14-0529 (MECH)P.O. BOX 1504
78-495 61 -LE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000529
Property Address: 54010 AVENIDA RAMIREZ
APN: 774-212`=001-24 -000000-
Application description: MECHANICAL
Property Zoning:. COVE RESIDENTIAL
Application valuation: 8595
Applicant: Architect or Engineer:
r
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
Licensass: C20— Lcense.No.: `A 89046.
actr
- -- .
Date: Contror: %
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury -that -1 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, orrepair any structure, prion to its issuance,`also requires the applicant for the
permit to file a signedstatement that he or she is licensed pursuanttothe provisions of the Contractor's ;State
License Law (Chapter 9�(commencing withtSection 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 I, as owner of the property, -ormy "employees with wages as their sole compensation, will do the work, and
the structure is notintendedor' 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 excjusively 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 buildsor improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 1 1 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
Owner:
CAROL MARCKS
54010 AVENIDA RAMIREZ
LA QUINTA, CA 92253
(760)771-3309
Contractor:
ESSER AIR.CONDITIONING &
P-0—BOX 1636
CATHEDRAL CITY, CA 92235
(760)324-0550
Lic. No.: 489046
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
'D
Date: 4/30/14
WORKER'S COMPENSATION DECLARATION
I hereby affirm under. pendiv, 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.. - - -
/ r ave and will maintain: workers' compensation insurance, as required by Section 3700 6f. 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 CASTLEPOINT' NTL Policy Number WSLTHPE90140304
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 tiecome subject to the workers' o pensation lawsof California,
and agree, ha if t should become subjec- to the workers' co en atiolprov'ns f Section
7 of L bor Ca hallf wit co ly with thos-,pr vi io .�p:�Date: A licaWARNING: FAILURE TO SECURE WORKERS' C MPENSATION COVERAGEISUNLAHALL
SUBJECT ANEMPLOYER TO CRIMINAPENAL IES AND CIVIL FINES UP TO ONE HSANO
DOLLARS ($100,000). IN ADDITION TO THE COST Ol COMPENSATION, DAMAGED. FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
�.APPLICANTACKNOWLEDGEMENT -
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 -V comply with all
city and co my ordinances nd ate laws relating to bbl g constru do ,and hereby authorize epresentatives
of this y e to upo a bove-mentionedpfrope y or inspe on urpose
'ate: igna Je(pplicant or Agentl�
Application Number
Permit . . . .
Additional desc
Permit Fee
Issue Date
Expiration Date
. . 14-00000529
MECHANICAL 2013
71.50
10/27/14
Plan Check Fee
Valuation . .
Qty Unit Charge Per
Extension
1.00
35.7500 EA
MECH FURNACE
35.75
1.00
35.7500 EA
MECH CONDENSER/COMP
35.75
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Special-Notes
and Comments
HVAC CHANGE
OUT - 13SEER/80AFUE SPLIT
SYSTEM [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
47.66
Fee summary Charged
Permit Fee Total 71.50
Plan Check Total .00
Other Fee Total 138.23
Grand Total 209.73
LQPERMIT
Paid Credited Due
.00 .00 71.50
.00 .00 .00
.00 .00 138.23
.00 .00 209.73
, .lp—e
Din #
City. of, La Quinta
Building wSafety-Tivision
P.O. Tox 1504,78-495 CalleTampico
La..Quinta;.CA=92253 - (760) 777-7012
Building Permri.,Application and Tracking Sheet.
Permit #
f ti�
Project Address: 5W 1 I, ,
Owner's Name:. CW(0 1 S
A. P. Number:
Address: 5 U VQ ' • Vr 1 I Y,C
Legal Description:
City, ST; Zip: h
L cA,QLlin X225.3
ntr cr: .1
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Coactor:
0 S 'r
:Tele hone:. 7 3
P a
Address: I . � p x
,• Project Description: N v L
13, /��
City, ST, Zip: ' `1 -,e 1-0('� l�.l .r A It,3
ne•
TeleP ho . CP D
State Lic. # : City Lic. #c
Arch., En gr., Designer: '—i -1 _� .E�
ac K-•0..
Address:
City., ST, Zip:
Telephone:
Cn tructio n -TY
Pe: OccuPan cY:
a Li
c. to . #: L c
rr. roJ: .Pect hPe circle one : Neµ 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
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted k .
Item
Amount
Structural Calcs.
Reviewed,.readyfor co-rrections
Plan Check Deposit
Truss Calcs.
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 I
Plans resubmitted
Grading
IN IiOUSE:-
'"' Review, ready for coriectionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Sim lified Prescri tine Certificate of Com liance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address.Q `.�
D - &.e, r)Conditioned
Enforcement Agency:
Date: Cif ,� ,\
Permit #:
E ui ment Typer
List Minimum Efficiency'
Duct insulation requirement
Floor
Area
Thermostat
Packaged Unit
Furnace
b
kAFUE ❑COPSetback
Over 40 ft of ducts added or
❑indoor Coil
ER ❑ HSPF
replaced in unconditioned space
p p
Se ed b
}�(
❑ Condensing Unit
_
❑ EER - ❑ Resistance
❑ R 6 .(CZ 10-13)
f /�
prose t, musty
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 -I R-ALT--HI'AC for each system.
2. Minimum Equipment Efficiencies; 13 SEER, 78%AFUE, 7.7HSPFfortypical 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 th6 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
si d. Be innin October 1, 2010, a registered co of the CF -1R and CF -6R shaH, also be on site for-1nal ins ection.
1. 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
Exemptedf'rnn duct leakage testing if:
Auct
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 ducts stems are constructed; insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:'
• Cut s: Changeout with new
ducts: CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
(all
l new ducting and all
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
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 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'leaks a < 6 ercent
❑ 4. New Ducting over 40 feet
-Required Forms:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned space.
CF-611forms: MECH-04, MECH-2I-HERS CF4R 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 Cal ifomia Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
r 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'l and 6 of the Califomia 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 s bmitted to the enforcement aRency for approval with the.permit lipplication.
Name: 1�
Signature:'
Company:
Date:
30,
Address: r c�
11 �j O 66� .
License: 104
ity/Statc/7.ip: 22
k
Phone: C) -1
2008 Residential Compliance Forms March 2010