11-0605 (MECH)4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/06/11
Application Number: — 11-00000_605_` Owner:
Property Address: 785-6:i POMPEII• CT LAURA LEE
APN: 609-551-027-14 -28458 - 78562' POMPEII COURT r�
Application description: MECHANICAL LA QUINTA, *CA 9.2253 !/[\ _�)� .
Property Zoning: LOW DENSITY RESIDENTIAL „- 1
Application valuation: 7985
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.1.
Lender's Name: _
Lender's Address:
LQPERMIT
of La Qwnta, 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 mfion is correct. I agree to comply with all
city and county ordinances and state laws relating to building const , n, and hereby authorize representatives
of this county [o enter up the above-mentioned property for insp i purposes.
11
Date: ignature (Applicant or Agent):
Contractor:
Applicant: Architect or Engineer:
GENERAL AIR CONDITIONING �Py4J j3El1A�ti
31170 RESERVE DRIVE r??l; 1 k
THOUSAND PALMS, CA 92276
I f A
(760)343-7488
Lic. No..:: 686310
-------------------------------------------------------------------------------------------------
J LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I.hereby affirm under penaltyof perjur that 1 am lice ed under provisions of Chapter 9 (commencing with -
Sect 000) of Division 3 of the sinass and Pro ionals Code, and my License is in full force and effect. -
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
' ense Class: C20 License No.: 686310
�65 �/"' �, ",�
nate: ntractor:
_
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 Lobar
/
Code, for the performance of the work for which this permit is issued. My workers' compensation
O NER-BUILDER 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 EVEREST NATL Policy Number 7600006147101
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
_ 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 becomes ect to 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 at, if I should become subje o the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 o e Labor Code, I shall forthwi omply 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).:
e: 6 t Applicant: ,
(_) 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 WORKER SATION 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
(_) 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 contractorls) 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,
I—) 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
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.1.
Lender's Name: _
Lender's Address:
LQPERMIT
of La Qwnta, 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 mfion is correct. I agree to comply with all
city and county ordinances and state laws relating to building const , n, and hereby authorize representatives
of this county [o enter up the above-mentioned property for insp i purposes.
11
Date: ignature (Applicant or Agent):
Application Number . . . . . 11-00000605
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50
Plan Check Fee
10.13
Issue Date . . . .
Valuation . . . .
0
Expiration Date 12/03/11
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. INSTALL FURNACE,
INDOOR
COIL & CONDENSER. 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 Compliancer2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
En orcein nt Agency:
Date
Permit #:
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
2
Conditioned Floor
Required Forms:
Equipment T et
List Minimum Efficiency
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
rnace
❑ AFUE 80 %
❑ COP
Over 40 ft of ducts added or
m
CF -4R fors: MECH- 21 and (for split systems) MECH-25
Setback
oorCoil❑SEER
t"Ltidensing
/3
❑ HSPF
replaced in unconditioned space
Served by system
(lfnot already
Unit
❑ EER / /
❑ Resistance
❑ R 6 (CZ 10-13)
sf
present, must be
❑ Other
❑ 3. New Ducts with Replacement
Required Forms:
❑ R 8 (CZ 14-15)
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
installed)
1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -1 R-ALT-HVACfor each system.
2. Minimum Eartinment EfBcienciec• l 3 .CFFR 7R•/ AFI/F 7 7KCPF f ti,.,: ,d ,•� :a �,: t ., ,
2008 Residential Compliance Forms Alf -,4 , 7n to
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being doneand
picks one of the appropriate Options. Each Option lists the HERS measures that mast 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 I, 2010, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection.
I. 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-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
m
CF -4R fors: 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 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: (a)l 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.
• 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 I and 6 of the California Code of Regulations.
• "rhe design features identified on this Certificate of Compliance are consistent with the ' orm, tion documented on other applic ompliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement a ency for appro al with t e perniit application.
Name: a.eeq uj�.-,s6�
Sig tire:
Company:
Com p� C�-7�i'1 •G'('Q.i A'i Y' i'ld.t �-.`o s'1 t`
CO
Date:
l0
Address:
.3117o 12eserue &n(L,/e,
License:
l08�03� v
City/State/Zip:—rkDt.-Sai,� Pa_-(_fmS, Gyp
Phone:
2008 Residential Compliance Forms Alf -,4 , 7n to
CaICERTS - CF -1R Registration
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CONGRATULATIONS
Aba,rt t1s
Your CF -IR -ALT -HVAC Registration is complete!.
'i4atging
You may want to print this page for your records.
,
ttaterAteect°1>
Site Address: 78562 POMPEII COURT
Earns
La Quinta, CA 92253
CEC Registration: 211-A0026763A-00000000-0000
Membehtpbtnefies
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
E�euts
Assigned Company: HARRISON ENTERPRISES INC
gadc
Do you know your HERS Rater? `
-
If you do, you may want to send this CF -1 R to them.
Dews
To register for our
CaICERTS Rater ID:
monthly
OR
newsletter, please
My Rater Quick Select: ' Energy Driven Solutions, Inc.
click here.
Every CaICERTS rater has a license number.
!f you need to find the rater by name (Click HERE/ to search our directory.
I_:__: _._S_ENDCF-1RT0_HERSRATER___ .: _j
[CLICK HERE] to do another
Copyright 02010 CaIC1a2:fs. Inc. All riLhts 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
Cr r
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BBB Find u_,2�onFaaebook10
https://www.calcerts.com/public_cflR.cfm?project_id=116942 6/3/2011
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'Permit # /
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Project Address:IRS&
City of La Quin to
Building &' Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and: Tracking Sheet
i � Owner's Name:
A. P. Number:
Address: 7 FS I'
Legal Description:
City, ST, Zip:. _"r g
Contractor:A
Co e
Telephone: 9- 7 akD
3 ��
;k ».
Address: 3
City, ST, Zip:
Telephone: 3
State Lic. # . 3
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City Lic. #;
Project Description: `OC
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:'
State Lic.
f,r•,%' t'`
>:: : _% ': 'r< :r< `;'• « ;>A \
Construction T e: Occupancy:
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:
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
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 no
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"1 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:-
'.a 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