11-0963 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-iht 4 4 Q"
Application Number:
11-00000963
Property Address:
79421 CETRINO
APN:
772-120-029- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
22000
Applicant:
Architect or gineer:
14��
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S CLARATION
I hereby affirm under penalty of perjury that I am licensed un rov i ns of Chapter 9 (commencing with
Section 70001 of Division 3 of the Busi nd Professio I an my License is in full force' and effect.
License Cl ss: C20 C36 cert No.: 20
Date: G 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).:
(_ 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, 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.).
(_) 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:
MAZZETTI PETER
79421 CETRINO
LA QUINTA, CA 92253
Contractor:
ALL SEASONS A/C, PLMBG & HTG
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: 9/06/11
u
SEP 0 6 2011
OF LA
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.
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' ALWC124.752
I certify that, in the performance of the work for which this p mi is issued, I shall not employ any
person in any manner so a become subje t to the compensation laws of California,
n agree that, if I sh d
be
me subj t he orke ation provisions of Section
3 0 of the Labor ode, I sh I fort it o y ith hose provisio
Date: "` .Applicant:
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 ($100,0001. 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, 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 mmence
within 180 days from date of issuance of such permit, or cessation rk for 1 days wil subject
permit to cancellation.
1 certify t t I have read this application and state th he abo a inform n is r I a ee to comply with
city and unt ordinances and state laws relating building nstru on, d reb au orize representatives
of this c my o enter upon the above-mentioned roperty f i pe ti pur ses.
Date: Signature (Applicant or Agent) -
Application Number . . . . . 11-00000963
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 66.00 Plan Check Fee
16.50
Issue Date . . . . Valuation . . . .
0
Expiration Date 3/04/12
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
33.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE (2) A/C UNIT ONE (4)TON AND ONE
(5) TON 17 SEER FURNACE AND COIL UNIT
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
Simplified Prescriptive Certificate of Compliance: 2008 'Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #: '
79421 Cetrino La,Quinta, CA 92253
City of La Quinta
Sep 6, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
[j Furnace
2 Indoor Coil
9 AFUE 78%
p SEER 13.0
❑ COP
E]HSPF
E] R 6 (CZ 10-13)
Served by system
2 Setback
If not already present, must be
Chi Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
2000 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-SR-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-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-111
and CF-611 shall also be on site for final inspection.
90 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6111 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-411 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
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
[12. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini-Split System)y(Also Exempt,from,Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
• Cut in or,Changeout with"
new ducts: (all new
0;-611-forms',MECH-04, MECW2WHERS,,,andt(for split systems) MECH-22ZHERS, and MECH-25-HERS
a.
ducting and all new
CF-4R forms:. MECH 20 and (for split systems)TMECH 22 and MECH 25 :
,�.
equipment)
}
_ ..?�" �.,':-- � •
For Split Systems: Duct leakage''<46 percent; RC, CCA!_>'350 CFM/ton; FWD; TMAH, 'STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
C 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new ducting
and/or outdoor condensing unit and/or indoor
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
coil and/or furnace. No or some equipment
CF-4R forms: MECH-20 and (for split systems) MECH-25
changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet
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.
• 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: Sep 6, 2011
Address: 73605 DINAH SHORE DR STE 1310M License: 827420
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 568-2663
Reg: 211-A0045988A-00000000-0000 Registration Date/Time: 2011/09/06 11:10:36 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of.Compliance:• 2008 Residential E/VAC.Alterath , CF4R--ALT-HVAC
Climate Zones 10 - 15
Site Address:Enforcement
Agency:
Date: •
loom
Permit #:
79421.Cetrino La Quinta, CA 92253
City of La Quinta
Sep 6, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
R Furnace
Pi Indoor Coil
R AFUE 78%
Q SEER 13.0
❑ COP
C]HSPF
❑ R 6 (CZ 10-13) .
Served by system
R Setback
If not already present, must be
91 Condensing Unit
❑ EER
❑ Resistance
El R 8 (CZ 14-15)
1600 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -1R -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 Cll and registered CF -411
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. o
Lei 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -6111 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 -411 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
Exempted from duct leakage 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
❑ 4. The system,will not be Ducted (ie. Ductless, Mini -Split System),(Als-o-Exempt from,Refrigerant Charge)
❑ 2. Nevil System
Required Forms: ; # k'AMC, t4,
. Cut In or;Changeout with
new ducts: all new
41
CF 6R.forms ;MECH-04, MECH 2O-HERS,]antl3(for split systems) MECH 22 HERS, and MECH-25-HERS
ducting all new �'
CF 4R forms MECH 20, and (for split systems)MECH 22,,and MECH 25 a. '
equipment) „t (..
ti zi_' ' {•_ .. ': 1; 1
For Split Systems: Duct leakagei<l percent; RC,-CCA�> 356 CFM/ton, FWD;�TMAH,'STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new ducting
and/or outdoor condensing unit and/or indoor
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
coil and/or furnace. No or some equipment
CF -4R forms: MECH-20 and (for split systems) MECH-25
changed.
For Split Systems: Duct leakage 76 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
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. r
• 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: Sep 6, 2011
Address: 73605 DINAH SHORE DR STE 1310M License: 827420
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 568-2663
Reg: 211-A0045987A-00000000-0000 Registration Date/Time: 2011/09/06 11:09:26 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Din #
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Q �'
Project Address:
Owner's Name: ek,
A. P. Number:
Address: `M42-1 GfMf00
Legal Description:
City, ST, Zip:
Contractor:
Telephone: —
Address: I 11?
Project Description:
City, ST, Zip: I 0?4SCO Chi q.2 -bl
" 7
csz - C
Telephone:
State Lie. # : City Lie. #.-
Arch.', Engr., Designer:
c� " 5242
Address:
C 7 .
City., ST, Zip:
Telephone: ��?�.:;:.<;:;�;:::::.>.::::� �;:
State Lie. # ><%%>'`.`<<:z>'
Name of Contact Person:
Construction Type: Occupancy:
Project type circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
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:-
"" Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees
Total Permit Fees