11-0926 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r 11-00000926 -
Property Address:
-80619 OAK TREE
APN:
775 -082 -023 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
13181
T4ht 4 4vQg«tw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or.Engineer:
A
LICENSED C TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lice under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prof i mals Code, and my License is in full force and effect.
Lice a Class: C20 License No.: 686310
Date: 8 L4nuactor: '
-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from 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 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 1, 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.).
(_ 1 1, 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.).
( ) I am exempt under Sec. , BAP.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:
LOUIE RICHMOND
80619 OAK TREE
LA QUINTA, CA 92253
Contractor:
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488
Lic. No.: 686310
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/29/11
^9 .
__________________ ______ _1-�_' _�2pUrI�N�rT—A___
WORKER'S COMPENSATION D LARATIONIFI C DGr 1.
I hereby affirm under penalty of perjury one of the following declarations.
1 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 EVEREST NATL Policy Number 7600006147101
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become . su ct to the workers' compensation laws of California,
and agree that, if I should become subjec the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwit mply with those provisions.
/e: Z9A Lplicant:
WARNIN E TO SECURE WORKER ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 i o ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building con ction, and hereby authorize representatives
of th' county to enter upon the above-mentioned property for in ction rposes.
i
ate: g L9 Si ature (Applicant or Agent):
Application Number 11-00000926
Permit . . . MECHANICAL
Additional desc .
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation
0
Expiration Date 2/25/12
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
CHANGE OUT 4 TON HVAC SYSTEM: CONDENSER,
COIL & FURNACE AT GROUND LEVEL. 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 .0000
10:13
Other Fee Total 1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address: Epforcetnok Agency:
._ / , 1 /\ _ r . � _ _ \ I Date: .Permit N:
Conditioned Floor
Equipment T el List Minimum Efficienc Z Duct insolation requirement Area Thermostat
Packaged Unit
Over 40 ft of ducts added or
�LFrnace ❑ AFUE 80 Xo ❑ COP NSetback
oor Coil ❑SEER i 3 ❑ HSPF replaced in unconditioned space Served by system (Ifnoi already
rtdensing Unit O EER / / ❑Resistance ❑ R 6 (CZ 10-13) sf present, mast be
❑ Other ❑ R 8 (CZ 14-15) installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R-ALT-HVACfor each system.
2. Aflitimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are fottrHVAC 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 -611 and registered CF -411 forms (no hand filled CF-4Rs allowed) are filled out and
Siged. eginning October 1, 2010,. a registered copy of the CF -IR and CF -611 shall also be on site for tlnal inspection.
1. HVAC Changeout Required Forms:
• All HVAC Equipment re laced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Condenser Coil and /or
• Indoor Coil and/or
CF-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• 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 Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempt rom duct leakage testing if:
)tQ. 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 forms: MECH 20-, an ( Plits )
d fors MECH-22, and MECH 25
systems)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, 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
CF4R 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 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Re uired Forms:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned space,
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 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.
• 1 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 t and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the " orm tion documented on other Pplic ompliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement agency for aDDro al with t e permit application.
Name: Cleeh WO-s6ij
Si tures
I
Company.
C�,en�era( 4t r Cort d-; fr`On r`
Date:
g'
Address: 311-70 /24Senje_
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la''/ _
License:
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City/State/Zip:—LtOG��SG/.x�� pa,(—fr—s, G�} %aa %�
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Phone: %�—,37,3_-%TE.0'
Ca10ERTS - CF -1 R Registration
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CONGRATULATIONS
About Us
Your CF -IR -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Training
80619 OAK TREE
Site Address:
La Quinta, CA 92253
Rater Directory
CEC Registration: 211-A0044362A-00000000-0000
Forms
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
Assigned Company: HARRISON ENTERPRISES INC
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News
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monthly
newsletter, please
click here.
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If you do, you may want to send this CF- IR to them.
Ca10ERTS Rater ID:
OR
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Every Ca10ERTS rater has a license number.
If you need to find the rater by name [Click HEREJ to search our directory.
[CLICK HERE] to do another
Copyright 02010 CaICI:R:rs, Inc. All rights reserved. Revised: January 11.201.0
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy]
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
BBB !Kltisi;a(pFd eba6ki :
https://www.calcerts.com/public_cflR.cfm?project_id=134419 8/26/2011
Bin #
Permit # /1 Vl
f�
1`
Project Address: �� Lr
.0ty of La Qurnia
Building 8i' Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Perm. it -Application and. Tracking Sheet
�.Name:
A. P. Number:
EAddA
O B (p Oak e�
Legal Description:
Zip: a�
Contractor:b envul
Address:-jcIProject
C-
k
Telephone• (vDlfSt'o� ��SS,<'.,;a`a'';
Description: TDYI 4,}'(/gQ-G
City, ST, Zip:
/c,� , a _q
C.�i�C K/II.lC
Telephone
State Lic. # : 3
Arch., Engr., Designer:
r;,>::'.<:Y> fr•:
City Lic.
Address:
City., ST, Zip: .. _ _ • :-.
' 'rf ti'.•2 `�N'�'.'.M1`'Y•/h�';•4'r}?Svr S�tii
Telephone:. v�#,h?;, •.F'
• •, t.,:
State Lic. #: estfwfes, '
Name of Contact Person: �p Uc vyV
_
Construction Type: Occupancy:
Project type circle one) New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 7& D
3 Estimated Value of Project:
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets.
Req'd'
Recd
TRACMG
Plan Check submittedItem
PERMIT FEES
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance •
Title 24 Calcs.
Plans picked up
Construedon
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
INHOUSE:-
7rd ReviewI ,.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