12-1303 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
� f
12-00001303---
2-00001303"Property
PropertyAddress:
80352 RIVIERA
APN:
762 -130 -012 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
7406
Tityl 4 XP Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ENGLANDER HARVEY A--
80352 RIVIERA D
LA QUINTA, CA 9225
F_
VOICE_ t._. _
FAX (011
INSPECTIONS (760) 777-7153
Date: 11/01/12
NOV 0120121
LD
Contractor: a CITY OF LA QUINTA I
Applicant: Architect or Engineer: GENERAL AIR CONDITIONING FINANCE DEPT.
31170 RESERVE DRIV9
THOUSAND PALMS, CA 92276
(760)343-7488
P'A
Lic. No.: 686310
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic sed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pr ssionals Code, and my License is in full force and effect.
Lic se Class: C20 icense No.: 686310
Date: 11 z.. p ntractor:
/ - NER-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 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 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.).
(_) 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
WORKER'S COMPENSATION DECLARATION
I 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.
41 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 Z071741501
I certify that, in the performance of the work for w 'ch this permit is issued, I shall not employ any
person in any manner so as to become subject he workers' compensation laws of California,
and agree that, if I should become subject totj�
orkers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith cc with those. provisions.
11
bate: ! Z/.,/qfplicant:
WARNING: FAILURE TO SECURE WORKERS' C ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND C VIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT .
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or ce tion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above infor ti n is correct. I agree to comply with all
city and county ordinances and state laws relating to building constru o , and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspe i purpog s.
n
Date: 1 1 Z.$i4nature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 12-00001303
Permit . . . MECHANICAL -
Additional desc .
Permit Fee . . . 31.50
Plan Check Fee
7.88
Issue Date
Valuation . . .
0
Expiration Date 4/30/13
Qty Unit Charge- Per
Extension
BASE
FEE
15.00
1.00' 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT: INSTALL NEW 4 TON
CONDENSER AND COIL. 2101 CODES.
------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS.ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
-------------------------------------
Permit Fee Total 31.50
--------------------
.00 .00
31.50
Plan Check Total 7.88
.00 .00
7.88
Other Fee Total 1.00
.00 .00
1.00
Grand Total 40.38
00 .00
40.38
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
80352 RIVIERA La Quinta, CA 92253
City of La Quinta
Oct 31, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
_
❑ Furnace
® Indoor Coil
❑ AFUE
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
3099 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.-
ystem:2.
2.Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 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 CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -IR
and CF -6111 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
All HVAC Equipment'
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -,4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, 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 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
reeRli
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 duct systems are constructed, insulated or sealed with asbestos
❑ 4. The not be Ducted(ieDuctlessLMiniSplit-System)j(Also-Exempt from;Refrigerant-Charge)
Fsystemrwill
.stem
❑ 2. Nev%`"VAC S
Required Forms: r - )fi"
.Cut inior Changeout with,'
new ducts`; (all
' ` *r� • l '- It
CF 6R'forms:,MECH-04, MECH=20ZHERS nd,,(for;split systems) MECH 22 HERS, a'nd
new
ducting�aII new
/
MECH 25 HERS if' u
CF -412 forms:iMECH-20, and (for split systems) MECH-22,rand MECH-25
equipment +Q` ,r.
t ,
.i lxc 'OiL, P,
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/or without
Required Forms:
Replacement ,
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
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-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 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 this Certificate of Compliance conform to the
-on
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: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC - Date: Oct 31, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0061089A-000000000=0000 Registration Date/Time: 2012/10/31 18:38:57 HERS -Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Y818 11
City Of La Quinia
Building &r Safety Division
Permit # �j�3 P.O. Box 1504, 78-495 Calle Tampico
7" La Quinta, CA'92253 - (760) 777-7012
1 . Building Perm- it- Application and. Tracking Sheet
Project Address: �� Iv Owner's Name: t
A. P. Number: .�'� �' Address: V " ,� `ff�s
Legal Description: City, ST, Zip: -f� (A''1 (Is QJ` g221
Contractor: ^
Address:. -7 'QCProject Description: f�C.
City, ST, Zip: 1 V it l\ i�rin /�1 iw) 6- C y%��l /i , � Ok -.-a .i — r!3. - _ P w D .
+
State Lic. # :
3 L City Lie. C
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:.
State Lic. #:
Name of Contact • Person:
M. '
`•< :l•rr +:�.`�:..�<^ . ,>?:;�.� ���.ProJs
�. p U40- �� GtJ;t s G7YU
Construction Type: Occupancy:
type �circle one): New. Add'n Alter Repair Demo
Sq. Ft.:
#. Stories:
# Units:
Telephone # of Contact Person 'Ito O �L-'� %'� g' V
— - -._ 4
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
# Submittal Req'd Recd TRACIUNG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked no
-
Construction
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
IN
'rd Review,.ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School. Fees .