10-1411 (MECH)r _S4.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00001411
Property Address: 80757 BELLERIVE
APN: 775 -360 -023 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7800
Ta!t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MCINTOSH JAY
Contractor:
Applicant: Architect or Engineer: PERFECT WEATHER
P.O. BOX 13308
PALM DESERT, CA 92255
(760)770-0404
Lic. No.: 897743
LICENSE -ONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic nsed under provision of Chapter 9 (commencing with
Section 7000) of Division 3 of toe Business and Pr ssionals e, d m License is in full force and effect.
License Class: C20 Lie o.: 857743
I
i
Date: contractor: f .
OWNER -BUIL R DECLARATION
I hereby affirm under penalty of peri that I am exempt from he Contractor's State License Law for the
following reason ISec. 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).:
1 _ 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
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 _ 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 contractors) 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:
L,QPERMIT
VOICE (760) 777-701.2
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/28/10
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 SOUTHERN INS CO Policy umber WSIO01365602
_ I certify that, in a performance of t ork for which thi ((mit is issued, I shall not employ any
person in any manner so as to co subject to th orker' compensation laws of California,
and agree the if I s o Id bec a su ject to t orkers' compensation provisions of Section
3 00 of the L or o e, I sh I fort r h cc with those provisions.
Date: �4PPlicant:
WARNING: FAILURE TO SECUR WORKERS' COMPENS TION 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 issuance of such permit, or cessation or for 180 days will subject
permit to cancellation.
I certify that I have read this applicati and state that the ab '1informa ' is correct. I agree to comply with all
city and county ordinances and state I ws elating to bull din c structi and hereby thorize representatives
of this copty tq enter upon the above me tiori�� property ori pectio rposes.
Application Number . . .
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 33.00
Issue Date . . .
Expiration Date . . 6/26/11
10-00001411
Plan Check Fee . . 8.25
Valuation . . . . 0
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
1.00 9.0000 EA MECH B/C <=3HP/100K
BTU
9.00
----------------------------------------------------------------------------
Special Notes and Comments
2T/13 SEER/78 AFUE HVAC CHANGEOUT - 2008
ENERGY.
December 28, 2010 12:55:33 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN
(SB1473)
1.00
Fee summary Charged Paid Credited
-----------------
Due
----------------------------=-
Permit Fee Total 33.00 .00
----------
.00
33.00
Plan Check Total 8.25 .00
.00
8.25
Other Fee Total 1.00 .00
.00
1:.00
Grand Total 42.25 .00
.00
42.25
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-IR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
80757 Bellerive Dr. La Quinta, CA 92253
City of La Quinta
Dec 27, 2010
,
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
0 Furnace
0 AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
0 Setback
0 Indoor Coil
0 SEER 13.0
[:]HSPF
[3 R 8 (CZ 14-15)
600 sf
If not already present,
0 Condensing Unit
C] EER
[:1 Resistance
must be 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 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-411 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.
0 1. HVAC Changeout
Required Forms:
. All 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-411 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
Exempted from duct leagage testing if:
[-11. 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
[13. Existing1duct-systems are_ constructed,*insulated-or sealed with-asbestos f=�-fiy�j
❑ 2. Nevi HVAC i
Required. Forms: N
System
. Cut in or Changeout
with new ducts: (all
new ducting and`all
' f
CF-6R;forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22and rwr
MECH=25 HERS 'If/ I / k � A ) f/
`—r
CFforms: MECH,20, and systems) MECHc22;.and:MECH 25�.+%
new equipment)"
.-split
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/or without
Required Forms:
Replacement
. Includes replacing or installing all
new ducting and/or outdoor
CF-611 forms: MECH-04, MECH-20-HERS, and (for split systerUi)J4EeHT75—HHERS
condensing unit and/or indoor coil
and/or furnace. or some
CF-4R forms: MECH-20 and (for split system
' ^ Q
CITY OFLA
equipment changed.
(-
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
BUILD
For Packaged Units: Duct leakage < 6 percent
PPROIllu
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more
than 40 linear feet of duct in
CF-6R forms: MECH-04, MECH-2I-HERS
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: David Cullen Signature: David Cullen
Company: I A S MECHANICAL INC Date: Dec 27, 2010
Address: PO BOX 13308 License: 897743
City/State/Zip: PALM DESERT / CA / 92255 Phone: (760) 770-0404
say
Reg: 210-A0034417A-00000000-0000 Registration Date/Time: 2010/12/27 23:54:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
041
Bin #
City of La Quinta
Building 8c Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Lo `� 1 `, .
Project Address:
Owner's Name: (�
A. P. Numbcr:
Address: \ rn
Legal Description:
City, ST, Zip:
Contractor.
Telephone:
Address:
Project Description:
�}
City, ST, Zip:QcufNU
Telephone: _ 6
State Lie. # City Lie. C
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person;
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft:
#Stories: 7#
Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Plan Sets
Req'd
Recd
TRACKMG PERMIT FEES
Plan Cheek submitted Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit ..
Truss Cala'
Called Contact Person
Plan Check Balance r
Tide 24 Cala.
Plans picked up
Construction S
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'! Review, ready for correctionsruisue
Electrical
Subconactor 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 correcdonslissue
Developer Impact Fee
Planning Approval
Called Contact Person
.LP.P. ..�
Pub. Wks. Appr
Date of permit issue
School Fees
t �
Total Permit Fees