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10-1361 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00001361 Property Address: 49820 COACHELLA DR APN: 646-250-014-14 -4275 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation; 8633 c&t�v 4 4 Q" - BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: STAUFFER STANLEY H 49820 COACHELLA DRIVE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/13/10 Contractor: Applicant: Architect or Engineer: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE 1x11 j� THOUSAND PALMS, CA 92276 (760)343-7488 ncr- 1 U 2U�0 i Lic. No.: 686310 1• ' f CITY �t4 �:tit.�i7'iL ------------------ ------------------------------------------------------------------------------ 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 Cie C20 License No.: 686310 at"affirm ntractor. GId� OWNER -BUILDER DECLARATION I hepenalty 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 ($5001.: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure ig 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 contractors) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , BAP.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: to I VX LQPERMIT 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 EVEREST NATL Policy Number 7600006147101 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 3-400 of the abor C , I shall fo thwith comply with those provisions. Date: pplicant: t WARNIN : FA LURE TO SECURE WOR ERS' 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 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 to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives j t i my t o ter upon above-mentioned pro r i pection purpose . Da' : nature (Applicant or Agen ' :) J� T77-7 r 'a Application Number . . . . . 10-00001361 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/11/11 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 INSTALL NEW 13 SEER 3 TON COMPLETE SYSTEM. 2007 CODES ---------------------------------------------------------------------------- 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 Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Addresy: Enforcement gencv: Date: �r Permit -10 Conditioned Floor E ui ment Type' List Minimum Efficienc 2 Duct insulation requirement Area Thermostat r1 Packaged Unit umace o ❑ APUE�U ❑COP Over 40 ft of ducts added or in Served by p� Setback "\ noor Coil ❑SEER ❑ HSPF replaced unconditioned space system (If not already ondensing Unit El EER ❑Resistance ❑ R 6 (CZ 10-13) ❑ R 8 (CZ /4-15) sf present, must be installed) Other 1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor typical residential systems. HERS VERIFICATION SUNS LARY 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 -4R 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 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 CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Indoor Coil and /or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFMAon(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted 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: • 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 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 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 CF -4R forms: MECH-21 linear feet of duct in unconditioned space. 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 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, calculatio tans ands ecifi ons submitted to the enforcement agency for approval with thej;eqnit applicA i . Name: 110 Signature: Company: Date: Address: � � e r� � License: City/State/Zip:'� Phone: 3 • '7 FINANCING THROUGH: REBATES L'...1/_I GENERAL * * Air Conditioning & Heating �k y: 31-170 Reserve Drive •Thousand Palms, CA 92276 (760) 343-7488 9 Fax (760) 343-7494 www.callthegeneral.com Residential Comfort Survey INSTALL DATE ! 2 -/O "�� JOB# a� Z CUSTOMER# 4 0—e NAME JOBADDRESS CITY 724 STATE ZIP CODE S PHONE -loo .2-g4 o CELL FAX SEPARATE BILLING ADDRESS? ❑ YES ❑ NO NEW EQUIPMENT /�Z. 50 EXISTING EQUIPMENT CONDI fl CX D3 G COND M # S # FAUS42-90 6419 y 32�--� FAUM# S# COIL LC 0 31z3% COIL M # S # TSTAT 'i2--d-2C g-8 c2 c::) UNIT LOCATION: FILTRATION /(2�1v lr, 28 MISC CRANE? ❑ YES ❑ NO SIZE PERMIT ❑ YES ❑ NO WARRANTY DUCTWORK PLATFORM SIZE ATTIC HEIGHT OPENING y'J NOTES C& ``^^ nw. A:IE 0 FINANCING DAYS ❑ CREDIT CARD ❑ C.O.D. ❑ COSTCO Bin # City of is Quint Building a Safety Division `- P.O. Box 15.04, 78.495 Calle Tampico La Quinta, CA 92253 - (760). 777-7012 Building Permit Application and. Tracking Sheet Permit # �0 Project Address: 8'� Owner's Name: , A. P. Number: Address: 411r Legal Description: City, ST, Zip: Contractor: � ,,•>%: :t"` Telephone. :r<F<4:.<.:. ,<n<. f. . •� Address: 3 Project Description: City, ST, Zip: Telephone: ' State Lic. # : 3 ~ City Lie. C Arch., Engr., Designer: Address: City., ST, Zip: Telephone:' . <; �; �.�` �:;�Z�,.�:::;::::}}�,,,;y,• State Lie. . . ;> . Construction Type: Occupancy: . 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: to3 3 �o APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted. Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes.. Called Contact Person Plan Check Balance. Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading" plan V. 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:- 1rd Reyiew,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue Schodl. Fees Total Permit Fees INSTALLATION CERTIFICATECF-6R-MECH-2S-HERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of Site Address: Enforcement Agency: Permit Number: Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verif cation for compliance, a MECH-24 Certificate. (instead of this MECH-25 Certificate) should be used to demonstrate compliance with the refrigerant charge verif cation requirement. TMAH and SIMS are not requiredfor compliance, when a CID is utilized for compliance. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form( for any additional systems in the dwelling as applicable. Temperature Measurement Access Holes (TMAH) and Saturation. Temperature Measurement Sensors (STMS) Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. [f refrigerant charge verification is requiredfor compliance, TMAH are also required for compliance. STMS are only requiredfor completely new or replacement space -conditioning systems that utilize prescriptive compliance method. TMAH - Access Holes in Supply and Return Plenums of Air Handler System Name or Ident ificadon/1`ag System Location or Area Served I3fb nte' 1 ayes ONO 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and labeled according to Figure in.Section RA3.2.2.2.2. 2 EVes ONO 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum and labeled according to Figure in Section RA3.2.2.2.2. Yes to 1 and 2 is a pass. Enter Pass or Fail ✓ ass ✓ ❑ Fail STMS - Sensor on the Evaporator Coil System Name or Identification/Tag The sensor is factory installed, or field installed according to manufacturer's 3 Oyes ONO specifications, or is installed by methods/specifications approved by the Executive Director. The sensor wire is terminated with a standard mini plug suitable for connection to a 4 ❑Yes ❑No digital thermometer. The sensor mini plug is accessible to the installing technician and the HERS rater without changing the airflow through the condenser coil 5 1 13 Yes ❑No The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 3, 4, and 5 is a pass. Enter p N/A ✓ ❑ Pass ✓ ❑ Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail STMS - Sensor on the Condenser Coil System Name or Identification/Tag The sensor is factory installed, or field installed according to manufacturer's 6 Oyes ❑No specifications, or is installed by methods/specifications approved by the Executive Director. sensor wire is terminated with a standard mini plug suitable for connection to a ❑ Yes ONO digital thermometer. The sensor mini plug is accessible to the installing technician and 4OYesThe the HERS. rater without changing the airflow through the condenser coil ONo The sensor measures the saturation temperature of the coil within 1.3 degrees F Yes to 6, 7, and 8 is a pass. Enter p N/A ✓ ❑Pass ✓ ❑Fail N/A if STMS are not applicable. Otherwise enter Pass or Fail Registration Number: Registration DateiTime: 2008 Residential Compliance Forms HER.SProvider: August 2009 Standard Charge Measurement Procedure (for- use if outdoor air dry-bulb is above 55 T) Procedures for determining Refrigerant Charge using the Standard Charge MeasurementProcedure are available in Reference Residential Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form Attach an addttlonal form(s) for any additional systems in the dwelling as applicable. • The system should be installed mrd charged in accordwwe.with the manufacturer's specifications before starting this procedure. • The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test. o If outdoor air dry-bulb is S5 °For below, the installer must use the Alternate Charge Measurement Procedure. Space Conditioning Svstems System Name or Identification/Tag System Location or Area Served g0 YGoc Outdoor Unit Serial # G / Outdoor Unit Make LEN IV U Outdoor Unit Model G Nominal Cooling Capacity Btu/hr vvJ Date of Verification /v . ,,o Calibration of Diagnostic Instruments Date of Refrigerant Gauge Calibration I Z . t /0 (must be re -calibrated monthly) Date of Thermocouple Calibration -T- lr . %, (must be re -calibrated monthly) Measured Temperatures (IF) LJ l System Name or IdentificaiiorvTag Supply (evaporator leaving) air dry-bulb temperature.(Tsu 1 , db) G / Return (evaporator entering) air dry-bulb •temperature. (Tretum, db) G Return (evaporator entering) air wet -bulb temperature (Tretorn, wb Evaporator saturation temperature (Teva orator, sa� Condensor saturation temperature (Tcondeasor, sat) LJ l Suction line temperature (Tsuction) b Liquid Line Temperature (Tiiquid) 99 Condenser (entering) air dry-bulb 7 temperature (Tcondenser, db) Registration Number: Registration Date/Time: 2008 Residential Compliance Forms HERS Pravider: August 2009 INSTALLATION CERTIFICATE CF` 6R-MECH-25 TIERS Refri erant Charge Verification -'Standard Measurement Procedure a e 3 of. Site Address: Enforcement Agency: Permit Number: Minimum Airflow Requirement Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge Verification. The temperature split method is specified in Reference Residential Appendix RA3.2. System Name or Identification rag [Calculate: Actual Temperature Split = Tretum, db - Tsupply, db Liv Target. Temperature Split from Table RA3.2-3 using Treturn, wb and Tretum, db Calculate difference: Actual Temperature Split —Target Temperature Split= Passes if difference is between -3°F and +3 °F or, upon remeasurement, if between -3°F and -100°F Enter Pass or Fail Note: Temperature SplitMethod Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below. Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton) System Name or Identification/Tag Calculated Minimum Airflow Requirement (CFM) Measured Airflow using RA3.3 procedures (CFM) Passes if measured airflow is greater than or equal to the calculated minimum airflow requirement. Enter Pass or Fail Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used for fixed orifice metering device systems System Name or Identification/Tag Calculate: Actual Superheat = Tsuction—Tevanorator, sat ' Target Superheat from Table RA3.2-2 using Tretum, wb and Tcondenser, db Calculate difference: Actual Superheat — Target Superheat = System passes if difference is between -5°F and +5°F Enter Pass or Fail Registration Number: Registration Date/Time: 2008 Residential Compliance Forms HERSProvider: August 2009 a i INSTALLATION CERTIFICATE Refrigerant 2Lme Verification - Standard Meas Site Address: CF-6R-AMCH-25=HERS cent Procedure.. • a e 4 of Enforcement Agency: Permit Number: Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used (or thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or Identification/Tag Calculate: Actual Subcooling = ?condenser. sat — Tli tiid target Subcooling specified by nanufacturer Calculate difference: Actual Subcooling — Tar et Subcoolin = System passes if difference is between -J°F and +PF Enter Pass or Fail self A4atering Device Calculations for Refrigerant Charge. Verification. This procedure is required to be used for tlxrmostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. System Name or IdentificatiowTag j Calculate: Actual Superheat = Tsaction - Teva orator sat. 2 Z ` Ener allowable superheat range from manufacturer's specifications (or use range between 4°F and 25°F if manufacturer's specification is not available)2�. System passes if actual superheat is within theallowable superheat range Enter Pass or Fail NS' Registration Number: Registration DatelTime: HERS Provider: ' 2008 Residential Compliance Forms. August 2009 INSTALLATION CERTIFICATE CF-6R=MECH-25-13ERS Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5) Enforcement Agency: Standard Charge Measurement Summary: System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all apLhcable verification criteria must be re -measured and/or recalculated. System Name or Identification/Tag System meets all refrigerant charge and airflow reouirements. Enter Pass or Fail I -,,Af r' DECLARATION STATEMENT o I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. o I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction (responsible person). m I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms to all applicable codes and regulations, and the installation is consistentwith the plans and specifications approved by the enforcement agency. o I understand that a HER rater will check.the installation to verify compliance, and that that if such checking identifies defects, I am required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking/testing of other installations in that HERS sample group will be performed at my expense. ® I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF -IR that apply to the installation have been met. ® I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data registry for multiple orientation alternatives, and beginning October 1, 2010; for all low-rise residential buildings. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Responsible Person's Name: Res nsible Person's Signature: /Q tV �� CSLB License: Date Signed; P ition With ompany (Title): 1,11- 'o, o I -E -O I?6r Is this installation monitored by a Third Party Quality Control Name of TPQCP (if applicable): Program (TPQCP)? Dyes . ❑No Registration Nwnber: Registration DatalTime: HERSProvider: 2008 Residential Compliance Farms August 2,009