12-0897 (MECH)55575 Medallist Dr
12-0897
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)'77777153
Date:. 8/09/12
Application Number:12`.-0'0— 000`89T Owner:
Property Address: 55575 MEDALLIST DR ROBERT CASTELLS
APN: 767-510-010-'' - 55575 MEDALLIST DRIVE
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL ;
Application valuation: 1800
Contractor: D
Applicant: Architect or Engineer:' BEST IN THE WEST
255 N. EL CIELO, 140-125 0
qq
PALM SPRINGS, CA 92262U 1 2QlL
/ (760)343-1002 t+
Lic. No.:. 826714 CITY OF LA QUINTA
111 FIN. - CE DyPT.
LICENSED• ACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I a ens underprovisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busines 'onals C e, 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
C20 -C38 cen a No.: 826714 for by Section 3700 of the Labor Code, for the performance of the'work for which this permit is
1 issued.
/,icensLClass:
ate:Z/C tractor: 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
WNEWBUILDER 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 GUARD INS GRP Polic&Cosubject
Number BEWC337354
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the perfor which this permit is issued, I shallnotemploy any
construct, alter, improve, demolish,'or repair any structure, prior to its issuance, also requires the applicant for the person in any manneract 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 sho 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 L bor Comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by /vim
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: .Date: \ ' pplicam: '
(_) 1, 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: FAILURE TO SECURE WORKERS' COMPENSATION 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 withinSECTION 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
(_) 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
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
of La Qwnta, 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 pg4lTiT71INcessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state th&vn is correct. I agree to comply with all
city and county ordinances and state laws relating tond hereby authorize representatives
of this unt to enter upo the above-mentioned prposes.
ignature (Applicant or Agent):
Application Number . . 12-00000897
PermitMECHANICAL
Additional desc
Permit Fee 31.50 Plan Check Fee
7.88
Issue Date Valuation
0
Expiration Date 2/05/13 .
Qty .. Unit Charge Per
Extension
BASE FEE
15.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K=500KBTU
16.50
------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT: INSTALL NEW 5 TON
CONDENSER. 2010 CODES.
---------------------- ------------------------ .----------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
-- - ----------------------------------------------
, Permit Fee Total. 31.50 .00 .00
31.50
Plan Check Total 7.88 .00 - .00
7.88
Other Fee Total 1.00 .00 - .00
1.00
Grand Total 40.3.8 00 .00.
40.38
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alteration
Alterations-
Reg: 212-A0042396A-00000000-0000 Registration Date/Time: 2012/08/06 16:06:46 ,HERS Provider: Ca10ERTS, Inc-
nc_u2008
u2008Residential Compliance Forms + 'R + ..'July 2010
A
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
55575.2 Medallist Dr La Quinta, CA 92253
City of. La Quinta
Aug 6, 2012
Equipment Type1 •
List Minimum Efficiency2
Duct insulation •
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
p SEER 13.0
0 COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
El Condensing Unit
9
❑ EER
❑ Resistance
❑ R 8 (CZ 14-Z5)
2000 sf
installed)
❑ Other .
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 -IR
and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
or oil and /or
CIF 611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split System :,Duct leakage;<'15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH -
19 peFeept
Exempted from duct leakage testing if: +
❑ 1. Duct system wis documented to have been previously sealed and confirmed through HERS verification, or
'systems
;'❑ 2. Duct with
with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct are constructed, insulated or sealed with asbestos ,
❑ 4. The,system;will not be Ducted (ie ;Duct9ess Mini-Split,5ystem):(Also Exempt fram,Refrigerant Charge) ,
,112. Neuv HVAC'system
Required Forms:.>
. Cut in.lor'Changeout witi .
new ducts: (all new
:. F . .. t h - ,
CF -6R forms: MECH-04, MECH-20-HERS, and -(for split systems) MECH 22 -HERS, and -
ducting and all new
MECH-25=HERS '.;' p
a _ Y • .+' '- +
CF -411 forms: MECH-20, and (for split systems) MECH-22, and MECHrZS k '
equipment)
F/ '_ 7 " dr/;=y} "•• s.
For Split Syste_ nis: Duct -leakage <.6'percent;•'RC,'CCA•>-35D CFM /ton, •FWD,.:TMAH,•STMS, and ,either HSPP or'PSPP. .
For Packaged Units:. Duct leakage < 6, percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement :
. Includes replacing or installing all' -new
ducting and/or outdoor condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH-20 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
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
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. ,
• 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.
• 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: Richard C Weaver Sr Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: Aug 6, 2012
Address: 255 N ELCIELO ROAD #140-125 License: 967982
City/State/Zip: PALM SPRINGS / CA / 92262 _ Phone: (760) 343-1002
CF-iR-ALT-HVAC
Bin #
City- of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico ,
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# .
Project Address: -S'SS 4
Owner's Name:
A. P. Number:
Address:' ' V
Legal Description: Description:
City, ST, Zip:L
Contractor.
Telephone:'? ,ME
. _
_.r_ .
Project Description:
Address:;ZS'SN, 96 ''
City, ST, Zip: , /Z/
s
e4f-, Z 2•
D' '
Telephone:;W33 /O,dZState
Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
LE K
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#
Stories:
# Units:
Telephone # of contact Person: ' t b 3
4 3 f -o Z-
Estimated Value of Project: vo
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIMG .
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
2°' Review, ready for correctionsrinue
Electrical .
Sabcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Pians resubmitted
Grading
IN HOUSE:-
M Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees