MECH (13-1093)51960 Avenida Madero
13-1093
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001093
Property Address: 51960 AVENIDA MADERO
APN: 773-154-010-15 -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 9800
Applicant:
Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION
4 VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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 :j C2//022 License No.: 6 10
Date: /" /J Contractor:
OWNER -BUILD ECLA ION
I hereby affirm under penalty of perjury that I am exempt f the C ractor's State License Law for the
following reason (Sec. 7031 .5, Business and Profession ny 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. 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: n
LQPERMIT
Date: 8/30/13
Owner:
JORGE JUAREZ
51960 AVENIDA MADERO
LA QUINTA, CA 92253
(760)702-5413
Contractor:
D
GENERAL AIR CONDITI I G AUG 3 A9qq
31170 RESERVE DRIVE 0 2013
THOUSAND PALMS, CA 22 6
(760) 343-7488 C17YOFLA0UINT
Lic. No.: 686310 FINANCE D12 -k.
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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
foybq"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 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 pr
Date: 3Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSA;COVERA NLAWFUl ANDSHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN CIPTO 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 county to enter upon the above-mentioned property f ' pe tion purposes.
Date: li Signature (Applicant or Agent):
Application Number . . . 13-00001093
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . .- 2/26/14 '
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
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Special Notes and Comments
HVAC CHANGE OUT - (1) 14.5SEER/80AFUE
SYSTEMS [2008 ENERGY) CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
August 30, 2013 10:02:05 AM skhatami.
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Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 71.5.0 .00 .00
71.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 139.23 .00 .00
139.23
Grand Total 210.73 .00 .00
210.73
0
LQPERMIT
City Of La Quinta
Saky Midon
P.O- Box 3504,-7649S Cie Tampko
4-q'614 CA 92253 -f740) 777.7012
l 8atlding Permit •Application' and Tracking Sheet
l'r )`"dares: 51960 AVENIDA MADERO
OwwlsName:. JORGE JUAREZ .
a P.•N'umbm •
ABd==- 5.1960 AVENIDA MADERO
rty,stzip: LA QUINTA, CA 92253
GENERAL A1C &HEATINGREM
Tet4how. 760-702-5413
.Addy=: 31170 RESERVE DRIVE
- Cdy. $T, I* THOUSAND PALMS, CA 92276 •
CHANGE OUT 5 A/C 3 TON 14.5 SEER,
Taiaphoat~ 760-343-7486 & FURNACE 110,000 BTU
State Ua N ;68.6310
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' Na 'orcoon+ tPaaon: PATRICK Rap4r Dcm•
rckEhOAG °f Cotdta Pa'9mn: 7.60-343-7488 '
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certificate of
to
51960 AVENIDA MADERO
Resident1g1HVACAlteTations CF -1R. -ALT -HVAC
A901cy. Date: Permit ]f:
Ln Ut i H is 08/3012013
Equi ment ea List A4inimunr E#lrcien Condition.cd Floor
O packaged Unit Duct insulation re uirement Area
® Furnace E AFUE 80% Cl COP Over 40 ft of ducts added or Thermostat
®Indoor Coil ®SEER 14'5 ❑ HSpF replaced in unconditioned space Served by system. ®anortreQ
® Condensing Unit 13 EER ❑ Resistance 17 R 6 (CZ 10-13) 1710 sf d'
11 Other DUCTS ❑ R 8 (CZ 14-15) present, roust be
installed)
1. Equipmext pe: Choose the equipment being Installed,• if more than one system, use another c r -1R AT HV.9C for each system,
2. Minlnuun Equlpraent,Cfciettcies: 13 SEER, 789Y,,.4FUE, 7.7hrSpFfor typical res/dential systems_
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picks Otte of the appropriate Options. Tach Option lists the I.F'RS measures that must be con.du.cterl 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 formwas in fact the work completed by the
installer. The inspector also vettifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF -4R8 allowed) are filled out and
si ed. Beffionjug October 1 2010 a registered COD xof the CF -IR and CF -6R shall also be on. site for .final ins ection.
IS I. IIVAC dangeout R
e utred Fornrs:
• All HVAC Equiptnont replaced CF -6R forms: Iv1ECli-04, MECH' .. .HERS and (for split systems) MECIl-25-HERS
CF 4R fotxns: MECH-21 and fors lit stems MECFI-25
• Condenser Coil and /or
. Indoor Coil and/or .... CF -6R forms: MECH-21-ITRS and (for split systems) MECH-25-111 R3
i lrhrf)8cC F=4R fotYrl MECFt-21 end7forsplifs Ssteuis). INCH -25
For Split Systeioas: Duct leakage < 1 S.percea.t; RC, CCA ? 300: CFM/tott(jvjinix)Uta Ail' plow Requirement), 1 MAFI .
For Packaged Units: Duct leakage < 15 percent
)Exempted from duct leakage testing if
❑ 1. Duct system was docuihdjAted to have been previously`seRled and confrrdied'throtigh HERS verification, or
❑ 2. Dudt systems with less than 40 linear feet in unconditioned space, or
13- 3Existin ducts sten,s•ore.constructed.:iasulated or sealed with asbestos
112. New HVAC System Required Forms:
• Cut in. or Changeout with new
ducts: (all new ducting od all. CF' -6R forms; • MECH-04, MECH-20-HERS,and (for split systems) NMCIJ-22-HERS, and .MECH 25 -HERS
new equipment)
CJ -4R for MECH-20, and.(for split systems) M) CH-22; and MECH-25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 3S0 CFM/ton FWD
)For Packaged Units: Duct leakage < 6 percent . 'TMS' STM,S, and either HSPP or PSPP;
E3.3. New Ducts with Replacement Required )aortas:
• Includes replacing or installing all new ducting CF 6R forms; N'IECH-04, MECH=20-HERS,and (for spli(systems) MECH-25 and/or outdoor condensing unit and/or indoor CF -4R forms: 1VSECli=20 and (for split Sy "
coil and/or furnace: Not all equipment changed, stems)1vlECH-25
For Split Systems: Duct leakage < 6 percen.t, RC, CCA > 300 CkM/ton, TMAH
For Packaged .U.nits: Duct leakage < 6 percept
-i A ''&r-
• Jncludes adding or replacing more than 40 - -
l.ini:ar fent of duct in unconditioned s ace. CF -6R fot7tts:. IvMCR-04, MECH-21-1V-RS, CF -4R forrrts: MECIi-21
For split system or packaged uollts:. Duct leak-agr < 15 percent .
0 - F-NCtPTION: Existing duet systems constructs insulated or sealed with asbestos.
Cout rector (Documentation Autb.or's /Respousible Designer's Declaration State)4eat)..
•
:I cc that thet'tliis .Certificate of Compliance documentation is accurate and co' mplete.
• ' I. am.`eljgiblc.u6.derDivjsion 3 ofttO California Business anal Professions Code to accept responsibility for the design identified o0 this Certificate of Compliance.
• I certify n that the enc Californiargyfeatures and performeoce specifications for the design identified oil this Ce.R.iftcate pf Comp]iaxlCc conform to the requirements Of C of Tithe 24,
Psrit I and 6 of the CalCode of Regulations
The design .features identified on chis Certificate of Coropljance aro consistent with the infonttation documented on other applicable compliance forms, wq sheeCS,
calculafxons lsxis ands eccations subt70.ittcd 20 the enforcement a enc
fi e' ALLEN JA for approval with the r .rt ii A,,.,v,.e.i—
COBY
Company:
GENERAL AIR CONDITIONING & HEATING
Address' 31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
2008 Residential Compliance .Forms
Date:
08/30/2013-
.686310
8/30/2013.686310
Phone: 760-343-7488
Judy 2010
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