12-0247 (MECH)- C"
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:12--0'0"0-00247
Property Address: 803163 OAK TREE
APN: 775 -081 -080 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7400
Applicant:
TAt!t 4 4Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DAVE HART
80363 OAK TREE
LA QUINTA, CA 92253
Contractor:
SPEEDY AIR CONDITIONI:
54685 AVENIDA HERRERA
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS. (760) 777-7153•
Date: 3/19/12
,o), nL, a
1` ,AR. 2012
will
LA QUINTA, CA 92253
`
(760)567-0133
Lic. No.: 834471
------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
------------------------------.------------------—
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury 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._
License Class: C20 license No.: 834471
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
,/ /►
/te:��/9�ontractor: U'��->e�/(/i/,L// (��/'�/7/jib
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
OWNER -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 } EMPT Policy Number EXEMPT
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
person in 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
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he she o exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
and'agree that, if I should become subject to the workers' co pensation provisions of Section '
3700 of the Labor Code/,//I h—a_ll fo�rtyhwith com 1 ith t pr nisi s.
�J .., /
li
any applicant for apermit-subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.:
( 1 I as owner of the ro art or m em Io ees with we es their I m n t n d th k d
tec3
—' Z� '�j
y p y g as ei so a co pe sa +o , wi o e wor , an
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.).
(_ 1 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. IN ADDITION TO THE 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. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby autljorize representatives
of this . my to enter upon thea ve-mentioned property for in ¢ection purposes.
re (Applicant or Agent):
LQPERMIT
Application -Number -12-00000247
Permit MECHANICAL
a
Additional desc .
Permit Fee . . . . 4.0.50 Plan Check Fee
10:.13
Issue Date Valuation . . . .
0
Expiration Date 9/15/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9..00
1.00 16.5000 EA _MECH B/C >3-15HP/>100K-500KBTU
16.50
------------------------ ----------------------------------------------------
Special Notes .and Comments
HVAC CHANGE -OUT, REPLACE FURNACE,
CONDENSER, INDOOR COIL. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 40.50 .00 .00
40'.50
Plan Check -Total 10.13 .00 .00
10.13
Other. Fee Total 1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63,
LQPERMIT
Simi 'lil9ed Presets tive'Crtificate ofCtirr>I liance'2008'ResitlentialHl�,4Cdlteralio
Climirite Zones,l0 to -I5:
Site Addie s: = cem
Enjor'ent Agency:. p
' O • .�G�• ..
„S`.;, cF-IR=Ai.r=Hvac
'it
V7
Equipment T r List Minimum Efficient •Zon
Cditioned Floor
❑ Packaged Unit
Duct insulation re uirement Area Therritostat
p -Furnace ❑ AFUE90 ❑ COP Over 40 ft of ducts added orB-Se
B'Indoor Coil ❑SEEck
R, p ❑ HSPF replaced in unconditioned space Served by system (/j„ot q/„Qadv
:ondensing Unit ❑EERY ❑ Resistance ❑ R 6 (CZ 10-13) �c5' sf present, must be
❑ Other ❑ R 8 (CZ 14-I5) installed)
l Equipment T)pe: Choose the equipment being installed: y more than one system, use another CF -I R -ALT -HVAC jor each system.
2. Minimum Equipment Efficiencies: 13 SEER. 78016AFUE• 7.7HSPFjortypical residential 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and
signed. Beginning October 1, 2010 a r tered co of the CF -1R and CF -6R shall also be on site for final inspection.
131:-HNtAC Changeout Required Forms:
• All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (f)r split systems) MECH-15-HERS
• Condenser Coil and /or CF -4R forms: MECH- 21 and for s lit stems MECH-25
• Indoor Coil and/or ' CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace CF4R forms: MECH- 21 and (for split systems) MECH-25.
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
I "tempted f-rotn duct leakage testing if:
❑ 1 Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment) CF -4R fors: MECH 20-, and (for split systems)MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, ST1vIS, and either HSPP or PSPP.
For Packaged Units: Duct leakage <6 percent
❑ 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFMhon, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forms:
• Inclucle; addma or replacing more than 40
linear feet of duct in unconditioned spice. CF -6R forms: MECH-04, MECH-2l-HERS CF4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts sterns comstructed, insulated or sealed with asbestos
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certtfi, that this Certificate of Compliance documentation is accurate and complete. .
• 1 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 arts I' that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements' Title 24,
Parts t ,nd (, of the Califomia Code of Regulations.
i fic dem,features idem led on this Certificate of Compliance are consistent with the information documented on other applicable compliance fomu, worksheets.
calculatio s, plans and specifications submitted to the enforcement a enc fora oval with the permit application
Name
. Signature:
IM
J0117
City/State/l.ip: ZQ
i
Z
Date:
License:
2008 Residential Cothpliance Forms March 2010
Bin.#
cis Of Q[(fn
`BU1Kpg BL Safety Division'.
P.O. Box 1504,78-495 Calle iamptco_
La.Quinta, CA 92253 - (760) 777-7012
Building PermitA lication'g and Tracking Sheet
pp
Permit # ,``.
K
Project Address:. . Q • 3�
Owner's Name:. Aave Ila
A- P. Number
Address' .
'
Legal Description:.
' c
Contactor. U C
E'
City, ST, Zip:
ep 2l -.�
Tel hon . �'— 9 11 :�a�ftxM'�� s: k✓
Address: j' ��`A 1 .o1 ,
Project Description:
City, ST, Zip: �.
Telephone: �r�1. •�: - _,
�' !!
State Lic. # : �'y %�/7� -City Lie. #;
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone: 1
State Lic. #: ;y�� '
:,.
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERIKfP FEES
Plan Sets
Plan Check submitted
Item Amount
Strnctum Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Pian Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plant plan
Plans resubmitted
Mechanical
Grading plan
2id Review, ready for correctionstiissue
Electrical
Subeoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked upt
S M L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for eorreetionsTissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A,LP,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees