14-0601 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht
BUILDING R. SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5•/ 0 8 / 14
Application Number: 14-00000601 Owner:
Property Address: 53585 AVENIDA RAMIREZ WARE JACQUELYN L
APN: 774-121-017-5 -000000- 53585 AVENIDA RAMIREZ
Application description: MECHANICAL LA QUINTA, . CA 92253
Property Zoning: COVE RESIDENTIAL (76 0) 564-3184
Application valuation: 6800 D
Contractor:
Applicant: Architect or Engineer: J ANTHONY PLUMBING HEAT/AI MAY 0 j 2014
72216 NORTH SHORE STREET, 10 i'Y
THOUSAND PALMS, CA 92276 CRYGF A
\ (760)343-2121 F4NCE IDE
Lic. No.: 777794
S
• t
--------------------------------------------------------------------------------------------------
LICENSEO CONTRACTOR'S DECLARATION - I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury thaS I am licensed under provisions of Chapter 9 (commencing -with
Section 7000) of Division 3 of the Businest and Professionals Code, and my License is in fullf rce and effect.
License.Class: C20 C36 - A. ALicenseNo.: 777794__ f
v - I 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 _ 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 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
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
ssued.
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
'fes insurance carrier and policy number are:
Carrier WESgO INS Policy Number WWC3083999
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner s as to becomes ject to [he workers' compensation laws of California,
and agree that, if I sho d become subje to the wwiththose
' compensation provisio-of-Secuon
//'�` 3 0 of the Labor I shall forthw' comply provisions.
e- Applicant:� '
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 ($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 issuandsucermit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read [his application and slate ve informati9iscorrect. Iagreetocompywith acity and county o dinances and state laws relatingconstucti andhof this�6 n to linter upon the above-mentioned ct urpoDatte"r Signature (Applicant or Agent
Application Number . . . . . 14-00000601
Permit . . . . . MECHANICAL 2013
Additional desc .
Permit Fee . . . . 83.42 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 11/04/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 1.1..92.00 EA MECH APPL REP/ALT
11.92
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
--------------------------------------------=-------------------------------
Special Notes and Comments
REPLACE PACKAGED UNIT FURNACE,COIL, AND
CONDENSING UNIT. 13 SEER 4 TON.2013
MECHANICAL CODES.2008 ENERGY CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2013 CALIFORNIA
BUILDING CODES.
----------------------------------------------------------------------------
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 #
Qty of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
L
Project Address: �3Sp S /�t// le6L_-
Owner's Name: L) L
A. P. Number:
Address:
Legal Description:
Contractor. V.}
City, ST, Zip:
Telephone: 760
Address: ANTa' ON"
f
Project Description:
.
.vn r.:.:: :r:-. a 1 . 5! 1 1
City, ST, Zip: 'jai,®USH • HOl)SAND PALMS, -CA 92276
S/9e/L
Telephone:
� (f n j Lt— •
State Lic. #: %' % City Lie. #-.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
:'><��`:.'^�%>"`':`':><`?«'`>
Construction Type: Occupancy:
State ie. #
S t L
-type �
Pro'ect circle one): New Add'n Ater Repair Demo
J P ) P
Name of Contact Person: 4 6N Qo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 2(Z
Estimated Value of Project: D
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Rcc'd
TRACKING
PE3MIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Depo_ it
Truss Cafes.
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.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionslissue .
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees .
C�_
F]
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
53585 AVENIDA RAMIREZ La Quinta, CA 92253
City of La Quinta
May 8, 2C14
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
® Package Unit
IM Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP'
® HSPF 7.7
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not alreac'y present, must be
•B Condensing Unit
[3 EER
[3 Resistance
[3 R 8 (CZ 14-15)
1600 sf'
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 wha: 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 -IR
and CF -61R, 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 (f9F Split _ yste s) MEG1_2li-WERS
replaced
CF -4R forms: MECH=21 _..a (F^- Slit systems) MECH 2
. Condenser Coil and /or
CF -611 forms: MECH-04, MECH-21-HERS and (f8F split systems) MEGH 25_u=oc
. Indoor Coil and /or
CF -4R forms: MECH-21 ,^a (F^- ^^l:* systems) wn Er u_,c
• Furnace
For Packaged Units: Dud leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Dud system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Dud systems with less than '40 linear feet in unconditioned space, or
[13. Existing dud 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 Charigeout with
CF 6R f 'rms MECH 04;'MECHC20 HERS, and (for split systems)-MECH `22 HERS; and -
new ducts ;(all new
"moi
MECH 25 -HERS l '�: l' s�4.
dudmg all new
:
GF 4R forms (MECH-20, and (for_split systems) MECH-22,cand MECH 25. .
i
equpment)
For Split Systems Dud leakage < 6- percent RC, CCAt> 350 CFM/ton, FWD; TMAH STMS;.and either HSPF or PSPP
For Packa ed Umtst-Duct IeakageF< 6 percents �'3'`, ,.I
... �.
❑ 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: Dud 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
linear feet of duct in unconditioned space. CF -411 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 ident_ifed on this Certificate of
Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate bf 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 perm t application.
Name: Kevin Robinson Signature: Kevin Robinson
Company: I ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: May 8, 2014
Address: 72216 NORTH SHORE ST #101 License: 777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121
Reg: 214-AO03247OA-000000000-0000 Registration Date/Time: 2014/05/08 11:48:42 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
t
0