14-0744 (MECH)11 //
P.O. BOX 1504 c&ht 4
-�: 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
14-00000744
Property Address:
79895 LIGA
APN:
772 -230 -039 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
9026
Appli t: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 a licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a rofessione , Code, a9d4py License is in full force and effect.
License Class: C10 C16 C2 Li e 0.:/45R554
�Qate:d�6� Contractor:
/�J O NER-B LDER DECLARATION
I hereby affirm under penalty of perjury that I am empt fr m the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professi de: 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).:
(_) 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.).
(_) 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.).
(_) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
ID a` C� te: /14
Owner: 1 1.
Jil
DAN ANDERSON
79895 LIGA JUN 0 ,;4 2.(191
LA QUINTA, CA 92253
OF LA QUIMN
Contractor:
PREFERRED PLUMBING HTG A/C
P.O. BOX 5120
PALM SPRINGS, CA 92263
(760)322-3173
Lic. No.: 457554
-----------------------------------------------
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 7600006445141
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 a o become subject to the workers' compensation laws of California,
and agree that, if I shout come subject to the rkers' compensation provisions of Section
3700 of the Labor Cod (/shall forthw' c y ith ose provis' ns.
,Date '.O &Applicant:
WARNING: FAILURE TO SE RE WORKER 'COM E SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN IE 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, indemnity 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 a information is correct. gree to comply with all
city and county ordinances and state laws relating to buil ' onstruction er a ho ize representatives
of this county to enter upon the above-mentioned prope y or insp ctio purpos '
Date 6 Signature (Applicant or Agent): r
LQPERMIT
Application Number . . . . . 14-00000744
P%
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 11/29/14
Qty Unit Charge Per
Extension
2.00 35.7500 EA MECH FURNACE
71.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE (2) FURNACES 80 %AFUE PER 2013
MECHANICAL CODES. [2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2013 CBC.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 71.50 .00 .00
71.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 139.23 .00 .00
139.23
Grand Total 210.73 .00 .00
210.73
LQPERMIT
I Simplified Prescriptive Certificate of Compliance: 2008 Residential RVACAlterations� CF-IR-ALY-HVAC
Climate Zones 10 to 15
5����< / ` ��
L1
E�fofcerne t A en ry � �
`Date Permit #:
S
�
EquipmentTypel
List Minimum Efficienc 2
Duct insulation requirement
Con(litionid Fl or
Area Thermostat
❑ P kaged Unit
mace
❑ COP
Over 40 ft of ducts added or
Setback
❑ Indoor Coil
❑
❑SEER
❑ HSPF _
replaced in unconditioned space
P P
❑ R 6 (CZ 10-13)
S rued b stem
system (If not already
Condensing Unit
❑ Other
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
�� sf present, must be
installed)
I. 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% AFVE, 7.7HSPFfor 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
installei. The inspector also verifies that each appropriate CF -6R and registered CF forms
-4R (no hand filled CF-4Rs allowed) are filled out and
Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
I. HVAC Changeout
Required Forms:
rieed•
All HVAC Equipment replaced
CF-6Rforms: MECH-04,MECH-2I-HERS and (for split systems) MECH- 25-HERSCF-4Rforms:
MECH- 21 and (fors lit stems) MECH-25
C ondenserr Coil and /or
an
• Indoor Coil and
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
CF -4R forms: IvIECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Mnimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
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
❑ 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
CF4R forms: MECH 20-, and fors lit stems
new equipment) ( P sY }MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA> 350 CFM/ton, FVJD, TMAH, STMS, and either HSPP orPSPP.
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 equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over 40 feet Required Forms:
• Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
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 er-pplicable compliance forms, worksheets,
calculations, laps and specifications submitted to the enforcement agency for a royal with the
pe [io
Name: Q� o Signature:
CompanA�4yr -E Q LJM � , q_ f ate:
Address��y� �� �� License:
City/State/Zip: ' �� �� Q 6 A
L Phone: �!./1 _ �o. . n 9 '.2
Simplified Prescriptive Certificate of Compliance: 2008 Residential RVAC Alterations CF-IR-Ay.,�--HVA
Climate Zones 10 to 15
S' ddr s� Ejrjorcement A enc��
' Dat Permit #:
Equipment T e'
List Minimum Efficiency 2 Duct insulation requirement
Conditioned floor
Area Thermostat
❑Packaged Unit
amerce
�j)
�
Over 40 ft of ducts added or
❑ COP
Setback
Indoor Coil
SEER
replaced in unconditioned space
❑ HSPF
S rved by system (If not already
!
❑ Condensing Unit
❑ EER
❑ R 6 (CZ 10-13)
❑ Resistance
6
(ti sf present, must be
❑ Other
❑ R (CZ 14715)
installed)
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, 7.7HSPFfor 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 replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF4R 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
CF4R forms: MECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/tonGV inimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
.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
❑ 2. New HVAC System
Required Forms:
• Cutin all new ducticacti Chang with new
ducts: (alng and all
CF-6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CH 20-d
CF -4R forms: ME , anforslit stems
( P sY )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
❑ 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 forests: 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:
o Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned s ace.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existina 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.
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.
o The design features identified on this Certificate of Compliance are consistent with the information documented on Qtber Applicable compliance forms, worksheets,
calculations, plaits andspecifications submitted to the enforcement agency for approval with the pe do
Name: VA -T79 D` ® Signature:
Compan .
�ED. ftC,�/moi 1, ' ate:
ressyPF_Ere
Address.T
O Wx 5,! 2_6 License: �.O —y's!.-.4
City/State/Zip: ` - 1 "l ���� S a� Q /o %; Phone: �iUCb —f_`7 — %i 7_
4.>
Bin Q ®f La �"nta
Building fat Safety Division
•P.®o Box 1504, 78-495 Calle Tampico
Permit # . IV%' La Quinfa, CA 92253 - (760) 777-7012
Suilderi Permit A plica and 7'
:Y pP racking Sheet
Project Address: _ T"• '::, ; / �v Owuer`s Name: aA^✓ 17 MOej .96 AI
A. P. Number. Address: '79 L) 6 A
L'e Descz� do c ; ' •: ==; ..:. ST Zip Q CJ -
re".f tr'2C. nditj fining dba
Con actor.. .:�....,..:: <„; -.:. ,.::.......
:..:.<<Aluiribirl Heatin &AJ�Telephone:
Fss: � ;P Q:.+ :; >�.� `:,:
:B.o. ,52.Q. Project Description:
SZipPi.n? gs CA: 9226 RE /�
P• a° s
State Lica.# :;'.=:_:4.7 55`.4' ' ;', ` City Lic. #: 222 9
_ Arch,;.Etigr:;Designer:.,". "
Address::
Telephone;.:
State,Ll # : . ' ; ; -' •> `'=-
ConstructionType:
Project type (circle one):
Occupancy:
cy:
New Ad(Pn Alter Repair Demo
Name..gf'.Co ctPeF$9g::' :.:'ES'g' , "BARAJAS Sq. Ft: #Stories: #Units:
” Telephone # ofigl�ifact F?ersous" u6 0) ) 863-0832 Estimated Value of Project a Q O
APPLICANT: DO NOT WHITE BELOW THIS LINE
# .•'Sgbinittal
->' :-.<'.1:;: ' ' . RegId
Reed TRACKING '
PERMkT FEES
::P1an,Sets::.
<:'"".;...
Plan CheckfsDmittedIte
Amount
.Strtictural:Cal�s:.
Reviewed, ready for correctionsP[a
CheckDeposit
Called Contaet Person
Pla Check Balance
nei gyalcs :• :
Plans picked up
Con traction
Flood plain plan "
Pians.resubmitted
Me cal
Grading plan' . . ".
2"d Review, ready for'correctionsrssue
Ele cal
: ,Sub66ntactor.L;ist
Cailed ContactPergon
Pln bin g
GrantDeed " "
Plans picked up
MO.A.. Approyal
Pians resubmitted Graing
Review„ ready for corrections/i; Devi oper Impact Fee
Planning ApproyaF.
Called Contact Person A L p
.-Pub. Wks. ApprDate
of permit issue
30001$+cc5
Tot Permit Fees •