11-1086 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
�1y0-0`001086
Property Address:
78530 SAGUARO DR
APN:
646-312-048-98 -000000-
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
15312
Applicant:
T4ht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WILLIAM FENNESSY
78530 SAGUARO DRIVE
LA QUINTA,.CA 92253
Contractor:
GENERAL AIR CONDITIONING
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 7.77-7153
Date: 10/04/11
i
FMCT 0.4 10?1
LQPERMIT
31170 RESERVE DRIVE—C1TY01t
THOUSAND PALMS, CA 92276 F LA Q51NTA
FIiQ&I
(760) 343-7488 la�Ri�i�T
�l
Lic. No.: 686310
---------------------------------
.-LICENSED CONTRACTOR'S DECLARATION
° WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury, that'I a .. censed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: ,
Section 7000) of Division 3 of the Business an Professionals Code, and myLicenseis in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 License No.: 686310
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate: 4 1 1 ontractor:
issued.
V-1 have and will maintain workers' compensation insurance, as required by Section 3700.of.the Labor
i
Code, Ifor the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION'S
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State LicenseLawfor 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
_ I certify that, in the performance of the work.for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance,. also.requiies the applicant for the
person in any manner so as to be me subject 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 that, if I should becom ubject to 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 of the L bor Code, I shall hwith comply with those provisions.
that he or she is exempt therefrom and the basis.for the alleged. exemption. Any violation of Section 7031.5 by
t
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate: 1 pplicant:
( 1, 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' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply town 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 peison 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, indemnity 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 sucipermor essation 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 ation 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 buildion, and hereby authorize representatives
Lender's Name:
of this county to enter upon th above-mentioned property purposes.
/k
I'
ate: (° 4 (1 S' ature (Applicant or Agent):
Lender's Address:
LQPERMIT
Application Number . . . . . 11-00001086
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation . . . .
0
Expiration Date 4/01/12
Qty Unit.Charge Per
Extension
BASE, FEE
15.00
1.00 9.0000 &A MECH FURNACE <=100K
9.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------=-----------------------
Special Notes and.Comments
HVACCHANGE;OUT: INSTALL ,NEW .4 TON
SYSTEM, FURNACE, INDOOk,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
Othek- Fee Total 1.00 .00 .00
1.00
Grard..Total 51.63 .00 .00
.51.63
LQPERMIT
Bin #. .
Permit # ��.
Project Address:
.
3 D
Cltr.of La. Quinta
Building 8L Safety Dlvlslon
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253'- (760).777-7012
Building Permit Applicationand Tracking Sheet
uo-r p' : Owner's Name: 1` ce-m Fen r/:°SS
A. P. Number:
Address:
Legal Description:
City, ST, Zip: (.moi-_
Contractor:
Address: 3
City, $T, Zip:'—
:. • :•:.
Telephone: �- ;y/r.: ,yrs : •u
Project Description:HV
GI
Telephone
f
State Lic. # : 3
City Lie. #; &C
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:.
.
State Lic.
�.`:".�• �.,�?;s�,�.;
•__. •:.�A,.•x::,�•��%:G r..:r;{x:��,.;s= :,;,�;.
ConstructionT e:
yp Occupancy:
; Project type (circle one): New Add, n .Alter Repair Demo
Sq. Ft: #Stories: #Units:
Name of Contact•Person: p (,� �dlcc%5 c7YL'
Telephone # of Contact Person: D 3 `C3 %'�$ Estimated Value of Project: c
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets
Re--]
q'd'
Rec'•d
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes..
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked no
Construction
Flood,pfain plan
Plans resubmitted
Mechanical
Grading"plan
2n° 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
7rd 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
Sim lifted Prescri true Certificate of Com liance:" 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
SiteAddress: n
Eforcer t Agency:
Date:
Permit #:
E ui menu T et
List Minimum Efficienc Z
Duct insolation requirement
Conditioned Floor.
Area
Thermostat
❑ Packaged Unit
urnace
o
O AFUE 80 0
O COP
Over 40 ft of ducts added or
KSetback
door Coil
OSEER !3
O HSPF
replaced in unconditioned space
Served by system
(/ not already
1 Y
ondensing Unit
_
❑ .EER / /
_
❑ Resistance
O R 6 (CZ 10-13)
sf .
present, must be
O Other
❑ R 8 (CZ 14=15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC fur each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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 CF4Rs allowed) are filled out and
si ed. Beginning October I, 201.0, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection.
1. 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 -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(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempt orn duct leakage testing if:
_/34. 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:
with new
• Cut s: al Chang outdueling
ducts: (all 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
O 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 s ace.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R 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.
• 1 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 • orm tion documented on other pplic ompliance forms, worksheets,
calculations, andspecifications
plans submitted to the enforcement agency for appro al with t e permit application -
lication.Name:
Name:
Clem Wt-6,5kj
Si ture:
Company: r1qt�nn ,e,e(`q,( 41'r Confit ��`Os9 r`
Date:
Address: 311
n _tt ✓�
70 /d7-
License:
�C_ity/State/Zip:—�—�t Dbc�SGt x�C Pi Lr' � A. G�aa 7�o
/�v
Phone: -760'.3T3_ -74ff ?
CaICERTS - CF -1 R Registration ..
Page 1 of 1
Public Home
Secure Home
About Us
Training
Rater Directory —
Forms
Membership Benefits
Events..
Industry Partners
News
To register for our
monthly
newsletter, please
click here.
Danielle Garcia logged in [Logout]
[Home]
CONGRATULATIONS
Your CF -IR -ALT -HVAC Registration -is complete!
You may want to print this page for your records.
Site Address: 78530 SADUARO ROAD
_ ILa Quinta, CA 92253
CEC Registration: 211-A0051156A-00000000-0000
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD _
Assigned Company:,HARRISON ENTERPRISES INC
Do you know your HERS Rater?
If you do, you may want to send Phis CF -1R to them.
CaICERTS Rater ID: I.
OR
My Rater Quick Select:: Energy Driven Solutions, Inc...
Every CaICERTS rater has a license number.
If you need to find the rater by name [Click HERE] to search our directory.
1-SEND•CF-.1 RTq HERS RATER:;
[CLICK HERE] to do another
Copyrighi t(? 1010 CalCE:R.fS. Inc. All rights reserved. Revised: January I I. 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-IfERS=R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us .
BBB fi du.cmFaoebccakQ
Sart WRnlMt ..: .
https://www.ca.1certs.co*m/p.ublic.cfl-R.cftn?,pfoject id=1.411307 10/3/2011