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10-0273 (MECH)e *'A P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000273 Property Address: 55456 FIRESTONE APN: 775 -151 -068 - Application description: B MECtAA rl (CA i•. Property Zoning: . LOW DENSITY RESIDENTIAL Application valuation: 5500 Applicant: T4ht 4 a (P Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: . IJA— VeMS�D CONTRACTOR'S DECLARATION , 1 hereby affirm under penalty of perjurI m censed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Bu (((Hess a rofessionals Code, and my License is in full force and effect. License s: _22 0 Li ee No.: 725283 Date: Contractor: OWNER -BUILDER 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).: (_) 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.). (_ I 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: HUBLEY RESIDENCE 55456 FIRESTONE LA QUINTA, CA 92253 ( .Contractor: AIR EXPERTS AIR CONDITI PO BOX 94 LA QUINTA, CA 92247 (760)777-1724 Lic. No.: 725283 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/01/10 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 EXEMPTlicy Number EXEMPT I certify that, in the perfo --- oft work for which this permit is issued, I shall not employ any person in any manne so as t b ome subject to the workers' compensation laws of California, and agree that, if. I s ould. be a subject to the workers' compensation provisions of Section r� 3700 of the Labor C de, I forthwit comply with those provisions. Date: / U . -Applicant: WARNU, FAILURE TO SECURE WORKERS' 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. I . 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 aae it, or cessation of work for 180 days will subject permit to cancellation. ' I certify that 1 ave read this application and state thnformation is correct. I agree to comply with all city and co nt ordinances and state laws relating totruction, and hereby authorize representatives of this ty oenter upon the above-mentioned prpection purpas Date: �� . Signature (Applicant or Agent): . e ri Application Number . . . . . 10-00000273 Permit . . . ELEC-SERVICE CHANGE Additional desc . Permit Fee . . . . 33.50 Plan Check Fee .00 Issue.Date . . . . Valuation . . .0 Expiration Date 9/28/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE AIR CONDITIONING & HEATING UNIT 16 -SEER. -----------'----------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged - Paid Credited Due - ----- - - - - - - - - - -- Permit Fee Total ---- - - - ---- 33.50 -- - - - - ------ - - - .00 ..00 - ---- -- - - - - - - 33.50• Plan Check Total .00 .00 .00 .00 Other Fee*Total 1.00 .00 .00 1.00 Grand Total 34.50 .00 .00 34.50 LQPERMIT Bin # City of La Quinta Building 8i' Safety Division ' P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ' Building Permit Application and Tracking Sheet ' Permit # Project Address: 1 � y�p�-i,C E S%7�+�.➢� Owner's Name: A. P. Number: Address:YeES�� C, Legal Description: Contractor:/� `4y t� a � i� — / T—, City, ST, Zip: L GL Telephone: Address: 06JCqq Project Description: City, ST, Zip: a�. ZZ lAL� A, L 'v Telephone: 'X0 i% 7 / ,bAl State Lic. # : City Lie. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ::..,.�:. ~Y Construction Type: Occupancy: .. State Lie. #: d:;;.1�5;;i;:?<:: .. ry��yr Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: �% 41.4,4 11i1q E ^/ Sq. Ft.: 1640 # Stories: # Units: Telephone # of Contact Person: — Estimated Value of Project: '00= APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Plan Sets Req'd Recd TRACKING Plan Check submitted PERMIT FEES Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance, Tide 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsfissue 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 correctionsrssuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue Schodl Fees Total Permit Fees Prescriptive Certificate of Compliance: Residential CF -11R -ALT Residential Alterations Page 1 of 1 Project Name: Climate Zone # of Stories UZL6 V _- General Information: Site Address: Ss- ZA Quo .j -rA CA 97 -Z -S --Z, Date , � U LS Enforcement Agency: Building Type:p-Single Family ❑Multi Family Front Orientation: ❑ N ❑ E OM171 Project Type: ❑ Alteration HVAC Replacement ❑ Duct Replacement ❑ Conditioned Floor Space (CFS): 1(pp NOTE: This form is not to be used for new construction or additions. HVAC Systems — Hea 'no: Duct Insulation Thermostat Configuration (Split Equipment Type Capacity AFUE HSPF R -Value Type or Package) jOd 4ax� moo 0 Z 5 ,(/ Z 7 - HVAC tems - HVAC Ina: Pipe Insulation Thermostat Configuration (Split Equipment Type Capacity SEER EER R -Value Type or Package) �-- HERS Verification Summary: Duct SealiWA Testing - HERS verification is required for this measure. ❑ Yes ZI No In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement duds are installed in unconditioned space, the duds are to be sealed per §152(b)1Dii and the newly installed duds are to be insulated per §151(1)10. O gxception: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ Yes No In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the duds are to be sealed per §152(b)1 Di. �es ❑ No In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per §152(b)1 E. ❑ Exception: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ Exception: Duct systems with less than 40 linear feet in unconditioned space. ❑ Exception: Existing ducts stems are constructed, insulated or sealed with asbestos. Re erant Charge — Split System — HERS verification is required for this measure. ,ZYes ❑ No In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per §152 b 1 F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of §150 o do not apply to existing residential homes. Ducted Spiit�,8ystems - Air Conditioners and Heat Pumps: Airflow - HERS verification is required for this measure. ❑ YesNo In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per §152 b 1 Ci to meet therequirements of §151 7B. Documentation Author's Declaration Statement I certify tha ertificate of Compliance documentation is accurate and cpfnpletef Name: ZAl(/A ,41 ✓L A1E ,,j Signature: �--�- Company: tieFXP A uC �N }J,73oar -/t��� `` Date: Address:`Ro .90,)c City, State, Zip Code: �LA CA ZZ'V-7 Phone: 760 777 f 7 Z Registration Plumber. Registration Date & Time: HERS Provider. 2008 Residential Compliance Forms PDAC January 2010