10-0746 (MECH)- ,t
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
it O - 0�` 0 746
Property Address:
788'8.5 — SANITA DR
APN: ,"
604-162-007=79 -23269 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
AFiPlication'valuation:
10000
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LADD JOE
78885 SANITA DR
LA QUINTA, CA 92253
(
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/11/10
J !'
Contractor:
Applicant: Architect`or Engineer: GENERAL AIR CONDITIONING
/Y 31170 RESERVE DRIVE
- n
&AJY//\/�J THOUSAND PALMS, CA 92276
(760) 343-7488 `
Lic. No.: 686310 r;(,, ;;✓:�_ z,�
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 la : C20 LicenseDo.: 686310
Dater , Conte to A A H�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 county that requires a permit to
construct, alter, improve, demolish, or repair any structure, priorto its issuance, also requires the applicant for the
permit to file aligned 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 penaltybf notmore than five hundred dollars (5500).:
(_ 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
Contractors' State License Law does not apply to an owner. of .property whobuilds 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 _ 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
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , BAP.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 perjuryone 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.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, forthe performance of the work for which this permit is issued. My workers' compensation
insurance farrier -and policy number are:
Carrier PREFERRED EMPL.- Policy Number WKN1295355
_ 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' compensation provisions of Section
700 of the La Code, I.sh II forthwith corn I th:those provisions.
at Applicant;
t e e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. 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 Quints, 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 construction, and hereby authorize representatives
of this my o enter upon the above-mentioned ", operty for
inspection purposes. n�
,' p is A .I I [
. Signature (Ippplicant•or Agentl✓V
Application Number . . . . . 10-00000746
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . . .
42.00
Plan Check Fee
10.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/07/11
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
HVAC CHANGE OUT 3 TON
SPLIT SYSTEM 13
SEER ,INDOOR COIL.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
---------- ----------
Paid Credited
---------- ------
Due
---
-----------------
Permit Fee Total
42.00
.00 .00
7
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
LQPERMIT
D!U fl
Clay. of La Quinta
Building &r Safety Mslon
P:b. Box 1504, 78495 Calle Tampico
B La Qdinta, C.A 92253. (7610)1777-7012
urlding.Permrt-Application and: Tracking Sheet
Permit #
Project Address:MIS
Owners Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip l
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Contractor:
Telephone: #.•.��^'' F3{?h>;
Address: J
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Project Description:
City, ST, Zip:
Tele hone:Z
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State Lic. # :
City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
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ConsttiType: e: Occu an
YP P cY:
.
Project type (circle one): New Add'n Alter Repair
Demo
' -
State Lic.
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets:
Req'd
Recd
TRACIGNG
Plan Check submitted
PERMIT FEES
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
2°" Review, ready for corrections/issue
Electrical
$ubcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INI HOUSE:-
'^' Review, ready for coirectionsrissue
Developer Impact Fee
Planning ApprovalCalled
Contact Person
Pub. Wks. ApprDate
of permit issue
School.Fees
"
Perm it Fees
Sim lified Prescriiptive Certificate of Com fiance: 2008. Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones. 10 to 15
dr .-�
nforcem Agency:
te: G�
Permit 1:.
PEquipment T er List Minimum Efficienc Z
Duct insulation reuirement
Conditioned Floor
Area
Thermostat
aged Unitkokndensioniglr
ace
❑ AFU
❑ COP
Over 40 ft of ducts added or.
�---__
r
r C
❑SEER
❑ HSPF
replaced in unconditioned space
Served by system
(fjnot already
Unit
❑ EER
❑ Resistance
❑ R 6 • (CZ 10-13)
sf
present, must be
❑ Other
❑ R 8 (CZ 14-1 S)
installed)
I. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R ALT -HVAC for 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. T Spector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
si eginning October 1, 2010, a registered copy of the CF -1R 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
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
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:
• Cut s: Chang with new
ducts: CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
(all new ducting and all
new equipment) CF -411 forms: MECH 20-, and (for split systems)N(ECH-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
❑ 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
Re uired Forms:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned space.
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 duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration.Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• 1 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 information documented on other applicable compliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement agency for approval with the t licatio .
Name:I's af
Signature:
Company:rote:
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Address: 1 jn r
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License:
City/State/Zip:
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Phone: -7 t rn , 2, Q q.