10-0790 (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: 8/23/10
Application Number.10=00000 "1 Owner:
Property Address: 48544VIA--ENCANTO CHERREY AMANDA
APN: 646-091-036- - 48544 VIA ENCANTO
Application description: MECHANICAL LA QUINTA, CA 92253
PropertyZoning: LOW DENSITY RESIDENTIAL , . (
Application valuation: 6565
o
Contractor: D 6
Applicant: Architect or Engineer: J ANTHONY PLUMBING HEAT/AI
CC/ 72216 NORTH SHORE STREET, 0
THOUSAND PALMS, CA 92276 AUG 2
T (760)343-2121 1010
Lic. No.: 777794
CITyOF
Fflygk EQuINtA
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 Professionals Code, and my License is in full force and effect.
License Class: C20 -C36 License No.: 777794
I-. /.a
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 countythat 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 (5500).:
(_ I 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.).
(_ 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
pursuantto the Contractors' State License Law.).
I _ 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
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 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 STATE FUND Policy Number 1932451
_ 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' compe anon provisions of etion
3700 of the Labor Code, I shall, forthwith c mply with [h visions.
µDate: � ���r Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -
DOLLARS 1$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.
Icertify 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 authoriz representatives
of this county to enter upon the above-mentioned propert or foss a purposes.
1 �d�Date: Lw�3�USignature (Applicant orAgent • ".r
Application Number 10-00000790
Permit MECHANICAL
. Additional desc .
Permit Fee 42.0.0 Plan Check Fee
10.50
Issue Date . . . Valuation
0
Expiration Date 2/19/11
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 APPL REP/ALT/ADD
9.00
1.00 9.0000 EA MECH B/C <=3HP/100K BTU
9.00
------------------=---------------------------------------------------------
Special Notes.and Comments
A/C CHANGE OUT 5 TON 14 SEER UPFLOW
SPLIT SYSTEM CHANGE OUT AND INDOOR COIL.
2007 CODES..
----------------------------------------------------------------------------
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 42.00 .00 .00
42.00
Plan Check Total 10.50 .00 .00
10.50
Other Fee Total 1.00 .00 .00
1.00
Grand Total 53.50 .00 .00
53.50
LQPERAIIT
of
'15
VtA E tied
2008 Residentid*HV,
Enforcement Agency:
CF -IR -ALT -HVAC
0 Permit M
1>
nagw wu,
mace @r� �O o ❑COP Over 4011 of ducts added or
jrtdoor Coil ®SEER ❑ HSPF replaced in unconditioned space Served by system
Condensing Unit ❑ EER ❑ Resistance p R6 (CZ 10-13) sf
Other ❑ R 8 (CZ 14-15)
(1f net already
present, must be
lnstalledj
1. Equipment Type: Choose Hose being installed: f more than one system, use another CF -1 R -ALT - HVA C or each
ment E j system.
2. Minimum
Equijp jJfcietrcies: /3 SEER, 78Sb AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work
picks one of the appropriate Options. Each Option lists the HERS measuree conducted. d
s that must be
inspection and n copy given to the homeowner. At A Dopy of t}ie fotvs shall be left on is being done
final, the inspector verifies that the work listed on this form was in e•and
final
fact the work completed by the
si B'ein
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
October 1 2010 a red copy of the CF -1R and CF -6R sha1C also be on site for ficial inspection.
E3 1 HVAC Changeout Required Forms.
• All HVAC.Equipment replaced Lr -ox totms: MECH-04, TECH -2I -HERS and (for split systems) MECH- 25 -BURS
CF -4R forms: MECH- 21 and for splitsystems).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 -4R forms: MECH- 21 and (for split systems) MECH-25.
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton
For Packaged Units: Duct leakage < 15 percent (Ivltntmtun Air Flow Requirement), TMAH
Exempted from duct leakage testing if -
0
f❑ 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. Existin duct systemsare oonstrucxed, insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-I3ERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment) CF -0R 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, SIMS, 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 Packa ed Units: Duct leakage <6 percent
❑ 4. New Ducting over 40 feet geguired Forms:
• Includes addin' or replacing morethan 40
linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R fors: 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 /Responsiblb Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I at 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,
Pans I and 6 of the Califomia 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; laic and specifications submitted to the enforcement for roval with the it lication.
Name:'
� � Signature:
Company:
J ANTHONY SERVICES Date:
Address: 72216 NORTH SHORES
THOUSAND PALMS, CA 92276 License:
City/Statc/Zip:
Phone -7 3 Z %.
2008 Residential Compliance Forms March 2010
Bin #
Qty Of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # n
Project Address: rD'4q G\)C6
.Owner's Name:. f 6 A t P t( -z'6
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: J ANTHONV SERVICER
Telephone6 ,�w � �
�..
C v II ) Se��
Project Description: J "[
72 NORTH SHORE ST. PTE 109
Address: THOUSAND PA
City, ST, Zip:
L.QL4/S PLAT
Telephone. 3 L43 2—t gCA4AhGCOUT
State Lic. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
.i"
State Lic. #:
Name of Contact Person:
Construction Type: Occur ancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 411�;S65 e
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIGNGPERMIT
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
Mechanical
Grading plan
2s° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"° Reyiew, ready for correctionvissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Sees