06-3814 (MECH)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
- BUILDING PERMIT.
Date: 10/25/06
Application Number: r 06-00003814 Owner:
4 p
Property Address: 4"8213 VISTA DE NOPAL PETRICKA FRANCE 6
APN: 646-110-081- - - 48213 VISTA D OPAL
Application description: MECHANICAL LA QUINTA, CA` 53
PP P I
Property Zoning: LOW DENSITY RESIDENTIAL ! r�T J '1006
Application valuation: 5200 U�,1
Contractor: CITY OF L A 4U114TA
Applicant: -Architect or Engineer: PALM DESERT AIR- CONDI ADEPT
t
42081 BEACON HP
PALM .DESERT, CA 92211
(760)346-0677
Lic. No.: 374937
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION. -
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ' I hereby affirm under penalty ofperjury one of the following declarations:
' - Section 7000) of Division 3 of the Business and Professionals Code, 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
License Class: C20 - License No.: 374937 - for by Section 3700.of the Labor Code, for the performance of the work for which this permit is
� I have and will maintain workers' compensation insurance, as required b Sectio
issued.
' i Date: a" ^0 Contraftor._i - _ p q y n 3700 of the Labor '
Code, for the performance of the work for which this permit is issued. My workers' compensation
NER-BUILDER DECLARATION insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1795546-2006
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 personin any manner so as 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 should become subject to the workers' 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 Code, I shall forthwith comply with those provisions. "
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).: (Date: a ��_Applicant_-- `
(_) 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 WORKERS' COMPENSATION 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 PENALTIES 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 ($100,000). 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 contractors) 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 ) I am exempt under Sec. , BAP.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.
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 information 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 construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Lender's Name: - �/� --
- - (_ ate:�� �p Signature (Applicant -or -Agent):
• lender's Address: - - � '— _—� - -
LQPERMIT
Application Number . . . . 06-00003814
Permit MECHANICAL
Additional desc .
Permit Fee .42.00
Plan Check Fee
10.50
Issue Date . . . .
Valuation .
.
0
Expiration Date 4/23/07
'^ Qty Unit Charge ,Per
Extension
BASE
FEE
15.00
2.00 4.S000:EA MECH
VENT INST/ DUCT ALT
9.00
2.00 9.0000 EA MECH
APPL REP/ALT/ADD
18.00
Special Notes and Comments
REPLACE ONE 5 TON 15 SEER UNIT
Fee summary Charged
Paid Credited
Due
Permit Fee Total 42.00
.00 .00
42.00
Plan Check Total 10.50
- .00 .00
10.50
Grand Total 52.50
.00 .00
52.50
.4.
LQPERMIT
Bin#
.City of La Quint'a
Building 8r 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:
Owner's Name:
A. P. Number:
Address: "X
Legal Description:
City, ST, Zip:
Contractor
Telephone:,% •:�?:�:. hw,:E;,,,,; !.;. A .<;3„;.
Address: l�•��
Project Description: ,
City, ST, Zip:
Telephone:
X.
ryi\2:.•yyryyyiih l.4:M:!!^Y.h. ^:�,:iii'i:i?!v:::•
State Lie. #: City Lie. #•:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lie. # :>::>y. s>r :;<y;yy?sr.•>:;:!.,kx,:,;;.
`"``"'
Name of Contact Person:
Construction Type: Occu an
Project type (circle one) New Add'n ter epair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Proj
APPLICANT: DO NOT WRITE BELOW THIS LINE
q
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 Coles.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2,d 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
i
Work Order
Palm Desert Air Conditioning &Heating Company
42-081 Beacon Hill
Palm Desert CA 92211
760-346-0677 FAX: 760-346-5200
95-3343831
Service At: Customer # 104336.
Bill To: Customer # 104336 Rating:
PETRICKA, FRAN 760-771-1995
PETRICKA, FRAN 760-771-1995
48-213 VISTA DE NOPAL
48-213 VISTA DE NOPAL
LA QUINTA CA 92253
li
LA QUINTA CA 92253 "
Type:
Open,Balance: ($796.30)
Source: DM
Payment Method: . NO CHARGE
Zone: LQ Map: LDLP
Credit Limit:
Skill: Tax:
Service Customer
Directions
Instructions INSTALL ONE (1) LENNOX 5.O TON 15.00 SEER
COMFORT SYSTEM WITH ONE (1) ELECTROSTATIC
FILTER.
" 10/20/06 SCHED. 10/23/06 8-9 AM.
Call Info
Job Info
Call No.: 127928 Booked by: KGALINDO
Job No.: '127928
Taken: 10/20/06 11:49 AM
Type: ISAC Booked Date: 10/23/06
Class: REPLACEMENT _
Taken by: KGALINDO
Scheduled: 10/25/06 8:00AM Sched by: KGALINDO
Type: ISAC
Cust PO:
Pri Level: 5
Ld Src: " LT -DB
SalesPerson:
Eq Age:
LS Ref:
Contact:
Equipment:
Assignments
-
Employee TaskCode Scheduled Time
LIN 8:00:00 AM
Equipment
Warranties
Type Sys Mfg Model # Serial #
Age Type Parts Ends Labor Ends
FAU 1 RHEE RGDGIONBRJR CW5D307F31931167
Filters: Loc:
Service History
Call # Date Tech Type Status Bal. Due
Job # 127914
127914 10/20/06 DENNIS NC CM
Instructions: 10/20/06 SCHED 10/20/06 8-12PM. TRIED COOL & HEAT MODE. WONT' TURN ON. COLLECT $85.00 DISP FEE. AL
10/25/2006 10:27 7603465200 PALM DESERT AIR COND PAGE 06
Certificate of Compliance
Prescriptive Method - HVAC -only Alteration CFA R -ALT
Project ' le: -
Date:
v
® CaICERTS 2005
Enforcement Agency (Jag OntV
Pro)ect Address: .
Climate Zone:
5-
11ullding Permit S
Doc`4737tation Aut Telephone76a, Plan Check Date
• / 9.S
Comp y e: Field Check Date
i
IMPORTANT: This CF -1 R -ALT form is for use when an HVACsonly aheration is made to an existing home
Use one form for each system being altered. This is s stem # ( of M systems altered in this house.
Check all lines that 212121y. Ch@ek only lines that anDly.
Scope of Alterations:
1 Q
An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue',) next line.
2 4�'
A Furnace Haat exchanger Is to be Installed or replaced. Dud sealing to be determined. Continue to next line.
3 B
An outdoor condensing unit Is to be Installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next Ilne,
40.
coding or heating coil is to be Installed or replaced, Duct Sealln and/or TXV(RCA) to be detanninad. Continue to next line.
5 ❑
More than 40 fast of new or replacement duct are to be Installed In unemditionAd space. Duct sealing to be determined,
❑ Check here n the ollix duct system Is also to be new or replaced. Continua to no>x lino.
6 ❑
If none or linea 1-5 are checked neither Duct Seallng 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 0
Thls a tem Is in Climate Zone 7 3 4 5 6 7 or 8. No duct sealing Is required, Go to Section 2,
8 0
This system hes lona than 40 rest of ducts in unconditlonod space. No duct SwIlng Is re mired, Go to Section 2.
9 ❑
This system was previously sealed and tested, and was cabled by a HERS rater,
No duct sealing Is required. Attach previous CF4R form. Go to Section 2.
10 El
This duct system Is sealed or insulated with asbestos. No dud sealina is mquimd. Go to Section 2.
Note:
If the entire duct system is to be new or replaced, Lines 11-14 do not apply.
11 ❑
In Climate Zones 2 12 and 16: An 0.92 AFUE fumace will be Installed in lieu of duct aarflin and TXV it a freable .
12 ❑
In Climate Zones 10, 13 and 15: An SEER 14 MM EER 12 condenser will be installed ,tAth TXV(RCA)
AND added dud insulation R4 wrap on wdsting ducts, R-8 new ducts in lieu of duct srtalln . Go to Section 2,
13 0
In Climate Zones 9, 10, 11, 13, 14, or 15; An SEER 14 AND, EER 12 condenser will be Installed with TXV(RCA)
AND a 0,92 AFUE Nmaee will he Installed In lieu of duct sealing. Go to Section 2.
14 ❑
In Climate Zones 2, 9, 11, 12, 14 or 18; An SEER 14 AM EER 12 condenser will be Installed with TXV(RCA)
AND an 0.82 AFUE furnace will be Installed with Increased duct Insulation In lieu of duc:seafflng. Go to Section 2.
150
None of lines 7.14 above are checked. Duct Sealing Is Required. Continue,
Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked otherwise got to Section 3)
16 ❑
Tho nVatom being altered is a e unit. No TXV(RCA) Is required. Go to Sectlon 3,
17 0
This system is in Climala Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace IS bang installed.
No TXV(RCA) is required, Go to Section S.
18 [3
This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCAJ is Muired. Go to Section 3.
19 ❑
This system is in Climate Zone 16 and line 14 is not checkel No TXV(RCA) isregulre[I. Go to Sectior.3.
20 ❑
This tVatern is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA)in "utred.. Go to Section 3.
21
IThissystem 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
220
fine 15 is checked HERS verification la required for Duct Sealing,
23 A
lifline 12, 13, 14, 20 or 21 ara checked and not;line 16 or 17, HERS verification Is required for TXV RCA ,
24 ❑
If line 12,13 or 14 are checked. HERS verification Is required for 12 EER.
Section 4 - Equipment Efficiencies
_M
25 ❑ If Ilnes 11, 12, 13, 14 or 17 are checked, upgraded equtpmerd efficiencies are requir(o, t.lst In Sectlon S.
Section 5- Duct R -Values ti
If mora than 40 feet of duct is bein installed or r laced ductR-value must meetOr e=!"n, Pac e D uirementa.
L26
7
If IMS than 4o feet of duct Is bel Installed of laud, duct R -value must meet or exceed R-4,7.ectlon
0 -see next page
version 03-io-06 Page 1 of 2
This form can only be used on projects being verified by CaICERTS certified ralexs. www,calcerts,com
10/25/2006 10:27 7603465200 PALM DESERT AIR COND PAGE 07
Certificate Of Compliance Prescrivtive Method - HVAC-onlir Alteration CF -IR -ALT
Prated Till '
Date;
®CaICERTS 2005
IMPORTANT: This CF -IR -ALT form 1..o.,1 for use when an HVAC -only aalleratton Is made to an existing home
Use one form for each system being altered. Thls is s tem of ' systems altered in this house.
Section 6 - Minimum Requirements for Equipment to be Installed/Altered.
In%MMd egWpment must match typehocatlon and meet or oxa.,ed eftk-hdeslR-Mm.
28 Conflpiaatlon put system C3 Peaege unh
29 O
AF Handhu ae hgmen, AFu6: 1311eaLpyin FAU t3Hydm* FAU 00thmf
30 B—
Heat Emhsn er
31 e'
Outdoor Condone U A/C Meatpurrip hWeng.SEERA S EER u rend):
32 0"
coomo or heaunp cal ENVO OHue#3w"P 0H refs
33 ❑
oucts ocatlon Lenpth(fl): vghm;
All mandatory measures apply to any altered com anent. Sue MF -1R- ALT form.
Compliance Statement:
This certificate of compllance.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 responsibllity. The undersigned recognizes that t ompfiarce 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
Documentation Author
Name:
Name: �
Address:
Comps a y
GtylSlate2lp:
A dress;.
Phone:
City/j�/erLi
Phqz—
Signature:
Signature: if
Enforcement Agency Bui[din 0e artment
Notevc mments:
Name:
_
Title:
Department:
-
Phone #:
Fax #:
-
Signature or Stamp;
"
Required forms:
CFAR-ALT: by anyone. Required at time of permit application. Copies to home owner• enforcement agency, HERS rater.
CF -6R -ALT: by Installing contractor. Required.to dose permit. Copies to home owner, enforcement agency, HERS rater.
CF -4R -ALT: by HERS ruler. Required to Gose permit. Copies to home owner, ertforo�ment agency, installer. The CF -4R forms for a
sam le group shall not be released u til all testing and veriflca ion i o feted and passed for the entire rou .
-~ - rage z or z
This form can only be used on projects being verified by CaICERTS certified. raters. www.calcerts.corn