10-1075 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO 4
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 10-00001075 Owner:
Property Address: 545'77 OAK HILL DEBBIE MEEKINS
APN: 775-071-002- - - 54-577 OAK HILL
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7459
Coniractor:
-Applicant: Architect or -Engineer: GENERAL. AIR CONDITIONING
p/- 31170 RESERVE ,DRIVE
V THOUSAND PALMS, CA 92276
(76,0).343=7488
Lit. No 686310
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 777-7153
Date: 10/19/10
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION"
-
'WORKER'S COMPENSATION DECLARATION _
hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one'o(06'foll6wing.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 ifice of consent to self -insure for'workers' compensation, as provided
License Class: 'C2 • Lice 686310 -
forby Section..3700 of_the Labor.Code, for the performance of.the:work_for which this'.permit is
/Date: I ractor: '•x
Issued...'. -
I Have and will'maintain.workers' compensation insurance, as required by Section°3700 of the Labor
'• } -t .,,
Code, for;the performance -of the work.for which this permrt:is,issuedr My workers'.compensation
•
OWNER -BUILDER DECLARATION
- 'insurance carrier and policy. number are: t- - r . -= -
I;hereby affirm under penalty of perjurytnat'I'am exempt from the Contractor's' State License Law. for the
Carrier PREFBRRED EMPL' Policy Number . WKN1295355Y
.following reason (Sec. 7031.5, Businessand'Professions Code: -;Any city or that --requires aopermit to
_>I certify,.thati in the performance of it4work for which this permit is --issued,.) shall not employ any
construct,-alier, improve, demolish,'orrepair any -structure, prior to. its issuance, also requires the applicant'�tor the
person in any manner so as to become subject to the workers' compensation laws:otCalifor 'i8,
permit to file a -signed statement that,he or she,is,liceosed:pursuant-to the provisions 'of -the Contractor's State
a A,agree that, if I should become subject to the workers compensation provisions of Section
-License Law.IChapter9 (commencing with Section -7000) of Division 3 of the.Business and Professions Code).or
3 0 of¢th Labor de, I shall f rthwith comply 'those provisions.
.that he or she is7exi6mpt therefrom and the basis for theialleged exemption. Any violation of Section,7031.5 by
'14rs'($500).:
,�'
�'
any applicant _fora permit subjects the applicant to a civil penalty. of not more than five hundred d
ate: v plicant: �•� '
(_ 1 1, as.owner of.the property, or my employees with wages as,their. sole compensation, will do.the work, and,
Y
the structureis not-intehdedor offered for sale (Sec. 7044, Business and Professions Code: The
WARNIN : FAI RE. TO SECURE WOR RS'_COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
- Contractors' State License Law does not apply to gn'owher 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:employ9ep,.provided that the ,.
DOLLARS; ($100,000).. IN ADDITIONTO.THE,COST OF•COMPENSATION, DAMAGES AS PROVIDED FOR IN
.. improvements we not intended oroffered forsale- 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
(_) 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 Buildingand Safety for a permit subject to the
7044, Business. an& 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. orimproves thereon, and who contracts for the projects with a contractorls) 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 pursuarit to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.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.
I 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 courfy ord' ances a d state laws relating to building construction, and hereby authorize representatives
his c4tlnt p he above-mentioned y for inspec on purposes.
Lender's Name: �
rppe
rD.:e: ture (Applicant or Agen
Lender's Address:
LQPERMIT
LQPERMIT
Application Number 10-00001075
.Permit ... . MECHANICAL
Additional desc .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation
0
Expiration Date 4/17/11
Qty Unit Charge- Per
Extension
BASE
FEE
15:00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.001. 9.0000 EA. . MECH
B/C <=3HP/100K BTU
9..00'
-- --- ---- --- --- --
. - -
„ ...r•
...,:, a- ;. Special' Notes and' Comments
--------------------
--
--
INSTALL NEW HVAC SYSTEM i3 SEER_,
2007
CODES.
------------ ---.-_---------------------------------
Other: Fees ::. .. . . .. BLDG. `STDS. ADMIN (SB1473)
1.00
?` Fee summary Charged
-.
Paid Credited
------------ ----------
Due
-- --- ----------------------,-
—Perinit Fee Total 33.00
0'0. 00
33'.00
Plan 'Check Total &.25
.00. .r60
8:.25..
Other:Ree--Total 1:00
.00. :0.0
1.00
Grand`total 42.25
.00 00
42.25
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008Residential HVAC CF-lR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit 7
54577 OAKHILL LaQuinta, CA 92253
City of La -.Quints
Oct 15; 2010
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑AFUE
'
-E] COP
❑ R 6 (CZ 10-13)
Served by system
0 Setback
p Indoor Coil
p SEER 13.0 "
p HSPF
-15)
R R 8 (CZ 14 -IS)
1500 5f
If not already present,
p Condensing Unit
EER
❑ Resistance
must be installed)
p Other > 40' Ducts
1. Equipment Type: Choose the equipment being installed; if more thah one system, use another'CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER,. 78% AFUE, 7.7HSPF for typical 4sidentia% systems.
HERS VERIFICATION SUMMARY Listed below.are FOUR HVAC alteration Options. The installer decides what work is
being done and picks one of the appropriate Options.Each Option lists the HERS measures that must be conducted. A
copy of the forms shall be left on site for final inspection and.a copy given to the.homeowner. At final, the inspector
verifies that the work listed on this form was in fact the.work completed by the installer. The inspector also verifies that
each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and sig ned.Beginning
October -1, 2010, a registered copy of the CF,71R and CF -6111 shall also be on site for`final inspection. .
❑ 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -6R forms: MECH-04,_ MECH-21-HERS'and (for split systems)'MECH-25-HERS
replaced
CF -4R forms: MECH721 and (for split systems) MECH-25
• Condenser Coil and /or
Indoor Coil and /or
CF-6R'form s: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF Oft forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15. -percent; RC, CCA --:5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For Packaged Units Duct leakage�< 15 percent
Exehipted`from duq.; leagage testing f
1 Duct system was documented to have been previously, sealed and confirmed through HERS verification, or
13 2. Duct systems with less thaV0 linear feet in. unconditioned space, or
3. Existing-7dusystems are 'constructedinsulated or sealed withasbestos.;
❑ 2. New. HVAC '.
Required Forms: -fix`
M
System
, _
. Cut mor CFiangeout
with newkqucts. (all
X11
"�
CF 6R forms MECH 04, MECH 20 HERS,, and (.,for split systems)xMECH 22 HERS;"and
.kms ,
!MECH 25 -HERS
new ductin a
g
CF 4R form -s`7 WECHt0 antl ({for split systems) MECH 22, and MECH 25
new, equjpment)
For Split SystemsF,DiJ leakage <"`6�percen-f RC; CCA > `350 CFM/ton; :FWD; TMAH "STMS, andteither'HSPP or PSPP.
For.Packaged l/n�ts Duct leakag <'6 percent
R3NeW ucts with/or without
Required Forms:
Replacement
. Includes replacing or installing"alf; ,:
new ducting and/or outdoor p
condensing unit and/or indoor, coil,
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or furnace. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
2 4. New Ducting over 40 feet
Required Forms:,,
• Includes adding or replacing more
than 40 linear feet of duct in
CF -6R forms: MECH-04, MECH-2I-HERS
unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Ductleakage < 15 percent
❑ EXCEPTION: Existing duct -systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible'Designer's DeclarationStatement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy.features and performance specifications for the design identified on this Certificate of Compliance conform to
the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Oct 15,72010
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 210-A0020119A-00000000-0000 Registration Date/Time: 2010/10/15 15:58:43 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
Ilk
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BuM14 Bt,Safery Dtv1slon
Permit # 'l
P.O.-Box 1504, 78-495 Calle:•Tamplco
V
La Qulnta, CA 92253 -'(760.).-777-7012
Building i'ermit Appiication and -Tracking Sheet
P
Project Address: J S % fib ^ ��� 1 11 S
��l. k � ; ` wner's Name:
A. P. Number:
Address:. rj'%'� Oct,k.%Ll
Legal Description: City, ST, Zip:LA,
Contractor
Telephone: io —�^(' — 1 -7 to�
>�y,` '?
Address: :
I Project Des
City, ST, Zip: cru
Telephone: '�.3 �:s,•.•;?..:;,.:3: � ��>%
fi �:4x /5��7l•;?;4v'•}i:�'•�q/?n .�;'�S'. )j/?.�f'�
i f�?\:r4�•�iil:ry\/1.:;?.?,G,.j $:O?\�3:"-�:['i%Fi��
State Lic. # : 3 City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip: e
Telephone: _?''``.•::>?,> yy4yf`
Construction T e:
w : • a� • }�;;• �,>:,�: " �, . YP 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: Estimated Value of Project:0. 7 ��
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
i!
Submittal
Req Id
Reed
TRACIUNG
PERMIT FEES
Plan Sets
Plan Check submitted ��// %
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Tide 24 Cafes.
Plans picked up
-
Construction
Floodplain 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 Rees
Total Permit Fees