11-0307 (MECH), .4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000307
Property Address:
79215 CETRINO J
APN:
772 -110 -047 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
12946
Ta�/ 4 4 Q"
n
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury thatI am licens under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prole i nals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
ioatei 3 L8 t Contractor.'
P�
R -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).:
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 I 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/28/11
Owner:
RIDDELL DELEROES
79215 CETRINO
LA QUINTA, CA 9225'3
( 4661OContractor:
MMFIMNANCEDEDT
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488 .
Lic. 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.
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 policy number are: .
Carrier EVEREST NATL Policy Number 7600006147101
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 becosubject to the workers' compensation laws of California,
and agree that, if I should become s j ct to the workers' compensation provisions of Section
3700 of the Labor Code, I shall fort th comply with those provisions..
Date: 1\ Applicant:
WARNING: FAILURE TO SECURE.WORKERS' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL -
SUBJECT AN EMPLOYER TO.CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001. 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 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, iridemnify 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 i ormation is correct. I agree to comply with all
city and county ordinances and state laws relating to building con ruction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for ins ction purposes.
Date: �%L� f 1 Signature (Applicant or Agent):
Application Number . . . . . 11-00000307
Permit . . . MECHANICAL
Additional desc .
Permit Fee 33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 9/24/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00
---------------------------------------------------------
Special Notes and Comments
------------------
INSTAL HVAC CHANGE OUT 5 TON 13
SEER
2007.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
-- - - -=- - - - - - -- - ------ - - - - ---
Paid Credited
--- - - - - ------ - - - - ----
Due
-- - - - - - -
Permit Fee Total 33.00
.00 .00
33.00
Plan Check Total 8.25
.00 .00
8.25
Other Fee Total 1..00
.00 .00
1.00
Grand Total 42.25
.00 .00
42.25
LQPERMIT
Simplified Prescriptive Certificate of Compliances 2008 Residential HVAC Alterations CF -111 -ALT -HVAC
Climate Zones 10 to 15
Site Address . t —
Enforce tne t Agency:
Date:
Permit #:
Conditioned Floor
Equipment T et
List Minimum Efficiency 2
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
p
❑AFUE 80 ��
❑COP
Over 40 It of ducts added or
Setback
Indoor Coil
❑SEER 13
❑ HSPF
replaced in unconditioned space
Served by system
(If not already
iFurnace
Condensing Unit
13 EER / J
❑ Resistance
❑ R 6 (CZ 10-13)
❑ R 8 (CZ 14-I5)
sf
present, must be
installed)
OOther
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -A L T -H VA Cfor each .tystem.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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. eginning October 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection.
1. 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 Coil and/or
CF -6R forms: MECH-2l-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or
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 from duct leakage testing if:
❑ I. 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 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: MEC14-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
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 -61K 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
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
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.
• 1 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 ' onn tion documented on other pplic ompliance forms. worksheets,
calculations, plans andspecifications submitted to the enforcement a enc fora ro al with t e permit application.
Name: peen WO -ILS 6'1
Si lure:
Company:
an �+
p � �en,era.( 41 r on d� 7�,`o n ,`
Date:
3 04 —I
Address:,3l17o eserve
License:
City/State/Zip:-�itr9u�5u�� }�d.Ls� Gf} G���7�
Phone: -760 -3 -7 4F9
2008 Residential Compliance Fornis # March 2010
CaICERTS _ CF -1R Registration
Page 1 of 1
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CONGRATULATIONS
Your CF -1 R -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Site Address: 79215 CETRINO
La Quinta, CA 92253
CEC Registration: 211-A0015331A-00000000-0000
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
Assigned Company: HARRISON ENTERPRISES INC
Do you know your HERS Rater?
If you do, you may want to send this CFA R to them.
CaICERTS Rater [D:
OR
My Rater Quick Select: Energy Driven Solutions, Inc.
Every CalCERTS rater has a license number.
If you need to find the rater by name (Click HEREJ to search our directory.
».$EN)CF
z1RkTO.HERS RATER;, t ,
[CLICK HERE] to do another
Copyright �d 2010 CaIC'ER.TS, Inc. All ri-his reserved. R.evised:.lanuary I L 2QI0
[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 -11811, (877-437-7787)
Fax: 916-985-3402 Contact Us
tS
BBB FFindus on'FaceboQk�j j
s>
UIII If
City of La Quinta
Building &r Safetypivislon
Permit #
P.O. Box 1504,'78-495 Calle Tampico
La Quinta, CA'92253 - (760) 777-7012
�.U
Building Permit Application. and, Tracking Sheet
Project Address: Owner's Name:
. o �iores 2r�oQe
A. P. Number:
Address: `
9 tS �,fi-i n v
Legal Description:
City, ST, Zip: a G p}— 9 a S,3
Contractor:
Y.�
:
Telephone:%(
Address- 3
Project Description: (✓�G C e� _
City, ST, Zip:
Telephone:
-:N ..f ::: in•: i Lis .!� }; �:: r'
City Lic. #; V
State Lic. # : 3
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:'
..} hi'i' �.•r{isi:}}��-•Y-,{'.+%i:}4:i:;>'l..i'`vi:�:; 4'•?i:
Yv.%}
}Ai v:vf.•Yf i;} i�.;.+x::4L+ ..y
W/ 4 N}++>'L`
_
Construction Type: Occupancy:
�`'f
,,YYvv �'+F is �: •`•:Y<:>¢j.o?r ;Ug .+M1Jp:
State Lic.
:
v.ti•Y:::•Y:i::::: f:.Gr•::{.:'' ..'Pro�ettyPa
(circle one): New Add'n Repair Demo:
Alter
Name of Contact-Person:
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project: -0-0
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d 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:-
3rd Reyiew, .ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School. Fees .
Total Permit Fees