10-0600 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
"LA QUINTA, CALIFORNIA 92253
Application Number:
10-00000600
Property Address:
48602 PASEO
APN:
646 -082 -030 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY
AppllG8LIUII valuation:
3600
Applicant:
f
c&14t 4 XP Q"
TARAZO
RESIDENTIAL
Architect or Engineer:
dl&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
UCENSED 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 n lasss: C20 License No.: 872703
Date: ! Z & ntracto .
OWNER -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 the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) 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.). "
(_) 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.).
(_) 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
Owner:
MUNSON
48602 PASEO TARAZO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 7/06/10
Contractor:
CR FRIEND LD TOLLEY A/C AT ) L. Lj 200
P.O. BOX 12100
PALM DESERT, CA 92255 C6TilS;Fl,ri;4'4rJ'CA
(760)346-"0434 (,);Je�
LiC. No.: 872703 .r
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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 fo,r 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 TRUCK INS. EXCH Policy'Number 801109591
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
h/ '3700 of the Lab d , I shall forthwit comply
those provisions.
Date: O�PURE'TOP'SCECURE
ian
WARNING: FA W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIM AL 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
l/coou ttjy to enter upon the above-mentioned pr e y for inssp/ection pu( oose/s..
/e: ( V Signa a (Applicant or Age ): ti` ux-
Application Number . . . . . 10-00000600
Permit . . . MECHANICAL
Additional desc .
Permit'Fee . . . . 33.00 Plan Check Fee
8.25
Issue Date Valuation
0
Expiration Date 1/02/11
Qty Unit Charge Per
Extension\
BASE FEE
15.00
1.00• 9.0000 EA MECH'FURNACE <=100K
9.00
1.00 9,0000 FA MF.(;H R/r .AHp,/i nnx RTTT
q. 011
Special Notes and Comments
INSTALL NEW 4 TON SPLIT SYSTEM (15
SEER). 2007 CODES.
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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
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT --HVAC
Climate Zones 10 to IS
Site Address: JOA&W
Enforcement Agency:
Date:
Permit #: -
Equipment T
List Minimum Efficiency'
Duct insulation re requirement
Conditioned Floor
Area
Thermostat
❑ Packaged UnitOver
Furnace
❑ AFUE ❑COP
40 ft of ducts added or
Setback
,Ind., Coil
�tbndensmg Llnit
OSEER O HSPF
❑EER
replaced in unconditioned space
OR 6 (CZ 10.13)
Se ed by system
pjnotnrreadv
O Other
❑Resistance
O R 8 (CZ I4 -I5)
,01sf:
1
present. mutt be
1 intra/led/
l Equipment Type' Choose the equipment being installed: ijmore than one system, use another CF -I R-ALT-HVACfor each system.
2. Minimum Equipment Ef cleneles: 13 SEER, 78•%oAFUE, 7.7HSPFjortypical 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 ir- fact the work completed by.the
installer. The inspector also verifies that each appropriate CF -6R and registered CF4R forms (no hand filled CF4Rs allowed) are filled out and
si ed. Beginning October 1, 2010 a registered copy of the CF -IR and CF -6R shall also be on site for Hnal:lns tion.
1. HVAC Changeout
_:
Required Forms:
• All H VAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25=HERS
CF -4R forms: MECH- 21 and fors lit stems .MECH-25
• Condenser Coil and /or
• indoor Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
CF-411forms: 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
I xcmpted 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 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
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 t!nits: 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 -411 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 2:300 CFMhon, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Re uired Forms:
• Include: aad:m! or replacing more than 40 CF-611fonns: MECH-04, MECH-2I-HERS CF -4R Tomas: MECH-21
linear feet ufduct in unconditioned space.
For split system or packaged units: Duct leakage < IS percent-
ercentO
0EXCEPTION: Existing ducts stems constrticted, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I tend' 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 cendt that the energy features and performance specifications for the design identified on this Certificate of Compliance cor form to the requirements of Title 24_
Pjtts I .nn1 6 ol'the California Code of Regulations.
•i he oc •tgu Natures tdenuf ed on this Certificate of Compliance are consistent with the information documented on other appl cable compliance forms, worksheets.
calculations, plans and specifications submitted to the enforcement agency fora roval with the permit application.
Name.-ro it
Signatu
Compan LR ` O
Date: � I� D!D
Address
License:
1 vC
City/statcf/ipFOLLM CA
Phone: 3
2008 Residential Compliance Forms March 2010
Bin #
.City of La Quinta
Building 8t Safety Division
Box 1504, 78-495 Calle Tampico
La Quanta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
WCP
Project Address: Lf O6Q2as"
Owner's Name:
Address:
A. P. Number.
Legal Description:
City, ST, Zip:
Contractor: C P—F R I W O LA IoL
Telephone:
Project Description: Ch a.ri
Address: 71
City, ST, Zip:
Telephone:
State Lie. # : 8 1 a� 7� City Lie. C .
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Orcupaney:
Project type (circle one): New Add'a Alter Repair Demo
Sq. FL: 1400
# Stories:
# Units: '
Telephone # of Contact Person:
Estimated Value of Project: oo -�
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rec'd
TRAMNG
PERMTf FEES
Plan Seta
Plan Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for eormetions
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Tldc 24 Cita.
Plans picked up
Construction
Flood plain plan_
Plans resubmitted
Mecbaalca:
Grading plan
2'! Review, ready for correction&4"ue
Elmtrlcal
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plaas picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctlon&4uue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees