13-0593 (MECH)P.O. BOX 1504,.
78-495 CALLE TAMPIC0
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
13-00000593
Property Address:
49190 RANCHO POINTE
APN:
649-660-017- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
8170
Applicant: Architect or Engineer:
-----------------
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.
Licen�seClass: C20 LicenseNo.: 686310
Dater 1� Con tor. 5:
OWNER -BUILDER DECLARATION
1 hereby affirm under peria� f 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 (5500).:
(_ 1 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 ISec. 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 on
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:
in
Lender's Address:
LQPERAIIT
'�— VOICE (760) 777-7012
/ FAX (760) 777-7011
v INSPECTIONS (760) 777-7153
Date: 5/08/13
Owner:
STEVE ROBBINS/MITCHELL CAMERON
49190 RANCHO POINTE
LA QUINTA, CA 92253
(
Contractor:
GENERAL AIR CONDITIk26
31170 RESERVE DRIVE
THOUSAND PALMS, CAMAY 0- 2093
(760)343-7488
Lic. No.: 686310 CITY OF LA QUINTA
------------------
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.
-A�z,Yhave 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
1 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, I shall forthwith comply with those provisions.
Dat" Applicant: ��/vW7?✓�' '
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 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
of this county -to enter upon the above-mentioned property -for inspection purposes.
Date: $ 13 Signature (Applicant or Age
-.Application Number . . . . . 13-00000593
Permit . . . MECHANICAL
_ Additional desc .
Permit Fee 24.00 Plan Check Fee
6.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/04/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 .9.0000 EA MECH B/C <=3HP/100K BTU
9.0.0
Special Notes and Comments
HVAC REPLACE (1) 2 TON 13SEER MINI
SPLIT CONDENSOR AND COIL DUCTLESS. 2010
CALIFORNIA BUILDING CODES.
-----------------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
-----------
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 24.00 .00 .00
24.00.
Plan Check Total 6.00 .00 .00
6.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 31.00 00 .00
31.00
sig.#
CIS}/ Of La Qulhta
Building $t Safety Division
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: Ll 9 1 g O c�-Y.c 1, 0 -1-)o i h c.
Owner's Name:. S7t���olob irtis t }c�, J i C�umero
A. P. Number.
Address: 491010 1�0.rcho �oir.}�
Legal Description:
Ci ST, Zip : GA 9 Z 3
�'� L•G-Qvin�}o�
Contractor. �';c -�;on�
s, n
Telephone: .W
Address: 3 11 -� p e e r v -.
Project Description:
City, ST, Zip: th S d 7 �m5 G4 422�id.
e - re— Z*0V-\ i
Telephone: --)(,0- 343- 714 M
-
State Lie. # :
City Lie #,
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: $ g 170 , C)o
APPLICANT: DO NOT WRITE BELOW THIS UNE
i! Submittal Req'd Recd TRACIMG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance •
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted '
Mechanical
Goading plan
Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Great Deed
Plans #irked up
S.M.I.
H.O.A- Approval
Phos resubmitted
Grading
IN HOUSE:-
3" Review, ready for eorreetionslicsue
Developer Impact Fee
Planning Approval
Called Contact Person
s.
AJ.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
�r
Simplified Prescri `tive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC
Climate Zones 10 to 15 .
Site Address:
Enforcement Agency:'
Date.
Permit #:
ygtgo �0.Y�c�o piv,}e a
Ci IN Ol: La vi•.�ci
5 8 !3
Conditioned Floor
Equipment T u
List Minimum Efficiency 2
Duct insulation requirement
Area
Thermostat
Packaged Unit
_ ; Fu
Q AFUE
Q COP
40 ft of ducts added or
Over•
'
[N Setback
SEER 13
HSPF
ced Z unconditioned space
6 (CZ IO -13)
ffi,
Served by system
sf
rese already
present, must be
lcqlndoorCoil
Condensing Unit
EER
Resistance
8 (CZ 14-15)
installed)
_ Other
1. Equipment Type: Choose the equipment being installed, • if more than one system, use another CF -1R ALT -HVAC jor each system.
2. Mmimu n Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPFfor 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 appropnate 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 CF4Rs allowed) are filled out and
signed. 'Beginning October 1 2010, are 'stered copy of the CF -1R and CF -6R shall also be on site for final inspection.
IN 1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
CF4R forms: MECH-21 and (for split stems) MECH-25
• Condenser Coil and/or
-
CF -6R forms: MECH-2I-HERS and (for split systems) MECH725-HERS
• Indoor Coil and/or
CF-411forms: 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
Exempted from duct leakage testing if:
1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
2. Duct sysiems with less than 40 linear feet in unconditioned space, or
3. Existin 'duct systems are constructed, insulated or sealed with asbestos
[32. New HVAC System
Required Forms:
• Cutin or Changeoui 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
CF4R 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, SIMS, 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
M. New Ducting over 40 feet
Required Forms: -
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21
linear feet of duct in unconditioned space.
For splits stem or packaged units: Duct leakage < 15 percent
EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Docume`ntation 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 Califomie 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 a enc forapproval with the permit application.
Name:Sfiw
Signature: r%
4
Company: •
Date: I $ I
S
t r
I 3
Address:
31 �e5erty� l�r nuc° - •
License: (o 8-G3 i 0
fDD
City/State/Zip: 'T&UsC V-`c.� `m 5 CA C12-2--7(,Phone:
?foU-3jl3
2008 Residential Compliance Forms - July 2010
INSTALLATION CERTIFICATE
(Page 10 of 12) CF -6R
Site AddressPermit
�G Sao ���� E
Number
� -��s�
Insulation Installation Quality Certificate
✓ ❑ Description of Insulation, (CF -611, formerly IC -1) signed by the installer stating: insulation manufacturer's name,
material. identification,.installed- R -values, and for loose -fill insulation;'minimum.weight per square foot and minimum
inches
✓ ❑ Installation meets all applicable requirements as specified in the'High Quality insulation,Installation Procedures.
(ACM, Appendix RH)
FLOOR
❑
Yes
❑All
No
A
floor joist cavity insulation installed to uniformly fit the cavity side-to=side and end-to-end
❑
Yes
❑Insulation
No
NA
in contact with the subfloor or rim joists insulated
❑
No
❑
NA
Insulation properly supported to avoid gaps, voids, and compression
WALLS
Nn
❑
❑
.Wall stud cavities caulked or foamed to provide an air light envelope
Yds
No
NA
Yes
❑
No
❑
NA
Wall stud cavity insulation uniformly fills the cavity side-to-side, top -to -bottom, and front -to -back
es
❑
No
❑
NA
No gaps
Yes
❑
No
V,
No voids over 3/4" deep or more than 10% of the batt surface area..
.O
❑
Hard to access wallstud cavities such as; comer channels, wall intersections, and behind
Yes
No
tub/shower enclosures insulated to proper R -Value
Xes
0
No
❑
NA .
Small spaces filled
❑
Yes
❑Rim
No
NK
joists insulated
Tes❑
❑
Loose fill wall insulation meets or exceeds. manufacturer's minimum weight -per -square -foot
No
NA
requirement
✓ ROOF/CEILING PREPARATION
❑
'Yes
❑
. No
SA
N
All draft *stops in, place to form a continuous ceiling and wall air barrier
❑
Yes
❑
No
❑
NA
All drops covered with hard covers
Yes
❑
No
NA
All draft stops and hard covers caulked or foamed, to provide anair tight envelope
El.
❑
❑
All recessed light fixtures IC and air tight (AT) rated and sealed with agasket or caulk between the
Yes,
No
NA,
housing and the ceiling
❑
Yes
❑
No
❑
NA
Floor cavities on.multiple-story buildings have air tight draft stops to all adjoining attics
❑
Yes.
❑
No
. A
Eave vents prepared for blown insulation - maintain net free -ventilation area
❑
Yes
❑
No
Knee walls insulated or prepared for blown insulation
❑
Yes.
❑
No
Area under equipment platforms and cat-walks.insulated or accessible for blown insulation
❑
Yes
0
No
❑
Attic rulers installed
Residential' Compliance Forms April 2005
INSTALLATION:CERTIFICATE (Page 11 of 12) CF -6R
Site Address l ' 01 1 1C) 1 �f ' orm itNu�er,� �1
ROOF/CEILING BATTS
❑
❑
Signature:Date:
Yes
No
NA
No gaps
❑
O,
.Yes
No
1
No voids over 3/. in: deep or more than 10% of the batt surface area:.
❑
❑
❑
Yes
No
NA
Insulation in contact with the air -barrier
❑
❑
❑
Yes
No
NA
Recessed light fixtures covered
❑
❑
❑
Aret free -ventilation area maintained at eave vents
Yes
No
NA
✓ ROOF/CEILING LOOSE -FILL
❑
❑
No
1 NA
Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls.
❑
❑.
❑
;Yes
No
NA
Baffles installed at eaves vents or soffit vents - maintain net free -ventilation area of eave vent
. ❑
❑.
Yes
No
1
Attic access insulated
Yes
No
. NAA
Recessed light fixtures covered
❑
❑
Ye
No
NA.
Insulation at proper depth — insulation rulers visible and indicating proper depth and R -value
❑
❑
❑
Loose -fill insulation meets or exceeds manuj cturer's minimum weight and thickness requirements
Yes
No
NA
for the target R -value. Target R -value Manufacturer's minimum required
weight for the target R -value (pounds -per -square -foot). Manufacturer's
minimum required thickness. at time of installation . Manufacturer's minimum
required settled thickness . Note: To receive compliance credit the HERS rater
shall verb that the manufacturer's minimum weight and thickness has been achieved for the target
R -value. CF -6R only
DECLARATION
✓ ❑ I hereby certify that the installation meets. all: applicable requirements as specified in the Insulation Installation
Procedures:
Installing Subcontractor (Co. Name) OR General
Contractor.(Co. Name) OR Owner
Signature:Date:
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
Residential •Compliance Forms
April 2005