MECH (11-0336)Z,
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 y yV
CE (760) 777 7012
7
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number:
11-00000336
Property Address:
52681 AVENIDA MENDOZA
APN:
773-302-020-7 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
5000
Applicant: Architect or Engineer:
rJA
Owner:
CITY OF LA QUINTA RE
787495 CALLE TAMPICO
LA,QUINTA, CA 92253
Contractor:
BUDGET AIR
PO BOX 1066
LA QUINTA, CA 92247
WCC: EXEMPT
Lic. No.: C20
Date:
APS 05.2011
4/05/11
7 ---------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under 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 Professionals 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
License Class: - - - - - ----- License No.: C20
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/te: -I ontractor: At IL
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
OWNER-BUILDE 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 EX MPT O5 31 lBolicy Number 796186
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 for 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 subject 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 subject to 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 Code, I shall forthwith 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•:
ate:„[[_ plicant: (/
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
WARNING: FAILURE TO SECUR ORKERS' COMPENSATION OVERAGE 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 Applicationis 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: ,1
Lender's Address: N '
LQPERMIT
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.
1 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 thi ountyCcto enter upon th bove-mentioned property for inspection pur os
aU te: Si ture (Applicant or Agent(:
Application Number
11-000.00336.
Permit
MECHANICAL
Additional desc .
Permit Fee . . . ..
. 40.50 Plan Check Fee
10.13
Issue Date . . . .
Valuation . . . .
0
Expiration Date
10/02/11
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
a
16.50 ,
------------ -------------------------------------
Special Notes and Comments
INSTALL ONE 4 TON 14
SEER AC SPLIT
SYSTEM. 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
J
ATTENTION:KIRK
BUDGET AIR
HEATING AND AIR-CONDITIONING
(760)899-1606
Lic. #796186
Proposal
Bill To: City of La Qui
nta Date February 17, 2011
Address: P.O. Box 1504 / 78495 Calle Tampico , La Quinta, CA 92247-1504
Job name and address: 52681 Avenida Mendoza
La Ouinta. CA 92253
Budget Air offers to install:
1. One 4 ton 14 seer Maytag air-conditioning split system, gas/electric
Necessary copper line set, new digital thermostat, combustion air;
Removal of existing rooftop unit
Total:
Buyer
Date
L.d LLS L -LLL -09L
$ 5,000.--
�au�se `r/49- ! -a
Seller
2 / 17 l 2011
Date
zenbzen N v f— 8 L£:60 L L L L Gad
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-iR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
52681 Mendoza La Quinta, CA 92253
City of La Quinta
Apr 5, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
Furnace
2Indoor Coil
0 AFUE 78%
0 SEER 13.0
❑ COP
❑ HSPF
E]erve
R 6 (CZ 10-13)
y system
Served btem
0 Setback
If not already present,
0 Condensing Unit
❑ EER
❑ Resistance
[IR 8 (CZ 14-15)
sf
must be installed)
❑ 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 Effdendes: 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.
D 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
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-411 forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leagage testing if:
❑ 1. Dud system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Dud systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing dud systems are constructed; insulated or, sealed with asbestos /. r
❑ 2. New HVAC '
Required.forms: r
System
1 1l1 L
. Cut in or Changeout
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
with new ducts: (all .
new ducting and all ,;
MECH=25-HERS /,. ff y r
CF-411forms:KMECH 20, MECH-22, MECH
new equipment)
and (forsplit systems) and; •25
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Dud leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all
new ducting and/or outdoor
condensing unit and/or indoor coil
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or furnace. No or some
CF-411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Dud 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
CF-611 forms: MECH-04, MECH-2I-HERS
unconditioned space.
CF-411 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: ]AIME VASQUEZ Signature: JAIME VASQUEZ
Company: BUDGET - AIR Date: Apr 5, 2011
Address: P O BOX 1066 License: 796186
City/State/Zip: LA QUINTA / CA / 92253 Phone: (760) 784-5333
Reg: 211-A0016983A-00000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2011/04/05 13:19:08 HERS Provider- .CalCERTS, Inc.
July 2010
uu�»
City of La Quin to
Building 8L Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
i , 3
La Quinta, CA 92253 (760) 777-7012
1
Building Permit Application and Tracking Sheet
-
Project Address: a _
e3l
Ale 'zod o Owner's Name:
A. P. Number:
t L
Address:
Legal Description:
City, ST, Zip:
Contractor:
LLAI
Telephone:
Address:
...................:::::::.
Project Description:
C.
City, ST, Zip:
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
C 0 ns ttvc •
h on Type:
Y P: Occupancy:
P anc Y:
State
t Lic. #•
•
Project type �a' r cl
eone): ) New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units:
Telephone #'of Contact Person:
- Q Estimated Value of Project: S
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Recd TRACKING
Plan Sets
PERMIT FEES
Plan Check submitted Item
Structural Cafes.
Amount
Reviewed, ready for corrections
Plan Check Deposit
Trgss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cafes.
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:-
3W Review, ready for corrections/issue Impact Fee
Planning Approval
Contact Person
Jeloper
P.P.
EDatte
Pub. Wks. Appr
permit issue
School Fees
Total Permit Fees
I