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07-1941 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant:' Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT • 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: C20 License No.: 857079 Dater V>v: Contractor: m 4c, I Y 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).: 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 _ )- 1, 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 1 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.).r. - Lender's Name- ' ` Lender's Address: LQPERMIT 4 Owner: ISIDRO ROMERO 78-645 VILLETA DR. LA QUINTA, CA 92253 Contractor: ALDCO AIR 52580 AVENIDA CARRANZA LA QUINTA, CA 92253 (760)564-9963•. Lic. No.: 857079 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-1153 Date: 7/05407 • WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: i 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 ENDURANCE REINS Policy Number WEN002063601 _ 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 F - 3700 of the Lab or Code, l_shall forthwith with those provisions.. Date: �" Ste. G-7 Applicant _ WARNING: 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. - • 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. certify that I 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 property for inspection purposes. If I Date: 7' f'��7 Signature (Applicant or Agent): �r � Application Number: I, 07-_O - 0001941 Property Address: 786,4VILLETA DR APN: 604-144-004-219 -23269 Application description: ' MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2800 Applicant:' Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT • 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: C20 License No.: 857079 Dater V>v: Contractor: m 4c, I Y 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).: 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 _ )- 1, 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 1 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.).r. - Lender's Name- ' ` Lender's Address: LQPERMIT 4 Owner: ISIDRO ROMERO 78-645 VILLETA DR. LA QUINTA, CA 92253 Contractor: ALDCO AIR 52580 AVENIDA CARRANZA LA QUINTA, CA 92253 (760)564-9963•. Lic. No.: 857079 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-1153 Date: 7/05407 • WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: i 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 ENDURANCE REINS Policy Number WEN002063601 _ 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 F - 3700 of the Lab or Code, l_shall forthwith with those provisions.. Date: �" Ste. G-7 Applicant _ WARNING: 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. - • 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. certify that I 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 property for inspection purposes. If I Date: 7' f'��7 Signature (Applicant or Agent): �r � " Application Number . . . 07=00001941. Permit MECHANICAL ; Additional desc Permit.Fee. 24.00 Plan Check Fee 6.00" Issue Date Valuation. 0 Expiration 'Date 1/01/08 Qty Unit Charge Per Extension • BASE FEE 15.00 1.00` 9.0000 EA MECH FURNACE.<=100K 9-.00 ----------------------------------------------- Special Notes and Comments --------------- " - REPLACE EXISTING FURNACE AND COIL Fee summary Charged. Paid" Credited' Due ---------- Permit Fee Total 24.00 ---------- :00 ---------- .00 24.00 Plan Check Total 6.00 -.00 - .00 6.00• . Grand Total" 30.00 .00 .00 `30.00 :: iQPExnscT Bin # City of La Ouinia 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 # Project Address:6 66 G Owner's Name: A. P. Number: Address: Ile � Legal Description: • . &/W p-./' ; / 9 ?2 j City, ST; Zip: (F& /W Contractor: Q C/� CCU Y—� lv Telephone: r ` Address: ? G ✓y v N Z C Project Description: , City, ST, Zip: GA ---7--7 Z. ? A: t' Telephone: .S L/. y yG N rti >•ft ✓� G C' P yr State Lic. # 70 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: s�', `' Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair . Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person:'— P Estimated Value of Project: 4 p APPLICANT: DO NOT.WRITE BELOW THIS LINE # Submittal Req'd Rec'd 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 Energy 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 O School Fees Total Permit Fees ti Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Pro Title: Dater ` S / © CalCERTS 2005 Enforcement A en Use Only Project Address: , -7,*`143� Climate Zone; 1, Documen tion Author: c p p Telephone: Plan Check Date , Company: Name: Field Check Date IMPORTANT: This, CF -1 R=ALT form is only, for use when an HVAC,: -only alteration is made to an existing home . Use one formforeach system beinq altered: This is system # of s stems altered in this house. Check all lines that aooly- Check only lines that aooly- Scope of Alterations: 1' ❑ ' ' z - Furnace Heat exchanger is to be installed or replaced. Dud sealing to be determined. Continue to next line. Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Pro Title: Dater ` S / © CalCERTS 2005 Enforcement A en Use Only Project Address: , -7,*`143� Climate Zone; Building Permit # Documen tion Author: c p p Telephone: Plan Check Date , Company: Name: Field Check Date IMPORTANT: This, CF -1 R=ALT form is only, for use when an HVAC,: -only alteration is made to an existing home . Use one formforeach system beinq altered: This is system # of s stems altered in this house. Check all lines that aooly- Check only lines that aooly- Scope of Alterations: 1' ❑ ' An Air Handler is to be installed or replaced. Dud sealing to be determined. Continue to next line. 2- - Furnace Heat exchanger is to be installed or replaced. Dud sealing to be determined. Continue to next line. 3-0- 6n outdoor condensing unit is to be installed or replaced. Dud Sealing and/or TXV(RCA) to be determined. Continue to next line. '4 W A cooling or heating coil is to be installed or replaced. Dud Sealing and/or TXV(RCA) to be determined. Continue to next line., 5 ❑ More than 40 feet of new or replacement dud are to be installed in unconditionedspace. Dud sealing to be determined. , ❑ Check here if the Mlitg dud system is also to be new or replaced. Continue to`next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked: Skip if Line 6 is checked- 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No dud sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of duds in unconditioned space, No dud sealing is required. Go to Section'2. - 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct Sealin i is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ is duds stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire duds stem is to be new or replaced, Lines 11-14 do not apply. 11 . ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of dud sealing and TXV if applicable). -12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 MM EER 12 condenser will be installed with TXV(RCA) D added duct insulation (R-4wrap on existing ducts; R-8 new duds) it lieu of dud sealing. Go to Section 2. T3' 0 In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AbQ EER' 12'condenser will be installed with TXV(RCA) AND a 0.92 AFUE. furnace will be installed in lieu of dud sealing. Go to Section 2. 14' ❑, In Climate Zones 2, 9-11, 12,14 or 16: An SEER 14 AMU EER 12 condenser will be installed with TXV(RCA) D an 0.82 AFUE fumace'will be installed with increased dud insulation in lieu of dud sealing. Go to Section 7- 15 1W None of lines 7-14 above are checked. Dud Sealing is Required. Continue. Section 2---TXV RCA (Only -if Lines 3 or 4 are checked, otherwise ot'to Section 3 16 ❑ The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3. -17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) isrequired:- Go to Section 3. 19 ❑ This s stem is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ hiss stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 . is system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) is required. Go to Section 3. Section 3 -HERS Rater verification 22 0 if line 15 is checked,. HERS verification is required for Duct Sealing. 23 JR If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RCA). 24 ❑ Ilf line 12, 13 or 14 are.checked, HERS verification is required for 12 EER. Section 4 - Equipment Efficiencies 25' ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipmentefficienciesare. required. List. inSection.6. Section 5- Duct.R-Values 26- ❑- If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Packa e D requirements. .27' ❑ if less than 40 feet of dud is being installed or replaced, duct R -value must meet or exceed R-4.2 Section - see next age Version 03-10-06 Page 1 of 2' This. form. canonly be used.on projects being verified by CaICERTS.certified. raters. www.calcerts.com. �I • +- .. fir. , Certificate of Compliance Prescriptive Method --HVAC-only_-Alteration- CF -1R -AL -T Project Title: Date: `7 ©. CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing. home . Use -one form for each system. bein.altered.-This. is system #--L- of s stems.altered in. this. house. Section 6 -"Minimum Requirements for Equipment°to'be Installed/Altered. Installed equipment must match typeRocation and meet or exceed efficenkies/R-valves. 28 Configuration: bSpritsystem ❑ Package Unit 29 0 Air Handier Was f unciae, AFUE:'- ❑Hea um ❑ tp P FAU Hydropic FAU ❑Other 30 ❑ Heat Exchan er. 31 ❑ Outdoor Condensina Unit ❑A/C 131-leatpump kfficiencv. SEER/HSPF: 11EER if d : 32: W Cooling or heating coo ❑AIC ❑Heatpkunp ❑Hyd=ic 33 ❑ Ducts Location: Length (ft): R -value: All mandatory- measures apply to any altered component: See MFAR -ALT form: Compliance Statement` This certificate okximpliance lists the building,features and specifications needed to. comply with.Title.24, Parts 1. and 6 of the. California Code of Regulations, and the administrative regulations to implement them. This certificate has been.signed.by.the individual with overall project responsibility: The undersigned recognizes that'compliance using duct sealing; verification of refrigerant' charge, and-TXV require. installer testing and certification and verification by: an.approved. HERS rater:. Home Owner or Authorized Agent DocumentatiomAuthor Name: sJ Wv Name: 2. , Ad ress: Ir Company Name: ->r- City/State7Zip: Address: Phone: CVStSttate/Zip: Phone: `ol Signature: Signature: Enforcement Agency Buildin Department) otes/Co ents: Name: Title: Department: Phone#.._.. _ Faz:#:_ _ _ Signature or Stamp: Required forms: CFAR=ALT: by anyone. Required at time of permit' application. Copies to homeowner,, enforcement*agency, HERS rater: CF -6R -ALT: by installing contractor. Required to Gose permit. Copies to homeowner,. enforcement agency, HERS rater. CF4R-ALT: by HERS rater: Required to dose permit. Copies to homeowner, enforcement agency, installer: The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Version 03-10-06 Page 2 of 2 This form can only.be used on projects being,verified by. CaICERTS certified raters: www.calcerts-.com