MECH (12-0487)4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
_12-00000487
Property Address:
80140 MERION
APN:
762-140-006- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
15170
Applicant:
terl [i
Architect or Engineer:
r—
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MOHTSHAM,MASON A & FAY S
80140 MERION
LA QUINTA,•CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/03/12
Contractor: . t -
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488
Lic. No.: 686310
• LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that l am licens 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 Profes nals 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: C20 License No.: 686310
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Date: $ Z Contractor:
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
• N •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 r -
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 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 subj 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 subject l he 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 ply 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 15
Date: '5500).: ! ZApplicant:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
1-
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' Q00RENSIATION 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
(_ 1,1, 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'_ 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
performedunderor 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. ,
I hereby affirm 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 i rmation 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 con ction, and hereby authorize representatives
'
of this county to enter upon the above-mentioned property for in ction purposes. _
Lender's Name:
-
//,.,�ate:,.!% Signature (Applicant or Agent):
Lender's Address:
'
LQPERMIT' ,
LQPERMIT
Application Number . . . . . 12-00000487
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . 66.00 - Plan Check Fee
'16.50
Issue Date Valuation
0.
-Expiration Date— 10/30/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
.2.00 9.0000 EA MECH FURNACE <=100K
18.00
2.00 -16..5000 EA MECH B/C >3•-_15HP/>100K-500KBTU
33.00
------------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT -. (2) 13SEER/78AFUE
SPLIT SYSTEMS• [2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING•CODES.
May 3, 2012 12:38:49 PM AORTEGA
-
-- - - -------------- --- - ----------
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
--- ---
1.00
,Fee summary Charged Paid Credited
Due -
Permit Fee. Total 66.00 .00 .00
66.00 "
Plan Check Total 16.50 .00 .00
16.50
C
Other Fee.Total 1.00 .00 .00
1.00.
Grand Total 83.50 .00 .00
83.50
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008. Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:'
Enforcement Agency:
Date:
Permit #:
80140 MERION (SYS 1) La Quinta, CA 92253
City of La Quinta
May 2, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13,
❑ COP
[3HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not alreadyresent must be
P
® Condensing Unit
[I EER
[3 Resistance
❑ R 8 (CZ 14-15)
1250 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 -411
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1111
and CF -6111 shall also be on site for final inspection.
® 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 -611 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
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 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. Thersystem-will not be Ducted•(ie. Ductless Mini-SplitSystem)-(A1.lso-Exempt -Refrigerant,-Charge)
❑ 2. New HVAC System
Required Forms.
. Cut in'or Changeout with
ducts:
CF -611 forms: MECH-04 MECH720 `HERS and (for split systems) MECH722-HERS and
new (all new ,
ducting ADA all new fe r
MECH-25-HERS --
4R
equipment)) p f fir.
CF forms:,;MECH;20, and (for split ystems) MECH=22, and .MECH-25
-Ps1.
For Split Systems: Duct,leakage < 6 percent; RC, ;CCA >_ 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or'PSPP.
For Packaged Units: Duct leakage < 6 percent
113. New-Ductswith/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 -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
❑ 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: Danielle Garcia Signature: banielle Garcia
Company: HARRISON ENTERPRISES INC Date: May 2, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0022081A-00000000-0000 Registration Date/Time: 2012/05/02 21:16:17 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
• t
Climate Zones 10 : 15
•
i
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 : 15
Site Address: • :.
Enforcement Agency:
Date:
Permit #:
80140 MERION (SYS 2) La Quinta, CA 92253
City of La Quinta
May 2, 2012
Duct insulation
Conditioned Floor
Equipment Type1,
List Minimum Efficiency2
requirement
Area .
Thermostat
❑ Package Unit
�+
® Furnace
® Indoor Coil
® AFUE 78%
® 3,� SEER
�
❑ COP❑
HSPF
[3y
R 6 (CZ 10-13)
13R 8 (CZ 14 -IS)
Served by system
1200 sf
® Setback
If not already must be
present,
® Condensing Unit
[IEER
❑Resistance
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. , L .1 1
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 -1111
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
• Indoor Coil and /or
CF -611 forms:. MECH-04, MECH-2I-HERS and (for split systems) MEC H -25 -HERS e `
• Furnace,
CF -4R forms: MECH-21 and (for split systems) MECH-25
,
For Split Systems: Duct leakageij< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
• ;.
Exempted from duct leakage testing', 'if:' F
❑ 1'Duct system was documented to have been previously sealed and confirmed through HERS verification; or ,
❑ 2. Duct systems with less than. 40 linear feet in unconditioned space, or ;
3. Existing duct systems are constructed, insulated or sealed with asbestos
❑"4. The�system.will not be Ducted`(ie,�Ructless•Mini-Split System),(Also-Exempt from Refs ge ant -Charge)
❑ 2. N6 'HVAC System
RequieW Forms s f ' r r
• Cut rotor Changeout with
new ducts:+(all new
r " r r --
CF 6R forms MECH 04 MECH 20 HERS and (for split systems) MECH 22 HERS and -'
ductin all new
9
6
s ,
MECH 25 HERS
, � � � ``' � fi
CF 4R forms MECH-20 and (for split systems) MECH 22, and MECH 25
equipment)°
For Split Systems:•,Duct leakage
<,% percent, RC 350 CFM/ton' FWD, TMAH SIMS and either HSPP oV PSPP '
For Packaged Units: Duct
leaks e<<'6 percent~
113. New,Ducts with /or without;
Required Forms:
Replacement �` •I I
• Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -611 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: r
. Includes adding or replacing more than 40
CF -611 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: Danielle Garcia, Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC _ Date: May 2, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310.
City/State/Zip: THOUSAND PALMS / CA /.92276 Phone: (760) 343-7488
�P . ` M � ••fit' � .�� .,.
Reg: 212-A0022083A-00000000-0000 Registration Date/Time: 2012/05/02 21:17:51. HERS'Provider: CalCERTS,.,Inc.
2008 Residential -Compliance Forms ! '. July,2010
yfr
Bin #
City of La Qurn to
Building &r Safety Mslon
Permit P.O. Box 1504, 78-495 Calle 7amplco
La QuIn ta, CA 92253 - (760) 777-7012
BuildingPermit- Application and Trackirlg Sheet
Project Address: (2Q L4 MQ( 0n Ownec'sName: M0%fi5hQM '
A. P. Number: -1 �02-1000(0_12 Address:
Legal Description: City, ST, Zip:
Contractor: :
Submittal
Plan Sets-
Req'd
Telephone: _7W
� (• ' 2q 2-
PERMIT FEES
Item Amount
Address:CID
Rg�qlvj
Project Description:
Reviewed, ready for corrections
City, ST, Zip:'-
Plan Check Deposit
'
'Z
Telephone:
3
" n ^� ' �• '
Plan Check Balance.
State Lic. # :
3
City Lic.
Arch., Engn, Designer:
Conshu¢tlon
Address:
Plans resubmitted
City,. S`T, Zip:.
C
... ..... _. . ' . ,._ ...
... _ .. _ _
.. _. ._ .... _...... ....... ._
Telephone:
2°" Review, ready for corrections/issue
h• a. �x
s .'" x• '
Construction Type:
Occupancy:
State Lic. #:
Subcoatactor List
;�. ,.,yf
n
Pcojeat type (circle one):
New4 Add'n Alter Repair Demo
Name of Contact Person:
CC) e -,l 4-f-9u*5 01YU
. Sq. Ft.: '246()
#.Stories: #Units:
Telephone # of Contact Person: 7Co D
3 Y3 -74E g
Estimated Value of Project: `P�-n c- c)O
Plans picked up,
S.M.I.
H.O.A. Approval
Appt [I'AIuT. r%f% Kir►r. \A'/nlrC nr......
Plans resubmitted
H
Submittal
Plan Sets-
Req'd
Recd
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calls.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Conshu¢tlon
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcoatactor List
Called Contact Person
Plumbing .
Grant Deed
Plans picked up,
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN
'r° Review, .ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.,
Pub. Wks.. Appr.
Date of permit issue
School. Rees . .
TO Permit Fees