BMCH2015-009578-495 CALLTAMPICO
LA QUINTA, CALIFORNIA 922
Application Number: BMCH2O15-0095
Property Address: 48325 CASITA DR
D VOICE.(7.60) 777-7125
FAX (760) 777-7011
IMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/30/2015
Owner:
THE CONCERNED GROUP INC.
APN: 602112013 PO BOX 2424
Application Description: RUSS POTTER HVAC CHANGEOUT PRESCOTT, AZ 86032
Property Zoning:
Application Valuation: $13,487.00
Applicant: Contractor:
GENERAL AIR CONDITIONING GENERAL AIR CONDIT
O OUTSIDE CITY LIMITS O OUTSIDE.CITY LIMIT
LA QUINTA, CA 92253 LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
(760)343-7490 u, MAR. 3 U 2015
Llc. No.: :LIC -0003606
Ci(YOFLAQUINTA
WORKER'S COMPENSATION'DECLARATION
I herebyaffirm under penalty of perjury that l.arn licensed Linder provislonsof Chapter I I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division3 of the Business and Professions Code, . I have and will maintain a certificate of'consent'to self -insure for workers'
and myLicense is in full force and effect.
License Class: _ License No:::LIC-0003606
!1 r� r
Dat�N; 3O 1J contractor: (1
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l am exempt from -the Contractor'sState
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 requlresthe applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions ofthe
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
Of the Business and'Professlons 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).:
( 11, as owner of the property,.or my employees withmages their sole
compensation, will do the work, and the structure Is not intended oroffered,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 employeesi provided that the improvements.
are: not intended or offered for sale. If, however, the building or improvement is sold
withinone 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 I I, as owner of theproperty„am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code -..The Contractors'
State license Lapudoes.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.).
(_J I am exempt under Sec. B.&P. C. for this
Date:
Owner:
CONSTRUCTION "LENDI NG.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
compensation, as provided for by Section 3700 -of the Labor Code, for the performance
oork for which this permit Is 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 insurance,carrier and policynumber are:
Carrier: Policy Number: _
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 Labor Code, I shall forthwith
comply with those, provisions.
gate: Applicant: US".t.t�2_ `��
}WARNING: FAILURE TO SECURE 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 LABORCODE,.
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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
shalbdefend,.Indemnify and hold harmless the City. of La Quinta, Its officers, agents, and
employees forany act or omisslonrelated to the.work being performed under or
issuance of this permit..
2. Any permitissuedas 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
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 relatingto building
:onstruction, and herebyauthorize representatives of this city to.enter upon the above•
,nenj;loned property for inspection purposes.
-31 30115_ Signature (Applicant or Agent):
STATE OF CALIFORNIA
ALTERIAMONS- HVAC
CEC-CF1 R -ALT -04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -111 -ALT -HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
Da e,Prpared:
Permit#:
Li 3 S s; �a
C:kN 6Q Lc.
3 Z-4 119-
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Gneset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System Evaporator Coil
_7al AFUE
COP
❑ R-6 (CZ2, 8-13) Ducting
Served by system
Setback
)(Split System j( condensing Unit
❑ Mini ❑
19
13 R-81 (CZ 11, 14, 15) Ducting
sqft
(if not already
Split Compressor
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
(Furnace ❑ LinesetO
EER
R-5 or R7:5) Lineset`
be installed)
❑ TXV
HERS VERIFICATION rSUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be: registered (no hand filled forms allowed) and a copy left on site.
1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF19-ALT-02-E
Condenser Unit, Evaporator Coil,.
CF2R: MECH-01, MECH720-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS=
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS=, MECH-25-HERS'
Air Handler/Fumace2 (Can.include new ducting)
Installer Requirement:' Duct leakage (!S.15%, or < 30%+to outside, or seal all accessible leaks), Air Flow i 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is; less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated,or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System Required Compliance Documents to.be left on site for Final:
All new equipment and All New Ducts3 CFIR=ALT-02-E
including Mini Split CF2R: MECH=O1, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or-24)-HERS2, MECH-25-HERS'
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement:. Duct leakage r6%, Fan Efficacy (.58W/CFM), Air Flow_ 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement I Required Compliance Documents to be left on site for Final:
All New Ducts" and one or more of the following CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01,,MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testingif ❑ .1. Exis ing duct systems.are constructed, insulated or sealed with asbestos
❑ 4. New 'Ducting,over40 fee_ t I Required Compliance Documentsto be left,on site for Final:
New ducting but less than All New Ducts' ,CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct1eakage (:5_15% or, <10% to outside or, or seal all accessible leaks)'
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes -in walls, between floors etc.
2 Heating only systems -and Air Handler/Furnace changesdo not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25.
3 All New Ducts is when at least 75 percent of the ductsystem.is new ductmaterial,and up to 25 percent may consist of reused parts from the
dwelling unit's.existing duct system (e.g., registers, grilles, boots, air handleri coil, plenums, duct material)
° R-5 (1" thick insulation) for linesets 1" and less. R-7:5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction.line Diameter
with insulation as the following 1.5 -2T -2%",-2.5-3T-2%", 3.5 to 4T-2%', 5T -4W
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
I certify the.following under penalty of perjury, underthe laws of the State of California:
1. The information provided onAhis Certificate of Compliance is true and correct.
2. 1 am�eligible.under Division 3 of the California Businessand Professions Code to accept responsibility for the information.on this document.
3. That the energy: features and performance,specifications forthe design Identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts land 6 of the California Code of'Regulations:(CCR).
4. That the energy;features and performance: specifications, materials, components, and manufactured devicesfor the building design or
system design identified on this Certificate of Compliance: conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified omthis Certificate of Compliance are consistent with the information
provided on other applicable compliance:documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Responsible Designer:,Name:
Responsible Designer Signature:
Da
a Signed:
:2_1F 1S
License:
Co863lC�
Company.:
Gene
Address: _
City/State/Zip:
alasc. �� 9
Phone:
—7c� 3�3 7488
-ml 1
1 \"l cd e5 ,jZbr
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
FINANCIAL INFORMATION..
DESCRIPTION ACCOUNT QTY° -': AMOUNT PAID' PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $1.00 $0.00
PAID BY' METHOD
RECEIPT# `CHECK It. CLTD BY ,
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION.
_ACCOUNT
QTY-
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT'#
CHECK #
CLTD BY
DESCRIPTION
ACC OUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC•CHANGEOUT - SPLIT -SYSTEM PC
101-000042600
0
$36.26
$0.00
PAID BY
:.METHOD.
RECEIPT
CHECK #
CLTD BY'
Totalfald forCHANGEOUT: $108.78 $0.00
DESCRIPTION
ACCOUNT
QTY:
AMOUNT
`PAID
PAID.DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID. BY
METHOD
RECEIPT #
CHECK #
CLTD' BY
Total Pald:forPERMIT ISSUANCE: $91.85 $0.00
• 00
Description: RUSS POTTER HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 3/25/2015 PJU
Approved:
Parcel No: 602112013 Site Address: 48325 CASITA DR LA QUINTA,CA 92253
Subdivision: TR 27835 Block: Lot: 5
Issued:
Lot Sq Ft- 0 Building Sq Ft: 0 Zoning:
Finaled:.
Valuation: $13,487.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
CA
Details: HVAC UNIT -CHANGE OUT FURNACE CONDENSER 78% AFUE,19 SEER 3TON PER 2013 MECHANICAL CODES 2013 ENERGY] CARBON
MONOXIDE ALARM(S) TO. BE INSTALLED PRIOR TO FINAL INSPECTION.
APPLICANT
GENERAL -AIR CONDITIONING
O'OUTSIDE-CITY LIMITS
LA QUINTA
CA
92.253
CONTRACTOR
GENERAL AIR CONDITIONING
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
OWNER
THE CONCERNED GROUP INC.
PO BOX 2424
PRESCOTT
AZ
86032
TINANCIAL
INFORMATION
DESCRIPTION
ACCOUNT
CITY ti AMOUNT
PAID PAID DATE"
CLTD=
RECEIPT41 CHECK-# METHOD' PAID'BY -
BY:
BSAS SB1473 FEE
101-0000-20306
.0 $1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00
$0.00
BSA:
Printed: Monday, March 30, 2015 2:51:58 PM 1 of 2 C srsTEMS
DESCRIPTION°
ACCOUNT
QTY"
AMOUNT
PAID
PAID DATE
RECEIPT /t
CHECK'#
METHOD
PAID BY
CLTD
ATTACHMENTS',.
'
BY
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT:
$108.78
$0.00
PERMIT ISSUANCE
101-0000-02404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE:
$91.85
$0.00
TOTALS:
$201.63
i0
INSPECTIONS
.INSPECTION TYPE INSPECTOR
SCHEDULED COMPLETED. RESULT - REMARKS' " NOTES .
DATE
DATE;
MECHANICAL FINAL" BLD
PARENT PROJECTS _
REVIEWS
RETURNED ., STATUS REMARKS
REVIEWTYPE . REVIEWER SENT DATE DUE DATE NOTES
DATE
WmAr
Printed: Monday, March 30, 2015 2:51:58 PM 2 of 2
- orpSY57EMS
BOND
INFORMATION
ATTACHMENTS',.
'
WmAr
Printed: Monday, March 30, 2015 2:51:58 PM 2 of 2
- orpSY57EMS
t
Bin #
City of % Q uin ta.
Rcc'd
-BuildingmSafety Division
Permit #
P.O. Box '1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012.
Plan Check submitted
Building Permit Application and Tracking -Sheet
Project Address; L $32.S -c-ck
S► � a 1,I)r• Owner's Name: vSS o
A. P. Number:
Address: L4g 3 25 CC3.S�
Legal Description:
City, ST, Zip: Lo, ivyl ck. C-• C1 Z 2 S'73'
Contractor: Ylere.� G';per `
Telephone:
.:.. .
Address: • 31 N-10
Project Description:
City, ST, Zip: �---
Ih soh
Q\ms 92z-�
t
1� 1 ace:3ko AIC., ,
Telephone: %(,0-__Y43 - 7q a 8
: , .
-7o oCA \3`lU
State Lie. #.: CcZ6310
City L C. #;
Arch., Engr, Designer
Address:
Mechanical
City., ST, Zip:
Grading plan
Telephone:
''` Construction Type-.- Occupancy:
State Lia #:•:1q-
Project,type (circle one): Now Add'n Alter Repair Demo
Name of Contact Persons ev t.,r�hn� QT �f Sq. Ft.: # Stories: # Units:
Telcphonc al,of Contact Person:
GS•1- ZA4) - i.R?(o
Estimated Value of Project: 3 �4 w?
I APPLICANT: DO NOT.WRITE BELOW THIS LINE I
tt Submittal
Req'd
Rcc'd
TRACICITIG
PERMIT FEES
Pfau 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 Catcs.
Plans picked up.
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'' Rcview, ready for correctionsrssue
.Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.OA. Approval
Plans resubmitted
Grading
IN 110USEi-
'`' Review,.ready for eorrcctionslissuc
Developer ImpactTee
Planning Approval
Called Conlact.Person
A•LP.P•.
Pub. Wks. Appr
Date orpermlt issue
Sch061 Fees
Ll
Total PerniiiFees