10-1204 (MECH)`f _
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00001204
l
Property Address:
79389 CETRINO
APN:
772 -120 -031 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
10000
Tu�/
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect r Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Su sin n Professionals Code, and my License is in full force and effect.
License Class: C20 -C36 L4nse N 7420
(i Date: Contracto .
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).:
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 _ 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
Owner:
MILCHMAN RESIDENCE
79389 CETRINO
LA QUINTA, CA 92253
Contractor: D
ALL SEASONS A/C, PLMBG
P.O. BOX 1112
PALM DESERT, CA 92261
(760)568-2663
Lic. No.: 827420
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/05/10
° D
NOV 0-8 2010
A2
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 NORGUARD INS Policy Number ALWC124752
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 la s of California,
and agree that, if I should b ome subject tothew s c pensation ons of Section
3700 of the Labor Cod sh I forthwith c with th a provi
Date: % O Applicant: ZIA
//
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 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, 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 a o comply with all
city and county ordinances and state laws relating to buil ' ��Iion,hereb a representatives
of this county to enter upon the above-mentioned pro ban
i se
_Date: Signature (Applicant or Agent).
11
4 . ..
Application Number . . . . . •10-00001204
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date . . .
Valuation . . .
. 0
Expiration Date 5/04/11
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
AIR CONDITIONING & FURNACE CHANGE
OUT 17
SEER 5 TON 2007 CODES.
----------------------------------- =----------------------------------------
_ Other Fees •... . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
----------------- ----------
Paid Credited
Due
-----------
Permit Fee Total 33.00.
I -------------------=
.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 Compliance: 2008 Residential HVAC CF -1R -ALT -HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79-389 Cetrino La Quinta, CA 92253
City of La Quinta
Nov 5, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
0 Furnace
0 AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
a Setback
0 Indoor Coil
0 SEER 13.0
[3HSPF
❑ R 8 (CZ 14-15)
2000 sf
If not already present
0 Condensing Unit
❑ EER
F] Resistance
must be 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, Z7HSPF 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 -611 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 -1R 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-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -411 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
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leagage testing if:
❑ 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
1:12. New HVAC I
Required Forms: V
System /
r- rl / f 1 ! _ ! J, • J
. Cut in or Changeout
new ducts:
CF -6R fo'rms: MECH-04 MECH-20-HERS and (for split systems) MECH-22=HERS, and�ti,.^�
with (all
new ductingaad' 11
MECH=25-HERS �J f - f � w g l;
, lf
CF -4R forms:,MECHr20,•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
El 3. New Ducts with/or without
Required Forms:
Replacement
s
. Includes replacing or installing all
new ducting and/or outdoor
condensing unit and/or indoor coil
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
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
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more
CF -6R forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in
CF -4R forms: MECH-21
unconditioned space.
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.
. 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: David Beale Signature: David Beale
Company: ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC Date: Nov 5, 2010
Address: P 0 BOX 1112 License: 827420
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 568-2663
t 0
Reg: 210-A0023704A-00000000-0000 Registration Date/Time: 2010/11/05 12:45:40 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
rro
===Jm���Projca
�tm
Type: Oa�ncy:
State LIP#: (circle one): New Add'n � Repair Demo
Name ofContnet person:
Sq- F-: Stories: I# units.
Telephony # of Contact Person:
Estimated Value of ptoJeet 0 00 Ci• ` 2
APPLICANT: DO NOT WRITE BB.OW THIS UNE
U
Bin #
Crty of U Quetta
Req'd
Building & Safety Division
Perrrilt # P.O. Box 1504, 78-495 Calle Tampko
La Quints, CA 92253 - (760) 777-7012
+ , Building Permit APPilcation and Tracidng Sheet
Item Anosnt
Project Address:'
Owner's Name: 1✓
Plan Se6
A. P. Number:
Address:
.
Legal Description:
City. ST, Zip:
Contractor. W, S
Plan deck Balance
Address:
city. sr, zip: Com- � CL:Z
Telepitoner76v —66 �6-2c-,63
Prqca Description: r)�_L
��� 5 • � ��
Rerievred, res
State Lia #: `—' City Lia #;
T m tea'
dy for eorrectionstassue
(}W.. Deoper
Person
Title 21 cafes.
Plumbing
Adm:
Plans picked a
Flood plain plan
City. ST. Zip:
Grading
Plans raubmi
Teleptione:
Person
===Jm���Projca
�tm
Type: Oa�ncy:
State LIP#: (circle one): New Add'n � Repair Demo
Name ofContnet person:
Sq- F-: Stories: I# units.
Telephony # of Contact Person:
Estimated Value of ptoJeet 0 00 Ci• ` 2
APPLICANT: DO NOT WRITE BB.OW THIS UNE
U
Submittal
Req'd
Reed
Item Anosnt
for corrections
Plan Se6
Plan Check Deposit
Person
Plan Chock
Plan deck Balance
Straetural Cafes
Coastrsction
Rerievred, res
T m tea'
dy for eorrectionstassue
C&IW contact
Person
Title 21 cafes.
Plumbing
p
Plans picked a
Flood plain plan
Grading
Plans raubmi
Grading plan
Person
2'! Rewlew, rea
issue
Subeontactor List
filled Cbnaa
Grunt Deed
Plans picked a
H.O.A. Approval
Plans resubml
IN HOUSE:-
Review, res
Planning Approval
Caked Contact
Pub. Wks. Appr
Date of permit
School Fees
IUCIMG
aba�Itted
d7
p
the
fled
a
PERMIT FEES
Item Anosnt
for corrections
Plan Check Deposit
Person
Plan deck Balance
Coastrsction
Mechanical
dy for eorrectionstassue
Electrical
Person
Plumbing
p
Grading
dy for eorreetionsAssue
Developer Impact Fee
Person
A.LP.P.
issue
Total Permit Fees