11-1357 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00001357;
Property Address: 49190 RANCHO 'POINTE
APN: 649 -660 -017 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6190
Applicant: , Al Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: Ct20 License No.: 68
ate 22 `I ontractor.
' O I ILDER DECLARATION _
I hereby affirm under penalty of perjury that I tempt from the Contraaor'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).:
(_ 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.).
(_ 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 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: MIA
LQPERMIT
VOICE (760) 777-7012
FAX -(760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/11
Owner:
STEVE ROBBINS
49190 RANCHO POINTE
LA QUINTA, CA 92253
7iU
it
- ' 2 Zai,
Contractor:
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE C ITY OF 1-4.1c) U Ib4TA
THOUSAND PALMS, CA 92276 s"tiAW* E '0EP?.
(760)343-7488
Lic. No.: 686310
------------------
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 ZENITH INS CO Policy Number Z071741501
_ 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
..13 0 of the L bor Code, I shall forthwith comply with those provisions.
D �I plicant:
WARNING: FAILURE TO SECURE WORKERS' OMPENSATION 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 .comply with all
city and county ordinances and state laws relating to building construction, and hereb ertf orize representatives
of this coun to rnter upon t above-mentioned property for inspection purp
Da l ( ature (Applicant or Agent):
Application Number . . . 11-00001357
Permit . . : MECHANICAL
Additional desc .
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation . . . .
0
Expiration Date 6/19/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K•
9.00
1.00 16.5000 EA MECH B/C >3-15HP/>10.OK-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE-OUT:.3 TON CONDENSER,
FURNACE & INDOOR COIL AT GROUND LEVEL.
2010 CODES.
---------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)'
------------
1.00
Fee.summary Charged Paid Credited
Due.
Permit Fee Total 40.50 .00 .00
40.50
Plan Check Total 10.13 .00 .00
10.13
Other Fee Total .1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63 .
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Addr s: // force, Agency: Date: Permit fl:
Olj
Conditioned Floor
Equipment T eList Minimum Efficiency Duct insulation requirement Area Thermostat
Cl Packaged Unit
ornate ❑AFUE 8000 [:]Cop Over 40 ft of ducts added or Setback
Indoor Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (lfnor already
ondensing Unit ❑EER / / 1:1 Resistance ❑ R 6 (CZ 10-13) sf present, mast be
Other ❑ R 8 (CZ 14-15) installed)
!. Equipment Type: Choose the equipment being installed; if more than one system, use another CF- IR -AL T-HVACfor each syslem.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFJor0!pical 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 -4R forms (no hand filled CF-4Rs allowed) are filled out and
si ed. Beginning October 1, 2010, a registered co of the CF -IR and CF -6R shall also be on site for final inspection.
1. HVAC ChangeoutRequired Forms:
• All HVAC E ui merit re ;aced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
. q p. ry AD t.........
1tltlX /1GPir/OYltlnl 17
• Condenser Coil and /or
• Indoor Coil and/or
CF-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
CF -4R 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
Exemptevom duct leakage testing if:
/CK. 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
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
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
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -411 forms: MECH-21
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.
• 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 1 and 6 of the California Code of Regulations.
• The design fear u -es identified on this Certificate of Compliance are consistent with the ' orm tion documented on other pplic ompliance forms, worksheets,
calculations, ands
plans specifications submitted to the enforcement agency fora ro al with t e cnnit application.
Name: Le i`enn uJo—ts.6ij
Si ture:
Company. G //1� �f1 ��/-y�tRA` rt..�Di1Gl.t f `.`O H t`
Date: /
Address:
3/i%o Peserije. /,_�/'t`✓e--,
License:
&8(3iv
City/State/Zip:——�Dt�$Glxe� I%%GC.Lh�S� Gl�} 9a�-��
Phone: -760_343_-74E9
1tltlX /1GPir/OYltlnl 17
CaICERTS - CF -1R Registration
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CONGRATULATIONS
Your CF -IR -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Site Address: 49190 RANCHO POINTE
La Quinta, CA 92253
CEC Registration: 211-A0066418A-00000000-0000
Forms
CF -IR -ALT -HVAC: I CLICK HERE TO DOWNLOAD
Assigned Company_1HARRISON ENTERPRISES INC
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Copyright cc> 2010 CalCUR.I'S. Inc. All rights reserved. Revised: January 11. 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy]
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
c �
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Stert vlM Trust ... ..... ..... ................. .... ..i �:s..:'
https://www.calcerts.com/public—cflR.cfm?project—id=l 57481 12/21/2011
FINANCING THROUGH:
REBATES
,enS,GIENERAL
* * * Air Conditioning & Heating *-
31-170 Reserve Drive • Thousand Palms, CA 92W6 In
(760) 343-7488 • Fax (760) 343-7494 O t�S
www.calithegeneral.com 6 /L
Residential Comfort Survey
INSTALL DATE, l �"l TnR� 1 rrrcrrnA41V1D "
NAME Li a. C 4- VK erort & L.('{ ecu e CDLc.,,4r . u
JOB ADDRESS 4
CITY I,tj� ung STATE Com- ZIP CODE
PHONE : CELL FAX
SEPARATE BILLING ADDRESS? ❑ YES ❑ NO
NEW EQUIPMENT
GOND_ 14 A&_ 07 -"�
FAU
COIL-
TSTAT Pro . swo
FILTRATION�i
MIS V�A\7,&-00 W\
PERMIT X YES LINO `
DUCTWORK
NOTES
EXISTING EQUIPMENT
COND M #
FAUM#
COIL M#
UNIT LOCATION:
S#
S#
S#
CRANE? ❑ YES ❑ NO SIZE
WARRANTY
PLATFORM SIZE
ATTIC HEIGHT OPENING
0 FINANCING DAYS ❑ CREDIT CARD ❑ C.O.D. ❑ COSTCO
Bin
City of 'La Quinta
"Building &r Safety.Divislon
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA92253 - (760). 777-7012
.. Building Perm-it-Applicationand.Trackmg Sheet
'Permit #
Project Address: / 1
TkZ p /
Owc's Name:Q�
e1 Ve
A. P. Number: '.
Address: �f'�d �i'`I �-•��
Legal Description:
City, ST, Zip: C�+
: # >?> :. :> a'•z 4 ti
Telephone: %
'':o•%W<o;':fi:^ r3 £ S• is iG
Contractor:1120
Address: 3
City, ST, Zip:'—��
Project Description:
Telephone:
State Lic. # :
YJ4.2 `}+Y+J.fv",�':��''iIJJi,:�Yi:'' A�tij
City Lic.
Px may/ jD�y_
�I
Arch., Engr., Designer:
Address:
City., ST, Zip:
....
..._.__.. _.. ..__ .�._._ "_.�_.__.._ _ _.” ., __
_
Telephoner .. afir'.f•:F�;�•7;;,<'„J:•><:Jw�:,..:>:,f>J�
w. ;, •.f. ry :;:
#�'�• ...;,JJ�,�y� of ;�:•s..;l:. �:^:��;..JJ::?.,ln..••;r'.yy`Fl.Co
State Lic. #: :: �v.�s':y��;••.�:ti'.Fi=``.�;":. ';
Name of Contact Person: cc*) evlr
� )";fL5 c7yu
nstnction Type: Occupancy:
y:
;' Project type (circle one): New Add, n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: %Co D 3 3 )'��
Estimated Value of Project:
APPLICANT: DO. NOT WRITE.13ELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
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 ,
Ti tie 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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
Jrd 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