11-0491 (MECH)4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT _
Date: 5/12/11
Application Number: ; _ 11-00000491 Owner:
Property Address: 79715_CETRINO CHARLES BOYKIN
APN: 772-330-026- - - 79715 CETRINO p
Application description: MECHANICAL LA QUINTA, CA 92253 j {
Property Zoning: LOW DENSITY RESIDENTIAL EMAY
Application valuation: 19872 2 20 q 11
Contractor:
Applicant: Architect or Engineer: GENERAL AIR CONDITIONII<7G CITY OF LA QUINTA
31170 RESERVE DRIVE - FINANCE0EPT
THOUSAND PALMS, CA 92276
�
(760)343-7488
Lic. No..:: 686310
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profesi nals Code, and my License is in full force and effect.
License Class: C20License No.: 686310
ate: s ontractor:
OWN 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 _ 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: rhe,
Lender's Address: ( '
r
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.
�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 become ?'�ject to the workers' compensation laws of California,
and agree that, if I should become sub' ct to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forth Ii comply with those provisions.
Date: 56-441 plicant:
WARNING:. FAIL RE TO SECURE WORKER OMPENSATION 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 abovIIformation is correct. I agree to comply with all
city and county ordinances and state laws relating to building con truction, and hereby authorize representatives
oft is county to enter upon the above-mentioned property for �ection purposes.
Date: i nature (Applicant or Agent):
Application Number . . . . . 11-00000491
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee
66.00 Plan Check Fee
16.50
Issue Date . . . .
Valuation
0
Expiration Date
11/08/11
Qty Unit Charge
Per
Extension_
BASE FEE
15.00
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
INSTALL (2) SYSTEMS,
FURNACE INDOOR
COIL, AND CONDENSER.
13 SEER, 80% AFUE.
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
LQPEIN1IT
Simplified Prescriptive Certificate of Compliancee2008.Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
En orcemet gency:
Date:
Permit #:
Conditioned Floor
Equipment T et
List Minimum Efficienc Z
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
❑AFUE 80%
Cl COP
Over 40 ft of ducts added or
Setback
ttrnace
ndoor Coil
❑SEER l 3
❑ HSPF
replaced in unconditioned space
Served by system
(lfnot alrepdy
ondensing Unit
❑EER / /
11 Resistance
❑ R 6 (CZ 10-13)
sf
present, must be
❑ Othet
❑ R 3 (CZ 14-/5)
installed)
1. Equipment Type: Choose the equipment being installed; iit'more than one system, use another CF -I R-ALT-HV4Q6o - each syslem.
2. Minimum Equipment Efficiencies: 13 SEER, 73% 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 mast 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 -411 forms (no hand filled CF -411s allowed) are filled out and
si ied. Beginning ' October 1, 2010, a registered coof 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-2I-HERS and (for splirsystems) 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 duct systems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF -411 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 -6R 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 equipmenrchanged.
For Split Systems: Duct leakage < 6 percent, RC, CCA 2:'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, iviECH-2I-HERS CF -411 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.
• I mn 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 I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the* orm, tion documented on other tpplic ompliance forms, worksheets,
calculations, plans ands specifications submitted to the enforcement a enc fora ro al with t e' cnnit application.
Name: C`Loe� v1/c5��
Sig ture:
Company:
P` y: C-7&n�e(,a.( /-�'; r Co�ld� f-,`os7,`
Date:
!l—C/
Address: ✓�
License: (08lo3�t�
qgj -7(
Phone:760_31"t)--7'�f��
CaICERTS = CF -1R Registration
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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: 79715 CETRINO l _
La Quinta, CA 92253
CEC Registration: 211-A0022760A-00000000-0000
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
Induary112rrners Assigned Com pany:IHARRISON ENTERPRISES INC
�« Do you know your HERS Rater?
To register for our If you do, you may want to send this CF -1 R to them.
monthly
newsletter, please CaICERTS Rater ID:
click here. OR
My Rater Quick Select: 1 The Energuy CA LLC
..--------
Every CaICERTS rater has a license number.
/f you need to find the rater'by name [Click HERE] to search our directory.
[CLICK HERE], to do another .
C:opi right'b` ^010
CaICERTS, 6ic. All rights reserved. f{evil d: January 11. ^010
[Terns 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-R8R, (877-437-7787)
Far: 916-985-3402 Contact Us
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h`ut tis CONGRATULATIONS
Tml"I"fi Your CF -IR -ALT -HVAC Registration is,.complete!
Racrr Dlrrctnry You may want to print this page for your records.
Forms 79715 CETRINO
Site Address: La Quinta, CA 92253
McmbenbipIIc�eics CEC Registration: 211-A0022763A-00000000-0000
Events CF-IR=ALT-HVAC: CLICK HERE TO DO\rNLQAD
Assigned Company: HARRISON ENTERPRISES INC
1`cvs Do you know your HERS Rater?
To register for our If you do, you may want to send this CF -IR to them. .
monthly,
newsletter, please CaICERTS Rater ID:
click here. OR
My Rater Quick Select:: The Energuy CA LLC
Every CalCERTS rater has a license number.
/f you need to find the rater, by name [Click HERE] to search our directory.
SEND CF j TQHE_R8.RA''gR
[CLICK HERE] to do another
Copyright i; °010 CaICER.TS, Inc. All ri8hts reserved. Revised: January 1 I, 2010
Tenns and Conditions [Privacy Statement Class Cancellation Policy]
I II ) II )]
CaICERTS Inc: 31 Natoma St Suite 120 Folsom CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
l
..p_dBB �Fmd us on;F Cd ebook
5/11"/2011
Bin # City of LA Quinta
Building 8L Safety Division -
Permit #P.O. Box 1504, 78-495 Calle Tampico
,\I�� La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and, Tracking Sheet /
Project Address: —/* % / S ��f -r /fid Owner's Name: G��,e5 h kln
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Address: 3
Telephone: r,<•.._:. �.:.M...�.�,.�rs:r.• :.
Project Description: f
City, ST, Zip:'�,AkkKs
Telephone 2 �7() 's:
State Lic. # : 3
City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:*
State Lic. #:,;:.<•:.
`' '"`�' ' `' `''' `"' [
;�,:�r:�z•<.�r <i��`:>:.r.: •. °''yj
,.;<,. > ;.;:;:«:,;;:ry Vit:, 4#�..
, Construction Type: Occupancy
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#• Stories:
# Units:
Telephone # of Contact Person:
# Submittal Req'd
Plan Sets
Estimated Value of Project: /'?j 97a. 00 .
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
Recd TRACIMG PERMIT FEES
. Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance.
Tide 24 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
20° Review, ready for correctionstissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up. S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN
'"' Review, ready for correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr.
Date of permit issue
Schodl-Fees
Total Permit Fees