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13-0460 (MECH)7 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000460 Property Address: 77941 LAGO DR APN: 658-270-049-24 -4418 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 14370 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: GERALD DICKEY 77941 LAGO DRIVE LA QUINTA, CA 92253 Contractor: Applicant: Architect or Engineer: GENERAL AIR CONDITIO 31170 RESERVE DRIVE THOUSAND PALMS, CA 22 (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 Professionals Code, and my. License is in full force and effect. License Class: C20 License No.: 686310 f Date: Contractor: v ` GOWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Slate 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 Cade) 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 acivil 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 sate (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 contractorlsl 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: Lender's Address: I,QPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/11/13 APR 111013 . OFLAQUIiV I 1NANr= ___ WORKER'S COMPENSATION DECLARATION 1 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. 631 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 ZENITH INS CO Policy Number Z071741502 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 laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I sh ll forthwith comply with those provisions. 4 � 1I )3 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 ($100,000). 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 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. �. Date: 1411f3 Signature (Applicant or Ageni)'�%!� LQPERAI IT Application Number . . . . . 13-00000460 Permit . . . MECHANICAL Additional desc . Permit Fee . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/08/13 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-SOOKBTU 33.00 ---------------------------------------------------------------------------- Special Notes and Comments ' HVAC CHANGE OUT (2) 3TON 13SEER/78FAU COMPLETE SYSTEMS (2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING 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 r 83.50 LQPERAI IT Bin. # Cit}/ Of La Qut'n: to Bullding U Safety Division P.O. Box 1504,78-495 Calle Tampico La..Qltinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # / ^ , 15- (L� Project Address: -7-7 C1 y 1 L 0. v -br: ve- Owner's Nn:-Gere-16 i A. P. Number. Address: 77 9 y La O �r i U C Legal Description: Contractor. G carer c- A�,r` City,ST Zi : Q p R J�'Y\ � G cA 9 2253 Telephone: Address: 3\1-10 _QeSet-VG Project Description: City, ST, Zip: �pv d Cl Z 2--7ty e �ac�31owa AjC_ .0, -70V— 'BT - Telephone: 760-343-7L1 88< r 1EM, rvrv�a�� — Z S �eXYI State Lic. # : (o � 3 1 O City Lic. #; Arch., Fngr., Designer Address: City, ST, Zip: Telephone: State Lie. #: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Detno Sq. Ft.: # Stories: # Univ. Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project i q 3 -70._ CXR APPLICANT: DO NOT WRITE BELOW THIS UNE H Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets PIan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Mile 24 Calci. Plans picked up Construction Flood plata plan Plans resubmitted.. Mechanical Grading plan Z'! Review, ready for correctionsfissue Electrical Subcoutactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M I. H.O.A. Approval Plans resubmitted Grading 17V HOUSE:- '"' Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Sy s�ern I Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACA/terations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit 4t: 77941 LAGO DRIVE La Quinta,_CA 92253 City of La Quinta Apr 10, 2013 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat L3 Package Unit ® Furnace ® Indoor Coil ® AFUE 8% H SEER 13.0 0 COP O HSPF - 13 R 6 (CZ 1013) Served by system ® Setback If not already present, must be ® Condensing Unit p EER Q Resistance ❑ R 8 (CZ 14-15) 1100 sf installed) l7 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 Efficiencles: 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 -411 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:: pis Duct system vires docutrie feQ to have been previously sealed and confirmed through HERS verification, or '.'[j'2.- Duct'systems with less that 40 linear feet in unconditioned space, or p•3. Existing duct systems aretonstructed, insulated or sealed with asbestos i Q 4; Th& xysteam-will not be Dud d`(ie DucdessMlarShtgSystem Al o Exe ' tifge Refs+gerarst�Charge) t._.... _ r :..........:. :.. ❑ 2. 1Nev� a3: i(•. Re ui�d::F,>orms.:::'. .�.::.::::. ;�... �::;:;;<•::,;: ��. '��=> q .m>�. a-�.:�:c- �..�:._::.....' ._. .:__•. x: ��•. mac. ��., • Cut fmGrChangeout wrtt► new k i ets; r(a1t new .4 ' t. r.._ CF f' Arms t+1ECH-04, Nti ��4 Z0 ITERS, d C(Qr 5lilit systet sj MECH' 2Z 1ERS, rtd duct ng and all new :. CF-43LhiECR EC1i 25 a ': equipr»e t: r. . For Spilt Sy§teisiJve}leakage2<yb percent,=#C, GCA 350 EfMJto; F1P1Cr CHAR, 5tfit5; and<Either #SPP or"PSPP. For•Packagje:d:Elnits: Duct leakage:=< 6:percent`? :::: = :' ::'.' ::: 3.:New,D..... rith/or without< <:"':: Required Forms: . includes replacing or in"stalfing a f -hew ducting and/or outdoor cb.h:densing i)nit . 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 Z 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 134. 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 dud in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Dud leakage < 15 percent E3 EXCEPTION: Existing dud 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, calailations, 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: Apr 10, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 213-A0021292A-000000000-0000 Registration Date/Time: 2013/04/10 15:12:05 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 S 5+ems► ?- Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT-HVAC Climate Zones 10 - 1S Site Address: Enforcement Agency: Date: Permit #: 77941 LAGO DRIVE La Quinta, CA 92253 City of La Quinta Apr 10, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat Q Package Unit ® Furnace ® AFUE 78% ❑ COP [3 R 6 (CZ 10-13) Served by system ® Setback ® Indoor Coil ® SEER 13.0 ❑ HSPF 0 R 8 (CZ 14-15) 1100 sf !f not already present, must be ® Condensing Unit [JEER 0 Resistance installed) p 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 -411 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 Exempted from duct.leakage testing i .: p 1: Dact system was docurrientieii to have been previously sealed and confirmed through HERS verification, or p 2: Duct'systei rns with less than 40 linear feet in unconditioned space, or C1.3. Existing duct systems are .: odpstructed, insulated or sealed with asbestos ❑'4; The.systetnxycill not be Ductei!'(ie: Ductless_Mini Split System)i4lso Exelt;fotRefrgerani Charge) ❑ 2. IMew_� Requi . Cut rn�oY>rtian east wt i new z4EGH duetengXa d .. ..................... . 6 arms MECH M. HERSdgr 25FtEItS. ;: F::..�„. ;`.,..:::.::.::: :.:.•<<.. wF:. • y_::. all n w. .C�FFt�for h1ECii- 0; ant {#cr: s lit s te}rts)htECH Zattd i!�ECiZ5 t equip�;, ), . .. ..., �. �..._y> . �.. �. � :: tom. i:< �x�` �. ��. �.�a �::i.�... s>�..� :.;;c �., . �•:..;�:: For SplitSV-ptetns ClidlJ{otr, FVJD;M. AF1, SfNtS; arideither t�SPP or"P5PP. For Packaged Units: Dui t leakage:;<;6: percent: :.:.::::.:.:.. ..,.:.:..:::::•:...::... :.. ..... :..:: •. . ❑ 3.: New Duc.'t;stirith/or withoufi:::;: Required Forms: . includes replacing or installing 6#-iiew ducting and/or outdoor coiiilens t:g:::unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or 6j'fna8ec:Na or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 0 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 E3 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: Apr 10, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 213-A0021293A-000000000-0000 Registration Date/Time: 2013/04/10 15:14:28 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forma July 2010