13-0304 (MECH)P.O. BOX 1504 � VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/19/13
Application Number: 13-00000304 Owner:
Property Address: 80057 RIVIERA GALLAGHER RICHARD C
APN: 762-120-007- - - 520 ALEXANDER CT
Application description: MECHANICAL BARRINGTON, IL 60010
Property Zoning: LOW DENSITY RESIDENTIAL D
Application valuation: 14789 p p 203
Contractor:
Applicant: Architect or Engineer: GENERAL AIR CONDITIONI Gof LP,31170 QUr♦�TjA
IVE
THOUSAND SPA MS,ERVE CAA 9227 CIV
ANCEpEPT_
(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 License No.: 686310
�^� S
Date: Contractor:
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 ($500).: .
(_) 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. 7644, 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 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.1.
Lender's Name: _
Lender's Address:
LQPERMIT
-----------------------------------------------—
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.
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 Z071741502
_ 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�shall forthwith comply with those provisions.
Date: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 1$100,0001. 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 authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date3 1-1 t3 Signature (Applicant or Agent):.�---
Application Number . . . . . 13-00000304
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation . . . .
0
Expiration Date 9/15/13
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 -'5 TON AIR CONDITIONING
PACKAGE & 90K BTU FURNACE. CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION.. 2010'CALIFORNIA
.
BUILDING 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
r'
03/19/2013 11:48AM 8187353575 IPERMIT ERATERS PAGE 01/04
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC ARterations
Climate Zones 10 - 15
CF -lit -ALT -HVAC
Site Address: Enforcement Agency:
80057 RIVIERA La Quinta, CA 92253 City of La Quinta
ate: Permit tit;
ar 19, 2013
Duct insulation Conciltione F
Equipment Typel List Minimum Efflciency2 requirement Area
oor
Thermostat
❑ Package Unit
IR Furnace
IR Indoor Coil
®AFUE Igo/
IN SEER 3
7 _ .0
[3 Cop
❑ HSPF
❑ R 6 (CZ 1D -.I3)
Served by sys
em
® Setback
not already present mus[ be
W Condensing Unit:
p EER
❑Resistance
C7 R 8 CZ 14-Z5
(
2 sf
installed)
in
❑ Other
1. Equipment Type: Choose the equipment being installed; if more an. one system, use another CF -ZR-
2. Minimum Equipment Efficiencies: 13 SEER, 7846 AFUE .7.7HSPF for typical residential systems.
T -HVAC for eaC system.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The instal
and picks one of the appropriate Options. Each Option lists the HERS measures that be
er decides what work is being done
must c
be left on site for final inspection and a copy given to the homeowner. At final, the inspector v
Dnducted, A copy of the forms shall
rifies that the work listed on this
form was In fact the work completed by the Installer. The inspector also verifies that each app
opriate CF -611 and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.8eginning October 1, 2010,
a registered copy of the CF -1R
and CF -GR shall also be on alto for final Inspection.
® 1. HVAC Changeout Required Forms:
• All HVAC Equipment CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) Iv
ECH-25-HERS
replaced CF -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems)
• Indoor Coll and /or
ECH-2S-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 R
equIrement), TMAH
Exempted from duct leakage testing>if:
Q ] Dui t system was documegted to have been previously sealed and confirmed through
HERS verification, or
::0.2;. Duct systertis with legs th4n;140 linear feet in unconditioned space, or
Cl3:'Exlsting duct systems are constructed, insulated or sealed with asbestos
E3'4: The II! not be Du(le. lett i� 7, .Irk ste S xe .Ifc !§..age
.-'hdrge)
:.. `,.... ;cc oft'... _. ,_.
"Sy Requi ':" - �. ;;�<:
0 2. N0Qkz
.•,
. Cut i ngeout w ;� --
::..✓5
new P(all new , TECH -04, M HERS i r split Sy j
C... ,
E i1ERS, find
ducti all n :v.-'' i•' S'W"'
Y+ =' MECH-.20, i;. ors It I:..
LOU ip i {f Its CM=? 'M
��:..� r,:wv ,.,. �,. `"�' <i
- AN
For SpFiit:,` .' a: ! p:L�r°t "5 FW[,TM. 5' a
For Package U'
For leakage e`;6 pertenf "
d, 77 _..
0.3c /or without--
Required Forms:
w
Repla
. Iridudes:•repladng or installing milt new
ducting and/or outdoor c6ndensirl9 unit CF -611 forms: MECH-04, MECH-20^HERS, an
and/or indoor coil and/or furnace:- No or some CF -4R forms: MECH-20 and (for split system)
(for split systems) MFCH-25-HERS
MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA Z 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
134. New Ducting over 40 feet Requlred Forms:
. Includes -adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. CF -4R forms: MECH-21
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 certlfy 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 If
Compllana,
a design Identified on this Certificate of
■ I certify that the energy features and performance specifications for the design identified on this CertificatA
requirements of Title 24, Parts 1 and 6 of the California Code a- Regulations.
of Compliance conform to the
• The design features Identified on this Certificate of Compliance are consistent with the information dOCUME
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for
nted on other applicable compliance
I
approvz
Name: Danielle Garcia Signature: Danielle 6arcla
with the permit application.
Company: HARRISON ENTERPRISES INC
Date: Mar 19, 2013
Address: 31-170 RESERVE DRIVE STE A
License: 686310
City/State/Zlp: THOUSAND PALMS / CA / 92276
Phone: (760) 343-7488
Reg: 213-A0016556A-000000000-0000 Regiatration Date/T�me: 2013/03/19 00:07:09 ERS Provider: Ca10ERTS, J)aC,
2008 Residential Compliance Eozma July 2010
e,».#
City Of 'La Quanta
Building sT Safety Division
P.O. Box 1504,78-495 Calle Tampico
La ..Qu1nta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
� � O VI
pi
Project Address: gcoS'7 P, i v i Gr 0
Owner's Name:. 0.
A. P. Number.
Address: $(>S-7 i v ic.f
Legal Description:
City, ST, Zip: L,- /�lv'it GA Ot2Z53
�
l�.
Contractor: ��eC-G\ Air Cox -,a �
Telephone: ,
Address: 3\N_70 14eSexv. r .
Project Description:
City, ST, Zip: Ii^0.t c.hc� �c.`rC1S Q 2Z%(a
7L G 1GG� S �OY� L �!O e $S�
Telephone:
State Lic.#: (og(o31 O c. #;
naty
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lic. #: Y
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Unit$.
Telephone # of Contact Person:
Estimated Value of Project: j i} .-7 $Ci .GIE--;O
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Pian Sets
Plan Cheek submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calm
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
2`! Review, ready for correctioustiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Gradlag
IN HOUSE:-
''d Review; ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees