12-0511 (MECH)P:O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: c:=-12:=-000005 11 -
Property Address: 80528 -PEBBLE BEACH
APN: 775-1317071- - -
Application description: MECHANICAL
Property Zoning: • LOW DENSITY RESIDENTIAL ;
Application valuation: .10000
c&ty/ 4 4 Q"
Applicant: Architect or: Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JULIE ECKLAND
80528 PEBBLE BEACH
LA QUINTik, CA 92253
Contractor:
PALOMA AIR..CONDITIONING
P.0. BOX 3.501
PALM DESERT; CA92261
(760)34741212.
tic: No. :'619091
VOICE (760) 777-7012
:FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/08/12
D.I.A .o
I
MAY Q8 2612,1:, .
CITY OF LA QUINTA
FINANCE DEPT.`
'-
-=-- - -- - - - --is/---- - ' -= ---- ----- ----------------------
-- -- --- -----------------
,"
LICENSED CONTRACTOR'S LARATION :' r•
I hereby affirm under natty of peryury thatfam licerised�under. ' isions of Chapter 9 lcommencing with
Y -WORKER'S.COMPENSATION'DECLARATION•'
hhereby.,affirm under penalty of perjury one"of.�the following declarations:
Section 7000) of Di sion3 of the Business and Professio ode,.and my License is in full force and effect..
I have.and:will maintain a cenificate of consent to self -insure for workers' compensation, as provide&
License Clas License`No.: "619091
_
'for by�Section 3700.'of the Labor'Code,-for the performance of the work forrwhich.this permit is,
^
. '• '-
niractor! - - - +' '" '
issued. i. ,.. _ ,• . ;•.o ,
- I have and will maintain Workers' compensation insurance;.. as required by Sectio 3700 of the Labor, .
'
Code, for the performance -of the work for which this permit is issued. My workers' compensation
•Carrier
OWNER -BUILDER DECLARATION .'"' s:
_
'- :> insurance earner and_ ;policy number are: '
�.
• I hereby affirm under penalty of perjurythat.l am exemptfrorit tR; Contractor's -State License Law for the ^
EVEREST`. NATL �- Policy Number- iIb000 56111 .
-following reason (Sec, 7031'.9,1Business and Professions Code: 'Any.city'or county that _requires a permit to
_ I certify that, I the erformance of the work hich this permit is issued; I shall not employ any
construct, alter, improver demolish; of repair any'structure, prior to its issuance, also requires'the applicant,for the
„' pers n!Y3n , manner so as to be ubject to the- workers' "compensation laws of California,
permitfto file.a signed statement that he or she is.licensed pursuant to` the provisions of.the-Contractor's State .-
- an''J�pGLgree .that, if t should m subject to the workers'comperisation provisions of Section
' License Law (Chapter,9: (commencing with Section 7000) of Division 3,of the Business and Professions:Code) or ..
_ _ -3 7$0, of the Labor C � ,- shall forthwith comply with those provisions.
that he or she,s'exempt therefrom and the basis fovi:6 alleged exemption. Any violation of Section:7031 5=by
VVV .,
• any applicantfor a permit sub)ects the•applicant to a civifpenalty.otnot more than five hundred dollars (S5001.: _
. ate: licant."
(_ 1 I, as;owner bf the property, or my.employe_es.wiWwages as their sole compensation—will.do the work, and..
_
- .. - -,
the structure is notSintended or'offered for said (Sec. 7044, Business.and Professions. Code:- The
WARNING: FAILURE TO.SECURE WORKERS*,:COMPENSATION -COVERAGE IS UNLAWFUL, AND SHALL
. - - Contractors' -State License Law does not apply to an owner of property who builds or improves thereon,' _
O CRIMINAL PENALTIES AND CIVICFINES UP TO ONE'HUNDRED HOUSAND
SUBJECT AN EMPLOYER rT
. and who'does the work himself or herself through his -or her own.eniployees, provided'that the
DOLLARS ($100,000). IN ADDITION`TO THE COST OF;COMP.ENSATION, DAMAGES AS PROVIDED FOR IN
roveents are'notintended or offered fors ale. If, however, the.building or. improvement is sold within
impm
SECTION 3706 OF THE LABOR CODE, INTEREST; AND ATTORNEY'S FEES: -
done year ofconipletion, the owner -builder will have the buiden of provmg'that he of she did not build or
-. ` �•
,. -`improve for the purpose ofaale.):. "- ^• • • ;F "'
' +; APPLICANT ACKNOWLEDGEMENT
r 1—) 1, 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
r 7044, Business and Professions Code: •The Contractors' State does.not applyto an owner. of
conditions and restrictions set forth.on this application.
•�. property, who builds -or improves thereon, end 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 ..
- pursuantid State License La W.I.
whose benefit -work is performed under, or pursuant to.any permitissued as a result of this application,.
am exempt under Sec. F' ,'B.&P.C: forthis7eason
the owner, and the'applicant, each agrees�to; and shall defend; indemnify and hold'harmle - he City
of La Ouinta, its officers, agents and employees for any act or omission related to t ork being '
-
performed ;under or following issuance'of this permit.
Date: Owner. -
2. Any permitissued-�s a�a suit of this application becomes null and void if is not commenced
wiihin 186 da f�'data of issuance of such permit, or cessatio work for 180 days will subject •-
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty,of perjury that there is a construction lending agency for the performance of the
permit pCnclation.
I certify that I haad this application and state that the, above i atis correct. I agree to comply with all
' work for which this permit is issued (Sec. 3097, Civ. C.).
city a county finances and state laws relating to,buil ' onstruction„and hereby authorize representatives
of s co to ter up n the above-mentioned rty for inspection purposes..
Lender's Name:
//
.Date:a
....
gnature (Applicant or Agent:
Lender's Address:
JJJJJJ '
L.QPERMIT
LQPERMIT
Application Number . . . . 12-00000511
'. Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 66.00 Plan Check Fee
16.50
Issue Date . . . . Valuation . . . .
0-
.Expiration Date 11/04/12
Qty" 'Unit Charge "Per
Extension
BASE FEE
15.00
2..00 9.0000 EA MECH•FURNACE <=100K
18.00
2.00: 16..5000;"EA MECH B/C >3-15HP/510OK-50,OKBTU
33..00•.
t Special Notes and5'Comments .
HVAC CHANGE-OUT REPLACE (2).SPLIT
'SYSTEMS,.FURNACES; COILS;., CONDENSERS.
2010-CODES.
"-
- ----- -' - - -- -- --------------'-------7-7----------------
Other 'Fees . x. ' ' BLDG' STDS ADMIN (SB3:473)
1•..00 `"
Fee .summary Charged i. Paid 'Credi.ted
--
Due .'
- -- ------ ----- --- - - ---
Permit Fee; Total ` " --- 66:00 --- : 00 ---- A0^ '
66.00.
r,. Plan=Check;=Total, 1"6LL..50" 00 .00
16:50
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:.
Enforcement Agency:
Date:
Permit #:
80-528 Pebble Beach La Quinta, CA 92253
City of La Quinta
Apr 19, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
0 Furnace
p AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served bb y system
® Setback
p Indoor Coil
10 SEER 13.0
❑ HSPF
R gCZ 14-15
( )
1600
If not already present, must be
[0 Condensing Unit
EER
[I 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-611 and registered CF-411
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-IR
and CF-6R shall also be on site for final inspection.
D 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
C17=4R.forms: MECH-21 and (for split systems) MECH-25
I.=x
For Split Systems: Duct leakage. < "15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Fe-. a d r
.. k... Units. i'ti . R1;
..:::: .
Exem ted: from-duct.leaka......stin if :: ^
:.P 9 9 '
1 'Duct sysiem was*:'documented to have been previously sealed and confirmed through HERS verification, or
2 Duet systems withaess thao�40 linear feet in unconditioned space, or
;p 3 Existing ductsystems are constructed, insulated or sealed with asbestos
❑4 The system will not be Ducted (ie Ductless MinrSpht System),&(Also Exempt fromRefrigerant Charge)
..-...3..hxrn '�`u,� .:: .. ;:-a......;c-'a��.,xw�;.,«+u• . _. -
❑ 2.0' .
RequiredFormsI=IM �. aaf
. Cut m or Changeout with
new dots (all new
i � � � � 3't tT
SCF 6R for�msMECH-04, MECH AZO HERS, and (+for split systems) MECH 22 HERS, and
MECH 25"HERS.I �a
ducting n all new'
CF 4R(forms MECH 20' and (for split systems) MECH 22 and MECH 25
equipment)
�>
For Split Sysiemis °'Duct leakageL-<`;6' percent, RCRCCAAz 350 CFM/ton FWD,TMAHt;4STMS and "either ViSPPor-PSPP.
.. bws
For;Packaged Units Ductaeakage_, 6 percent
3G New Ducts with /or without
wz,a
Required Forms:
Replacement 33
.Includes replacangor installing allfneW
ducting and/or outdoor.condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace N' ; 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
CF7-6R 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.
. 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: Herman Paredes Signature: Hertnan Paredes
Company: PALOMA AIR CONDITIONING Date: Apr 19, 2012
Address: P 0 BOX 3501 License: 619091
City/State/Zip: PALM DESERT/ CA / 92261 Phone: (760) 347-1212
Reg: 212-A0019513A-00000000-0000 Registration Date/Time: 2012/04/19 15:24:51 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
BIA #
City of =La Qurnta
Bu1lding 8i Safety-DivIsiori • .. � •
P.O. Box 1504, 78-495 Calfe Tampico
La:.Oulnta, GA 9225 =(760)'777-7012
Building Permit Application and; Tracking Sheet -
�h
Perinit # ��
•!�%.
�ti
Project Address: • (
Owner's Name:.
A. P. Number.
Address: .
Legal, Description:
Contractor. 11 ft4 4 L A C
City, ST, Zip; 4
Telephone:.. 3. I / : 3 6� tj " '' S ',
Address:13 tf'f/ E/:
1 C..
Project Description:
..
City, ST, Zip: r
Telephone:
State Lic. #: City Lrc'#•:;' y
Arch., Engr., Designer
� tk
Address:
City., ST, Zip:
Telephone:(onstrudion
State Lic.'#:- .. � ui.>::
aw i u '.
Type Occupancy:
� .
; Protect type (circle one) .New AMn Alter Repair Demo
FL: #'Stories: #Univ:
Name of Contact Person:Sq.
Telephone # of Contact Person:
Estimated Value of Project i�. p 0022,
APPLICANT DO NOT WRITE BELOW THIS LINE
#
Submittal.
Req'd °
' RecdTRACICIlNG
PERMIT FEES
Plan Sete
Plan Check submitted
item
Amount
Strnctuial Calcs
Reviewed, ready for corrections
Plan Chcck Deposit. .
Truss Cates.
Called Contact Person -
PIan:Check Balance_
Title 24 Calm
Plans picked up.
s
Cogstrpcdon'
Flood plain plan
Plans.resnbmitted. '
Mecbarilcsl
Grading plan
2sd Review, ready for correc%oasfissue „
'Electrical
Subcontactor List
Called Contact Person
Plumbing
Graut Deed
Plans picked uP
SM,b
H.O.A. Approval
Plans resubmitted
Gradlag
IN ROUSE:-
''d Review; ready for correetionsRssae
Developer•Iotpaet Fee
Planning Approval:
Called Contact Person.
Pub: Wks. Appr
`Date of permit Issue
School Fees
Total.Permit Fees