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MECH (12-0006)
77561 Los Arboles Dr 12-0006 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: ,12-00000006 77561 LOS ARBOLES 658-260-042- - MECHANICAL LOW DENSITY RESIDENTIAL 2499 T4bt 4 44umrw Architect or Engineer: PIP BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am I}' ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 4'l fessionals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Fate: 5 I ontractor: WNER-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 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.). 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—) 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 Owner: MIKE GRGICH 77561 LOS ARBOLES 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: 1/05/12 JAN 05 27 012 _Crry4FDrr...__ 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. Y 1 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 1 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. mate: Imam: 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 ($100,0001. 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 inf Rr ation is correct. I agree to comply with all city and county ordinances and state laws relating to building cons !{ion, and hereby authorize representatives of this county to enter upon the above-mentioned property for ins ion purp es. ate: AS' ature (Applicant or Agent): Application Number . . . . . 12-00000006 Permit . . . MECHANICAL . Additional desc . Permit Fee . . . . 19.50 Plan Check Fee 4.,88 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/03/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4,.5000 EA MECH VENT INST/ DUCT ALT 4.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC DUCT.CHANGE-OUT. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid -------------------- Credited -------------------- Due ----------------- Permit Fee Total 19.50 .00 .00 19.50 Plan Check Total 4.88 .00 .00 4.88 Other Fee Total 1.00 .00 .00 1.00 Grand. Total 25.38 .00 .00 25.38 LQPERMIT Simplified Prescriptive Certificate of Compliance 2008 Residential HVACAIterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: nforcemet Agency: le: 1. Z Permit JI #: Conditioned Floor Equipment T14. e List Minimum Efficient z Duct insolation re uirement Area Thermostat ❑ Packaged Unit Over 40 ft of ducts added or ❑Furnace ❑ AFUE 80% ❑COP Setback ❑ Indoor Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (Ifnotalready ❑ Condensing Unit ❑ EER / / ❑ Resistance OR R 6 (CZ 10-13J sf present, nntst be I!rOtheC ❑ 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. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfortyyical 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 mast 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 Lsigned. Beginning October 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: --•- - • All HVAC Equipment replaced - CF-611forms: MECH-04, MECH-2I-HERS and (for split systems), MECH, 25: HERS CF -4R forms: MECH- 2l and (for split systems) MECH-25 • Condenser Coil and/or • Indoor Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA _> 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted frqM f.. duct leakage testing i N I. 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 ❑ 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 CF -4R 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, 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 -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF -4R 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-2I-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 ducts stems 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. • 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 1 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 a ncy for appro al with t epen-nit avolication. Name: 1(eeri u xts6il Si tures Company: y' Gen,erd_( 41'rDate:r Condi f,'o tt` 1 4 ( 12 - Address: Address: License• JII70 M-e-pserve- 68(3/v [—City—/State/Zip: —r Q L Pa,( -A-1 G 9 7 Phone: 7&0-3-',13-74ffP CaICERTS - CF -1R Registration https://www.calcert§.cori'1/public_Cfl R.cfm?project_id=159778 v `oe 4 rj r 4_1 _i e;n_zer ttr i:er y.tt tcirrgPsovsder Public Home Danielle Garcia logged in [Logout] [Home] Secure Home. CONGRATULATIONS About us Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Training - Site Address: 77561 los arboles Rater oirectory La Quinta, CA 92253 ..._..........._..._.__. _ -- - .... _---_.._........ .... ._....._........._........_......_......._......_.. .............._.._:... .._. ..._.._._..__._._.._._........ --- .... -............ CEC Registration-._._..: 212'-A0000508A-00000000-0000: _.._.............—__.-...._.._.............__......._....------...__......_._..__....-................................ --._..._.............................. -----._._................ __._._. :.......-........._... Forms . CF -IR -ALT -HVAC: CLICK HERETO DOWNLOAD ........................................................... ..._............................ :..... ........... ...... ..... .... ............................ ...................... _................. .......................................................................................... ....... ................................................... .-.......................................... Membership Benefits Assigned Company: HARRISON ENTERPRISES INC Do you know your HERS Rater? Events If you do, you may want to send this CF -1 R to them. Industry Partners CaICERTS Rater ID: OR News My Rater Quick Select: Energy Driven Solutions, Inc.. Every CaICERTS rater has a license number. To register for our If you need to find the rater by name [Click HERE] to'search our directory: monthly SEND CF -1 R TO HERS RATER; newsletter, please click here. [CLICK HERE] to do another Copyright(D 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2010 [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: 877-437-7787)Fax: 916-985-3402 Contact Us BBB j' find usyon FaCebook© J FINANCING THROUGH: REBATES E GENERAL. Air Conditioning. & Heating 31-170 Reserve Drive • Thousand Palms, CA 92276 (760) 343-7488 • Fax (760) 343-7494. www.callthegeneral.com Residential.Comfort'Survey INSTALL DATE l 1 ' JOB# ; ` CUSTOMER# NAME JOB Al CITY_ PHONE ( Pd +`C CELL FAX SEPARATE BILLING ADDRESS? ❑ YES ❑ NO NEW EQUIPMENT COND COND M FAU COIL TSTAT FILTRATION MISC PERMIT YES ❑ NO DUCTWORK EXISTING EQUIPMENT # S# FAU M #. COIL M# UNIT LOCATION: 9E MIA CRANE? Cl YES ❑ NO SIZE WARRANTY PLATFORM SIZE NOTES ❑ FINANCING DAYS ❑ CREDIT CARD ❑ C.O.D. 0 COSTCO Bin # City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico Quinta, CA 92253 - (760) 777-7012 . Building Permit Application and. Tracking Sheet Permit # 6--La Project Address: —1 —isbl l V S 1 e Owner's Name: kQrot IC V A. P. Number: p Address: 3 W Legal Description: City, ST, Zip: L CA s 3 Contractor:', Address: 3t CIDProject y City, ST, Zip: Telephone: b Cu a ;^f:z• • • • Description: NAC Telephone: 3 I q, State Lie. # : 3 City Lie. #; [off (o Arch., Engr., Designer: Address: -Clty,ST,Zip. _ Telephone, her ;ts:: fy s : ., ` Construction Type: Occupancy: ,' Project type (circle one): New Add'n Alter Repair Demo Sq. Ft: #•Stories: T# Units: State Lie. #: Name of Contact Person: Co G! e-✓t GtJ,Cts 07Yh Telephone # of Contact Person: O 3 L13 % 4 ?3' Estimated Value of Project: 2 OL) APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACIGNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan. Check Balance. Tithe 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for correctionsAssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review,.ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr. Date of permit issue School Fees Total Permit Fees