14-0706 (MECH)P.O. BOX 1504,
—78-49�'CALLE TAMPICO
to LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000706
Property Address: 77947 LAGO DR
APN: 658-270-048-23 -4418 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8000
Applic t'
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MURRAY JIM
77947 LAGO
LA QUINTA,
VOICE (760) 777-7012 .
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/28/14
DRIVE
Itt2914 CA 92253
Contractor: CITY LAQUWTA
Architect or ginger: LA QUINTA AIR COND/HEATING INC F110PICE [DEPT
5387.5-AVENIDA NAVARRO
LA QUINTA, CA 92253
(760)837-9344
Lic. No.: 902029
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 P ssionals Code, and my Li is in full force and effect.
/License Class: C20 License 029
Date Contractor:
OWNER -BUILDER DECLARATION
1 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.l.
1 _ 1 I am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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
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 STATE COMP Policy Number 9037215
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 �becobjectto the workers' compensation provisions of Section
` (and a of the Labor to t with those provisions.
Data✓ 2 � r Applicant:
WARNING: FAILURE TO SECU WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C IMINAL 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 i mation is correct. I agree to comply with all
city and county ordinances and state laws relating to building con r tion, and hereby authorize representatives
of this cou ty tt enter upon the above-mentioned property for in a tion purposes.
Date: Z�f / Signature (Applicant or Agent):
Application Number . . . . . 14-00000706
Permit . . . MECHANICAL 2013
Additional desc .
Permit -Fee . . . . 83.42 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 11/24/14
Qty Unit Charge' Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 11.9200 EA MECH APPL REP/ALT
11.92
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
---------------------------------------------------------------------
Special Notes and Comments
HVAC FURNACE & INDOOR COIL CHANGE OUT 13
SEER 5 TON PER 2013 MECHANIOCAL
f CODE:CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION.-
---------------------------------------------------------=-------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E'
90.57
PLAN CHECK, MECHANICAL
52.43
Fee summary Charged Paid Credited
-------------------------------------
Due
--------------------
Permit Fee Total 83.42 .00 .00
83.42
Plan Check Total .00 .00 .00
.00
Other Fee Total 144.00 .00 .00
144.00
Grand Total 227.42 .00 .00
227.42
LQPERMIT
Bin #
Permit #
w P-roject Addcess9 7-1/7L
City of La Qulnta
Building &r Safety Division
P.O. Box 1504,.78-4 95 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
p FOwner's Name:
A. P. Number:
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Address: I -7 — I Lf -7 v -
Legal Description:
City, ST, Zip: 4—tA 6L V t K�14 C44 q 2-2__<__3
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•onracor: lY
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,telephone:
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State Lic.,# :� C) ).- 0 q
City Lie. #.
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Arch., Engr., Designer:
Address:
City, ST, Zip:.
Telephone:
State Lie. #:
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Construction Type: Occupancy:
Project circle one): New Add'n Alter Repair De
� type ( ) p mo
Name of Contact Person: �•(N
Sq. FL:
# Stories:
# Units:
Telephone_# of_C-on_tact Person: '� 7
�'►� --�- d t� 6Y
Estimatedi\/a`!ue of-P-cojcct
APPLICANT: DO NOT WRITE BELOW THIS LINE
/f
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss C21cs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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.
R.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
i
Total Permit Fees
r
05/23/2014 15:02 FAX 7603603277 AIR SOLUTIONS Z001
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
77947 lago drive La Quinta, CA 92253
City of La Quinta
May 23, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
..❑ Package Unit-
nit
® Furnace
0
Indoor Coil
❑ AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
IM
®SEER 13.0
® HSPF 7,7
E]R 8 (CZ 14-15)
1200 sf
If not already present, must be
Condensing Unit
[I® EER
Resistance
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 -1111
and CF -611 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 -411 forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Far Pac,16ag ..t
Units. PyEt 19
ed p
Exempted from duct leakage testing: f.:
[11. Duct system was.dacdrrierited. to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with rless.than'40 linear feet in unconditioned space, or
❑.3.. Existing duct .systems are. constructed, insulated or sealed with Fsbestos
❑ 4: The'system will riot be Du'cte'd (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2: New HVAC System
Required. Forms:
. Cut in or Chang out with
new duct,, (all new `
CF -6R forms MECH 04; MECH 20 HERS, anc.(for split systems) MECH=22 HERS, and
-.
ductinc i all new
J Z�IISi.
nt)`.
MECH 25 -HERS :;
-� _.
CF -4R forms MECH-20, and (for split systerrs).MECH-22 and MECH-25. _.
equip
ForSpI ystems: Duct lea_kag
< 6'perceit;.RC, CCA: 350 CFM/ton ;FVVD,.TMAH SlT1S,.and eidier HSPP orPSPP.
For Pac. aged Units:'IDuct
tealage; `c:6 :percent
❑ 3. New. Ducts with/or without
Required Forms: .:
Replacement
. Includes.r.eplicing: or. installing ali;nevv
ducting and/pr outd6or condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or.indo.)r coil and;/or-furnace.-No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakag=..< 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 -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 complpte.
. 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: Steve Garcia Signature: Steve Garcia
Company: LA QUINTA AIR CONDITIONING & HEATING INC Date: May 23, 2014
Address: 53-875 AVENIDA NAVARRO License: 902029
City/State/Zip: LA QUINTA / CA / 92253 Phone: (760) 837-9344
P.r--g:'214-A(#037627A-000000000-0000 Registration Date/Tilne: 2014/05/23 18:00:45 HERS Provider: CalCEP..TS, Inc.
2008 Residential Compliance Forms July 2010