10-0472 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000472
Property Address: 54440 EISENHOWER DR
APN: 774-253-009-15 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 4800
Applicant:
T41Y-4
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
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 and Professionals Code, and my License is in full force and effect.
License Class: ---- - - - - -- License No.: C20
rn tractor: r
OWNER-BUI ER 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).:
(_ 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.).
(_ ) 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
Owner:
MICHAEL MINSKY
54440 EISENHOWER DRIVE
LA QUINTA, CA 92253
Contractor:
BUDGET AIR
PO'BOX 1066
LA QUINTA, CA_92247 �)
WCC: EXEMPT
Lic. No.: C20
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/02/10
. 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 0
5 31 19olicy Number 796186
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 workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Jae�anUt:
r v
WARNING: FAILURE TO R ORKERS' 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 of work for 180 days will subject
permit to cancellation. '
1 certify that.1 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 construction, and hereby authorize representatives
of this county to enter upon the above-mentioned propert for inspection purposes.
Pl_. Si re (Applicant or Agent):
Application Number . . . . 10-00000472
Permit MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date Valuation . . . .
0
Expiration Date 11/29/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.0.0 9.0000 EA MECH FURNACE <=100K
9.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-50OKBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
INSTALL NEW AC UNIT INCLUDING CONDENSER
AND AIR HANDLER, 4 TON 16 SEER. 2001
CODES.
--------------------------- --------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 40.50 .00 .00
40.50
Plan Check Total 10.13 .00 .00
10.13
Other Fee Total 1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63
LQPERMIT
05/16/2010 08:49 7607777011 LA WINTA BLDG DEPT PAGE 01/01
Slm lined P ' twve Certificate or Com Bance: 2008 ResidwW KVAC Akeradoerr CF 1R ALT-RVAC
Chmnte Zones 10 to 15
Sire A d _
�{4 A5 Ou) &,4 JrD e.
Enj t A,gaegr
Dalt-•
- /D
P'[ritrbttl•
Conditioned Floor
Equipment T t
Lied Minimum Efficiency,
Duct imulatioa requirement
Arca
Thermostat
O Packaged Unit Over 40 fl of ducts added or Setback
O Furnace O AFUE O COP
i'dt,(ndoor Coil OSEER,�:1 O HSPF 9r D RPl A
in unconditioned boned sjwet Served by systcret trTftW,
wr
OLCondensing Unit O EER /� D Resistance 6 muffbe
• O R 8 la I4 -1s i -Wile.)
O Otlwr % irotaHe/
1. Equipment Type: Choose theequomenr bdng installed, ifrxom Than onesynam. use anorher CF--1R-ALT-HYACforead► sjarem.
2. Minimum EgwfparearBWhnda: l3 SEER.78%AFEW 7.7K5PFfortypcdreddeatialsystems.
HERS VERIFICATION SUMMARY Liked below are fmr HVAC alienation Options. The irwaller decides what weAt is being done and
pit % one of the spprppriaoe Options. Each Cption lists the il[ERS measuree dw ensu be conducted. A copy of the totms sltali be left on site for final
inspection and a copy given to the homeowmr. At fmat. the inspector verifita that the work listed on this Boort was in liter the world compleeod byte
installer. The inspedw also vnrifles that each appropriietc CF-blt and rcgistaed CF -4R forms (no hand !tilled CF-4Rs allowed) are filled "and
sianed. Be etNn 0eftber 1 2010 s of tilde CF -IR d+,d CFVR s ffl An been elle for finM
1. HVAC Changeout
R itr+ed Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-214ERS and (for spM sysmns) MECW 25 -HERS
CF -4R forts: MECH- 21 and for lit NECK -25
• Condenser Coil and /or
• Indoor Coil and Idle
CF -6R forms: MF,CH-2I-1HERS and (for �systems) MECH- 25 -HERS
CF4R foms: MECH- 21 and (for split system) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percept; RC, CCA 2i 300 CFMhon(MW=um Air Flow Requitement), TMAH
Por Packaged Units: Duct leakage < 15 percent
T.acmpicd from duct Itskage testing if
❑ I WQ system %vas docu netued to have kcri previously scaled and confirmed through HERS vaifdcation. or
❑ 2. Dun systems with Icss than 40 linear feet in unconditioned spact. or
O 3. ExWma duct system aro 222g2gd insulated or sealed with asbestos
❑ 2. New HVAC S em
Rwpind Forms
■ Cut in or Chen goout with new
ducts: (all new ducting Ed all
CF4R forms: MECH-04. MECH-20-MMSAW (for split sy"w) MECH-22-HERS. and MEC14-25-HERS
CF -41t formes: MECH 2a, and frt
(for rp systemsJMfiC122, and MECH ZS
new a ri
For Split Systetmm Duct leakage < 6 paaeat: RC, CCA > 350 CFM/tan, FWD, TWAH, STMS, and either HSPP or PSPP.
For Packer ed Vita ts: Duct 1 <6
O 3. New Ducts with Replats:talent
I R Fortes:
• Includes replacing or installing all new ducting
CF -6R fomes: MECH44. MECH 20-HBRS,and (for split systems) NECH-2S-HERS
andlor outdoor condeming unit and/or indoorCF4R
forms: MECH 20 and (for split systems) N ECH-25
coil and/or fortace. Not all cquiptnertt durtged.
For Split Systems: Duct leakage < 6 pemenl, RC, CCA > 300 CFMhon, TMAH
For Packwd Units: Dudicailcome <6
❑ 4. New Ductling over 40 feet
ReWred Forms:
a Includes adding or replacing moor than 40
linear fact of duct in unconditioned
CF -01R fauns: MECH-04, MECH-214ff.RS CF -4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
Cl EXCEPTION: E!isft due system insulated or sealed vrith asbestos.
Contractor (Documentation Author's /Responsible Valgaees Deciluatilan Statemem)
• 1 certify that this CertificeleofCamplianeedKinnenatlon is amanoe andeompleta
• lam eligible under Division 3 of dee Californv Business end Profaosims Code to accept mponsiblity Pot the design identified on this Certifrnte of Compliance.
• 1 cer ifv that the energy features and performance sptxifrtxtions for the design idemified on this Cettifreatc of Compliance conform io the require Irma of Title 24.
11,%c is 1 and 6 of the Catifamis Code of Reaufetions.
• 'alta de•ngn features identif od on this Certificate of Compliance are consistent with dee information doe mored on Other applicable compliance forms, worksheem
calcutuions. plans and sowficadons submitted to the entomcmertt arimy rcarnmvd with dee icstion.
Name: 74
A zq ere Stgititepae: I
Company: /
Address I.ie:
CUysf
City/Stateff ip: Phone: '7 — 57 9 7 / G 0 9
2008 Residential C-omplidnce Forms March 2010
Bin #
City of La Quinta .
Building 8r Safety Nvirion M
P.O. Box 1504, 78-495 Calle Tampko
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
10 "
Project Address: s y I a t,
Owner'.s Name: M G S 'c
A. P. Number.
Address: N ,v e1.
Legal Description:
Contractor: G v e_ 4,/L
Lj
City, ST, Zip: t!!/✓ / �-S`.3
Telephone:
Address: S^(., %v %(o 34ewI. j/�;
Project Description:
City, ST, Zip: I LIAITA cA.
C AAAIQQ �Ct
Telephone:7&v a
COAJ Of t 10N1 A/ 17
IA/l ud e -S CD QA/ V a4
State Lic. # : 7 City Lie. #;WJC14-.
Arch., Engr., Designer
AtA- A 4A --'le 4
Address:
^� n/ l 'S e e
City, ST, Zip:
A!!#
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: y
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKIIVG PERMrr FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Pians picked up
Construction
Flood plain plait
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for eorrectionsiissue
Electrical
Subcoutoetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.MJ.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
v
''' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees