MECH (13-1675)P.O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001675
Property Address: 80090 MERION
APN: 762-140-003- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 16000
Applicant:
T-i&f
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
-----------------
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.: 967263
11 // �/
Date: `� ' � •Contractor:
OWNER. UILDER 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
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.).
(_) 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 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:
Lender's Address:
LQPER,M1T '
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/02/14 -
Owner:
THOMAS PROKOP
80090 MERION
LA QUINTA, CA 92253
(631)235-9828 n
D
RIGHTtAWAY AIR CONDIT G rON 42 2014
P.O. BOX 752
PALM DESERT, CA 92261 CITY OF�`�UINTA
(760)408-0280 FINANCE DEPT
Lic. No.: 967263
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
have and will maintain acertificate 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
r Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NORGUARD INS CO Policy Number RIWC484330
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 Labo e, I shal forthw th comply with those. provisions.
Date, Z -� i Applicani
WARNING: FAILURE TO SECURE WORKERS' COMP NSATION 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 the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, ani hereby authorize representatives
of this county to enter upon the above-mentioned pro y r i c n urpi ses.
Datia► Signature (Applicant or Agent
LQPERA11T " - --
Application Number . . . . 13-00001675
Permit . . . •.. MECHANICAL 2013
Additional desc .
Permit Fee . . . . 143.00 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 6/28/14
Qty Unit Charge Per
Extension
2.00 35.7500 EA MECH FURNACE
71.50
2.00 35.7500 EA MECH CONDENSER/COMP
..71.50
----------------
Special Notes and Comments
HVAC CHANGE OUT - (2)16SEER/80AFUE SPLIT
SYSTEM [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
Fee summary Charged Paid Credited
Due
Permit Fee Total 143.00 .00. .00
143.00
Plan Check Total .00' .00 .00
.00
Other Fee Total 186.89 .00 .'00
186.89
Grand Total 329.89 00 .00
329.89
LQPERA11T " - --
Din #
City Of L" Quinta
Building 8i' SafetyDivision
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760).777-7012
Building Permit Applicat10n "and Tracking Sheet
Permit #
Project Address: C JIJ� 9 Q
Owner's Name: I 0 WARS . Rrs> ,/—D
A. P. Number: LA Qu j f\'tA (�A q22 %-
Address: ';0o0(0 v
Legal Description:
City, ST, Zip: (,A 40 ► V\ T A, CA. , '2 2 S 3' '
Contractor: "Ai �
p1 i C �4c`\ �,Trll
_
Telephon �D�JI 235 9 S 2-5
%«a r>, ::F%. .S+•A:S?
Address:
[
Project Descrption:X
\JAC Cl n e_ QV T
1
City, ST, Zip: PAl P.'ir efa 91a-(D C-)
2 S s—neMS . FQ MAC-6,t^ o \ k5 '4.
hone: 1(0O�oQ-02$0
i� •: v4:5::ii$
<<> ...:.:.>Tele .v:
State Lic. # : glp'1,'Z `1j
City Lie. #.-
-Arch.,
Arch.,Engr., Designer.
Address:
City., ST, Zip:
Telephone:
•;<<% % .' :}.>:'.' > » =`' :` <>«
::<.;:.:<:«.•;;:;,;;r>:•;;::<'<:<::^r.:r�<
Construction"T e• Occupancy:
State Lic. #:
Project a circle one): New Addn Alter Repair
type '
J ) P Demo
Name of Contact Person: �PtTrr 1
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ('o )Ice-
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 Cluck Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2p° Review, ready for corrections/issue
Electrical
SubcontactorList
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE ___ _ . -� - �_. MECH-IC-ALT-HVAC
Prescriptive. HVAC Alterations a e 1 of 2).
Project NamelAddressi -- -' - -
LA wm\T0, CA
Date:—
30 13
Enforcement Agency:
Permit Number:
i Climate Zone
NOTE: This form maybe used only for single zoneconstant volume sys'iems. This form shalCnot be used for newly constructed
building , additions, or VA multi -zone systems.
Select one "Existing Building Project Type" and complete the corresponding steps listed in the "Complete Steps" column--
olumnbelow.
below.Note: After installation of HVAC units and/or ducts, the Installation and the applicable Acceptance Forms are required to. be
submitted, or-veri tcation by the. teld inspector. and acopy shall be made available to building owner.
Existing Building,Project Type select one): Complete Ste s:
___.
New or I& HVAC unit , 1, 4, 5 and 6 (If criteria is met),,7 When economizer is installed) - -
New or Replacement ducts 1, 4, 5 and 6 (If criteria is met)
" New Space Conditionin S stem HVAC and ducts
P S.. Y (_. - _.): 1, 2,,3, 4, S and 6 ffcriteria is met), 7 [When economizer is installed), 8 (DCV)
Ste _ 1 -Ducts and HVAC E ui meiit--
Equipment Type, Efficiency Floor Area Distribution
Type
Duct Insulation
. Thermostat
i Configuration
_e0 k)_and Capacity-, Served' . , -and
Location 3 ., ,
R -Value °
Types
(Central, Split, Package)
bSE�R y�000 :3o Flex,c,R_-4�2'.�oarAm
gpl�'C
FUrOW-E 80` , AFuE `1S 000
1. Indicate Equipment Type; Air Handler; Condenser; Heat Pump, Evap. Cooling, Boiler, Electric Resistance, etc. & HVAC Capacity; or Ducts_
(new or replaced).
2. If the Floor Area Served (per duct system) exceeds 5,000 square feet, skip Steps 5 and 6.
3. Indicate Type and Location (Ducts on roof, ducts in conditioned space, ducts in attic, etc.)
4. Newly installed or replaced duct insulation: R-8 in unconditioned space or in buried concrete slab; R-4.2 in indirectly conditioned space; and R-0
for conditioned space.
5. Existing non -setback thermostats shall be replaced with setback thermostats for all altered units, and all newly installed space conditioning
systems requiring a thermostat shall beequipped with a setback thermostat.. Setback.thermostats shall meet the requirements of Section l 12(c).
Step 2 -- Mechanical Ventilation Calculations '
Both options (Area and Occupancy Basis) shall be completed to determine the minimum mechanical ventilation rates and Column I must be the
greater. of either Column E or H._ -
AREA BASIS—
`!
` -OCCUPANCY BASIS
'
A—'
_ __.B_
_.D
E._.__
F. _:.<,_:
G
_--H
r I.-._�,
Zone/
`Type of Use'
Condition ;
CFM
Min
Num of
CFM
Min ': ;Design
Vent CFM
System
Area (ft2) j
Per ft2
CFM'
' People' '
per
CFM'
Larger of
CxD
Person
FxG
EorH
15
15
15
AREA BASIS
1. Minimum ventilation rate (CFM/ ft2) for the Type of Use in the Table below.
2. The conditioned floor area of the space multiplied by the applicable minimum ventilation rate from Table 4-1 CFMIfe Column below;.
For additional ventilation rates, see Table 4-3 and use the values listed in the Required Ventilation Column in the Nonresidential
Compliance Manual. This provides dilution for the building -borne contaminants like off -gassing of paints and carpets.
OCCUPANCY BASIS a
2. For spaces with fixed seating such as a theater or auditorium, the expected number of occupants is the number of fixed seats.,
3. The expected number of occupants or people multiplied by 15 cfm per person.
Type -of Use 7 ' r� .' -CFM, erft2 rf ; ,
- "C
- _.:Ty a of Use — �'_-- _— — FM ..er- ft2 -
Auto repair workshops 1.50
_-
High-rise residential = ` Ventilation Rates
Specified by the CBC
Barber shops 0:40
Hotel guest rooms less than 500 ft2 30 cfm/ uest room
Bars, cocktail lounges; and 0.20
Hotel guest rooms (500 ft2 or greater) i -0.15
-casinos_- - -•-- --, -.. _ -_ - -.:
Beau shop Sr_ �. _ 0,40. _' .__ = _ _'_ �
Retailstores _" -- t _. _. _ _ . 0.20 -
. _. ; -
Coin -o �crutcd ili:.?clemiirr _ _ .. .0.30, ._
All Others' _- 0.15
Commercial dry cleaning 0.45
,
1. For additional ventilation rates, see Table 4-3 in the Nonresidential Compliance Manual
2008 Nonresidential Compliance Form July 2010
�t - t
�CERTIFICATE-OF _WMTLIANCE-'_ MECH-1C-ALT-HVAC
Prescriptive HVAC Alterations __ —(I?age2oft ),-
Project Nam- e/,kddr_eSs-,1_,'_
Dale:
-300-9 (b M__". A Z Is �3
QN �_U-f N
I
Installation Certificate requirement. The installing contractor shall complete and sign an Installation Certificate (MECH-INST)
to certify that the installed HVACfeatures, materials, components, or manufactured devices (the installation) conforms to all
applicable codes and regulations, and the installation is consistent with any required plans and specifications approved by the
enforcement agency.
---
Certificate of Acceptance . requir.ement: After completingtheinstallation, all required --a'c-c-ep--Ia'nce'testing shall be- completed,
and all applicable Certificate ofAcceptance forms are required to be filled out completely, signed, and made available to the
enforcement agency at final inspection. Copies of the completed, signed Certificate of Acceptance forms shall also be made
javailable to the building, owner..,
[3 Step 3 - MECH-2A _- Outdoor Air Acceptance This -test -is--required -for newly . installed - or replacement HVAC' Systems -(HVAC .
equipment and ducts) to verif
y minimum outside air is provideAin-accordance with Section 125 qfthe Energy Standards.
❑ Step 4 — MECH-3A - Constant Volume, Single Zone Unitary A/C and HP Controls Acceptance-- This test is required
for new or replaced constant volume, single -zone unitary air conditioners and heat pumps to verify, controls function, including: thermostat
installation and, programming.5upply. fan, 1 0
-heating. cooling, and damper operation in accordance with Section 25 f the Energy Standards.
[3 Step 5 — MECH-4A - Air Distribution Systems Acceptance - This test is required when the new or altered system is . a s1 Pte
aline: coia3fant=voitririe-.cyxtein=serves 5,000 f11 or less, and 25% or more of the duct surface area is located in the outdoors, unconditioned space,
orayentilated attic in - accordance with Section 125 of the Energy Standards.
-
[3 Step 6- MECH-44WkS - Air Distri'fbu_tion System- Leakage Diagnostic This test is required to be completed by a HERS
Rater when the new or altered system meets the criteria in Step 5 to verify duct leakage in accordance'with Section 125 of the Energy Standards.
.
-The HERS.Ratershall register -the MECH4�11ERS.Form_with an -approved -HERS Provider_ -
E3 Step7- MECH-5A -Economizer Testing Acceptance --T-his test is required for newly installed or replacement HVAC -equipment.- -
when an economizer is installed in accordance with Section 125 of the Energy Standards
[3 Step 8 - MECH-6A - Demand Control Ventilation Systems (DCV) Acceptance - This test is required for newly installed'
DCV systems or replacement of HVAC equipment with the fallowing characteristics to verify controls and sensors function in accordance with 125
of the Energy Standards.: A. They have an air economizer; and B. They serve a space with a design occupant density, or a maximum occupant.
load factor for egress purposes greater than or equal to 25 people per /000 fl2 (40 square foot per person); and C They are either:'
i. Single zone systems with any controls; or
ii. -Multiple zone systems with Direct Digital Controls -(DDC) to the zone level.
ocumentation Author's Declaration Statim�in_i_
• I certify, that this Certificate of Compliance documentation is accurate and complet p,
Name:
Compan
CZ4% Ti VA t rt , fl C
�Date-
AVress,
c>' (�>o K '1!5"2_
�lf Applicable'
CEA #
;CEPE
City/State/Zip
Cot I!Uo k
one:
2- IS - 93 &S -
Principal Mechanical Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the mechanical
design.
e This Certificate of Compliance identifies the mechanical features and performance specifications required for compliance with
Title 24, Parts I and 6 of the California Code of Regulations.'-
'
• The design features represented on this Certificate of Compliance are consistent with the information provided to document this
design on the other applicable compliance forms, worksheets, calculations, plins and specifications submitted to th.eA
enforcement agency for approval with this building permit application.
Name',Signature:
Company Name,:
Date:
Address:
�L i cens6 #
'-City/State/Zip:
�/State/Zip:
Phone:
2008 Nonresidential Compliance Fbrm'