14-0577 (MECH)P.O. BOX 1504
,. 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000577
Property Address:
79395 BRIARWOOD
APN:
772 -020 -016 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
24900
Tit!t 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penal of per' t t I am li ensed under provisions of Chapter 9 (commencing with
Section 7000) of Division of th usiness n F fessionair Code, and y License is in full force and effect.
Lice6lass 20 License No.: 89046
�(J Dater/ Tlract.r�
WNER•BUILDER RATION
I hereby affirm under penalty of perjury that I am exempt from the o ractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: A ity 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 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.).
(_ 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.).
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:
LQPERMIT
Owner:
SHIRK RICHARD
79395 BRIARWOOD
LA QUINTA, CA 92253
(
Contractor:
ESSER AIR CONDITIONING & HTG
P.O. BOX 1636
CATHEDRAL CITY, CA 92235
(760)324-0550
Lic. No.: 489046
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/05/14
------------------------------------------------
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.
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 CASTLEPOINT NTL Policy Number WSLTHPE90140304
I certify that, in the performance of the work for which this permit is is ed shall not employ any
person in any anner so o become subject to the workers' comp ns ion laws of California,
and agree tha if I sh d be ome subject t th workers' compensa ion revisions of Section
3 00 of t e L bor de, I shall fo hwith c m y with/those provisi s. '
-23700
, A Plican :
WARNING: FAILURE TO SECURE WORKERS' +PENSATION COVERAGE IS UNLAWFUL, AND SHAL
SUBJECT AN EMPLOYER TO CRIMINAL PENAS 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 cessat n of work for days will subject
permit to cancellation.
I certify that I have read this application and state that the ov infor atio is correct. I agr a to c mply with all
city and county ordinance and state laws relating to bull
ing con tru tion, nd hereby authori a re resentatives
of this count t ent p [he above-mentioned prope ty for inspec on rposes
Date ign ure (Applicant or Agent):
Application Number . . . . . 14-00000577
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee 214.50 Plan Check Fee
.00
' Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/01/14
Qty Unit Charge Per
Extension
3.00 35.7500 EA MECH FURNACE
107.25
3.00 35.7500 EA MECH CONDENSER/COMP
107.25
----------------------------------------------------------------------------
Special Notes and Comments
(3)HVAC & (3)FURNACE CHANGE OUT 806 AFUE
16 SEER 2013 MECHANICAL CODE8
ENERGYCARBON 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
142.98
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 214.50' .00 .00
214.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 234.55 .00 .00
234.55
Grand Total 449.05 .00 .00
449.05
LQPERN11T
Bin #
City of La Quinta
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
jL
Project Address: —7T3 3 —/ S Zmrwmd.
Owner's Name: %-, �
A. P. Number:
Address: 3 `%c�; i tom+ tO d 0 d
Legal Description:
City, ST, Zip: L Gi � ( A !22
Contractor: Y
TelePh e.� )&
Address: (,('3 Q `FjjB�
Project Description: A C
City, ST, Zip:
c(_ -
CA 4223
-to n +eavxx, ' X to
Tele hone:
P 0
LO 2
I
State Lie. # : City Lie. #•:I,��
X�
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:hone:
:
Con tructi n Type: Occupancy:
cY
State Lic. #:
eone • e Add'nA]ter Repair Demo
Project (circle rc
Name of Contact Person:
Sq. Ft.:3� Q V
# Stories: 1
—# Units: 3
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
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrections/issue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"d Review, ready for corrections/issue
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 HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address
Enforcement Agency:
Date:
Permit #:
Conditioned Floor
E ui ment T r
List Minimum Efficiencyz
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
.Furnace
G�
t9 AFUE �✓
❑ COP
Over 40 ft of ducts added or
etback
❑ Indoor Coil
XSEER -l%
❑ HSPF
replaced in unconditioned space
Served by system
l'(lfnotalready
)&Condensing Unit
❑ EER
❑ Resistance
❑ R 6 (CZ 10-13)
sf
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 -IR -ALT -HVA Cfor each system.
2. Minimum Equipment Efficiencies: /3 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 fortes 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 CF4R fortes (no hand filled CF-4Rs allowed) are filled out and
sirled. BeginningOctober 1, 2010, a registered co of the CF -IR and CF -6R shall also be on site for final inspection.
_. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R fortes: 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
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or
CF -411 forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Fxempted from duct leakage testing if -
F❑
01. 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
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all 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 CF411 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 leakage <6 percent
❑ 4_ New Ducting over 40 feet -R uired Forms:
• Includes adding or replacing more than 40 CF -611 forms: MECH-04, MECH-2I-HERS CF4R fomes: MECH-21
linear feet of duct in unconditioned space.
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.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
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 I 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 it application.
Name:/�
tJ`-
Signature:
__Ak
Company: �C � w
D 1
Address: 13 l�
License: h 4
C.'ity/Statc/7.ip:
r 017n
Phone -1 Q Z
2008 l esidenrtal Compliance Forms March 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 1S
Site Address
/
rcement Agency:
Date:
Permit #:
Conditioned Floor
Equipment T '
List Minimum Efficient ?
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
.Furnace
Gr)
4,AFUE C✓
❑ COP
Over 40 ft of ducts added or
etback
❑ Indoor Coil
SEER —(U
❑ HSPF
replaced in unconditioned space
Served by system
rffno�t already
`)&Condensing Unit
❑ EER
❑ Resistance
❑ R 6 (CZ 10-13)
sf
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-HYAC 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 CF4R 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 -6R shall also be on site for final inspection.
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
• Condor Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Fxempled 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
❑ 2. New HVAC System Required Forms:
r
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -411 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
113. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-I•IERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF4R 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 leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forms:
• Include, adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21
lincar feet of duct in unconditioned space.
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)
• 1 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.
r I cenify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Parts I 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 it application.
Name: I
�
Ad (//� WAWA
Signature:
Company: �c �
(L— 14 j J�t
D
Address:I V 3& h
V
License: 419 61 I t_O J
�
City/Statc2ip:
Phone C)Z'-�
'�
2008 Residential Compliance Forms March 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address
Enforcement Agency:
Dale:
Permit #:
Conditioned Floor
Equipment T r
List Minimum Efficient •Z
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
.Furnace
43I AFUE
❑ COP
Over 40 ft of ducts added or
etback
O Indoor Coil
jrJSEER T
❑ HSPF
replaced in unconditioned space
Served by system
(ynot already
.Condensing Unit
❑ EER
El Resistance
❑ R 6 (CZ 10-13)
sf
present, must be
' ❑ Other
❑ R 8 (CZ 14-15)
installed)
/. Equipment Type: Choose rhe equipment being installed: if more than one system, use another CF -I R-ALT-HVACfor 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 the work listed on this form was in fact the work completed by the
installer. The inspector also verifies that each appropriate CF -611 and registered CF4R forms (no hand filled CFARs allowed) are filled out and
si ned. Beginning October 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection.
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
CF -411 forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA 2:300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Duct ss -stern 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
❑ 2. New HVAC System Required Forms:
r
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all 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 -61K 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 2:300 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 CF4R fomes: MECH-21
linear feet of duct in unconditioned space.
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 California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
f I certifj• that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Paris I and 6 of the Cal ifomia 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 wi $8e linit application.
Name:
Signature:
Company:c
D
Address: 13PoLicense:
v
419
6 4 to
City/State/Zip: (`
Phone Q Z
2008 Residential Compliance Forms March 2010