09-0356 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 .
78-495 CALLE TAMPICO FAX (760) 777-7011 ;
LA QUINTA;' CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/22/09
Application Number:.09 _0.0000356 Owner:
Property Address: 53650 'AVENIDA VILLA MOLNAA BARRY
APN: 774-134-008-17. -000000 53650 AVENIDA VILLA
Application description: MECHANICAL LA QUINTA, CA 92253 '
Property Zoning: COVE RESIDENTIAL (562) 243-8801
Application valuation: 6576 n\
o 2 rM
Contractor: n
Applicant: Architect or Engineer:.. PREFERRED PLUMBING G A/Cl
P.O. sox 5120 � CITY Cly �-�;au'ie�► ••a
PALM SPRINGS, CA 92263
�yg (760) 322-3173
Lic. No.: 45.7554 �.---
---- ----- ------------------------------------_---------•_-----'--,-,------------------------------------
LICENSED CONTRACTOR'S DECLARATION _ WORKER'S COMPENSATION DECLARATION -
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - . I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business • nd Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
_ License Class: C10 C16 C2 a se No.: 457554 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
_ ../ issued.
Date: % t7 Contractor: .. _ 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
W��, R -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that If mpt from the Contractor's State License Law for the Carrier DELOS INS CO Policy Number 02DKRM12002143
following reason (Sec.' 7031:5, Business and Pro ons Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that' if I shou� ecome subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencingwithSection 7000) of Division 3' of the Business and Professions Code) or _ _ 3700 of the Labor Co , I s tal ith o ly Hi e -provisions.
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 IS500).: Date:Q 6 -Applicant:
(_ 1 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 _ WARNING: FAILURE TO SECURE•WORKEf�)OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided. that the DOLLARS ($1.00,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN -
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, -INTEREST, AND ATTORNEY'S FEES.
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.), APPLICANT ACKNOWLEDGEMENT
1—) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
_ 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for :
pursuant to the Contractors' State License Law.). - - - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B:&P.C. for this reason 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.
Date: Owner:. 2. Any permit issued asa 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
CONSTRUCTION LENDING AGENCY permit to cancellation. '
hereby affirm under penalty of perjury that there is a construction lending agency for the. performance of the I certify that I have read this application and state that thea ove information is correct. I -agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to build' construction, and her y authorize representatives
of this county to enter upon the above-mentioned proper for i pe o�pP pos
Lender's Name:.. v4
- --0ate: –4 _ /• Signature-(APPlicant or_Agentl'
Lender's Address:. -
LQPERMIT -
Application Number 09-00000356
Permit' . . . MECHANICAL
Additional desc,.
Permit Fee 33.00.
Plan Check Fee
8.25
Issue Date . . . .
Valuation ••
0
. Expiration Date 10/19/09
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.0.0
1.00 9.0000 EA MECH
B/C <.=3HP/100K BTU
9.00.
Special Notes and Comments
REPLACE EXISTING HEAT PUMP SYSTEM AND
FAV WITH SAME.
Fee summary Charged
Paid Credited
Due
Permit Fee Total 33.00,
.00 .00
33.00""
Plan Check Total. 8.25
.00 .00
8.25
Grand Total 41.25
.00 .00
-41.25
LQPERMIT
.
i
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 1) CF -IR -A
Project Title
Date - Y
Building Permit .#
Project Address
Documentation Author
Telephone
Plan Check /Date
Field.Check / Date.,':
Compliance Method (Prescriptive — HVAC and/
or Duct System Alteration - § 152(b)1C, D, and E)
Climate Zone
Enforcement Agency Use Only
HVAC SYSTEMS
'Heating Equipment Type Minimum Distribution Type
and Capacity (furnace, heat Efficiency and Location (ducts,
pump, boiler, etc. (AFUE or RSPF) attic, etc.
Duct or Piping Thermostat Type Configuration
Insulation (setback). (split or package)
R -Value
Duct Location Duct Insulation
(attic, etc.) R -Value
Thermostat Type Configuration
(setback) (split or package)
�..
�.4,1
❑
Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
Cooling Equipment Type
and Capacity (A/C, heat
pump, evap cooling)
Minimum
Efficiency
(SEER or EER)
Duct Location Duct Insulation
(attic, etc.) R -Value
Thermostat Type Configuration
(setback) (split or package)
❑
TXV (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑
Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑
ALTERNTAVE to Duct Testing: High EER as indicated in Table 8-3 of the Residential Compliance Manual (SEE Table 8-3 for
additional requirements and available Compliance Options) - Installer testing and HERS Rater field verification re uired
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
High EER
CF -6R pages 3 and 8 of 12
CF -4R page 5 of 8
f.. , z
SEALED DUCTS, REFRIGERANT CHARGE (TXV) AND EER
Before the permit can be finalized, a signed CF -6R Form and CF -4R Form must be provided to the building department for any of the
fnllnwino nmmnlinnnP rPnnirPmente that ara ✓
-✓
Compliance Requirements
❑
sled Ducts (Climate Zones 2 and 9-16) - Installer testing and HERS Rater field verification required
❑
TXV (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑
Refrigerant Charge (Climate Zones 2 and 8-15) - Installer testing and HERS Rater field verification required'
❑
ALTERNTAVE to Duct Testing: High EER as indicated in Table 8-3 of the Residential Compliance Manual (SEE Table 8-3 for
additional requirements and available Compliance Options) - Installer testing and HERS Rater field verification re uired
' The prescriptive requirement for either a retrigerant charge or a TXV does not apply to packaged units.
1,
EXCEPTIONS
Tf anv of the follnwinrr three excentinns are ✓_ the duct system is exemnt frnm sealed'ducts-
#
✓
Exceptions
1
❑
Duct systems that are documented to have been previously sealed as confirmed through field verification and diagnostic
testing in accordance with procedures in the Residential ACM Manual.
2
ElExisting,duct
systems that are extended, which are constructed, insulated or sealed with asbestos?
3
❑
Duct systems with less than 40 linear feet of ducts in unconditioned space.
` Duct alterations are exempt from duct sealing ONLY if they meet Exception 2 above.
SPECIAL FEATURES REQUIRING HERS RATING VERIFICATION
A ✓ indicates which comnliance renuirements are nart nfthis nrniect and need HERS rater verificatinn_
✓ Compliance Requirements
Installer Forms (inapplicable)
HERS Rater Forms (if applicable)
❑ Duct Sealing
CF -611 pages 3 and 4 of 12
CF -4R page 1 of 8
C Thermostatic Expansion Valve (TXV)
CF -611 pages 3 and 5 of 12
CF -4R page 3 of 8
Refrigerant Charge
CF -.6R pages 3, 5 and 6 of 12
CF -4R pages 3 and 4 of 8
High EER
CF -6R pages 3 and 8 of 12
CF -4R page 5 of 8
k/
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
RX 3
Project Address:'
Owner's Name: r.�oGi✓�1�
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Preferred Air Conditioning dba
Contractor: P r e f e r r e d Plumbin Heatin &Ai
Telephone:,z— _ ���/
Address: PO Box 5120
Project Description: Zk/5- 7-1A I C;
City, ST, Zip:palm Springs, CA •92263
y°U1llo St.
Telephone: ( 760 ) 322=3173
State Lie. #: 457554
City Lic. #':
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
a
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:�,O
Sq. Ft.:
# Stories:
#Units:
Telephone of Contact Person: —
Estimated Value of Project: �p.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING •
PERMIT FEES
Plan Sets
Plan Check submitted
Iten
Amount
Structural Calcs.'
Reviewed, ready for corrections
Plai Check Deposit
Truss Calcs.
Called Contact Person
Play Cb!ck Balance
Energy Cales.
Plans picked up
Con tru::tion
Flood plain plan
Plans. resubmitted
Mec an�cal
Grading, plan'
2"d Review, ready foc'correctionsrjssue
Ele leml
Subcontactor List
Called Contact Pergon
Plumbing
Grant Deed
Plans picked up
S.M I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
Review, ready for corrections/issue
Dev loptr Impact Fee
Planning Approval
Called Contact Person
AXI .P.
Pub. Wks. Appr
Date of permit issue
School Fees '
Tot 1 Permit Fees