09-0732 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
609=00000732
54404 INVERNESS
775-101-013- -
MECHANICAL
LOW DENSITY RESIDENTIAL
6000
ceity/ 4 4 a"
Architect or Engineer:
A,+
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 ksiness and Professionals Code, and my License is in full force and effect.
License CI s: CSC ^ License No.: 906115
4Date; cContractor:
ER -BUILDER DECLARATION
I hereby affirm under pen y rj tha I am exempt from the Contractor's State License Law for the
following reason (Sec. 70 .5, usi ss an Professions Code: Any city or county that requires a permit to
construct, atter, improve, demolish, or a- ny 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.).
(_) 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.).
(_ 1 .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:
RAY SPEAR
54404 INVERNESS
BERMUDA DUNES, CA
Contractor:
HYDES
77825 WILDCAT STREET
PALM DESERT, CA 92211
(760)360-2202
Lic. No.: 906115
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
03 ✓0/ 04 V
?Q479
Date: 7/10/09
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 DELOS INS Policy Number 01DKRM120000408
I certify that, in the performance of th work for which this permit is issued, I shall not employ any
person in any manner so as to bec me subject to the workers' compensation laws of California,
and agree that, if I s uld be m subject to a workers' compensation provisions of Section
�//�/ 3700 of the La or C , 1 II f rthwith ply with those provisions.
fDa(e: ��D Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPE SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENH IES D CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COS 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 ' as a r sult of this application becomes null and void if work is not commenced
within 18 day fr ate of iss nce of such permit, or cessation of work for 180 days will subject
permit to nna
-�.- '
I certify that I have rea t that the above information is correct 1 agree o c jply with all
city and county ordinain building construction, and hereb authorize representatives
of this county to enter ioned property for inspection purposes.
Dat`` SAgent)
Application Number .
. . . 09-00000732
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
42.50
Plan Check Fee
8.25
Issue Date . . . .
Valuation . . . .
0
Expiration Date
1/06/10
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
00 9.0000
EA MECH
FURNACE <=100K
.00
1.00 11.0000
EA MECH
FURNACE >100K
11.00
.00 9.0000
EA MECH
B/C <=3HP/100K BTU
.00
1.00 16.5000
EA MECH
B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
INSTALL (2) 8 KG UNITS
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
----------
----------
Paid Credited
--------------------
Due'
-----------------
.Permit Fee Total
42.50
.00 .00
42.50
Plan Check Total
8.25
.00 .00
8.25
Other Fee Total
1.00
.00 .00
1.00
Grand Total
51.75
.00 .00
51.75
LQPERMIT
CERTIFICATE OF COMPLIANCE:, RESIDENTIAL
Project Titl
Project Address
Documentation Author Telephon�
Co 1' M thud
1 of 4) CF -IR t'
mp�(Press. Fuve) Clemmaate Zone Enforcement Agency Use Only
O Alternative Component Package Method: (check one) ✓ C D D (Alternative)
M Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1 R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ftZ Average Ceiling Height ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-0 — (5% X CFA) ft
Maximum Allowed Total Fenestration Products Per Table 151-B or 151-0 — (20% X CFA) g
❑ Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 83.2
for Additions and 8.3.3 for Alterations.)
Number.of Stories: Number of Dwelling Units:
'Floor Construction Type: Slab/Raised Floor (circle one or both)
Front Orientation' North / South / East / West /.All Orientations (input froni orientation in degrees from True
North and circle one).
✓ ❑. RADIANT BARRIER (required in climate zones 2,4,8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Assembly U -
factor (for
Cavity Continuous• wood, metal
Insulation Insulation frame and mass
R. -Value R' -Value assemblies
Joint
Appendix
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed (attic, garage,
Yes or No typical, etc.
■I � avuu nlJFV11U1a i v in j5ec11011 1 v.l, 1 V J ana 1 v.4, Whtcn is the basis Tor the U -factor criterion. U -tactors can not
exceed prescriptive value. to show equivalence to R -values:
Residential Compliance Forms March 2005
I
CERTIFICATE OF COMPLIANCE: RESIDENTIAL
20f4
C&IR
�� s� ate,,., .� ��✓� � ,.- . .
Project Title Date
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓ ❑ FENESTRATION MAXIMUM ALLOWED. AREA WORKSHEET WS-4R—must be included for New Construction,
Additions and Alterations.
Fenestration
#/Typelpos.
• '
(Front, Left, Orien-
Rear, Right, talion, Area U -factor SHGC
Skylight) N S, E, Wi (fe),Source' SHGC° Sources
Exterior
Shading/Overhangs6• 7'
✓ box if WS -3R is
indluded
Distribution
Type and Capacity
Efficiency
Type and Location Duct or Piping Thermostat Configuration
heat m ler
AFUE or HSP
ducts attic, etc. R -Value Type lit or e
yG
L
11 .ikvlivhtc arr nnvr;nrl..rlo.i ;. the a _:_ r____
❑
-- - b �.. •�•� =a �.� �nru�,U do uueu to ule west or uvea in any uirecnon
when the pitch is less than 1:12. See § 151(f)3C and in Section 3.2.3 of the Residential Manual
2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table 116A,
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R.
5) lridicate source either from NFRC or Table 116B.
6) Shading Devices are.defined in Table 3-3 in the Residential Manual and see WS -311 to calculate Exterior Shading devices.
'n See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
Heating Equipment
Minimum
Distribution
Type and Capacity
Efficiency
Type and Location Duct or Piping Thermostat Configuration
heat m ler
AFUE or HSP
ducts attic, etc. R -Value Type lit or e
yG
L
Cooling Equipment
Type and Capacity.
C heptnvnip,va .. li
Minimum
Efficiency Duct Location
SEER or EER attic
Duct Thermostat. Configuration
R -Value TypeC. lit or ck e
0
Residential Compliance Forms
March 2005
a
F
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
}
Project Title 7Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
required.
V
Sealed Ducts all climate zones Installer testin and certification and HERS rater field verification required.)
TXVs, readily accessible (climate zones 2 and 8-15 only)
(Installer testing and certification and HERS Rater field verificationrequired.).
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.)
nu
[b I Alternative to Sealed Ducts and Refrigerant Charge /TXVs.(See Package D Alternative. Package Features for
Project Climate Zone in the RM Appendix B Table 151-0, Footnotes 7-14.
For additions and alterations, duct systems that are not documented to have been previously
0 sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
W A TRR AF A •r1Til- cvc9rwi%xv
Water Heater
Type/Fuel
Distribution
a
❑
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per
dwelling unit. If the water heater is a storage type, 50 is the
Tank
Capacity
Wtons
gallons maximum capacity and recirculation system is
not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
❑
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
Altemative Water Heating table. In. this case, the Performance Method must be be included
used and must in the
submittal.
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units .
Water Heater
Type/Fuel
Distribution
a
.Number
in S stem
Rated
I
(kW or
Bh /ft)
Tank
Capacity
Wtons
Energy
Factor or
Thermal
Efficiency
Standby'
Loss %
Tank
Extemal
Insulation
R -Value
1 F u
Water Heater
e
Distribution
e
Number
in stem
Rated
Input'
(kw or
BtWhr
"Tank
Capacity
Mons
Energy
Factor' or
Thermal
Efficiency
Standby'
Loss %
Tank .
External
Insulation
R -Value
1 F u
or sma gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr), list Rated Input, Recovery Efficiency, Thermal Efficiency and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies. j
Pipe Insulation.(kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures thatW'/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 0) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 4) CF -1R
t.,
Project Title Date
Indicate which special fe
nreScrintive methrui atures are part of this project. The list below only represents special features relevant to the
-
✓
Feature
Required Forms if applicable)
Descriptio n
❑
Metal Framed Walls
CF -1R
❑
Radiant Barriers
CF -1R
❑
Exterior Shades
WS -4R
❑
Cool Roof
N/A; Attach CRRC Label to
Forms.
❑
Dedicated Hydronic Heating
Performance Calculation
Sys n
R uired• Attach Run to Forms.
❑
Combined Hydronic System
Performance Calculation
Required;. Attach Run to Forms.
❑
Gas Cooling
Performance Calculation
Required.
❑
Buried Ducts
N/A; Indicate on plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
stems in Residential Manual.
❑
Multiple Water Heaters'Per
See Table 5-13 or use
Dwelling Unit
Performance Calculation and
attach Run to Forms.
❑
Central Water Heating System
Performance Calculation and
Serving Multi le Dwellin s
attach Run to Forms.
❑
Non-NAECA Large Water
Heater
CF -1R
See Table 5-13 or use
❑
Indirect Water Heater
Performance Calculation and
attach Run to Forms
❑
Instantaneous Gas Water Heater
See Table 5-13 or use
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and
attach Run to Forms
❑
Wood Stove Boiler ..Performance
Calculation and
attach Run to Forms
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
(add extra sheets rfnecessarv) Indicate to the HERS Rater which credits are
verification. part of this project and need
Feature Required Forms if applicable) Description
l Duct Sealing CF -6R part 4 of 12
1
Refrigerant Charge CF -6R part 5 of 12
1 Thermostatic Ex anion Valve CF -6R part 6 of 12
Residential Compliance Forms
March 2005
i ��
Bin #
City of La Quinta
Building at Safety Division
Box 1504, 78-495 Calle Tampito
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit.#P.O.
(`�a
0�
Project Address: _ 4 b
Owner's Name.
A. P. Number:, ' ' ^ •
Legal Description: `''
Address: S
City, ST, Zip:
Contractor:csA
Telephone.��
Address:±U
Project Description:
City, ST, Zip•
Telephon
State Lie. # City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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
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
School Fees
Total Permit Fees