13-1248 (PLBG)7.1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001248
Property Address: 53711 AVENIDA BERMUDAS
APN: 774-175-028-4 -000000-
Application description: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 10815
Applicant:
Architect or Engineer:
5 �p
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t!'�itiGv
J
BUILDING & SAFETY DEPARTMENT �-
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I 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 License No.: 686310
Date: 10 1 t 1 1-N Contractor:.�✓��
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, 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 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 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/01/13
Owner:
ROBERT WARD
53711 AVENIDA BERMUDAS
LA QUINTA, CA 92253
(
Contractor: D
GENERAL AIR CONDIT NG
131170 RESERVE DRIV OCT 011013
THOUSAND PALMS, CA92 76
(760) 343-7488 LINO—F—a NTq
Lic. No.: 686310 FINANCEOE N
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
/!—:� 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
insurance carrier and policy number are:
Carrier ZENITH INS CO Policy Number Z071741502
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, 1 shall forthwith comply with those provisions.
Date: r�t, Appticantf n ,
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 Ouinta, 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. 1 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 for inspection purposes.
Date: jell 13 Signature (Applicant or Agent):' �L
LQPERMIT
Application Number . . . . . 13-00001248
Permit . . . PLUMBING 2013
Additional desc . .
Permit Fee . . . . 11.92
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 3/30/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS,
----------------------------------------------------------------------------
1-4 OUTLETS
11.92
Permit . . . MECHANICAL 2013
Additional desc .-.
Permit Fee . . . . 11.92
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 3/30/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA MECH APPL
----------------------------------------------------------------------------
REP/ALT
11.92
Permit . . . MECHANICAL 2013
Additional desc . . -
Permit Fee . . . . 11.92
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 3/30/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA MECH VENT
FAN
11.92
----------------------------------------------------------------------------
Special Notes -and Comments
WATER HEATER CHANGE OUT - 40GALLON/GAS
[2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. MECHANICAL REPLACE
EXHAUST FAN AND DUCT RUNS 2010
CALIFORNIA BUILDING CODES.
=---------------------------------------------------------------------------
Other Fees . . . . . . . . . PERMIT
ISSUANCE M/P/E
90.57
PLAN CHECK,
PLUMBING
7.15
Fee summary Charged Paid
---------------------------
Credited
----------
Due
----------
Permit Fee Total 35.76
----------
.00 .00
35.76
Plan Check Total .00
.00 .00
.00
Other Fee Total 97.72
.00 .00
97.72
Grand Total 133.48
.00 .00
133.48
OD
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Bin #
City QI 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.#
_
61
Project Address: 3% j l /QV �r� c�=. �7�r mveia S
Owner's Name: _�obex V L,) a•, d
A. P. Number:
Address: 53711 Avcx\ie1ca 3ermvelas
Legal Description:
City, ST, Zip: �� Qjl �c, CA 922 S 3
Contractor•Gehcr�.
Telephone: (
its
Address: 31.170 >eServG
Project Description:
City, ST, Zip: uvs c.hd P CA G 2Z7 (o
_�,e1 GGG 40 Gc_kkov\' I,J 0 ar N M-) e -f
Telephone: -76&_—q43—_7439
P
..is,;.:.,,.;;;!.s;.rl,:>;:::^.v iv:;i>;•<.:vii.:;:t:.
` ` y�
State Lic. #
City Lic.
Arch., Engr., Designer:
Address:
S_ ••f' Sem �h
City., ST, Zip:
Telephone:
State Lic.
{•+!ry
:ii iii.: •n'ii:�t;% �:% ii vl:iyi: �G:^
- ^^ ;
�viv%<<v:7�+iii r'lv i'i:{':jti,M.,x•W:
....... .............................
ConstructionTYPe: Occupancy: cy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone #,of Contact Person:
Estimated Value of Project: 1(7 ►'S'. c.a
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACMG
PERMIT FEES
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.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°' Review, ready for corrections/issue
Electrical
�SubcontactorList
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`° Review, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
7City
Enforcement Agency:
Date:
Permit #:
53711 AVENIDA BERMUDAS La Quinta, CA 92253
of La Quinta
I Sep 30, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
Q Package Unit
Q Furnace
13 AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
❑ Setback
❑ Indoor Coil
❑ SEER
❑ HSPF
❑ R 8 (CZ 1415)
1044
If not already present, must
[3 Condensing Unit
Ll EER
Q Resistance
be installed)
® Other > 40' Ducts
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-1R
and CF-6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
.All HVAC Equipment
CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
. Furnace
CF-411 forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage-,<..:15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from dud leakage testilig if;'
❑ 1.. Dtict:system-Was documehied to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct'systems with fess thi. AD linear feet in unconditioned space, or
p 3. Existing duct systems are 6'6ttructed, insulated or sealed with asbestos
0-4: The,system.,will not be Dui Eed�(ie: D;ttctfessMibi:-Splits,System;}( nAs em.."aW{tefngeraxt�.0 Vge)
ernReq
~:
. Cut m;,Cttan eout with,
,. .�-.,..
��-:<::::-..� ,.: .<3_�v:�:;': _
H- 4 HRS a fiort: lit sterns MECH T ERS =end
CF 6R�f,.orms MEC 0 ,
�
new ducis:`(aA new : ' .'..
f
ducts and all ne.w.rCH-20...__:..
�; ._�
.
:%x.
equipi:._,.:.. .',..:..:•><: .,4
,.att�:�far
:%err='.-:SS::>:. _ '' .>„_ Sys;,:• a.:
�.�.:.-...'::::amu?,". .::•::..
For Split SysiEeens6 Duct leakage
< 6 percent ItC, CCz 35{1 CFM/tan, # WE?, TMAH, SIMS, and either 145PF or PSPP.
For Packaged Units: DucCleakage;
<;:6:percent:::' ':
......... .
3: New:.Qucts tivtth/or withouE;:*-,:
Required Forms:
Replacement:':::.`:::`:
. Includes replacing or installing i lUnew
ducting and/or outdoor condens h-4:0it
CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or fiirnat:e : No or some
CF-411 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
11114. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF-611 forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF-4R forms: MECH-21
Q EXCEPTION: Existing dud 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: Dayana Valdez Signature: Doyano Valdez
Company: HARRISON ENTERPRISES INC Date: Sep 30, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 213-A0074596A-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2013/09/30 13:16:17 HERS Provider: Ca10ERTS, Inc.
July 2010
Prescriptive Certificate of Compliance: Residential Water Heatin CF -IR -ALT -WH
General Information
Site Address: 3'7 V 3errnvCl Climate Zone: Date: 10 i
NOTE. 7hir orm is only used or alteration or addition of water heatin terns.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and 1 yd nic space heating. Individual dwelling DHW
heaters must be gas or propane fired and may not exceed SO gallons. Hot water pipe insulation from the DHW heater to the
kitchen(s) and on all underground hot water pipes is required in all component packages in all climate zones.
• I certify that the energy features and performance specifications for the building 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 building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
Energy Factor or
Name: S�eve� S'��r�ere�
Water Heater Type /
Distribution TIpe
Number of
Tank Capacity
Thermal
External Tank
Fuel Type'
Standard
stem
al
Efficiency
Insulation R-Value3
S-Vor ck e- Ga s
S C, CNC,-,
1
t -i o
a 58
(Z 1 Z
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of 150(n). 77te PrescriMve requirements do
not allow the installation of a recirculatittr water heating system for single dwel inz units
3. The water heating tank and pipes shall be insulated to meet the requirements of 1506).
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 building design identified on
this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building 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 building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name: S�eve� S'��r�ere�
Signature: S- — CYC
rL
Company:
Gev�ercL
t� Arc oY.c,:kzor\ir\^
Date: /o) i 113
Address:
31\1t� �ese�(ve_ �r;vt
License: I
(o8b3
City/State/Zip:
�
Phone: -7(,c
_3- -74 g&
2008 Residential Compliance Forms March 2010