MECH (12-1203)78830 Lowe Dr
12-1203
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00001203'
Property Address:
78830 LOWE DR
APN:
604-232-032-161 -23268 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4187
Tu p
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
Lice n 1,Class: C20 License No.: 878533
Date: tl7'tu—t 'Co ractor:
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).:
(_ 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.).
(_ 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.).
(_ 1 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:
CHERYL ROBINSON
78830 LOWE DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/10/12
Contractor: "FIN(AME
DIAL ONE'S ONE HOUR A/C2712 E. LA CADENA DRIVERIVERSIDE, CA 92507
(951)276-9744 Lic. No.: 878533
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.
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 EVEREST NATL Policy Number CA -10001300121
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.
scant:
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 countyt'o`e1nter upo the above-mentioned property for inspection purposes.
ate:nature (Applicant or Agent):
Application Number . . . . . 12-00001203
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 37.50
Plan Check Fee
9.38
Issue Date . . . .
Valuation . . . .
0
Expiration Date . . 4/08/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 22.5000 EA MC B/C >15
<=30HP/500K-1M BTU
22.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT: REPLACE 3.5 TON A/C
UNIT LOCATED AT SIDE YARD. 2010 CODES.
--------------7-------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
----------
Credited
--------------------
Due
---------------------------
Permit Fee Total 37.50
.00 .00
37.50
Plan Check Total 9.38
.00 .00
9.38
Other Fee Total 1.00
.00 .00
1.00
Grand Total 47.88
.00 .00
47.88
JLQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - iS
Site Address: Enforcement Agency: Date: Permit #:
78830 LOWE DR La Quinta, CA 92253 City of La Quinta Oct 9, 2012
Equipment 1 ypel List Minimum Efficient 2 Duct insulation Conditioned Floor
Y requirement Area Thermostat
O Package Unit
O Furnace ❑ AFUE O COP
p Indoor Coil ® SEER 13.0 ❑ HSPF [3 R 6 (CZ 10-13) Served by system ® Setback
® Condensing Unit (] EER ❑ Resistance O R 8 (CZ 14-15) 1400 sf lfnot already present, must be
p Other installed)
1. r_Vugnnenr r ype: (_noose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Mlnlmum Equipment Efficiencies: 13 SEER, 78110 AFUF_, 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 -611 and registered CF -4R
forms (rio hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1111
rCF-6Rshall also be on site for final Inspection.
Changeout Required Forms:
quipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
CF -4R forms: MECH-21 and (for split systems) MECH-25
Coll and /orCF-6R forms: MECH-04 MECH-2I-HERS and fors litll and /or ( p systems) MECH-25-HERS
.
Furnace CF -411 forms: MECH-21 and (for split systems) MECH-25
For s, lit Systems: Dud leakage < 15 percent; RC, CCAS 300 CFM/ton (Minimum Air Flow Requirement), TMAH
PeFGBRk
Fca i r;
Exempted from dud leakage testing If:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
(12. Duct systems with less than 40 linear feet In unconditioned space, or
. Existing duct systems are constructed, Insulated or sealed with asbestos
^:. The system will not be Ducted (le. Ductless Min[ -Spilt System) (Also Exempt from Refrigerant Charge)
O ',, w HVAC System Required Forms:
• ,i or Changeout with
- ''ucts: (all new CF -6R forms: MECH-04, MECH-20-HERS, and (for spilt systems) MECH-22-HERS, and
cu .r,i jnA all new MECH-25-HERS
e ,pr gent) CF -411 forms: MECH-20, and (for split systems) MECH-22, and MECH-25
For : ollt Systems: Duct leakage < 6 percent; RC, CCA 2 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For -lckaged Units: Duct leakage < 6 percent
❑ 3. v+ Ducts with/or without Required Forms:
Rn -hent
• s replacing or installing all new
C : and/or outdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
a indoor toll and/or furnace. No or some CF -411 forms: MECH-20 and (for split systems) MECH-25
e unt changed.
For di ;yetems: Duct leakage < 6 percent; RC, CCA 2 300 CFM/ton, TMAH
For rk;iged Units: Duct leakage < 6 percent
O v Ducting over 40 feet Required Forms-
• :, adding or replacing more than 40 CF -611 forms: MECH-04, MECH-2I-HERS
et of duct in unconditioned space. CF -4R forms: MECH-21
For system or packaged units: Duct leakage < 15 percent
1 t PTION: Existing dud systems constructed, insulated or sealed with asbestos.
Cor•. T (Documentation Author's /Responsible Designer's Declaration Statement)
• I • ' 'It tills Certificate of Compliance documentation :s accurate and complete.
• i i
:'Ie Wider Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
• :
;',,it the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
is of Tale 24, Parts 1 and 6 of the California Code of Regulations.
• ' Ieatures identified on this Certificate of Compliance are consistent with the Information documented on other applicable compliance
ru,`-IcLligot meets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
r1__ Signature: Tipn McEligot
Cor t NVL51 RAI LARD INr'
Ads _. i2 EAST LA CADENA
Cit . p: RIVLRSIDE / CA /
Phone:
t
Re. .27 :-000000000-0000 Reg-strat^on Date/Time: 2012/10/09 11:54.57 HERS Provider: Ca10ERTS, Inc.
20 ? _ompliance Forms
July 2010
i
Bin.#
;.
City of La Qui , to ,
Building 8t Safety Division
Permit # h Q
P.O. Box 1504,78-495 Calle Tampico
4'
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:is—San I
ow
Owner's Name: .
Y0
A P. Number.too
Address: •
i
Legal Description:
City, ST, Zip: 6 n+a 3
Contractor.DI cd.lie
Telephone: —1 —
G
'
Address:1 c
Project Description: 9,0—p
City, $T, Zip: X
^_
C A ;j0-7
i
Telephone:
p 5 a. cro Li'l'
r
MEN 11 ; . - .- ;
State Lic.
City Lic. #;
'
Arch , Engr., Designer Iv
Address:
City., ST, Zip:
Telephone:
Construction Type . Occupancy:
State Lic. #:;w;y
al" rte:
project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
-4
Sq. FL: #Stories:
#Units:
i
Telephone # of Contact Person:
Estimated Value of Project:
= oQ
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES'
Plan Sets
Plan Check submitted
Item Amount
Structural Cates
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calci.
Called Contact Person
Pian Check Balance-
Tide 24 Calci.
Pians picked up
Construction
.-Plans-rtsubmitted _' . —
-Mechanical
— — -
Grading plan
2'! Review, ready for correctionsfime
Electrical
"
Subcoautctor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IiUI]SE:
'"° 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