11-0797 (MECH)#---. - 5j"i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11x00000797
Property Address: 7858SAGUARO DR
APN: 646-313-008-108 -000000-
Application description: MECHANICAL
Property Zoning: MEDIUM DENSITY RES
Application valuation: 1447
Applicant: = Architect or Engineer:
h.
4 e(P Qu&&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
KIRK KAREN
78585 SAGUARO DRIVE
LA QUINTA, CA 92253
Contractor:
DOVE AIR INC
69749 RISUENO ROAD
CATHEDRAL CITY,. CA
(760)327=1890
Lic. No.:.794315
92,
VOICE,(760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/25/11
----------------------------------------------
LICENSED CONTRACTOR'S DECLARATION - -
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed 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 and. Professionals Cod and my License is in full force and.effect.
.1 have and will. maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 .Lice o.: 794315
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
T Z _ f -/ `
ate:' 1 ontractor:
— 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 '
/// OWNER -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 EXEMPT Policy Number EXEMPT -
"for
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit toI
certify that, in the performance of the work which 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 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 beco subject tot e)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 abor Code, I, orthwith co' y wit those provisions. '
that he or she isexempttherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
. wt ^..
any applicant.for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
' pplicant:
(_ 1 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' COMPENSATION 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 _ 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
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
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.
I certify 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 consction, and hereby authorize representatives
of this county to enter upon th bove-mentioned property for in ection pur ses.
I'll
: I (Si ture (Applicant or Agent):
Application Number . . . . . 11-0000079.7
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 31.50 Plan Check Fee
7.88
Issue Date . . . . Valuation . . . .
0
Expiration Date 1/21/12 .
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE 3.TON HEAT. PUMP CONDENSER IN
SAME LOCATION. 2010, CODES,
-------------------------------- -------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary. Charged Paid Credited
Due
Permit Fee Total 31.50 .00 .00
31:50
Plan ..Check Total 7.88 .00 .00
7.88
Other Fee=Total 1.00 00 :00
1.00.
Grand Total 40'.38'. 00 00
40.38
LQPERMIT
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Bin #
City of is Quintd
Building a Safety Division .
P -O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Budding Permit Application and .Tracking Sheet
Permit #
Q�
Project Address: 5 S Ar 0Owner's
0(.
Name: 1C
A. P. Number:
Address: % Ssi S_ S 4 UA ✓V 14
Legal Description
Contractor: .'D G r rtn
City, ST, Zip: LQ : n `'/ U 53
I'elcphoue:
Project Descriptions
Address; (9
R
City, ST, Zip:��%�dc� ,%� 27,`3
Telephone: b y a. – g
State Lic. # : , 113 City Lie. #: 0. 3 519
Arch., Eagn, Designer:
YVwt C0'N �6S�s61'\
p C —� ..,� ti tQ % A 0 Vni 0
Address:
City, ST, Gip:
Teiepliene:
;tate Lie. #:
Constriction Type: Occupancy-
Project type (circle ane): New Add'n Alter Repair Demo
Name of Contact PCrson:
Sq. Ft.:
#Stories:
# Uuits:
Telephone # of Contact Person: Zia 0�61–dQDLEstimated
Value of Project:. Oen
Mom APPLICANT: DO NOT WRITE BELOW THIS UNE
ti
Submittal
Plan Sets
Req'd
Req'd
TRAI KING
Mi (heti submitted
PERMT FEES
Iteta Amount
Structural Cates.:
Reviewed, ready for corrections
Plan Check Deposit
Trass Cales.
Called Contact Person
Ptaa' Check Baia.ace
Energy Cates.
Plans picked up
Consr motion
Flood plain plan
Plans reaubmttted
Meehsnieal •
Grading.plan
V Review, ready for eorrectioas/issue
Electrical
Subcoutactor List
Called Contact Person
Planthtng
Grant Deed
Plans picked up
g bI L
li.O.A. Approval
Plaas resubtuitted
l:radlrig
IN HOUSE:-
'' Review, ready for correcfioosliasue
Developer Impact Fee
Planniag Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issac
School Fees
—
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit fit:
78585 Saguaro RD La Quinta, CA 92253
City of La Quinta
l3ul23,2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
p SEER13.0
❑ COP
2 HSPF
❑ R 6 (CZ 10-13)
R 8
Served by system
Q sf
`J Setback
If not already present, must be
0 Condensing Unit
ElEER
[:1Resistan e
[1 (CZ 14-I S)
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-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.Beginning October 1, 2010, a registered copy of the CF-111
and CF-611 shall also be on site for final inspection.
D 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
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 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
713. Existing duct systems are constructed, insulated or sealed with asbestos
114. The system will not be Ducted (ie..Ductiess,Mini-Split:System)3(Also Exempt from Refrigerant Charge)
❑ 2. New`'HVAC System
Required Forms: it
. Cut rotor Chan eout with;'
� ;
new ducts: (all new
CF 6R forms MECH-04, MECH-20and;(for split systems) MECH-22-HERS and MECH-25-HERS
all new
CF-4R forms • MECH 20, andi(for split systems) MECH-22, aha MECH 25 s ` :
a
equipment) tr�idA
r'
For Split Systems: Duct leakage<°6
percent; RCI 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
. Includes replacing or installing all new ducting
and/or outdoor condensing unit and/or indoor
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
coil and/or furnace. No or some equipment
CF-4R forms: MECH-20 and (for split systems) MECH-25
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
7-6R 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: Gary Laster Signature: Gary Laster
Company: DOVE AIR INC Date: Jul 23, 2011
Address: 68-749 RISUENO ROAD License: 794315
City/State/Zip: CATHEDRAL CITY / CA / 92234 Phone: (
Reg: 211-AO03697OA-00000000-0000 Registration Date/Time: 2011/07/23 14:02:46 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010