13-0300 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-000003.00
Property Address:
55663 OAK HILL
APN:
77.5-231-019- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20505
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty,of perjury that I amficensed'under provisions of Chapter 9 (commencing with:
Sectionl7000)of-Division 3,of the Business and Professionals'Code, and:my License•is in full force and.effect.
Ucense,-6'ss . C20 : License No.:'' 686310
Dke�- 1J •Contract�J�ilMi1��:.
VOWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempf,frnni 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 Contracior'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 Aolation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil pen alty of not more than five hundred dollars ($500).:
(-_ 1 I, as owner,of the property, or my, employees with. wages as theirsole compensation,,vgill 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 toanowner of property who builds ;or improves thereon,
and w6i does. the. work himself or: herselfthrough his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement issold_within
one year of completion, the owner -buil der will.have,the burden of proving; that he or she did not build or
improve for the purpose of sale.). f -
(_) I, as owner oi: the property, am exclusively contracting with licensed contractors to construct the"project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does novapply 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.Cw 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.I.
Lender's Name:
Lender's Address: 0/t
LQPERMIT
Owner:
BILL WADSWATH
LA QUINTA, CA 92253
(760)564-5253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 3/19/13
Contractor: D U
GENERAL AIR CONDITIONIN MAR 19 n 2013
31].'70'RESERVE DRIVE 1°IFI
THOUSAND PALMS, CA -9-2.27f
(760)343-7488 CITY OF LA QUINTA
Lic. No. 686310 FINIANC' DEPT.
WORKER'S COMPENSATION. DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain 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. '
have and will'maintain workers' compensation( insurance, as required by Section 3700 of the Labor.
Code, for the performance of the work for'whict�this permit is issued. My workers' compensation
v insurance carrier and policy number are:
Carrier ZENITH INS• CO Policy Number Z071741502
I certify that, in the performance of the work for which this permit is issued, 1'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
3700 of the Labor Code, I shall forthwith comply with those. provisions.
Da�� 13 .Appli
WARNING: -FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS. UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO.CRIMINAL PENALTIES -AND CIVIL FINES -UP TOONE,HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TOTHE 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.
I certify that I have read this application and state that the above information is correct. 1 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.
Date- )r9 13 Signature (Applicant or Agent)_O_S;Za7�-7 �'�
Application Number . . . . . 13-00000300
Permit . . . . . . MECHANICAL
Additional desc .
Permit Fee 66.00
Plan Check Fee
16.50
Issue Date . . . .
Valuation . . . .
0
Expiration Date 9/15/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH
FURNACE <=1OOK
18.00
2.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
33.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE 2 COMPLETE HVAC SYSTEMS
(1)4TON
AND(1)'2TON. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG
STDS ADMIN (SB1473)
1.00
Fee summary Charged
-------------------------------------
Paid Credited
---------------_----
Due
Permit Fee Total 66.00
.00 .00
66.00
Plan Check Total 16.50
.00 .00
16.50
Other Fee Total 1.00
.00 .00
1.00
Grand Total 83.50
.00 .00
83.50
LQPERA11T
Din #
0ty of LaQui�.ta
Bultdtng Bt Safety DivFsion
P•O Box. x504, 78-495_ Caife Tarnpicfl
ia,.Q ta, CA 92253 (760} 777-7012'
Bui(drng Permit-Application and,TrackingSheet
.,
Pe it #
Project Addiess: rJS(o(o `11
Owner's Name:.
A. P. Number.
`Address:
Legal Description:
City, ST, Zip:..L �. � 1"c— C ZZS3
/�� \
Contractor. � Air l-O�T�O�I
s .,.
�TelepEorie %60-5
Address: 3\VI0 )�e se_yve_ c-
.Project•Descciption:-
City, ST, Zip: zpi Ut r
':.' �G ;, 1 2tpY�
Telephone: X00.343--71+9&.Co
v
State Lic. # :lp3l O City Lic ({:
Arch., F,ngr., Designer-
esignerAddress:
Address:
City., ST. Zip:
Telephone:
State Lic. #: ;• ' • -.
Name of Contact Person:
Coi stiuctiod Type:. Occupancy:
. Project tYPe (circle one): New • Add'n, • Alter Repair Demo
Sq: Ft:. #Stories: #Units:
Telephone # of Contact Person:
: Estimated Value of Project: ': 2-P, SC , 00
G
APPLICANT: DO NOT- WRITE ,BELpW, THIS UNE
# Submittal Rcq'd Reed TRACMG PERl4 r FEES
Plan Sets
Plan Check submitted
item Amount
Structural Calm
Reviewed, ready [oreortecdoos "
Plan Check Deposit. q
Truss Calci.
Called Contact Person
PlanCheck Solana
Tide 24 Calci.
Plane picked up
Construction
Flood plain plan
I
' Plans resubmitted'..
Mechanical
Grading plan
'Review, ready for correcHons/issue
Electrical
Subcontector List
Called Contact Person
Plumbing
Great Deed
7.Plans
picked up
S DLI.
MO:A. Approval
Plans resubmitted
Gradlug
IN HOUSE:-
1j d Review; ready for,correedonslissne .
. - _.
Developer Impact Fee
....
Planning Approval
Called Contact Person.
' A.I.P:P:
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
03/19/2013 11:48AM '8187"3535.75 IPERMIT ERATERS PAGE 03/04
Simplified Prescriptive'Certificate of.,Compliance 2008'Resudent/a/;'"VACA [era00s CF-1R-ALT7HVA
C imate Zones 10 =15 _ t• v
a.
Site Address: Enforcement -Agency: 4 at
Permit #;
55663'OAKHILL La Quints, CA 92253 City of<la{zQuinta a`r°19,.2013 .
Equipment 1 2 Duct.insulatlon;, Condltloned oor ."
Type List Minimum Efficiency? requirement Area Thermostat
.11Package Unit
® Furnace 19 AFUE'78% ❑ COP
� Indoor Coil SEER ❑ HSPF R 6 (CZ 10-.13) Served by sys em j®Setback
® ConderiVn Unit - 0 R,8 CZ)14-15 sf ff not already present, must be
❑other 9 VEER• �� Resista'nce ) Installed)
1. [qu/pmenr Type! Choose the equipment being7nstalled; if more' an. one'system, use ertoNrer C 1R- 'T HVAC for eeCN system.
2. Hlnlmum *qu1p&8nfEff?cleneiea , 13 SggpR 7i3% AFUE, 7 7HSPF Por:typlral-esldenGaf "systems-, s
HERS VERIFICATION SUMMARY Us led below, are POUR HVACaIteration .0ptlons. The instal er decides what work is being done
and picks one of the.appropriate Options. E$ch` Option lists the: HERS measures that:must-be c nducted, A copy of the forms•shall
be left on site for final Inspection and a. copy •given to the homeowner 'At final, the inspector v rifies ,that the work listed on this
form was In fad the work completed.by the Installer. The Inspector afso verlfles that each app pnate CF -6R and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed aeglhning October 1. 2010, :registered copy of the CF -111
CF -6R shall also be on slte4iirfirial.Inspectlan.
® 1, HVAC Changeout Required• Forms:
• All HVAC Equipment CF -:6R forms: MECH=04, MECH-21-HERS,and (for split.,Systems) ; ECH=25-HERS
replaced CF=4R forms: MECH=21 and (forsplit systems), MECH-2S
. Condenser Coil and /or CF -6R forms: MECH-04, MECH-21=HERS and (for Split systems) CH -25 -HERS
. Indoor Coll and•/or CF -4R forms: MECH-21 and fors lit" stems MECH-25
. Furnace (. P " SY )_
For Split Systems: Duct leakage:<.,15 percent; RC, CCA 5 300 CFM/ton (Minimum Alr Flow R equirement), TMAH
r :.,
Exempted from duct leakage testing'if:
Ductaystem was document to. have been previously sealed and confirmed through HERS verification, or
E3:2.. buct systems with less _than:`40.linear feet in unconditioned space; or •.
Q.3,'Existl'ng• duct systems are `0-nstructed, Insulated or'sealed with asbestos
p 4:, Ghe II, not be Duct d (ie:'. a tet I' ? o&e• er 6ki �cge)
❑ 2. N. L:..:
. Cut i " ijngeout w
et' .
new (all new >;: "ECH-04, I , HERS rsplit sy §) EC I fiFi,
RS, and
ducti -all
equip n r ECH- 0; ,e5r s It s ECM i�f X25 , e
For Split; ;. 3t � ttteFM r F• IAHi S,.a er t o
For.pa :.Units: "t7uct leakage, c E "percent
❑ 3eN iiM or wlthotjt ' Required Forms:
Repla' '^
. Includes repladn'd or installing ali:'new
ducting and/or outdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, an (for split systems) MECH-25-HERS
and/or indoor call and/or furnac2,'No or some CF -411 forms: MECH720 and (for split system) MECH-25
equipment changed.
For Split Systems:, Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH'
For Paekayed Units: Duct leakage < 6 percent'
O 4i New Ducting:over 40 feet. Required ForMs:
. Includes adding or replacing more than 40 , CF OR rms:'MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. CF -4R forms: MECH=21
For split system or packaged unites; Duct leakage <15 percent
❑ EXCEPTION: Existing dud systems constructed, insulated or sealed with asbestos..;
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation isaceurate grid complete.
I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for tt a design identified on this Certificate of
Compliance.
s I certify that the energy features and performance specificatlons for the design Identlfied on this CeMficati of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code'of RegulatloPS.'
• The design features Identified on this Certificate of Compliance are consistent with.the information documeted on other applicable compliance
forms, worksheets, calculations, plans and spoi6fications submitted tb4he enforcement agency for approva I with the permit application. Danielle Garcia Signature: bwdelle Garcic,
Zompany: HARRISON ENTERPRISES INC nnfo• rN�� yo �n,�
.Reg. 213-,8.0016562A-000000000-0000 Registration Date/Time: 2013/03/19 00:22:09
2008 Residential compliance Forma
11-I"cense: 686310
Phone: (760) 343-7488
Provider: Ca10ERTS, lac.
July 2010
03/19/2013 11:48AM 8187353575 IPERMIT ERATERS
21rmPIMea rrescriptive certlfic;l!" of Com,pliarti;,e: 200WResidential.HVAG,i
Climate Zones 10 15 "
Site Address: enforcerneM.Agency:
55663 OAKHILL La Quinta, CA 92,253 City of.La. Quinta
Duct insulation, Condltlo6ed
Equipment Typel List Mlnlmum Efficlency2 requirement Area
0 Package Unit
® Fumace IM.AFUE 78% ❑ COP
® Indoor Coil '0,SEER 13.0 p,HSPF 0 R 6 (CZ 1013) Served by sy
® Condensing Unit p EER pReslstance ❑'R 8 (CZ 14-I5) sf
❑ Other
I. Equipment Type; Choose 8 equipment being-1nsig ed;'If more than one system, use another CF -1R•
2. Minfinum lquipment �cienc Psr 13 SfER, 78% ARYE, 7.
7HSpF !or typital'residenttabsystems. '
HERS VERIFICAITON.SUMMARY Listed below are FOUR•HVAC alteration Optfons. The instA
and picks one of the appropriate Options. Each Option lists the.HERS measures that must be•
be left on site for final inspection and atopy given to the homeowner. At final, the Inspector
form was In fact the work completed by the Installer. The inspector also verifies Chat each app
forms (no hand filled CF-4Rs allowed).are filled out and signed -Beginning October 1, 2010,
and CF=6R shall also be on site for final inspection.
1. HVAC Changeout Requited Forms:
• All HVAC Equipment CF -611 forms: MECH-04, MECH-21-HERS and, (for split systems)
replaced CF=4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or CF -6R forms' MECH-04 MECH-22=HERS and fors ht s stems
.Indoor Coll and /or � ( p. y )'
. Furnace CF -4R forms: MECH'-21 and (for split systems) MECH-25
For Split Systems: Duct leakage;_<.15.percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow
PAGE 04/04
r;19, 2013
Thermostat
® Setback
If not already present, must be
nducted. A copy of the forms shall
'Ifies that the work Ilsted on this
priate CF -611 and registered CF -4R
registered copy of the CF -1R
Exempted, from duct leakage' testiny,'if:pereent
`Du't:system'was documefjted to have been previously sealed and confirmed through HERS verification, or
Duetsystems with' Tess thAh 40, linear feet in unconditioned space, or
Q3::Ezistmg duct Systems are tonstructed, insulated or sealed with asbestos
Th11not be Duc s
MI lit; tern e
Fx pt„frper rrge)
C3 2. Ne' it1 Requl '�.� �1 �,
. Cut i' angeout wl iECH-04, M HERS ' 1
new .;tall new �pUt sy s) EC ERS, and
equip .ECH- 0,rsit-s,
H
For Split: 9 C-
:., :: ,...• - s .., .r,,.f.FW ,Ci'-i.+.�1A..�-15TIM, S, aid-f�ftlier..H p'o ' P. "°� ."
For Pack* ' ' nits.l�'ud leakagi�;,'.;,i6' percent
u aciniE-.Yor Wltltout� Required Forms;
Repili e135
. Includes replacing'or installing ail`new
ducting and/or outdoor cCndimf' unit CF -6R forms; MECH-04, MECH-20=HERS, an (for split systems) MECH-25-HERS
and/or Indoor coil and/or fumaC No or some CF -0 forms: MECH-20 and (for split system )MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent;. RC, CCA >_ 300 _CFM/ton; TMAH
For Packaged Units: Duct leakage < 6 percent
0 4. New Ducting over 40.feet Required Forms:
. Indudes adding or replacing�more than 40CF-6R form§: HEC H-04, MECH-21-HERS
linear feet of duct In unconditloned space. ICF -'4k forms:'•MECH-21
For split system or packaged units; Duct leakage < 15 percent
E3 EXCEPTION: Existing.duct systems constrirctedi Insulated or.,sealed with asbestos..
Contractor (Documentation A or's1Responslble Designer's Declaration Statement)
. I certify that this Certificate of Compliance documentation Is accurate and complete.
• I am eligible under Division 3 of the Califomia Business and professions Code to accept responsibility for th des)gn IdBntified on this CernflCate 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 Tide 24, Parts 1 and 6 of.the California Code of Regulations."
• The design features identified on this Certificate of Compliance are consistent with, the.lnformation docume ted on other applicable compliance
forms, worksheets, Calculations, plans and specifications submitted to'the enforcernent`agency for. approva with the permit appiication.
Vame; Danielle Garcia Signature; banielle 6nrciu
License; 686310
CA/ 92276 Phone: (760) 343.
- --- - n=y�3uaciop uat,e/Time: 2013/03/19 00:24:31
2008 Residential Compliance Foms
Provider; Ca10ERTS, Inc.
July 2010