11-0355 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO,
LA QUINTA; CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MCCOY JOSEPH
79410 LIGA
LA QUINTA, CA 9225
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/11/11
Applicant: _ Architect or Engineer: -
Contractor: ' U APR1011
GENERAL AIR CONDITIONINtG U I
Application Number: -•'
11-00000355 =
Property Address:
6.79410 .LIGA
APN:
772-130-055-
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
- 5585
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MCCOY JOSEPH
79410 LIGA
LA QUINTA, CA 9225
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/11/11
Applicant: _ Architect or Engineer: -
Contractor: ' U APR1011
GENERAL AIR CONDITIONINtG U I
31170 RESERVE DRIVE
C1 OF to
THOUSAND PALMS , • CA 922 QV1NrA
OL
1A,(760)
343-7488 Depr
LiC. No.: 686310
------------------------------=------------------------------------=-----------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed 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 gtofessionals Code, and my License is in full force and effect._
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 �� I License No.: 686310
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�1issued.
Date: t` (\ ntraaor: , _
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 .
—4WNER-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier EVEREST NATL Policy Number 76 0 00 0614 7101
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for 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 b Fome subject 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 subject to 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 of the Labor Code, I shat
forthwith comply 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: plicant:
(_ 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
WARNING: FAILURE TO SECURE WORKERS' OMPENSATION 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 1$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.).
(_ 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 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
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.
1 certify that I have read this application and state that the above ll•Rformation is correct. I agree to comply with all
city and county ordinances and state laws relating to building co Struction, and hereby authorize representatives
of thi ounty to enter upon th bove-mentioned property for in 'rection purposes.
ate: 1 Si ture (Applicant or Agent):
LQPERMIT
Application Number . . . . . 11-00000355
Permit . . . MECHANICAL
Additional desc .
Permit Fee 31.50 Plan Check Fee
7.88
Issue Date . . . . Valuation . . . .
0
Expiration Date.. 10/08/11
Qty Unit Charge 'Per
Extension
BASE FEE
15.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
--------------- - -
Special Notes and Comments
INSTALL NEW 3.5 TON (13 SEER) CONDENSER
AND.INDOOR COIL. 2010 CODES.
-------------------_------------------------------------ - -
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary. Charged Paid Credited'
Due
Permit Fee Total '31.50 .0.0 .00.
31.50
P1an.Check Total 7.88 .00 .00
7.88
Other Fee.Total 1.00 .00 00
1.00
Grand Total 40.38 .00 .00
40.38
LQPERMIT
Sim lifted Prescri tive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
794/0
Enforcement Agency:
L -c-
Date:
Permit #:
E ui ment Type
List Minimum Efficiency Z
Duct insulation requirement
Conditioned Floor
Area
Thermostat
❑ Packaged Unit
❑ Furnace
❑ AFUE 80%
❑ COp
Over 40 ft of ducts added or
Setback
Indoor Coil
❑SEER 13
❑ HSPF
replaced in unconditioned space
Served by system
(1)'not already
Condensing Unit
❑ EER 1/
❑ Resistance
❑ R 6 (CZ 10-13)
sf
present, must be
❑ Other
❑ R 8 (CZ 14-15)
installed)
1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -1 R-ALT-HV1I Cfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPFJor 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
i ed. Beginning October I, 2010, a registered co of the CF -IR and CF -6R shall also be on site for final inspection.
it1. 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
• Indoor Coil and/or
CF -6R forms: 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
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:
with new
• Cut s: al Chang outducting
ducts: (alt new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new a ui ment)
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
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
113. 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 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.-
orms:Includes
Includesadding or replacing more than
linear feet of duct in unconditioned space.
CF-6R forms: MECH-04, MECH-2I -HERS CF -4R forms: MECH-21
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 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• 1 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 feantres identified on this Certificate of Compliance are consistent with the * orm tion documented on other ppli ompliance forms, worksheets,
calculations, plans ands ecifications submitted to the enforcement agency for appro al with t e permit application.
Name: leen Uja_ .S,5y1
Si ture:
Company.
C_-7 &n eOraj n' YC ` `
l7
ETDdate:Address: 311-70 /Z�serue &tt✓g,
Lic n 68010
tA-S��C.GN�S. G��
,3CyState/Zip:
e:7x-3443— TIi�
ZUUn ttesrclential (.ompliance Forms March 2010
tsm )v
City of La Quinta
• Building &r Safety Division
Permit # y
P.O. Box 1504, 78-495 Calle Tampico
til
La Quinta, CA 92253 - (760) 777-7012
f
Building Permit Application and. Tracking Sheet
Project Address: 7 N/ L
o l
/ C
Owner's Name: Jpse h G O
A. P. Number:
Address: 79Y/ O Lt• oL--,
Legal Description:
City, ST, Zip: La9 �
Contractor:
Telephone: %( �-
Address: 3
y Project Description:
City, ST, Zip: '' ``
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. �....;✓ 'moi it�a,-- L
Telephone:
s ;
� S
State Lic. # :
City Lie. C
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
r;�;,:f�;:,>r:?:�>;::;:` �:<:>;•:.:::�•:>.::�;:<::;� , _
/ :.:r•,.> :::<' ';:>r" Construction Type: Occupancy:
{k..;�.r�{;$�;ir5:2; {r4i::4i/.•. �{i:::�4{}i
State Lic. #:
`` :,?F•,f;, : ` ,:;;::•.::•,•,{...,-� R" ` Project type (circle one): New, Add'n Alter Repair Demo
Name of Contact Person:
-7-
Sq. Ft.: #Stories: # Units: ,
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Re
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Am oant
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Plan Check Balance
Truss Calcs.
Called Contact Person
Title 24 Calcs.
Plans picked up
Construction
Mechanical
Flood plain plan
Plans resubmitted
Grading" plan
2"' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing.
S.M.I.
Grading
Grant Deed
Plans picked up.
H.O.A. Approval
Plans resubmitted
IN 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
I