MECH (12-0178)77463 Calle Mazatlan
12-0178
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
- Date: 2/29/12
Application Number. 12-000;001781 Owner:
Property Address: 77463 —CALLEi MAZATLAN SHARON WYPICH .
APN: 658-250-013- - - 77463 CALLE MAZATLAN
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 14000'. ` ,.,
Architect or Engineer.
Contractor: i
Applicant: GENERAL AIR CONDITIO N q I
31170 RESERVE DRIVE J FEB 2 2012
THOUSAND PALMS, CA 9227
760)343-74 88 CITY OF LA QLih!'T
Lic. No.: 686310 (Zn pdt;i- a pT
LICENSED CONTRACTOR'S DECLARATION .- - WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that I am licensed hder provisions of Chapter 9 (commencing with .. I hereby affirm under penalty of perjury one of the following declarations: - -
Section 7000) of Division 3 of the Business and Professi als Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided'
Licens lass: C20 - License No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
issued.
ate:/Z-°i Zontractor. 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
-BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier ZENITH INS CO . Policy Number Z071741501 -
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work f which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become sub t to the workers' compensation laws of California,
permit to file a signed *statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,. if I should become subje t the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Cade, I shall forthwit mply with those provisions.
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).: ate: _Z. icant: - -
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 WARNING: FAIL RE TO SEC URE.WORKERS' MP SATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO, ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of.the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 Each person upon whose behalf this application is made, each person at whose request and for ,
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or -pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason 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.
Date: Owner: - ' 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
herebyaffirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above infor ti n is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construc 'on and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspect n urposes.
Lender's Name:
ate: e(Applicant or Agent): -
Lender's Address: r '
LQPERMIT
Application Number 12-00000178
Permit MECHANICAL
Additional desc'.
Permit Fee . . 40.50
Plan Check Fee
10.13
Issue Date
Valuation . . .
0
Expiration Date . _8/27/12
Qty Unit Charge Per.
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K -
9.00
1.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU,
16.50
Special Notes and Comments
-- ------
-------------
HVAC CHANGE -OUT: INSTALL 4 TON SYSTEM,
FURNACE, INDOOR COIL, CONDENSER.
2010
CODES.
----:------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
-------
1.00
Fee summary Charged
Paid Credited
Due
--.--.----- ----------
Permit Fee Total 40.50
---------- ----------
00 .00
40.50
Plan Check Total 10.13
.00 .00
10.•13
Other Fee Total 1.00
.00 .00
'1.00
Grand Total. 51.63
.00 .00
51.63
LQPERMIT
-
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
77463 CALLE MAZ_ATLAN La Quinta, CA 92253
City of La Quinta
Feb 28, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
R AFUE 789(o
® 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) •
1922 sf
installed)
❑Other
r
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -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 signed.Beginning October 1; 2010, a registered copy of the CF -1R
and CF -6111 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms: -
• All HVAC Equipment
CF -6R forms: MECH-04, M=Gm 2+ HER& EXEMPTED and (for split systems) MECH-25-HERS '
replaced
CF -4R forms: P49GGH 21 EXEMPTED 111 NOand (for split systems) MECH-25
. Condenser Coil and /or.
. Indoor Coil and /or
CF -6R forms: MECH-04, ^ _ - + _ = EXEMPTED and (for split systems) MECH-25-HERS
`
• Furnace
CF forms: ^^_GW2+ EXEMPTED and (for split systems) MECH-25
f
For Split Systems: Duct leakageL<;15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
FGF Paeliaged URI r, P wit 1pawi4'
Exempted from duct leakage testing.if: `r
` ❑ 1: Duct'system'was documented to have been previously sealed and confirmed through HERS verification, or
m 2. Duct systems with less than 40 linear feet in unconditioned space, or
[13. Existing duct systems are constructed, insulated or sealed with asbestos
4 Thes (
❑ f y"stem will not be Ducted ie:DuctlessxMmf=Sp .lit System)r(`Also Exernp -LfromRefrigerant Gha,rge)
❑ 2. Neve HVAC System
Required Forms.- '404 ,,ue ),
. Cut inor Changeout witFia
new ducts, "(all new
+ rr.; , ¢ • r - -.
CF 6Rrfo Ams MECH 04, ^ _ = =iEXEMP;TED and (for split systems) MECH 22:HERS, and --3_ <<<
MECH 25 HERS,
ductin6, all new
)r ,
equip ment ,
CFS"4R forms •MECH. 20;'and,(for splitsystems) MECH!i2, and MECH-25': + ' .
{
• >.
For Split Systems: Duct, leakage :<,16 percent,.RC, CCA > 350_CFM/ton, FWD, TM_AH, STMS, and;either,HSPP or PSPP. y
For Packaged Units: Duct leakage¢.<6'percent -'w` " y, ,"`""f t.• ° ' `
❑ 3..New'Ducts with/or without
Required Forms: -
Replacement r ,,:•, y
«k
. Includes replacing or installing all'::
- . ,
new ducting and/or outdoor,
condensing unit and/or indoocoil-
M
CF -6R forms: MECH-04, =G14 a@ 14_R= EXEMPTED, and (for split systems) MECH-25-HERS
CF forms: ""tee
and/or furnace. No or some
-4R EXEMPTED 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 linear. feet duct in
CF -6R forms: MECH-04, mr!GH 2+ m=oma EXEMPTED °' •' '
unconditioned space. e.
CF -4R h+
forms: rxw ;ij EXEMPTED •-- '
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. n
• 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 on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • • i s
I
• 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: banielle Garcia
Company: HARRISON ENTERPRISES INC Date: Feb 28, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA /,92276 Phone: (760) 343-7488
Reg: 212-A0010531A-00000000-0000 Registration Date/Time:'2012/02/28:20:30:50-+. HERS'Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms A, i ' ;; I+••, F, f July '2010
; i.
05
Bin#'
City of La Quin to
Building &r Safety h4slon
Permit /` P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760): 777-7012
Building Permit•Application and Tracking Sheet
Project Address: C an Owner's Name: c
A. P. Number:
Address"lloi
I ,
Legal Description:
City, ST, Zip:%Ai NO- 2_19_
Contractor:
f c-
Address: 3
City, ST, Zip:
Tb I:M
Project Description:
tl Vv ` vi)
Telephone:A L,
LA '3 '' "•'•' Y ,
V r1
Oft
State Lic. # :
3 City Lic. #; Coo o
Arch., Engr., Designer:
Address:
(`i}., STI Zip.
Telephoner .
State Lic. #:
: ? J ' .
• : ''
:•, ' 'ms`s
Construction Type: Occupancy:
Project type. (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Name of Contact Person:
p (,(; eel 60C4_ (s Oyu
Telephone # of Contact Person: -7& D 3 v-6 " % 4 ?80
Estimated Value of Project: O
# Submittal
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
Req Id' Recd TRAMING 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
Plumbtng
Grant Deed
Plans picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review,.ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr.
Date of permit issue
School. Fees
Total Permit Fees