13-0675 (MECH)P'.O. BOX 1`504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000675
Property Address: 49560 RANCHO LA MERCED*
APN: 649-620-031-50 -28964 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5900
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FALCONER JOHN M
*NOT ON FILE
UNKNOWN, CA 99999
Contractor:
J ANTHONY PLUMBING
72216 NORTH SHORE
THOUSAND PALMS, CA
(760)343-2121
Lic. No.: 777794
VOICE (760) 777-7012
JFAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/30/13
Ay 80 201D
2 T,101
Z276CITY f)F * Aa111914a
------------------------------------------------------------------------
LICE ED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
.I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with
1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busines a d Professionals Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License lass'. C20 -C36 License No.: 7
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
I ued.
Date' 1 Contractors
fiy
cave 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier WESCO INS Policy Nu ber 3051016
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the w for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to beco subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should beco a b ect to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Co thwit comply ose provisions.
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.:
'
Da�_�5 ApplicantA .
( ) 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
WARNING: FAILURE TO SECURE W04 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
- improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 1 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:
��
L4- LQPERA11T
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 [ t the abo information is correct. I agree to comply with all
city and county ordinances and state laws relat buildin construction, and hereby authorize representa
of this my enter upon the above-mentioned inspectio purposes. _
D Signature (Applicant or Age t��
Application Number 13-0000675
Permit MECHANICAL 2013'
'!
Additional desa
• Permit. -.Fee 35:75 Plan Check Fee
.00
_. Issue Date : . . Valuation
0
Expiration Date 11/26/13
Qty Unit Charge Per
Extension
1.00.. 35.7500 EA MECH CONDENSER/COMP
35.75 .
Special Notes and Comments
HVAC CHANGE OUT (1) 5 TON 13 SEER [ 2 0 0 8
ENERGY] CARBON MONOXIDE ALARM(S), TO BE
INSTALLED.PRIOR TO FINAL INSPCTION. 2010
CALIFORNIA BUILDING CODES. .
- --------------------------------
Other Fees . . . . . . BLDG STDS ADMIN"(SB1473)
1.00
PERMIT ISSUANCE M/P/E
.90..57
PLAN CHECK, MECHANICAL"
23.83
Fee summary Charged Paid Credited
Due
Permit Fee Total 35.75 .00 .00
35.75
Plan'Check Total. .00 .00 .00
.00
Other Fee Total 115.40 .00 .00
115.40
Grand Total 151.15 .00 .00
151.15
ct LQPERMIT
t
Sin. #
City of, La Quints
ARWIdIng a Safety DiMon
Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 -:(760) 777-7012
Building Permit "Application" and Tracking Sheet
Pemilt #P.O.
Project Address: too a N N C4W i, A, U-CCb
Owner's Nammc:j v. /1. 4) o6--4-LC.,0 -)J.
A. P. Number.
F:Addr=:
Legal Description:
.
City, ST, Zip:
Contractor.
Telephone: -
Address: J ANTHONY SERYMES
'.
Project Description:
72216 WUR I R Sr9r E "J-1 ";-! ". 8
City, ST, Zip: .1MUSAND PALMS. CA 92276.
12--p lAcel s-- e -0-0s 0 60
Telephone:
State Lie. #::7 -7 7 7 C City Lialor6s-Y..
Arch, EaU., Designer.
Address:
City, ST. Zip -
Telephone:
State Lic. #:
Construction type: Oc--upancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq.* FL: # Stories: #Unit$:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
I
Submittal
Reqld
Rev'd..TRACKMG
PERMIT FEES
Plan Sets
Plan Check submitted'
Item Amount
Structural Cales.
Reviewed, ready for corrections
PhD Check Deposit.
Trust Cates.
Cla.led Contact Person
Plan Check balance
Mile 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans rcsubmlttcd.*.
MeC112MCAl
Grading plan
TL! Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.XL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review; ready for corrections issue
Developer Impact Fee
Planning Approval.
Called'. Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
7City
Enforcement Agency:
Date:
Permit #:
49560 RANCHO LA MERCED La Quinta, CA 92253
of La Quinta I
May 30, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil
® SEER 13.0
[IHSPF
❑ R 8 (CZ 14-15)
1800 sf
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC far 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-611 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-1111
and CF-6R shall also be on site for final inspection.
® 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-411 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
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
❑ 4. The system will not be Ducted (ie. Ductless Mini-Split-System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms::
. Cut in or Changeout with
new ducts: (all new -
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-224HERS, and _--
ducting and all new '
MECH-25-HERS
CF74R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
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/or without
Required Forms:
Replacement
• Includes replacing or installing all new
ducting and/or outdoor condensing. unit
CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. 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
❑ 4. 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-411 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 ;dentified 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: Kevin Robinson Signature: Kevin Robinson
Company: ] ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: May 30, 2013
Address: 72216 NORTH SHORE ST #101 License: 777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121
Reg: 213-A0032889A-000000000-0000 Registration Date/Time: 2013/05/30 11:21:34 HERS PrDvider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010