12-0770 (MECH)4.4 a*&
P.O. BOX 1504 1 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
Application Number:
,�,.� s
iCT2=O:O;OA:O.7_7_0'_- 1
Property Address:
52194 ROSEWOOD LN
APN:
772-410-997-41 -32070 -
Application description:
MECHANICAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
3521
Owner:
KENT PEARSE
52194 ROSEWOOD LANE
LA QUINTA, CA 922.53
Date: 7/12/12
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.).
I—) 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:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of B 'I ' and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this applicatione, eachper Lose requestand for
whose benefit work is performed under or purs arm' ed as a f this application,
the owner, and the applicant, each agrees to, II defen , nify and Id harm a City
of La Quinta, its officers, agents and employe or ny act or omissio to the wor e
performed under or following issuance of this m' . y
2. Any permit issued as a result of this applicati n be me s %Jb vc�d j(wo not co I
within 180 days from date of issuance of s ch p mit, or ces i0 oJWVo :p80 d i subject
permit to cancellation.
I certify that I have read this application and state that a above intgi rrect. I agree to with all
aty d county ordinances and state laws relating to bw nstr orize r rese atives
of is cou ty to enter u n the above-mentioned property for ins
Date:. � [ - ignature (Applicant or Agent):
LQPERMIT _ ..
t
Contractor:
Applicant: Architect or Engineer:
PALM DESERT AIR COND CO INC
42081 BEACON 'HILL
PALM DESERT, CA 92211
(760)346-0677
�Pe
Lic. No.: 374937
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 Professionals 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 gense No.: 374937
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
h ��/E�s'
/ate[ " t/t ontractor.,: - G� ' "
issued.
1 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
OWNER -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 MID CENTURY Policy Number A09454905-12 -
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_'1 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 become 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 oft a Labor Code, I shall forth w' 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).:
Date:? �i Applicants—rte%
(_ 1 1, 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' COMPENSATION 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$100,0001. 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.).
I—) 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:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of B 'I ' and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this applicatione, eachper Lose requestand for
whose benefit work is performed under or purs arm' ed as a f this application,
the owner, and the applicant, each agrees to, II defen , nify and Id harm a City
of La Quinta, its officers, agents and employe or ny act or omissio to the wor e
performed under or following issuance of this m' . y
2. Any permit issued as a result of this applicati n be me s %Jb vc�d j(wo not co I
within 180 days from date of issuance of s ch p mit, or ces i0 oJWVo :p80 d i subject
permit to cancellation.
I certify that I have read this application and state that a above intgi rrect. I agree to with all
aty d county ordinances and state laws relating to bw nstr orize r rese atives
of is cou ty to enter u n the above-mentioned property for ins
Date:. � [ - ignature (Applicant or Agent):
LQPERMIT _ ..
t
Application Number . . .. 12-00000770.
Permit . . MECHANICAL..
Additional desc .
Permit Fee 31.50
Plan Check Fee
7.88
Issue Date . . . .
Valuation . . . .
0'
Expiration Date 1/08/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 16.5000 EA MECH
B/C >3-15HP/>100K-5'OOKBTU
16.50
T --------------------------------e
Special Notes and Comments
REPLACE (1) AIR CONDITIONING CONDENSER.
2010 CODES.
- -----------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473),
1.00
Fee summary Charged
Paid Credited
Due
------- ----------
Permit Fee Total; 31.50
---------- ----------
.00 .00
31.50
Plan 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
��
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
7City
Enforcement Agency:
Date:
7
Permit #:
52-194 ROSEWOOD DR. La Quinta, CA 92253
of La Quinta
Jul 9, 2012
Duct insulation
Conditioned Floor
,
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
7City
Enforcement Agency:
Date:
7
Permit #:
52-194 ROSEWOOD DR. La Quinta, CA 92253
of La Quinta
Jul 9, 2012
Duct insulation
Conditioned Floor
,
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
•❑ AFUE
❑ COP .
❑ R 6 (CZ 10-13)
Served system
p Sett•ack
❑ Indoor Coil
0 SEER 13.0
❑ HSPF ..
❑ R 8 (CZ 14-15)
1600 sf
If not a'ready present, must be
• Condensing Unit
❑ 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 tine 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 -111
and CF -611 shall also be on site for final inspection.
D 1. HVAC Changeout.
Required Forms:
. All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HEP_ S
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 I
CF -4R forms: MECH-21 and (for split systems) MECH-25 y
., . .
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 _
0;4• The _system,will not be Ducted (ie;`Ductless Mini -S Iit;System)I(Also Exempt�fromRefrigera�t Charge)
._< _ . r.,_ twin
112. New HVAC System
Requir'ed•Forms ,....>r`�'F ?''r.'`' V'S 4'`�.:b��`�•'.�`��f "e
lfiz*�` . r
. Cut in(or;,Changeout with{
,
ducts ;(all
` *f4 , T..•
A ��, 4 - ,, , n, ,. �M
CF_ 6R forms: MECH 04, MECH-20 HERS,tand"*(fortsplit systems) MECH-22 HERS and
new new ;
ductii `` n all new
MECH-25'HERS ;; y- `ser
F + *�" �-
CF 4R forms.jMECH
„9
equipment);.
, .20 and (for split systems)'MECH-22and°MECH=25' , -
Pe
�.
. e,f� .*tt ._ Y ..r�_�. �► � .�.-nr�a:....c. • x � � r #a� k � � st .�-
. -
Split Systemsc-Duct leakage;<I6 percent RC'CCA}>_r350 CFM/ton--FWD !,�TMAH,,STMS, and'either HSPF o'r`PSPP. -7—'
For "
For Packaged Units:'Duct leakage c6 percent
❑ 3'New.Ducts with/or without",'--
Required Forms:
Replacement ;5y
• Includes replacing or instal ling � all new
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split sistems) 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 -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 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. ' r
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliaace 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: Karl Brown Signature: Karl Brown
Company: PALM DESERT AIR CONDITIONING CO INC Date: Jud 9, 2012
Address: 42-081 BEACON HILL License: 374937
City/State/Zip: PALM DESERT/ CA / 92211 Phone: .'760) 346-0677
4 _
Reg:.-212-A0036084A-0000.00000000. Registration'_Date/Time: 2012/07/09 12:16:09 HERS Provider:` Ca1C_ERTS;'Inc.
2008 Residential Compliance For_____.-�. July 2010"
f
• yjl"-'•.f..�.; ==''�.��, "a" j�IauI1ICj/ �` Gam.
P.O.'Box`1504 • 78-495 Calle. Tampico, La Quinta,'Califofriia 92211
/! /! Tel: (760) 777-7012 • Fax: (760)-7:77; 7112 - -
••-!6hN qh6. DESERT Website: wwW:La-Quinta.Or6:- Email; Building@La-Quinta'Org. c"^•ar•r+�4w•
Bin # Permit M ,2
l_ Building Permit,Applicaton Tracking Sheet
Project Address: 52-194 ROSEWOOD DR.
Owner's,Name:' PEARSE, KENT
AR'...Number:
Address: 52-'194'ROSEWODD DR. ,
Legal Description.:
City, •State, Zip; LA QUINTA, CA 52253
Contractor: Palm Desert Air Conditioning & Heating, Company,.,
Telephgne: (
.Address: ' 42-081 Beacon Hill
Project Description'.
City, State, Zip: Palm Desert, CA
92211
REPLACE(1) AIR CONDITIONING CONDENSER.
Telephone No:: (760) 346-0677
k k iii w .�
.State: Llc. #: 374937
-City Lic. #: 100886
Arch:YEngr,/Designer:
Address:
.City, State, Zip:
Tele
Telephone No::
p
�r
w Pik.
Construction Type:
Occupancy:
State:: Lit. #:
.w
®Add'r0AlterOT• . Repair O Demo
Name of Contact Person: KARL BROWN
:Sq. -Ft":
#'Stories:
# units:
Contact.T -Iephone No.:• (760) 346-0677
'Estimated Value:of Protect $3,5.21.00
APPLICANT: DQ NOT WRITE.
-BELOW THI8'LINE
#
Submittal
Req'd
Recd
* Tracking
Permit Fee's
Plan Sets
Plan Check -Submitted
Item
Amount
Structural Calcs.
Reviewed, Ready for Corrections
`
Plan Check Deposit '
Truss Calcs. •
,.
Called Contact Person
Plan Check Balance:;
-
Title 24'Calcs.
ti
Plans Picked Up
Construction;
Flood Plain Plan
`Plans. Resubmitted
Mechanical
Grading Plan.
2"O -Review, Ready for Corrections
Electrical
Subcontractor.List
Called:Contadt Person
Plumbing
Grant Deed
Plans Picked Up
�
S:M.I.
,
N.O.A. Approval
Plans.Resubmitted
'Gra dirig
IN HOUSE
3i° Review; Ready for,Corrections
Developer Impact Fee
Planning. Approval
Called; Contact Person
Pub. Woiks'Appr I
Date of Permit Issue
School Fees
Total .Permit ee's