14-0502 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000502
Property Address: 53640 AVENIDA OBREGON
APN: 774-115-006-6 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 7945
Applicant: Architect or Engineer:
�op K." - Nq - i
r
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
coe� • Owner:
KATE RUST
53640 AVENIDA OBREGON
e LA QUINTA, CA 92253
(760)559-0110 n
U
Contractor:
GENERAL AIR CONDITIONI-�
31170 RESERVE DRIVE
THOUSAND PALMS, CA 922J6
(760)343-7488
Lic. No.: 686310
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 Business and Professionals Code, and my License is in full force and effect.
License Class: C20 A p License No.: 686310
ate:: P4 Contract4_
OWNER -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'15500).:
1 _ 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 offeredfor 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. , 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/24/14
APR �tft
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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. -
SO>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 ZENITH INS CO Policy Number Z071741503
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 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.shalt forth"with comply with those provisions. '
'Applicant:
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 ($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 permitsubject 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 authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes. '
Date�� 14 Signature (Applicant or Agent-
Application Number . . . . . 14-00000502
Permit . . . . . MECHANICAL 2013
Additional desc . .
Permit Fee 35.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 10/21/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 13SEER 4TON CONDENSING
UNIT [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
23.83
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 35.75 .00 .00
35.75
Plan Check Total .00 ..00 .00
.00
Other Fee Total 114.40 .00 .00
114.40
Grand Total 150.15 .00 .00
150.15
LQPERMIT
Simplified Prescriptive Certificate ofCom liance: 2008 Residential RVACAfterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address.
Enforcement Agency:
Dat:
Permit #:
S 0 i t^
Gi OF LG ui +a
LA29 ► e-4
Conditioned Floor
Equipment Type'
List Minimum Efficien 2
Duct insulation reauirement
Area
Thermostat
❑ Packaged Unit
❑ Furnace
❑ AFUE
0 C
❑COP
Over 40 ft of ducts added or
Z Setback
(Indoor Coil
®SEER 13
PF7. i
replaced in unconditioned space
Served by system
(If not already
MCondensing Unit
13 EER
❑ Resistance
13R 6 (CZ 10-13)
13R 8 (CZ 14-15)
sf
present, must be
installed)
13 Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AME, 7.7HSPF for typical 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 CF -4R forms (no hand filled CF4Rs allowed) are filled out and
signed. Beginning October 1 2010 a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
18' 1. HVAC Changeout
Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH-21 and fors lit stems MECH-25
• Condenser Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH-25-HERS
• Indoor Coil and /or
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA 2:300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent,
Exempted from 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
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF4R forms: MECH-20, and (for split systems)MECH-22, and MECH-25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, SIMS, 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
Required Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-21-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 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 spocifications submitted to the enforcement enc for approval with the it application.
Name: 5c-V\Y i
Signature: <'�
--�"
Company.
Date: u Zy I
Address: 3i1 —70
�eSerV� r
�
License: 86310
City/State/Zip: OV Sc��n �G CA 4 2 2-7(o
Phone: —1�. O _ 3y 3 - 74 S'g
2008 Residential Compliance Forms July 2010
Qin #
.: ... ..
City: of La Qurnta
Building 8i Safety>piviston .
P.O. Box 1504, 78-495"Calie'.Tampico
La.QuM6, CA 92253 (760).777-701,2
Building Pe*rrriit Appllcat►o6�6nd Tracking fleet
Permit #
14—
Project Address: S3(.440 w ern i aG
Owner's Name:
A. P. Number:
Address: -S 3coy 0 . v e C—0b
Legal Description:
Contractor:Telepho,
City, ST, Zip: L' Q 6 j v� C 4. c Z Z S 3
n e. 760-559- Otto .... :..... ..::.:
Address: 3\1-70 e.Se.:cv
PtojectDescription:
City, ST, Zip: JKOJSY\a��.� rn S, ZZ
y k e cA w t
Telephone: �c�o-3N3 7ti 88
State Lie. # : (q8(o 3i U
City Lie. #•:
Arch., Engr., Designer:
Address:
y
City, ST, Zip:
Telephone:
< v_
T ecu"ane
.: Constructi n e• O
YP • P . Y
Lie. #:
Add n Alter Repair Demo
Pect' type (circle
ne New oJ
Name of Contact Person:
Sq. Ft.:
` # Stories:
#Units:
Telephone #,of Contact Person:'Estimated
Value of Project:' 7 q.y S,
APPLICANT:'DO NOT WRITE:BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
u
Item
Amount
Structural Calcs.
'Reviewed, ready for corrections
Plan Check:Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
.Plans picked up
Construction.
Flood plain plan
Plans'resubmitted
Mechanicab..
Grading plan
tad Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dced
Plans picked up
H.O.A•'Approval
Plans resubmitted
Grading
IN ROUSE:-
'"! 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