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14-0450 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-i&t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 . Date: 4/16/14 Application Number: 14-00000450 Owner: Property Address: 53900 AVENIDA CARRANZA SUSAN VANDERHOEK APN: 774-161-010-15 -000000- 53900 AVENIDA CARRANZA Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL ( i A D Application valuation: 6900 Contractor:i A P� i ;_r `o� 4 Iwi Applicant: Architect or Engineer: MENDEZ AIR COND & HEATIId PO BOX 871 THOUSAND PALMS, CA 9227E CITY OF LA UNTA \ FIACECtPT. (760) 348-5041 LiC. No.: 791437 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under i ' sof Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof ' as nd my License is in full farce and effect. LicenseCla s: C20 eNo.: 791437 Date: E Contractor: 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 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).: (_) 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 ISec. 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 1 1 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: LQPERMIT ---------—---——--------------------—---------- 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. 7�'!1 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 insurance carrier and policy number are: _ Carrier FARMERS INS Policy Number B09242175 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 became subjvA work _ ompensation provisions of Section 3700 of the Labor Code, I shall fo tiwi c m t th-those provisions. Date: Applici;I - WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION 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 mode to the Director of Building and Safety fnr a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whosebehalf 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 constructs , an hereby a Hor'ze representatives of this co ty to enter upon the above-mentioned property fo .poses. Date: Signature (Applicant or Agent): Application Number . . . . . 14-00000450 Permit . . . MECHANICAL 2013 Additional desc-. Permit Fee 35.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/13/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - 15SEER CONDENSOR (2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE .INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. - ---------------------------------------------------------------------------- Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL. 23.83 Fee summary Charged Paid Credited - Due -- - - - - - - - - - - - - - ----- - - - - ------ - - - - ------ - - -- --- Permit Fee Total 35.75 .00 .00 --- - - - - - - 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 114.40 .00 .00 114.40 Grand Total 150.15 .00 .00 150.15 LQPERMIT Bin # City Of La Quinta Building u Safety Division Permit # P.O. Box 1501,78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 • Building Permit Application and Tracking Sheet r � Project Address: �C(,t Owner's Name: yl Q 1-C A. P. Number: Address: Legal-Description: City, ST, Zip: Qv kAz�, 0.^ Contractor:RX KC/`� Y G4 Telephone Address: (� �Q 't ` �Poject Description: (c 1 Z City, STZip-T�k0Q0AYA l V 1' Telephona v� ( y 5 `. <'```3'>s:<.<::'>:4<:> :<:#::r; :::»::: '#:. IQAI Lg State Lic. # : Lf City Lie �(� Arch., Engr., IJesigner. Address: / City, S , Zip: . Te phone: 1-4tate. Constructionn Type: Occupancy: cY: Project type (circle one): New Add'n Alter Repair Demo L ic. # ame of Contact Person: ' Z Sq. Ft.: f # Stories: # Units: elephone # of Contact Person: �� L %� stimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE t! Submittal Rcq'd Recd TRACVJNG PERMIT FEES Plan Sets Plan Check submitted Itcm Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cala. 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 correclionsCssue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN I10USE:- '"' Review, ready for correctionsrissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit-issue School Fees Total Pcrmit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 53900 avenida carranza La Quinta, CA 92253 City of La Quinta Apr 9, 2014 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit Indoor Coil ❑ AFUE ❑ SEER/,S : O ❑ COP ❑ HSPF 91.4;_ ❑ R 6 (CZ 10-13) ❑ R 8 Served by system sf ® Setback If not already present, must be Ig Condensing Unit ❑ EER/a, s� ❑Resistance (CZ 14-15) �1t 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 -6R 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 -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 leakanP 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH r+, . 15 pe%eRk Exempted from duct leakac• +l ; ❑ 1. Duct system wa . :o have been previously sealed and confirmed through HERS verification, or r" ^lirt system, linear feet in unconditioned space, or x / vcted, insulated or sealed with asbestos e. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge) G - ne �4.3nd duel equiF, For Sp l r For P° Rer� ` CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS r some CF -4R forms: MECH-20 and (for split systems) MECH-25 .,.angeu. For Split Systems: Duce , :reent, RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Dud - percent ❑ 4. New Ducting over 40 fey._- 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. v, • 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, calculatioris"plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Enrique Mendez 1r-,_ Signature: EMique Mendez Company: MENDEZ AIR COND & HEATING Date: Apr 9, 2014 Address: P O BOX 871 License: 791437 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-5041 Reg: 214-AO02436OA-000000000-0000 Registration Date/Time: 2014/04/09 21:58:51 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma July 2010