11-1089 (MECH).r
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:�11`00.0001.08�
Property Address: 4-9770=ENTRADA CIR
APN: 646 -240 -001 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15882
A—li—t•
T-vy 4 4 Qum&
Architect or Engineer:
PIS
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
OCj 0 4 2011
OF LA
/11
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
Owner:�D
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
JAY SKENDERIAN
I hereby affirm under penalty of perjury one of the following declarations:
49770 ENTRADA CIRCLE
LA QUINTA, CA 92253
CIO C16 C2 L' No.: 7554
License ClMel
Contractor:
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
PREFERRED PLUMBING HTG
A/C
P.O. BOX 5120
Date: ntractor•
PALM SPRINGS, CA 92263
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
(760)322-3173
LiC. No.: 457554
O NER-BUILDER DECLARATION
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
OCj 0 4 2011
OF LA
/11
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I 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 Busine nd Professional ode, 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
CIO C16 C2 L' No.: 7554
License ClMel
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/
AA// issued.
V_
Date: ntractor•
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
O NER-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
Carrier EVEREST NATL Policy Number 7600006445111
following reason (Sec. 7031.5, Business and Professions 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 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 sho become sub' to the ers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor c,I sh I fo withom y W th t se provisi s.
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).:
ate:/a pplicant• - -
(_) 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 WORK E{S'C MPENSATION 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 PE IES 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 ($100,0001. 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 I, 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 contractor(s) 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 _ 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 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
CONSTRUCTION LENDING AGENCY
permit to cancellation.
I 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 the above ' formation 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 building struction, a eby rize representatives
of this county to an up n the above-mentioned property f nspec ' n pur ose
Lender's Name:
ate: ;// ignature (Applicant or Agent):
Lender's Address:
LQPERMIT
Application Number . . . . . 11-00001089
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 66.00
Plan Check Fee
16.50
Issue Date . . . .
Valuation
0
Expiration Date 4/01/12
Qty Unit.Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH
FURNACE <=100K
18.00
2.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
33.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE (2) A/C & HEATING UNITS,
FURNACES, INDOOR COILS, & CONDENSERS AT
GROUND LEVEL. 2010 CODES'.
---------------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473.)
-------------
1.00 ,
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total 66.00
.00 .00.
66.00
Plan Check Total .. 16.50
.00 .00
16.50
Other Fee Total 1.00.
.00 00
1.00
Grand Total 83.50
.00 .00
83.50
LQPERMIT
Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
�1
Site Address:
Enforcement Agency:
Date:
Permit #:
776 4rad� I
L
16-3-11
Floor
Equipment T er
List Minimum Efficiency,Duct
insulation requirement
Area
Thermostat
❑ Packaged Unit
'mace
door Coil
FUEX
ER
❑COP
❑ HSPF
Over 40 ft of ducts added or
replaced in unconditioned space
p P
Sery d b system
Y Y
VSetback
(If not already
Condensing Unit
ER
_
❑ Resistance
❑ R 6 (CZ 10-13)
100 sf
present, must be
❑ Other
❑ R 8 (CZ /4-15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final
inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the
installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
i ed. Beginning October 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
113. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information docum nted on other applicable compliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement agency for approval with the pe lication
Name: Q,:�(U a f
Signature:(
Compan
Date: L
Addre`s:®tv g� y ��
/�
License-
City/State/Zip:
Phone: `7
2008 Residential Compliance Forms March 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
9 -OD
Enforcement Agency:
Date:
1 - - H
Permit #:
Conditioned Floor
Equipment T e'
List Minimum Efficiency Z
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
FurnaceE�%
�ndoorCoil
JAFU��
❑COP
Over 40 ft of ducts added or
replaced in unconditioned space
Served by system
Setback
fnor already
EER
❑ HSPF
Condensing Unit
EER
_
❑ Resistance
❑ R 6 (CZ 10-13)
sf
present, must be
installed)
❑ Other
❑ R 8 (CZ 14-15)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final
inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the
installer. T>4nspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
s;gne,aelgeginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and /or
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Parts I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documenteo on other applicable compliance forms, worksheets,
calculationsplans andspecifications submitted to the enforcement agency for approval with the a it a l' tion.
Name: { ns
Signature:
Compan
n
Date:
l
Ad ess:
License:
U
City/State/Zip: P,5 C 41 gg
Phone: 3 '13
2008 Residential Compliance Forms March 2010
Bin #
City of La Q U*inta
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
Permitfl (�
qj
Project Address:' y 9 % '70 C,-Jr-a(26C',,r j
Owner's Name:
A. P. Number:
Address: (I E"-, Ira " e- .
Legal Description:
City, ST, Zip: L cj 53
Preferred Air Conditioning dba
Contractor: Preferred Plumbing. Heatin &Ai
Telephone:
Address: PO Box 5120
Project Description:
city,ST,Zip:Pa'lm Springs, CA •92263
? G
Telephone: ( 760 ) 322=3173=Eli
1
/ �' ' r
State Lie. # : 4, 5 7 5 54
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Projecftype (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:b'
_ '
#Stories: ,
#Units:
Telephone # of Contact Person:Estimated
Value of Project: / a
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.,
PERMIT FEES
Plan Sets
Plan Check submitted
Ite
Amount
Structural CaIcs.
Reviewed, ready for corrections
Flat Check Deposit
Truss Calcs.
Called Contact Person
Plar Check Balance
Energy Calcs.
Plans Dicked up
Con itruction
Flood plain plan
Plans. resubmitted
Mee Innical
Grading. plan'
211 Review, ready foi correctionsrissue
Elec Irical
Subcontactor List
Called Contact Person
Flubang
Grant Deed
Plans picked up
SMIL
H.O.A. Approval
Plans resubmitted
Gra ling
IN HOUSE:-
''' Review, ready for corrections/issue
Devicloper Impact Fee
Planning Approval
Called Contact Person
A.1.1 I.P.
Pub. Wks. Appr
Date of permit issue
School Fees
"
Totfl I Permit Fees