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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