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MECH (13-0830)57121 Medinah 13-0830 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000830 Property Address: 57121 MEDINAH APN: 762-110-033- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL. Application valuation: 18350 Applicant: Architect or Engineer: 1v BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ROOT HAROLD L *NOT ON FILE UNKNOWN, CA 99999 r 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. License Class: C20 — License No.: 686310 Date:7 3 I 13 Contractor: — - (/ OWNER -BUILDER DECLARATION " 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 (5500).: (_ 1,1, 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 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.). ( 1 I am exempt under Sec. , BAP.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 I Contractor: GENERAL AIR CONDITIONI 31170 RESERVE DRIVE THOUSAND PALMS, CA 9226 (760)343-7488 Lid. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760)777-7153 Dater 7/03/13 w u JUL 03 2013 CITY OF LA QUINTA . FINANCE DEPT. WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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. cr haveand 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 P61icy 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 provisions. - j1 _ Date: /-L311 Applicant:. `-- 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 15100,000)• 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 for inspection purposes. j ate:- 3 j3 Signa (Applicant or Agent): C LQPERMIT Application Number 13-00000830 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee 143.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 " Expiration Date 12/30/13 Qty Unit Charge Per Extension ' 2.00 35.7500 EA MECH FURNACE 71.50 2.00 35.7500 EA MECH CONDENSER/COMP 71.50 ' Permit. . PLUMBING 2013 Additional desc Permit Fee 11.92 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 12/30/13 Qty .Unit Charge Per Extension '1.00 11.9200 EA PLBG WATER HEATER/VENT 11.92 ------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT AND WATER HEATER CHANGE -OUT - 16 SEER/78 AFUE, REPLACE TWO (2) 3 TON HVAC SPLIT SYSTEMS AND REPLACE 50 GALLON GAS WATER HEATER [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. -------------------------------------------------------.--------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 95.32 PLAN CHECK, PLUMBING 7..15 Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 154.92 .00 .00 154.92 Plan Check Total .00 .00 .00 .00 Other Fee Total 194.04 .00 .00 194.04 Grand Total 348.96 :00 .00 348.96 C LQPERMIT Bin # City of La Quinta . Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Burldrng Permit Application and Tracking Sheet Permit # Project Address: _5 7 -4 e - Owner's Name: Q t o A. P. Number: Address: Legal Description: City, ST, Zip: LG. Qv; rk, CA Q Z253 Contractor: CjPYltxiG., { pY. Telephone: —760-7-7 -7 - g0(o3 Address: N V-7 O `<C.SeN c_ Project Description: City, ST, Zip: I h _ a 70. c( Z Z -7b Ze 1ace 3 o L 701 TU Tele P hone: 3 7 v •r Z c ria c S eJM 1Z 1 a e. 5 State Lic. # : 0, $(0310 City Lic. #: S-0 .Go A k . W o, e_cJe Arch., Engr., Designer- esignerAddress: Address: City., ST, Zip: Telephone: ;::::<: <:::»::;::>::>:;..;; ; >::::;:;<::?::>::: nType: Occupancy:u ancY Constructio • State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: "' # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: ( $ 3 So - Ori APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21' 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 Simplified Prescriptive Certificate of Compliance: 2005 Residential HVACAlterations CF -IR -ALT -HVAC Climate Zones 10 - 15 ' Site Address: Enforcement Agency: , Date: Permit #: 57121 MEDINAH La Quinta, CA 92253 City of La Quinta Ju1,2, 2013 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area .Thermostat ❑ Package Unit - ® Furnace % ® Indoor Coil ® AFUE 78% ® SEER 160 ❑ COP E3 HSPF [3 R 6 (CZ 10-13) Served system 10 Setback - If not already present, must be ®Condensing Unit L3 EER_ E3 Resistance L3 R 8 (CZ 14=15) 205 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 -6111 and registered CF -411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginnitig 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 CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced J CF -4R forms: MECH-21 and (for split systems) MECH-25 - Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Indoor Coil and /or . _ CF -4R forms: MECH-21 and (for split systems) MECH-25 Furnace ., FFor Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH . ..s Exempted from duct leakage testing if:: - ❑3: Duct-system:i ias docunienied to have been previously sealed and confirmed through HERS verification, or' • _ 0'2*. Duct systems with less thAn40linear feet in unconditioned space, or ,,'• ❑ 3. Existing duct systems are'c66structed, insulated or sealed with asbestos ❑:4 The systemvill not be Duc_ tietnt Spilt System)A1so ExemEffn Re,gegttGharge) e '=.ate :9 : y, y s`;s; :: fir:. y; :<ure w _ :as-., ..4.:, s'7•a;ls ::`.; i: ed ❑ 2 QAC: e Re utr o - Newr> m - SYS... -C, - ... - . Cut inChangeout witted rx pz a '::.. ... new fir cts 'all new u . tC bRfortrts h1ECH-04, M.. ,QH 4 HERS,andI split sys t ::( fi7ECFi 25 H1 RS:. .:::_ ducting at d all new CF -4i2 farms FIECtit3;.ani1?fior ft:systemECH .2,2'"anl NtEG}+ equipment). .., ..N a. .:r., fix. r., : z - a. 117-8 -01 -ate 3F.: 4 For Split 5ys'tems Duct lea ge<tb percank, Jt£ tCA z 350 CFM#tnh; FWDMAH, TMS, and either tiSPP`oi PSPP For Packaged`UriitS= Duct leaks-.:... ..... 4 P , ❑ 3:.a+ievu D.ucis!—Witls/or witbouts ;;:;: Required Forms: Z.J , Rep . Indudes replacing or ifiAal1ing:6ll. neva ducting and/or outdoor coridensingAinit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or 'fum:ace No .or some CF -4R forms: MEC_ H-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 ti ❑ 4. New Ducting over 40 feet " Required Forms: . Includes adding or replacing more than 40 ' CF -.611 forms: MECH-04, MECH71-HERS ` linear feet of dud in unconditioned space. CF -4111 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent _ - ❑ EXCEPTION: Existing dud 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 Complianoe 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: Danielle Garcia ` Company: HARRISON ENTERPRISES INC - Date: Jul 2, 2013 Address: 31-170 RESERVE DRIVE°STE A J, License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760)343-7488 Reg: 213-AO04906SA-000000000-0000 Registration Date/Time': 2013/07/02 23:43:20 'PIERS Provider: Ca10ERTS, Inc.V• 2008 Residential Compliance Forms' + + v` F July 2010 u • .. "'i � � •. r - , n + •1 . .. �, r•f �� MC - V x �. � TTi�'-"1. �` T � - .. • Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACA/teirations-CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 57121 MEDINAH La Quinta, CA 92253 City of.La Quinta ]u1.2, 2013 , '' : Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 y requirement Area -Thermostat 13 Package Unit ® Furnace ®AFUE 78% ? ' E3COP ' '.., p R 6 (CZ 10 13) Served by system ®Setback ® Indoor Coil ®Condensing Unit ® SEER x,6.0 L3 EER E3HSPF .. L3 Resistance O R 8 (CZ 14-15) 05, sf• If not already present, must be installed); y ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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. each appropriate CF -6R and registered CF -4 form was in fact the work completed by the installer. The inspector.also verifies thatR _ 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-611'shall also be on site for final inspection. _ ® 1. HVAC Changeout Required Forms:. • All HVAC Equipment CF -611 forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERSy , 4. replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 " • Condenser Coil and /or • Indoor Coil and /or CF -6R 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 -.rs For Split Systems: Duct leakage'< -15 percent; -RC, CCA:5 300 CFM/ton (Minimum Air Flow Requirement)„TMAH Exempted from duct leakage testing if.:: '- `. ❑ 1: Ductsystem:was docume teir to have been previously sealed and confirmed .throudh HERS verification, or ❑ 2:'Duct systems with less thW40linear feet in unconditioned space, or - : '+ •` , - �` ❑ 3. Existing duct systems are`cortstructed, insulated or sealed with asbestos ❑:4..'T stemt _will not be Ducted:(ie Ductless,Mttri- tfi� a Exetnp from: tltCharge) Re arr o . New H� C` ed q - . y .Cut im arChangeout with *F-6R�firmsME.CH-04, MECH 2eHERS 'orsfit-setrsMECH= d(alt new new ct (� ad a F: --: C-OftforriisMECH-2 0 Nt£Ct-25::.; ardor s st syslemwECt1-22a . equi For Split SysFemis pact leakage W&5 R, CCAAz 350 CFM/tnn, FNilDTMAH, s7{NS anti eftCier HSPP or PSPP. ”' ..:. :. For Packaged`Units: Duct tea gel<5`perteW`w ❑ 3: New:D.ucWuv"WOr withotitt`= `: Required forms: r � `-, . Replacement ,:r iX . Includes *replacing or installing.all;.new ducting and/or outdoor condeds"ki!`:unit. CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-257HERS: and/or indoor coil and/or:f ihiace :No .or some CF -411 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 134. 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 r ❑ EXCEPTION: Existing duct systems constructed, insulated or seated with asbestos. '` " Contractor (Documentation Author's /Responsible Designer's Declaration Statement) c • 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 Califomia 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: Danielle Garcia _ - Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC > . Dater Sul 2, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 y_ City/State/Zip: THOUSAND PALMS / CA / 92276 , , ' , - Phone: (760) 343-7488 Reg: 213-A0049065A-00000000070000 Registration Date/Time: 2013/07/02 23:43:20 -HERS Provider: Ca10ERTS,,Inc.•, 2008 Residential Compliance Forms F 4 IJul2010" , � � } •�� ''� � - 2 �, �; `�,�. 4th ' - Prest riptive CertI&'ate of Cattjjj 1iVan EX02n;6 5-7 1Z1. (l e. 8)arrafs psed r abaavefoa er aa4 tree m der h4* Contractor (Dotomentatioit Atethot'slRrsponstbl .btsEgDer's rledaration $tatetnent) • 1 certifp that this Cvrificate of Calm hamr docum—lazion is accurate and compete • l am eligibk tsrkr Division 3 of the Cdiforiuia Business and .professions Code to -this: Certificate of Compliance. aroept responsibi)iry fa ttie building design identified on • .l certify tTiat the rnergy feetttres and prriorncmce specifications for thebuilding* dcs*a idmtifwd.on this CcrSTicate of Conupliaatce condortn . to the *bquirem . of Tide 2A, Parts 1 and 6 of the Ca)ifoinia Code of Rcgn)ations, • lbrbu ldeig design fewwcs identified on this Certificate of CotrTTanc, are eunsistcnt:widt die i4mmfion provided to docwnt* this ' building desipi on the Ow applicable ¢ornplimce for this fomes, vVOW, hcets„ealenlmions, plansaETn-and. speciTications submitted to the enfor n ova) with boildin i Ntune' Signoprrr COY pale radar 3 u License: . 5 rv fir• -. . ei►yeSlaie/Zipc .. , s, CA a ?2 >on :. 0 3 -. 488 • W&Rerid mia..I Complies re a Forms March 2010