Reqld
RWd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title UCalcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d 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:-
Reylew,ready for corrections/issue
Developer Impact Fee
Planning ApprovalP
Called Contact Person
Pub. Wks. Appr
Date of permit issue
..A.I.P.:
School Fees
Total Permit Fees'