12-0323 (MECH)4 P.O. kX=4504 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: 3/28/12
Application Number: 12-0000032-3.� Owner:
Property Address: 60434 HONEYSUCKLE ST BORZACHILLO FAMILY TRUST
APN: 764-420-032- - - 60434 HONEYSUCKLE ST
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 5500
Contractor:
Applicant: Architect or Engineer: GENERAL AIR CONDITIONI
31170 RESERVE DRIVE
�� 2U12
THOUSAND PALMS, CA 92274
(760)343-7488
I Lic. No.: 686310' CITY OF5ArOUINTA
--------------------------------------------------- --------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am I' ensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and P essionals Code, and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 License No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: 4 Z ontractor: YT 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
NER-BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury t at I am exempt from the Contractor's State License Law for the Carrier ZENITH INS CO Policy Number Z071741501
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance ofthe work r which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to becomes .1c
to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subj t the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 :ofthe abor Code, I shall forthwpkomply with those provisions.
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)•: ate: 3 28 p"car
(_) 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 WARNING: FAILURE TO SECURE WORKECOMP NSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706. OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 abov ormation is correct. I agree to comply with all
city and county ordinances and state laws relating to building c ruction, and hereby authorize representatives
Zof t is 3 q G I county
� to enter upon the above-mentioned property for ' ection purposes.
ate: � nature (Applicant or Agentl:
• V
�• Application Number .. . . . . 12-00000323
Permit . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
'10.13
Issue Date . . . . Valuation . . . .
0
Expiration Date 9/24/12
Qty Unit Charge Per
Extension
BASE FEE
15.00 C
1.00 9.0000 EA MECH FURNACE <=100K
9.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT: INSTALL NEW 4 TON
SPLIT SYSTEM, FURNACE, INDOOR COIL,
CONDENSER. 2010 CODES.
---------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
-------
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 40.50 .'00 .00'
40.50
Plan Check Total 10.13 .00 .00
10.13
Other Fee Total 1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63
,
LQPERMIT ` f
CaICERTS,-, CF -1R Registration
Page 1 of 1
A V61Wi ?e _ o;n i60gy`806flg'bvvider
Public Home Danielle Garcia logged in (Logout]
[Home]
CONGRATULATIONS
• Secure Home '
Your CF -IR -ALT -HVAC Registration is complete!
About. Us You may want to print this page for your records.
-Training Site Address: 60434 HONEYSUCKLE STREET
La Quinta, CA 92253
CEC Registration: 212-A0015158A-00000000-0000
Rarer Directory= ---- CF -IR -ALT -HVAC: CLICK HERETO DOWNLOAD
Forms " Assigned Company: HARRISON ENTERPRISES INC
Membership Benefits Do you know your HERS Rater?
If you do, you may want to send this CF -1R to them.
Events CalCERTS Rater ID:
OR
Industry Partnersi
My Rater Qulck Select:Select From List
Every CaICERTS rater has a license number.
News k you need to find the rater by name Click HERE to search our directory.
�� SEND>GF 1R TQ HERSRATER ,,
To register for
our monthly
newsletter, [CLICK HERE] to do another
please click here._,
Copyright O 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2010
[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
Find us on
BBB�ba�
,»
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
60434 HONEYSUCKLE STREET La Quinta, CA 92253
City of La Quinta
Mar 28, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
[3EER
❑ Resistance
[IR 8 (CZ 14-15)
1693 sf
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, 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 -6R 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 -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 -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
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
04. The system will not be Ducted,(ie�Ductless�Mini-Split system)T(Also,Exempt-from•LRefrigerant Charge)
`(
❑ 2. New HVAC System
Required Forms:`
. Cut in,".or Changeout with",
new ducts: (all new -
r�,. — -
CF 611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and _ -
ducting � all new
MECH-25-HERS I t )P f -s
CF -4R for'ms: MECH 20, and (for split systems) MECH-22, and MEC -}
equipment)
equipment)
I/ .tom �+ - �- •.�,*,+ 1J"�'`
For Split Systems: Duct leakage <"6'percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage' < 6 percent '
❑ 3. New -Ducts with/or without
Required Forms:
Replacement 11,1
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil 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 than 40 CF -61k 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: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Mar 28, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0015158A-00000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2012/03/28 09:52:02 HERS Provider: CalCERTS, Inc.
July 2010
Bin # ' .
Permit #
`Y
Project Address: (004-3,q 14prl
City of La Quin to
-Building 8i' Safety Division
P.O. Box 1504, 78.495 Calle Tampico.
La Quinta, CA 92253 - (760): 777-7012
Building Perm.it- Applicad n and Tracking Sheet
l7 LXK1 Q cot . Owner's Name: An`Q I p _ FoO Z q Gh I I I o
.
A. P. Number: 44 -2—L32...
Address:
Legal Description:
City, ST, Zip: LArA2�3
Libeml kf
Ad4ress:3
City, ST, Zip: 7 te-10
�'7
Telephone. $+ G
Project Description:vwkc 1Q wenr
4 -bni S'1",e m
Telephone: 3
; :"<r">>QY
a ,rA,
State Lic. # : 3
City Lie. #; &0 (10-
Arch., Engr., Designer:
Address:
(.J.ty S`T rip
..
..,
Telephone:
f y:,•. .,MIT
,r
'` r n=`>rr'' rY.:
a ye' %4 1! ;•••w,-
Construction Type: Occupancy:
State Lic.#: �
Project type (circle one): New Add'n Alter Repair
• Sq. FL: #• Stories: #Units:
Demo
Name of Contact -Person: CC') (,(.2 e -dl 60_cc�-S VYU
Telephone # of Contact Person: -
Estimated Value of Project: j S 0 O
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets
Req'd'
Recd
TRACIMG
Plan Check submitted
PERMIT FEES
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:-
7rd Review,.ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.Y.
Pub. Wks. Appr.
Date of permit issue
School Fees
Total Permit Fees