14-0525 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number:
14-00000525
Property Address:
52383 AVENIDA RAMIREZ
APN: .
773-261-023-9 _000000 -
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1076
Applicant: Architect or Engineer
------------------
LICENSED CONTRACTOR'S DECLARATION
•t_4 4aQ"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
AI
r A P2, SO
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1 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 C38 Lic`enseNo.:•/967982
Date: -, — y Contractor:
V OWNER -BUILDER DECLARATION
I 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).:
(_) I, as owner of the property, ormy employees with wages as their sale 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(sl licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Seo. , 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
Owner:
SUSAN GONZALES
52383 AVENIDA RAMIREZ
LA QUINTA, CA 92253
(760)399-7483
Contractor:
BEST IN THE WEST AIR COND/HTG
255 N. EL CIELO, 140-125
PALM SPRINGS, CA 92262
(760)343-1002
Lic. No.: 967982
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153-
Date:
77-7153
Date: 4/29/14
- 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.
j�lLave 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 NORGUARD Policy Number 13EWC337354
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 h/wiithh comply with those provisions.
Date /'� '� Applicant //�7 _
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 15100,0001. 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 f '/`/�Ction purposes.
/Date* Signature (Applicant or Agen�_'"
l
Application Number . . . . . 14-00000525,
Permit MECHANICAL 2013
Additional desc .
Permit Fee. 11-92 Plan Check Fee
.00
Issue Date . . Valuation
0
Expiration Date 10/26/14
Qty Unit Charge Per
Extension �.
1.00 11.9200 EA MECH APPL REP/ALT
11.92
----------------------------------------------------------------------------
Special Notes and lY5Yiment"S
HVAC CHANGE OUT - REMOVE AND REPLACE 5
TON COIL [2008 ENERGY] CARBON MONOXIDE
'ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
4.77
Fee summary Charged Paid Credited
Due
Permit Fee Total 1,1.92 00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 95.34 .00 .00
95.34
Grand Total 107.26 .00 .00
107.26
LQPERMTT
B1n.# '
Clty. of LQ QLl1[1ta
ButWg BE Safety Division
P.O. Box 1504,76-495 Calle Tampico
1.a.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application -and Tracking Sheet
Permit #
Project Addt'ess:2' 7j g Pbt 01-t/i^
Owner's Name:. S v s G —G Gile
A. P. Number.
Addccss: �)'Z, 3 _ r Z
Legal Desctipdon:
Contractor. S4 I �N
City, ST, Zip: LC � l
Telephone: -7 —3 91 — 74 $ j
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Adam: 11 i- e/" t of t PA / q o—lz5
Project Description: J.P wLe'lve le.0 e
city, ST, zip: At.,S r; 7 c'
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State Lia #: Lic, fl,
Arch., Eng., Designs?
Address:
City. ST. Zip: '
Tebph= Construction Type:. C Oa ancy:
IStftLic.#: Project type (circle ono): New Add'n Alter Repair Demo
I3ame of Coataet Person (G W,0c, Sq. FL: I # stories: J a Uaits
Telepbonc # of ContaMPerson:
Estimated Value of Project 10.7&, 6 O
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Tills 24 Cala.
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Snbcoataetor List "
Called Contact Person
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Date of permit issue .
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Total Damp Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HV
Climate Zones 10 - 15 +?"
Site Address:
Enforcement Agency: Date:
Permit #:
52383 Ave Ramirez La Quinta, CA 92253
City of La Quinta Apr 21, 2014
Duct insulation
Conditioned Floor
-
Equipment Typel
List Minimum Efficiency2
requirement '
Area
Thermostat
❑ Package Unit
® Furnace
❑ Indoor Coil
❑ AFUE
❑ SEER
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
❑ Condensing Unit
❑ EER .
❑ Resistance
❑ R 8 (CZ 14-15)
2000 sf
installed)
❑ Other
I
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-lR-ALT-HVAC for each system. ..
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, Z 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 tie 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:
. AII'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:
❑ 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
;❑ 4 .The system will not be Ducted;(ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut in or Chan eoutjwith
X"� g
CF 6R forms MECH-04 MECH-20-HERS and (for splitsystems) MECH-22 HERS and
new ducts:.(all new
ducting and.all new
�' I—• '
MECH25 HERS. � �s�,u.`"�_
�+'CF
equipment)=
4R forms MECH-20 and (for split systems)RMECH-22„and MECH-25
For Split Systems Duct leakages< &percent, RC; CCAS X350 CFM/ton FWD, TMAH?STMS; and either. tiSPP or'PSPP :•
”
ri
.
For PackagedUni'ts: Ductleakage< 6�percent
��Rla*�1-...`
—
❑ 3. New Ducts with/ or, without' '" Required Forms:
Replacement _ ..
. Includes replacing or, installing all new
ducting and/or outdoor condensing. unit 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 >_ 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.
. 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: Richard C Weaver Sr Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: Apr 21, 2014
Address: 255 N ELCIELO ROAD #140-125 License: 967982
City/State/Zip: PALM SPRINGS/ CA/ 92262 Phone: (760) 343-1002
AC
1
Reg: 214-A0027574A-000000000-0000 Registration Date/Time: 2014/04/21.14:15:56 HERS Prcvider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010