11-1268 (MECH)P.O. BOX 1504
78=495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
-Application Number:
Property Address:
APNi
Application description:
Property Zoning:
Application valuation:
Applicant:
-11 00001268-,- �.
81845 MOUNTAIN VIEW IN
767-480-006--
MECHANICAL
67-480-006- MECHANICAL
LOW DENSITY. RESIDENTIAL
18700
c&ht44Q" -
Architect or Engineer:
BUILDING& SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury that I am lice e�1 under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prof si nals Code, and my License is in full force and effect.
License Class: C20 k_Liconse!Slo.: 686310
ate: 1f 2 tractor:
OWNER -BUILDER 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 tothe 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 (55001.:
1 _ 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.).
(_ 1 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 ham 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: - a
Lender's Address: 1
LQPERMIT
Owner:
KEITH BRYAN
81845 MOUNTAIN VIEW LANE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/23/11
g �pp rr''����
Contractor: g E s�JV
GENERAL AIR CONDITIO II;TG
31170 RESERVE -DR] _
THOUSAND PALMS, CA 2276 CITY OF.i "4. 001 pt
(760) 343-7488
Lia. No.:'686310
WORKER'S COMPENSATION DECLARATION
. I hereby affirm under penalty of perjury one of the following declarations:
I 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:
Y I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T� 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 Policy,Number Z071741501
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 ubject to the workers' compensation laws of California,
and agree that, if I should become su ct to the workers' compensation provisions of Section
3700 of the bor Code, I shall forth th comply with those provisions.
11
/D at 2 3 pplicam:
WARNING: FAILURE TO SECURE WORK S' COM .ENSATION 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.
/PPUCANT 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 omissionrelated 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, essation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above in r ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building cons ion, and hereby authorize,representatives
of this county to enter upon the above-mentioned property for insp on purposes.
N
Date: 23 r Si tura (Applicant or Agent):
Application Number 11-00001268
Permit . . . MECHANICAL
Additional desc .
Permit Fee 66.00 Plan Check'Fee
16.50
Issue Date Valuation . . .
0
Expiration Date 5/21/12
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
33.0.0
Special Notes and .Comments
CHANGE OUT (2) HVAC SYSTEMS: COILS,'
CONDENSERS & FURNACES. 2010 CODES.
----------------.---_-----_-------------------------------------------
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
Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Add a s: /
L%
En orceme Agency:
Date
Permit #:
Conditioned Floor
Equipment T e]
List Minimum Efficiency 2
Duct insulation requirement
Area
Thermostat
ckaged Unit
furnace
M AFUE_
COP
Over 40 ft of ducts added or
Setback
indoorCoil
LEER
HSPF
re laced in unconditioned space
(CZ 10-13)
Served by system
sf
(Ifnot already
present, must be
ndensing Unit
EER
ResistanceR6
er I
R 8 (CZ 14-15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF- IR -ALT -HVA Cfor 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
I.s' ned. Beginning October 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection.
HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Co r'
and /o
• Indoor Coil and/or
CF-6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
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 ffiom duct leakage testing if:
1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
.Duct systems with less than 40 linear feet in unconditioned space, or
3. Existing ducts stems are constructed, insulated or sealed with asbestos
2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-1-fERS
new equipment)
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
E]3. New Ducts with/or without Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor coil CF -4R forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some 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-21-14ERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For splits stem or packaged units: Duct leakage < 15 percent
EXCEPTION: Existing ducts stems 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 infition documented on o er applicable compliance forms, worksheets,
calcul ns plans ands specifications submitted to the enforcement agency forapproval rtpermit a lication
Name:
Signa e:
Company:
Date: / V
G
Address:�`��� ��
License: 4"1
City/State/Zip: !�,,-d C.-_ '? �7 C
Phone: d 3 VJ `7
2008 Residential Compliance Forms March 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:, p U J En yrceme/�gency: Date: Permit #:
PS t) `I' /
Conditioned Floor
Equipment T el List Minimum Efficienc 2 Duct insulation requirement Area Thermostat
11 Packaged Unit
Over 40 ft of ducts added or
Furnace ❑ AFUE 8D �o ❑ COP Setback
Indoor Coil
OS
l3 ❑ HSPF replaced in unconditioned space Served by system (1J"not already
ondensing Unit ❑ EER / / ❑ Resistance ❑ R 6 (CZ 10-13)fiLIsf present, must be
❑ Other ❑ R 8 (CZ 14-15) installed)
1. Equipment Type.• Choose the equipment being installed; if more than one system, use another CF -I R -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPFJor 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
S192 ed. Beginning October 1, 201.0, a registered copy of the CF -IR and CF -611 shall also be on site for final inspection.
1. HVAC Changeout Required Forms:
• All HVAC E ui _Ment re laced _ CF -6R forms: MECH-04, MECH-2I -HERS and (for split systems) MECH- 25 -HERS
� _ P. r c _
2nnR
• Condenser Coil and /or
-- ---------• •----•`••• �• •.•.0 •v. J a,iJ JIMIIIJ lvlLl.l l—LJ
• Indoor Coil and/or
CF -6R forms: 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
For Packaged Units: Duct leakage < 15 percent
Exempte f m duct leakage testing if.
I. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
- Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-FIERS, and MECH-25-HERS
ducts: (all new ducting and all
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all 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
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems 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.
• 1 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 I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the ' onn tion documented on other pplic ompliance forms, worksheets,
calculations, laps ands specifications submitted to the enforcement agency fora ro al with [ e ennit application.
Name: r!��eh� �.6
Si cure:
Company://��
6' enera.� /art^ GDi1Git.��`Os7t
Date:
Address:License:
-3/1-70 �Z>°S �� U� tt ✓�
�
�08�o3�v
City/State/Zip:—��D1/-S01r_ 11L pal(—& -s' 1 Gg a-�? �
Phone:
7/ 0 -3 43 - 74 ek
2nnR
CaICERTS - CF -1R Registration
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Secure Home CONGRATULATIONS
About Us Your CF -IR -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Training
Site Address: 18845 MOUNTAIN VEIW LANE
Rater Directory
La Quinta, CA 92253
CEC Registration: 211-A0060869A-00000000-0000
Forms CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
Assigned Company: HARRISON ENTERPRISES INC
MembershipBenefits __..._ ...... .___._..._...---_--........... _.__._...__........-.._...... _.. _..._._...._..._.___
Do you know your HERS Rater?
If you do, you may want to•send this CF=1R to• them:--
Industry Partners
News
To register for our
monthly
newsletter, please
click here.
CaICERTS Rater ID:
OR
My Rater Quick Select: Energy Driven Solutions, Inc.
Every CaICERTS rater has a license number.
If you need to find the rater by name [Click HERE] to search our directory.
I... :SEND:CF-1R,TO:HERS. RATER I
[CLICK HERE] to do another
Copyright cry 2010 CaICERTS. Inc. All rights reserved. Revised: January 11. 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy]
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
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1
CaICERTS - CF -1R Registration
Page 1 of 1
Public Home Danielle Garcia logged in [Logout]
[Home]
Secure Home
About Us
Training
Rater Directory
Forms
CONGRATULATIONS
Your CF -IR -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Site Address: 18845 MOUNTAIN VIEW LANE
La Quinta, CA 92253
CEC Registration: 211-AO06087OA-00000000-0000
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
Copyright X52010 CaICERTS. Inc. A11 rights reserved. Revised: January 11, 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy)
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
BBBBBB fins
d,uonFaG8bo0k1
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Assigned Cornpa -I HARRISON ENTERPRISES INC
Membership Benefits
— _.___._...-'—.----.---'_--------------...--
Events
Do you know your HERS Rater?
..
-If you-do,youmay want to send this -CF=IRto-theirl:
Industry Partners
CaICERTS Rater ID:
OR--_--.._
News
My Rater Quick Select:: Energy Driven Solutions, Inc.
Every CaICERTS rater has a license number.
To register for our
!f you need to find the rater by name [Click HERE] to search our directory.
monthlyL�._....•.,SENp;GF:,1;R•,TO
yER$,R9TER:..
newsletter, please
click here.
[CLICK HERE] to do another
Copyright X52010 CaICERTS. Inc. A11 rights reserved. Revised: January 11, 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy)
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
BBBBBB fins
d,uonFaG8bo0k1
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Bin
City of La. Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinl:a, CA 92253 - (760). 777-7012
Building Per mit"Application and Tracking Sheet
Permit #,Lip
$
Project Address:
Owner's Name:
A. P. Number:
Address: a!•2GjL ..?r `
Legal Description:
City, ST, Zip: CIO—?
Contractor:
Telephone:Z` L (�.
<•..�c^?:�•• < �w?, �;
;s:f ,�>• � <;•
Address:
y
City, ST, Zip:
Project Description:
� .
Telephone v `'
State Lic. # : 3 City Lic.
ror
Arch., Engr., Designer:
Address:
City., ST, Zip:.
"
Telephone:*
State Lic. #..-
�:•:t..:: ,.:
i' h:C{`.�}�! Zvi %''.i.. •}'
r' % :.• ''`
<• r- ren;.::•:.:,;?14c::..�.,,..: c� v
�< ;::..;,r �r'
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Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft :# Stories: #Units:
Name of Contact •Person: CD Gl �� liCJcc%i`5 vrU
Telephone # of Contact Person: 7!o O ,3'13 -7-4 Estimated Value of Project: '7t%..
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets
Req'd'
Recd
TRACIMG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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:-
7rd Review,.ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees