12-0584 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000584
Property Address: 81686 PRISM DR
APN: 764-270-999-192 -300232-
'Application description: MECHANICAL
Property Zoning: MEDIUM HIGH DENSITY RES.
Application valuation: 12987
Applicant:
Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011:
INSPECTIONS (760) 777-7153
Date: 5/24/12
Owner:
HUNTER,BRUCE S & MARY SUSAN
81686 PRISM DR
LA QUINTA, CA 92253
ode, and my License is in full force and effect.
Section 7000) of Division 3 of the Business aIIUILDER
Contractor:
_ I have and will maintain a certificate of'consent to self -insure for workers' compensation, as provided
GENERAL AIR CONDITIONIjr1G��
d
31170 RESERVE^DRIVE
11{{I
THOUSAND PALMS, CA
92' 76 UAV ��
f�/
(760) 343-7488.
Lic. No.: 686310
- DECLARATION
•
+� � SCF QUID i"P
---------------------------------------------------
LICENSED CO CTOR'S DECLARATION -
------------------------------------- - -----
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury that I am licens u der provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of, the following declarations: '
ode, and my License is in full force and effect.
Section 7000) of Division 3 of the Business aIIUILDER
_ I have and will maintain a certificate of'consent to self -insure for workers' compensation, as provided
' License Class: C20� • nse No.: 686310
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-
Date: '?4/ 1'?- Contractor:
issued.
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor -
J
Code, for the performance of the work for which this permit is issued. My workers' compensation
- 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 ZENITH INS CO Policy Number.- Z071741501
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 work fo hich 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 become subj o 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 become subject a 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 Code, I shall forthwith pl with those 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 ($500)•:
S� /,'
Date: Applicant: t
(_) 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
WARNING: FAILURE TO SECURE WORKERS' MION 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.).
-APPLICANT ACKNOWLEDGEMENT
(_ 1 I; as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner -of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1.. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec.. , B.&P.C. for this reason
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. -
Date: Owner:
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 .
CONSTRUCTION LENDING AGENCY -
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above inform n is correct. I agree to comply with all .
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building constru , and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspe t purposes.
Lender's Name: � � �
•
/ � '
Date: Sgj ¢/' ?—Signature (Applicant or Agent):
Lender's Address:
Tom—
LQPERMIT
Application Number .. . . . . 12-00000584
Permit MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation . . . .
0
Expiration Date 11/20/12
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/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 13SEER/78AFUE SPLIT
SYSTEM [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
May 24, 2012 1c13:47 PM AORTEGA
-
-----------------------_------------------------------------ --
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
e
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF71R-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
81686 PRISM DRIVE La Quinta, CA 922.53
City of La Quinta
May 23, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 8%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil
® SEER .13.0
❑ HSPF
❑ R 8 (CZ 14-15)
24112 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 for 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 -6R and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beg inning October 1, 2010, a registered copy of the CF -1R
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 -4R 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 -4R forms: MECH-21 and (for split systems) MECH-25 -
For Split Systems: Duct leakageii <,15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH ,
Exempted from duct leakage testing if:
,❑ 1.'Ductsystem was documented to have been previously sealed and confirmed through HERS verification, or
[12. Duct systems with less than`40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
0"4. The�systemnwill not be'Ducted (ie, DR ctlessl! ipi-Sp)it--System)m(Also-Exempt-fr}om,Refrigerant-Charge)
❑ 2. Nev%HVAC System
Required+brms q: 4A.f f
• Cut inior Changeout with"
new ducts -,(all new
' —*--a—
CF 6R forms: IMECH-04, MECH-20, HERS, and (for split systems) MECH722 HERS, •and »-
.''
ductmgall new
MECH-25 HERS s `"' '
3 ,).' ,
CF 4R forms_),MECH 20 and (for split systems) MECH 22, andMECH-25
equipmyent);i
ravw
For Split Systems: -Duct leakage <r6 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 t• <"
,
. Includes replacing or installing all new _
ducting and/or outdoor`condensinglunit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R 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 -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R 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 identified on this Certificate of
Compliance.
o 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: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: May 23, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0026474A-00000000-0000 Registration Date/Time: 2012/05/23 21:47:16 HERS.Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
BIR # QoV.Of 4 QUlilt4a
Building a Safety Division
Permit # P.O. Box 1504,78-495 Calle Tatnplco
4.Quinta, CA 92253 -:(760) 777-7012 .
�� •°� Building Permit Application and Tracking Sheet
Project Address:Q 1 b tQ r i sm . pr. Owner's Name:. �jr (Qu`p, r
A P. Number.
Address: ► I fG
Legal Description:
Contractor.3QN)val Xi CbodM(M n I
City, ST, Zip.
Telephone: •5 2 . r
Project Description:
Address:
.
/��
City, ST, Zip: 1 F 111�J--�� I d ilA 1 I b, l .l 1 q2210-
RAM
Telephone:
State Lic. #; �o 0 City Lic. #;
`lt q 6 WV. Q 1` C u
Arcfi., Engr., Designer.
Address:
City., ST, Zip.-
ip:Telephone:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Name of Contact Person: � �.� RQl l l�1
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: qA # Stories: # lunit,s:
Telephone # of Contact Person , 4
Estimated Value of Project: 11 S-7. Q
!f Submittal Req'd
Plan Sets
APPLICANT: DO NOT WRITE BELOW THIS LINE
Reed TRACKING PERMIT FEES
Plan Cheek submitted. Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Cales.
Pians pieud up
Constmcdon
Flood plain plan
Pians resubmitted..
Mechanical
Giading plan
2'! Review, ready for correcdonsrasue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
MO .& Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review; ready for correedonMasne
Developer Impact Fee
Planning Approval
Caked Contact Person
AXP.P.
Pub. VVks. Appr
Date of permit issue
School Fees
Total Permit Fees