13-1399 (MECH)P.O. BOX 1504 -
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001399
Property Address:
48721 SANTA
APN:
646 -130 -013 -
Application description:
MECHANICAL
Property Zoning: .
LOW DENSITY
Application valuation:
1800
Applicant:
Tihf 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
URSULA ST
RESIDENTIAL
Architect or Engineer:
------------------
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 an Professio I Code, and my License is in full force and effect.
Lice nseClass: C20 'cense N 7943 15
e:lt� � I/
1�a` 'pritractor:
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 county that 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 lcomMencing 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 ($500).:
1 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 JSec. 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, 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
pursuant to the Contractors' State License Law.).
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�
Owner:
KATHY HATFIELD
48721 SANTA URSULA ST.
LA QUINTA, CA 92253
(
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/04/13
Contractor:
DOVE AIR INC
69749 RISUENO ROAD
CATHEDRAL CITY, CA 92234 NOV 04 2013J
(760)327-1890
Lic. No'.: 794315 CIT.V-OF LA QUINTA
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirrii 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.
ss'
h4. 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 P Policy Number EXEMPT
I Mert fy 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' compensation provisions of Section
3700 of the Labor Code,,l shall fonhw)(h comply with those provisions.
/* CAp pl i c a n t: _/AZ
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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CO DE, 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.
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 buildin c struction, ano4ereby authorize representatives
of this county to enter upon the above-mentioned property . specti
Dat, //' y- / Si-g-n-a—ture (Applicant or Agent):
6- f�ry \1_J
Application Number . . . . . 13-00001399
Permit . . . . ... MECHANICAL 2013
Additional desc
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 5/03/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA - MECH FURNACE
35.75
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------
Special Notes and Comments
----- -
HVAC CHANGE OUT - 13 SEER/78AFUE,
REPLACE 3 TON PACKAGE UNIT ON GROUND
(2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
--------------------- ------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN -(SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged Paid Credited
m ---------- ---------- ---------- -----------
Due
-------------- ----
Permit Fee Total 71.50 .00 .00
71.50
Plan Check Total .00 ..00 .00
.00
Other Fee Total 139.23 .00 .00
139'23
Grand Total' 210.73 .00 .00
210.73
LQPERMIT
4 Y U 0 MV V Y
Bin #
-.b 'a. QuInta
Ity CL
911111ding ex Safety Division
P.O. Box 1004,'*495 Cal le Tampico
La QuInta, CA 91253- (.766).777-7012
Building. Permit Application and TrackIng.Sheet
Permit # AA
/�43
-Project Address:
Owner's Waipc
A. P. Nun*=:
Icily,
Addrws" qf 7d-1. Orj-V1CId'f.
Legal -Description:
ST. Zip: I -q Cott, C'+
Contrwwr: k is iz A -r -1, L
Telephone: - .
Addr�p;
-22 ZNO r')
City, ST, Zip, CLLL/3 ('4A C .11%; 3 1
/V,4
0
7 �'q 3 -57
Arch., Engr., Designer.,
Address:
Cityj 9r, Zip:
jtate Lie.
..... .....
Name of Contact Per�vn-
eon*�qdoa Type: OC46UPanCY
Proj!!A ty"rele qn�): New, Add'.n ..Alter Repair Demo
Sq. Ft. Fw
# UuIts:
Telephone #_of Coatact Perso n
Esdmiw Value OfFmajoct. /PV, 00
. .
APPUbANT: 00.,X9, EIBMOYV-THIS UNE
T
fi
Submittal
Aced TRA VfG PERYOr FEES
Plan $ets
Plai Meck submitW4
item Amount
Structuratcalm:
Reviewed, ready for correctlow
Plan Che*Dcpgt
Trus Cafes.
Called Contact Person
Plan Check B-2-111-Lact
Energy Catics.
Plus Ncked up
ConstkWtion
Flood plaln-pla�
Plans resubmitted
Mechanical
Grading.plan,
2" ReTiew, ready ibr corrections/lasist
Eledrkm
Subcoutictar List
61164 Contact Nrson
Plasibing
Grint Deed
SALL
H.OA. Approval
W..
Grgdidg
IN HOUSF:-
rtady for torrectiondinue,
Developer hilpset Fee
Planning Approval
Pub. Wks. Appr
Called Contact Peroon
Date of permit Wat
School Fees
Total Perjull fees
I
0
I
IM
simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Oct 31, 2013
Permit, #:..,
48721 Santa Ur'sula St. La Quinta, CA 92253
City of La Quinta
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
a Package Unit C9 Setback
_[3_FUHi5Ee` -Cg-AFUE-:Z_80/,y— -0-GO Served -by -system -
IVC15(CZ10-13) ff not already present, must be
[3 Indoor Coil N SEER 13,o E3HSPF_
C] R 8 (CZ.14-15) 1200 sf installed
[3 Condensing Unit [3 EER [3 Resistance
[3 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, Z 7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
lists the HERS measures that must be conducted. A copy of the forms shall
and picks one of the appropriate Options. Each Option
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 -1R
and CF -611 shall also be on site for final inspection.
CM 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
_H 25 14ERS
CF -6R forms: MECH-04, MECH-21-HERS -afid (f9F split systefflS)r ME(=
replaced
CF -4R forms: MECH-21 and (feF Split systems) 04EGH 2&
• Condenser Coil and /or
CF -6R forms: MECH-04, MECH-21-HERS and (feF Split systems]l MEGH -25 HERS
• Indoor Coil and /or
CF -4R forms: MECH-21 and (feF Split systefos)
• Furnace
r.eF_splot Systemse Puret leakage ; 19 peKeRtj RG, GGA 5 999 GFN�teR imum AiF ra19w--Re9WiFeF:PeAt4, TMAW
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing,if:
0 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
0 2. Duct systems with less than 40 linear feet in unconditioned space, or
0 3. Existing duct systems are 666structed, insulated or sealed with asbesto�
-qpt;:frq Refr'-
4. The yst&ft,will no be Ducted (ie.., uctless,�Oini:�plit �,Ystem)�(A!�b�Exet jge��nt:�C"�ge)
m
0 2. Ne%W..�HVAC Sy�tenn Requiebdi,Fde s:
Cut in'drChangeout withW` MECH"il"
CF�Wfofn... MECH-,zu-nr- lit s s
new d tdi: (all new ,( , IMECH-04,
RS, llilllt-
clucti6gak all new,.,. -4R,forms: - MECH.:;20, 5
I F
41
.. " " ,
0. W,7
equip . W'L��,, -
men 1
For Split Systems: Duct leakage, -<.,6 percent;.�RC,0 CCA��t 350 CFM/tofi;�FWD�,`TMAH, STMS, a nd either HSPP or PSPP.
For Packaged Units: Duct leakage'-< 6 percent
El 3. New Ducts with/or without',
Required Forms:
Replaceme - 6t'
Includes replacing or installing all new
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 fu - mace. No 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
13 4. New Ducting over 40 feet
Required Forms:
Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-21-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
0 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.
Code to accept responsibility for the design identified on this Ce rtificate of
I
• I am eligible under Division 3 of the California Business and Professions .
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. I
• 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 T�i�gn_ature: Gary Laster
. Date Oct 31, 20 13
Company: DOVE AN INC
Address: 68-749 RISUENO ROAD License: 794315
City/State/Zip: CATHEDRAL CITY / CA 92234 Phone: (760) 327-1890
Reg: 213-AO082713A-000000000-0000 -Registration Date/Time: 2013/10/31.,14-.21':05 HERS Provider: CalCERTS, - Inc.,
2008 Residential Compliance Forms July 2010