11-0314 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:J11=00000314'
Property Address: C-51425—CALLE QUITO
APN: 770-173-011-173 -000000-
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7585
Applicant: Architect or Engineer:
1114
BUILDING & SAFETY DEPARTMENT.
BUILDING PERMIT
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 ofessionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
Date: �l3 ` / Contractor:
" / '---- J
" -' WNER-BUILDER DECLARATION
I hereby affirm under penalty 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 theapplicant to a civil penalty of not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees withwages 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: . 3/30/11
Owner:
GREENBERG SANFORD
51425 CALLE QUITO.
LA QUINTA, CA 92253
(760)340-2200
Contractor. i94�
GENERAL AIR CONDITIONI 302011
31170 RESERVE DRIVE I
THOUSAND PALMS, CA 922 6 CRY OF
LA (760)343-7488 .FNA. EDEPT
Lic. No.: 686310 NC�EP7:
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 come subject to the workers' compensation laws of California,
and agree that, if I should bec a subject to the workers' compensation provisions of Section
3700 of the Labor Code, I sh orthwith. comply with those provisions.
Date: 30 .Applicant:_
WARNING: FAILURE TO SECURE f ' 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 whosebehalfthis application is made, each person atwhose 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 Ouinta, 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 appJ
me null and void if work is not commenced
within, 180 days from date of .issuance i cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state thi f rmation is correct. I agree to comply with all
city and county ordinances and state laws relating to ction,'and hereby authorize representatives
of this county to enter upon the above-mentioned prion purposes.
-Date: 3 ,11 pignature(Applicant or Agent(:
Application Number .
. . . 11-00000314
Permit . . .
MECHANICAL
Additional desc .
Permit Fee
33.00
Plan Check Fee
8.25
Issue Date
Valuation
0
Expiration Date..
9/26/11
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
HVAC CHANGE -OUT 4 TON
13 SEER 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
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
2008 Residential Compliance Forms March 2010
Site Address:
Enforcement Agent :
Date:
Permit !l:
Equipment T et
List Minimum Efficiency Z
Duct insulation requirement
Conditioned Floor
Area
Thermostat
❑ Packaged Unit
Furnace
❑ AFUE 80%
_ ❑COP
Over 40 ft of ducts added or
Setback
Indoor Coil
❑SEER 13 ❑ HSPF
replaced in unconditioned space
Served by system
(If not already
VLCondensing 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 --HV,- C for each system.
2. tblinimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMNIARY Listed below are four HVAC alteration Options. The installer decidcs 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 w:.s 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 -Rs allowed) are filled out and
si ed. Beginning October I, 2010, a registered copy of the CF -IR 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-2l-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
Exempted from duct leakage testing if:
❑ I. Duct system was documented to have been previously sealed and confirmed through HERS veriftca'ion, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Exi sting ducts stems 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
.new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH d5
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and eitier 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 -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existingducts 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.
• I certify that the energy features and performance specifications for design
the 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 ' orm tion documented on other pplSc ompliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement for
a enc a ro al with t e e"it application.
Name: Co Cleen (� -�D{Sig lure:
Company:
6,en,ee-aJ 141 r C011A; f.`0 n �`
Date:
Address:
,31170 Peyer ue rt ✓Pi
IC
License:
�8t�31 v
ity/State/Zip:-7--�Phone:
�
Phone: -7&-) _3 `f3 - -7 4
2008 Residential Compliance Forms March 2010
CaICERTS. - CF=1 R 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: 51425 CALLE QUITO
La Quinta, CA 92253
CEC Registration: 211-AO015909A-00000000-0000
CF -1R -ALT -HVAC: CLICK HERE TO DOWNLOAD
r..rnets
Assigned Company:IHARRISON ENTERPRISES INC
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To register for
If you do, you may want to send this CF -I R to them.
monthly
newsletter, please
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Office: 91.6-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
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1/29/2011
uu, n
City of La Quinta
"Building &r Safety pivislon
Permit #
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA'92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:/qhs— ��CI�,�D
Owners Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone• 7/0o 310
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Address: ✓ , .
Project Description:
City, ST, Zip:
e Ou
Telephone: '� rvh<z;::>,:<;r;ryz•<.: }>;:ry z;: :: ,
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State Lic. # . 3 City Lic.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephoners..>;:<frv';.,:ff.>•<<.:<;..
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.Construction Type: Occupancy:
State Lic. #:
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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: ?S85 OQ
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
# Submittal Req'd Recd TRACIQNG PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called.Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
MechattLal
Grading plan
2"" 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:-
Jrd Reyiew,.ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I,P,P,
Pub. Wks. Appr.
Date of permit issue
School Rees
Total P-rmit Fees