09-1038 (MECH)<i.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T,iht 4 4v Q"
Application Number:
09-00001038
Property Address:
52565 EISENHOWER DR
APN:
773-295-017-3 _000000 -
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3800
Applicant:
Architect or Engineer:
All
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Owner:
REDEVELOPMENT AGENCY CITY OF L
78495 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor: D
PRIORITY ONE A/C & HEATI
P.O. BOX 1681PALM
(7601773-0811
92261
9/28/09
I Ij fr
11 Lic. No.: 752180 ClTi'GiF,
-�
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed un er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profession s ode, and my License is in full force and effect.
Licens CI ss: C20 i ense No.: 752180
Dater C actor:Jf
OWNER -8 DER LARATION
I hereby affirm under penalty of perjury that I am exempt m 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).:
(_ 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
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 _ 1 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
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 NORGUARD INS Policy Number ROWC013690
I certify that, in the performance of t work for which this permit is issued, I shall not employ any
person in any manner so as to bec a subject to the workers' compensation laws of California,
and agree that, if I should become u iect to the workers' compensation provisions of Section
% 3700 of the Labor-ee9B, I SJhWl fodhivith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS'SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENATIEAN; D CIVILFINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE F 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 inforn Aanid
orrect. I agree to comply with all
city and unty ordinances and state laws relatin�,te�balfdilrg constructioereby authorize representatives
of th' co�nty to enter upon the a -mention propert or i94)AjKs.
(Applicantor Agent):
Application Number . . . . . 09-00001038
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
33.00
Plan Check Fee '.
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
3/27/10
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
INSTALL NEW HEAT PUMB
SYSTEM 3.5
TON, 13
SEER. 2007 CODES.
----------------------------------------------------------------------------
Other Tees . .
. . . . 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
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 1 CF -1R
Project Title ate
Project Addresses
{A
'3�°.RY .3:Prs^2' '?x' .+':� T'§' : S�' 'x'
u�Id�ngPerm�t #% x
1
❑
Documentation Author
Telephone
Fte1 Check/Date, xr
ComplianceMethod (Prescriptive — HVAC and/or Duct
System Alteration - § 152 (b) l C, D and E)All
Climate Zone
nforcement AgencyUse Only
ION
EXCEPTIONS
If anv of the following three excevtions are ✓, the duct system is exempt from 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
❑
Existing ducts stems that are extended, which are constructed, insulated or sealed with asbestos.
3
❑
Ducts stems with less than 40 linear feet of ducts in -unconditioned space.
HVAC SYSTEMS
Heating Equipment Type
and Capacity (furnace; heat
pump, boiler, etc.)
Minimum Distribution Type Configuration
Efficiency and Location (ducts, Duct or Piping Thermostat Type (split or
(AFUE or HSPF) attic, etc.) R -Value package)
Configuration
Thermostat Type (split or
package
Sealed 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.)
CoolingEquipment Type
q pment yp
and Capacity (A/C, heat
pump, evap. cooling)
Minimum
Efficiency Duct Location
Duct R -Value
(SEER or (attic, etc.)
EER)
Configuration
Thermostat Type (split or
package
Sealed 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.)
❑
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 required.)
CF -6R pages 5 and 6 of 12
CF -4R pages 3 of 8
SEALED DUCTS, REFRIGERANT CHARGE .(TXV) 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 followine ✓ compliance reauirements:
✓'
Compliance Requirements
❑
Sealed 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.)
❑
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 required.)
SPECIAL FEATURES REQUIRING 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 -6R page 4 of 12
CF -4R page 1 of 8
❑
Thermostatic Expansion Valve (TXV)
CF -6R pages 5 and 6 of 12
CF -4R pages 3 of 8
❑
Refrigerant Charge
CF -6R pages 5 and 6 of 12
CF -4R pages 3 and 4 of 8
❑
EER
CF -6R page 8 of 12
CF -4R pages 5 of 8
Bin #
C/ty Of La Quinta ,
Building 8t' Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
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Permit #P.O.
OR, `�
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Project Address: Z_ �j(�� F1 s �iJ� P�
Owner's Name: Ci ��77
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
ract
C ont r: o Pn 1't
Tl
Telephone:
P one:
Address:
Project Description:
City, ST, Zip: l >7 Q Ev CA P 2� J
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Tele ne- o 3
..::........:.::::.......:::::::::....:::::::::::.::::
N Q.
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State Lie. # : `a 2) (7
City Lie. #-.
3 1-0 1-j
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
�#
PancY•
Constructionn Type: Occupancy:
State Lie. #:
Project hP (circle one): New Add'n Alter Repairair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" 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:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees