13-0240 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000240
Property Address: 54479 RIVIERA
APN: 775-031-027- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 9153
Ta�v 4��
/� VOICE (760) 777-7012 '
/ FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153.
BUILDING PERMIT J
Applicant: Architect or Engineer:
-------------------
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: C2�0 eNo.: 374937
Date: Contractor -7-
OWNER -BUILDER DECLARATION
1 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 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.). .
(_) 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
Date: 3/06/13
Owner:
JAMES & PAM HUDSON
54479 RIVIERA
LA QUINTA, CA 92253
(
5A 1
Contractor: A
PALM DESERT AIR COND C't cl
42081 BEACON HILL t f\4
PALM DESERT, CA 92211 �•^+"
Vr
(760)346-0677
Lic. No.: 374937 c"%TVOhLA(Ql1yNT�S
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
_.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
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 MID CENTURY Policy Number A09454905-12
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,, II shall forthwith comply with se provisions.
Date: -? lAPPlicant: / .�-� �%ir.✓
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 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 authorize representatives
of this count to enter upon the above-mentioned property for inspection purposes
Date:;: i� /` - Signature (Applicant or Agent): i
Application Number . . . . 13-00000240
Permit ... . MECHANICAL
Additional desc .
Permit Fee . . . 42.50 Plan Check Fee
10.63
Issue Date . . . . Valuation . . . .
0
Expiration Date 9/02/13
Qty Unit Charge Per
Extension
BASE FEE
15.00 .
1.00 11.0000 EA MECH FURNACE >100K
11.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
---------------------------------------------------------------------
Special Notes and Comments
-------
HVAC PACKAGE CHANGE OUT. 2010 CODES.
-----------------_-----------_----------------------------------------
Other Fees ... . . . . BLDG STDS ADMIN (SB1473)
---
1.00
Fee summary Charged Paid Credited
---------- ----------
Due
------------ - ---- ---------- ----------
Permit Fee Total 42.50 .00 .00
42.50
Plan Check Total 10.63 .00 .00
10.63
Other Fee Total 1.00 .00 .00
1.00
Grand Total 54.13 .00 .00
54.13
LQPERMIT
t
aur
s+• �— GEM,dlcee DESERT --w ^�v.
..R:O,: Boz Y504 •, 8 495.Calle Tampico, -:. La Q'uinta, California 9221.11
Tel (760):,7;77.--7d ax (760) 777 7112
Website www La=Quinta.-,rg.• Email Bwltlmg@La Qumta.O g
Bin #: [P.errr lt:# �-Zy Building Perr t�7Appl cat on �&�Tra"cK-1 Shasta
Pro�ectAddre"S'K.54-479 RIVIERA
R �
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t
Address: 54-479 RIVIERA
Legal.Descnption:;�
* F,
;City,,State,iZip:• LA QUINTA, CA 92253
,Contractor.. Palm Desert Air Conditioning & Heating Company
Telephone. (
- -
Address:: 42-081 Beacon Hill
Project Descri trona
,City, State Zip;:, Palm Desert, CA 92211
REPLACE (1) GAS ELECTRIC PACKAGED SYSTEM.
Telephone No., (760) 346-0677
1�F
z
State` Lic #: 374937
City'Lic :*%' 100886
Arch 7Eng� /Designer`.
Address
"City, State .`Zip:'
Teleptione N&.:r
:;" ' ,. -�
Construction Type.;
Occupancy
State.`Lic: #:
f3a `" 'f
--
.Project Type:: O ,New .' ®Add'n :� l7 Alter O;Repaic 0 Demo
Name`of Contact Person: KARL BROWN
Sq'Ft:
#Stories::
#`.Units:
Contact Telephone No::' (760) 346-0677
Estimated Value Project.$9,153.00
APPLICANT- 'DO. NOT WRITE:
BELOW ;THIS;,LINE
#
Submittal
Req'd;,
Recd
Tracking
Permit Fee's
Plarf Sets
'Plan:Che :Submitted
Item
; Amount
Structural Celcs.
Reviewed, Ready for Corceations,,
1PI6n:Che6k,DeposlE,.
•Truss.Calcs.�
iCalled'GontactRdrson?
Plan,Check Balance.{
j
Title 24 Calcs.,
Plans Picked Up.
Construction
-
I
Flood Plain:Plan
'.Plans Resubmitted!
Mechanical
,Grading Plan,
-2n0 Review; Ready for Corrections
ElectricalI
f
Subcontractor List.
+
;Called'ContactPerson'
kPlu'mbing
Grant'Deed
'Plans PickedUp
S.M.Ie
H�p..k Approval +
Plans Resubmitted!
Grading
INHOUSE.
3id Review Ready for Corrections,'
Developer Impact Fee
,
;
Planning Approval
Called Contact.Person
Puti:.lNorks'A r f .
I
Date & Permit Issue'
SchooC.Fees:
I
I
Total-P..errriit'Fees;
21'3=A0013826A-000000000=606,0.pdf https://www.caicerts.com/files/PiojectFiles/247237/plan_310650/21...
Simplified .Pi escriptive Certificate,of Compliance 2008 Residentlal.HVAC Alteratrons = CF -11R -ALT -HVAC
Climate Zones 10 - 15
Site Address: ' '
Enforcement Agency:
Date:
I Permit,*-.
54-479 RIVIERA La Quints, CA 92253 A
City of`La Qufnta
Mar 5, 2013
Equipment Type.
r List Minimum Efficiency2 "'
_. - - _
Duct insulation
i requirement.
Conditioned Floor
Area
'
Thermostat
_ ... __. ..
0 Package Unit
0 Furnace
O Indoor Coil
H AFUE 78%:
®.SEER 13.0
p COP
0 HSPF _
p R 6 (CZ 10-13) ,_
Served by system
sf
®'Setback
If not, already, present; must be
0 Condensing Unit
D EER'
p Resistance •
O R 8 (CZ 14-15)
1200
installed)
p Other - -
-
1. Equipment Type: Choose the equipment being installed; if�more than one systerrt use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER; 78°io AFUE, 7.7HSPF for typical residential'systerris. r_
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-slte 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 signed.Beginning October 1, 2010, a registered copy of the CF -1111
and CF=6111 shall.also •be on site for final inspection:
0 1. HVAC Changeout .'
Required Forms:
eAll HVAC'Equipment s
CF -6R. forms: MECH-04, MECH-2I-HERS and. f F splits; teFAG)-lj4EGl4
replaced
CF -4R forms: MECH-2T .c
Condenser Coil and /ot
.Indoor Coil and /or �
CF 6R. forms MECH-04; MECH-21 HERS + rv; i.►
°'
CFforms: MECH-21
. Furnace ,
For Packaged Units Ductal
akage 'Nn percent
Exempted f�coffi". duct leakag�sting
®iDuct�systemwas iloetarneiitedito
�
have been
Xp2�Ductsy�stemswthess`tha�n40
3 Existin ducts stems�are
9 y
previously sealed and confirmed through HERS verification, or .
linear feet in unconditioned space, or '
constructed insulated or sealed with asbestos
:�«tis , --
p4. Thome system willno�t
�e
be Ducted(ieDuctless,MtniSpli�tS,yemi} (AIsoAExem�ptfromRefrigerantCha ge)
0 21LW0HVAC„Sys[M?RequifedF,ornis
,
' . IN- r
e, Cut'in"for"Changeout with'�r�ax
newiduc all nenr
g t
ductin and all new��
a�
CF 6R forms�MECH 04,x, MECH-20ZHERS and (€for.,spli y,,stems) MECH;-292 HERS ,'a r,
�MEGH 25 HERS."•
CF 4R forms t MECH 2Oand (for split systems)'s'MECH-r22�and MECH 2>5 i
-
For<SplttSystemsDuct leakage 6 percent, RCGCA>350CFM%itonF�1NDTMAH;STMS andeither f13PP orPSPP
ForPackaged Unttsuctleakage <6percent.
_.
0�„3 NewiDuct9 wit�h�/or-unthfout Required Forms
Replacernentr�I
-..
.In,�lud eplacing 1 g�ll ne
ducting and/or outdooNzondensi. nit .-
.� .
and/or indoor coil andjttr%furnace: Noor some
CF -6R forms: MECH-04, MECH=20-HERS, and (for split systems) MECH-25-HERS
CF 4R forms EC
MECH 2O.and (for split systems) MH -25
equipment changed
- -
For Split Systems: Duct leakage" 613percent, RC, CCA 2 300 CFM/ton, TMAH -
For Packaged Units- Duct leakage < 6 percent z
0 4. New Ducting over 40 feet
Required Forms:.
Includes adding or replacing more than 40
CF -611 -forms: MECH-04; MECH-21-HERS
linear feet of duct in: unconditioned space.-
CF -4R forms:'MECH 21
For•split system or packaged units: Duct leakage < 15 percent
p'EXCEPTION: Existing duct systems constructed insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
e I certify that this Certificate of Compliance documentation is accurate and complete:'
e I ameligible under Division 3 of the California Business and Professions Code to accept re'sponsibility'for the design identified on this Certificate of
Compliance.
e I certify that the energy features andperformance specifications for the'de5ign 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: Karl,Brown : ; Signature: Karl Brown
Company: PALM DESERT AIR CONDITIONING CO'INC ; Date Mar 5, 2013
Address: 42=081 BEACON HILL w- - License:,, 3,74937_ _._
City/State/Zip: PALM DESERT /.,CA/ 92211: Phone: (760) 346-0677