MECH (11-0363)53615 Avenida Martinez
11-0363
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ht 4 4 Q"
Application Number:
11-00000363
Property Address:
'53615 AVENIDA MARTINEZ
APN:
774-131-018-6 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury at am licensed and ovisions of Chapter 9 (commencing with
Section.7000) of Division 3 of the Busi a and Professional Co e, and my License is in full force and effect.
License'' L: C20 ractoraI : can a No.: 874583
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 fora 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.).
(_ 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—) 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:. A'
Lender's Address: 7
LQPERMIT
Owner:
VANDECARR FRANCIS & KRISTEN
1770 GLEN OAKS DRIVE
SANTA BARBARA, CA 93108
Contractor: D
ALL ABOUT AIR
PO BOX 5936
LA QUINTA, CA 92248
(760)578-7913
Lic. No.: 874583
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 4/12/11
:PR 12 2011
'TY Of LA QUINTA
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 EXEMPT Policy Number EXEMPT
I certify that, in the performance of the work for which this permit is issued; I shall not employ any
person in any mann s as to become subject to the workers' compensation laws of California,
and agree that, if I h Id becomes t to the workers' compensation provisions of Section
3700 of the Labor C de,.l shall f wi comply with those provisions.
ate: I plicanY
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 a ova informati correct. I agree to comply with all
city and county'ordinances and state laws relating to it ng constructio , an hereby authonze representatives
of this c unt to enter upon the above-mentioned pro a for inspect n urp ses.
Date: \ ` ' Sig re (Applicant or Agentl:
Application Number 11-00000363
Permit . .
. MECHANICAL
Additional desc .
Permit. Fee ..
24.00
Plan Check Fee
6.00
Issue Date
Valuation
0
Expiration Date
10/09/11
Qty 'Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9.0000
EA MECH
FURNACE <=100K
9.00
--------------------------------------
Special Notes and
Comments
--------------------------------------
REPLACE INDOOR AIR
HANDLER. 2010
CODES.
-----------------_----------------------------------------------------------
Other Fees .
. . . . . . BLDG STDS ADMIN (SB1473).
1.00
Fee.summary
Charged
Paid Credited
Due
Permit Fee Total
24.00
.00 .00
24.00
Plan Check Total
6.00
.00 .00
6.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
31.00
.00 .00
31.00
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA CAlterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:,T13 ✓ f
JJ r]
Enforcement Agency:
Daly.
Permit #:
1z
Conditioned Floor
Equipment T e
List Minimum Efficienc 2
Duct insulation requirement
Area
ermostat
❑ Packaged Unit
'umace
❑AFUE
❑COP
Over 40 ft of ducts added or
Setback
O Indoor Coil
SEER $
❑ HSPldv
replaced in unconditioned space
Served by system
(Ynot already
❑Condensing Unit
❑EER
❑Resistance
❑ R 6 (CZ 10-13)
15-03 sf
present, must be
O Other
❑ R 8 (CZ 14-15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -I R -ALT -HVAC for each system.
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
-Siw. Beginning October 1, 2010, a registered copy of the CF -111 and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
• Indoor Coil and/or
CF -6R forms: MECH-2l-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Syste`ms: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMA14
For Packaged Units: Duct leakage < 15 percent
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 ducts stems 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 -6R 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
linear feet of duct in unconditioned
CF -6R forms: MECH-04, MECH-2l -HERS CF -4R forms: MECH-21
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.
formto the requirements ofTitle 24,
• I certify that the energy features and performance specifications for the design identified on this Ce2(cumentedo o
of Compl4rap
Parts l and 6 ofthe Califomia Code ofRegulations.The
design features identified on this Certificate of Compliance are consistent with the inform io icable compliance forms, worksheets,
calcula ' ns plans ands ifi tions submitted to the enforcement agency for approval with permit a licatio
Name: a yr1, G Gt2
Signature:
Company: P Y ,} t 6 uIr
1 D L t t L.
Date:
/
Address:
VDLicense:
City/State/Zip:
.L
Phone: a _ 9
2008 Residential Compliance Forms March 2010
Total Permit Fees
Bin #
City Of La Quinta ..
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
'
Permit # �y,��
\`, ✓
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
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Project Address: �7�� I ' Y/�✓
Owner's Name: S�. �r�
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
. Telephone:
Address:
3 t�� • T—i
Project Descr. iption:
City, ST, Zip:
do
7�1
Le
Telephone: —
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State Lic. # : ?"7 415-8- City Lic. #.:::.;>:
Arch., Engr., Designer:
Address:
City, ST, Zip:
'
Telephone:ti'".:.>.
'
Construction Type: i.•>,:;;.:.,>.�:�:.f:�:. ':f:. e: Occupancy:
State Lic. si:
..,.:r;, �:;s:; :.
" `''`'" ''' "'' ' ..X;; Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: 01''1C-\',.._ � Ci 2 Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: IOQ - �'� g — cl t Estimated Value of Project: t]
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
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 up
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 HOUSE:-
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