12-0489 (MECH)I a
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Y BUILDING PERMIT
Date: 5/03/12
Application Number: 12-00000489 Owner.
Property Address: 50020 MONTELOMA-CT BISIO, J M TRUST
APN: 777-250.-019- -
---------
-PropProperty
erty Zoning; LOW DENSITY RESIDENTIAL
1:CE
Application valuation: 21455 qContractor: 0 3 2612Applicant: Architect or, Engineer: GENERAL AIR CONDITIO31170 RESERVE DRIVELAQUINTA
THOUSAND PALMS, CA•9DEPT.
�,Q�►Fv,iLv R4 (760) 343-7488
Lic. No.: 68631.0
LICENSED CONTRACTOR'S DECLARATION _ WORKER'S COMPENSATION DECLARATION '
1 hereby affirm under penalty of perjury than am I. ensed 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 Pr essionals 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
_I Iissued. '
Date: (Z- Contractor: _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
i Code, for the performance of.the work for which this permit is issued. My workers' compensation .
' OWNER -BUILDER DECLARATION - iinsurance 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 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 jea 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 subj 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 forthw 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 - S
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: /31
- '
Applicant: -` ^
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 WARNING: FAILURE TO SECURE WORKERS OMP SATION 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 LAB_ OR 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 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 in 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
pursuantto 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, indemnity 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.
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.
1 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 in mation 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 cons ction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for ins tion purposes.
Lender's Name:
Date: 3 Z. Signature (Applicant or Agent):
Lender's Address: ,
LQPERMIT
Application Number . . . 12-00000489
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•'12:28:33 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
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 -IR -ALT -HVAC
Climate Zones 10,. 15
Site Address:
Enforcement Agency:
Date:
Permit #: '
50020 MONTELOMA COURT Le Quinta, CA 92253
City of La Quinta
May. 2, 2012 '
Duct insulation
Conditioned Floorr
,
Equipment Typel
List Minimum Efficiency2
requirement
Area
. Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF,
❑ R 6 (CZ 10-13) '
Served by system
® Setback
If
If not already present, must be
® Condensing Unit
EER
[IResistance
❑
❑ R 8 (CZ 14-15)
1411 sf
,
❑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 Sig ned.Beginning October 1, 2010, a registered copy of the CF -1R0,
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-21=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 -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace r
CF -4R forms: MECH-21 and (for split systems) MECH-25
, •
For Split Systems: Duct leakagej< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow, Requirement), TMAH , ; • , c- .
Exempted from duct leakage testi ngif:- 1 - • r '
�,❑ 1 "Duct system was d6cumented 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
04. The�system;:will not be Ducted(ie, DR Bless Mini-Sph(System),(Also,Exempt fr.omRefrigera�nt Charge)
❑ 2. New` HVAC System
Required Forms �„
.
. Cut moor Changeout with'
new ducts:'(all new
�''1m` r
CF 6R forms 'MECH-04, MECH-20 HERS, and'(for split systems) MECH-22 HERS, and
ducting all new
MECH='25 HERS W yr` t_
t
CF 4R'forms:kMECH-20, and (for split systems) MECH=22, and MECH-25 kz
e ui ment
For Split Systems: Duct leakage;<,6'percent; RC,';CCA,>_;350 CFM/ton; FWD, TMAH STMS, and either,HSPP'`oi- PSPP. "'°` "n'
For PackagedUnits: Duct leakagqe< 6 percent -t" ,
❑ 3,.New„Ducts with/or without :: •' ”'
Required Forms:
Replacement
- r
• 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 t '
❑ 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. r • • I •
• 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: bani¢Ile Garcia
Company: HARRISON ENTERPRISES INCDate: 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-A0022071A-00000000-0000' Registration Date/Time: 2012/05/02,20:59:53 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance-Forms_'�.`D + t•�'' ' ;:JulY ,•2010`
'A
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:,
Date:
Permit #:
50020 MONTELOMA COURT. (SYS 2) 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
R AFUE 78%
® SEER 13.0
❑ COP[I
[3HSPF
R 6 (CZ 10-13)
Served by system
®•Setback
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-I5)
1400•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 -111
and CF -611 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 -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
`
For Split Systems: Duct leakage! .< 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 ,
0'4. The.,system will not be Ducted•(ie:aDucttess�Mini,Spht_System)<(AIso.Exempt from Refrige¢ant Charge)
.�. , z .� Y
❑ 2. New HVAC System
Required Forms -P
,w
.Cut inlor Changeout with'
ducts,'(all
r a r
LF 6R forms M. ECH-04, MECH720 HERS, and (for split systems) MECH-22 HERS, and ,
new new
dudm9 i all new /
MECH'25'HERS `' `
��At ". ;k a
CF 4R forms MECH-20, and (for split systems) ME -H=22, 25 r
equipment)
and MECH
"p
a-.
For Split SV stems:�Duct 1eaka9 a <,=6` -percent- 'RC CCA > 350 CFM/ton`.FWD; TMAH STMS and either,HSPP or PSPP.
Pk„
,.... .
For Packaged Units: Duct leakage..< 6.percent
113. 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 7
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: Dud 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.• C -, ,
• 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-A0022072A-00000000-0000: Registration Date/Time: 2012/05/02:21:01':13',•'HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms r �, "^�''' July 2010
#
Submittal
Bin #
Oty .of La QuInt'a
TRACKING
Building & Safety Mslon '
Permit(>`
P.O. Box 1504,78-495 Calle 7amplco
La Qulnta, CA 92253 - (760): 777-7012
Nam
.Building Permit-A•pplicadon and Tracking Sheet
Project Address: 5
��,j It a . Ownec's Name: S I V
A. P. Number: �1_1 215 Q O Iq ' .
Address: a ffiU)�
Legal Description:
City, ST, Zip: Lua q) -2s3
Contractor:en&Tele
.A
honer '
Address: T
Project Description: U �C TO GaMeM - CZ '
City. ST, Zip:'—�_Vo
t -A Aon t• : S
Telephone: ,..: ;
State Lie. # : 3 City Lie. #; 410 �2
Arch., Engr., Designer:
Address:
city'. ST, Zip=
:... _. , , .... _..�
Telephone:'.
Construction Type: Occupancy:
State Lic. #: Pro
. Project J type circle one): New Add'n Alter Repair Demo
Name of Contact Person:�p 61,9 e-4
�� U Sq Ft : +2 g 1 I #.Stories: #Units:
Telephone # of Contact Person: "7!a O 3 Y-6 ek Estimated Value of Project:I CA 55 ' o
APPLICANT- nf% hVIT W10M'r nt. amu. ru.n .....-
#
Submittal
Req'd
Recd
TRACKING
PERMFB FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
flan Check Balance •
Tithe 24 Calls.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechantcat
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing .
Grant Deed
Plans picked up.
IS.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN
'rd Reyiew,.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