11-0778 (MECH)P.O. BOX 1504
787495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:. 11=0006077
Property Address: X79262 CALLE PALMETO
APN: 604-381-021-29 -25953
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 9855
Applicant:
Architect or Engineer: "
u�i(,rGv
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I '
hereby affirm under penalty of perjury that I am licens under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Proles .Is
Code, and my License is in full force and effect.
license Class: -C20 License No.: 686310
Date:
gWRER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 (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 ($500).:
(_) 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.l.
. (_) 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.).
( ) 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: P
LQPER.AIIT "
Owner:
ROSS ANTHONY
79262 CALLE.PALMETO
LA QUINTA, CA 92253
Contractor:
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488
Lic. No.: 686310
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Dater 7/19/11
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
—7
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 EVEREST NATL Policy Number 7600006147101
_ 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 Ishould bacft subject to the workers' compensation provisions of Section
3700 of the Labor Code, I sha rthwith comply with those provisions.
iSate: M 1 _,,�Pplicant:
WARNING: FAILURE TO SECURE V%rIR 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 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.
I certify that I have read this application and state that the kruction,
s correct. I agree to comply with all
city and county ordinances and state laws relating to buildid hereby authorize representatives
of this -county to enterupon the above-mentioned property oses.
jam: 7 (1 SignatupeKApplicant or Agent):
Application Number 11-00000778
Permit . . . MECHANICAL
Additional desc .
Permit Fee 40.50
Plan Check Fee
10.13
Issue Date
Valuation
0
Expiration Date 1/15/12
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1..00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
16.50
-- -- -------------------
Special Notes and ComM4iLACS
-----------------------
INSTALL NEW HVAC SYSTEM, FURNACE,
INDOOR
COIL, CONDENSING UNIT (13 SEER, 80%
AFUE). 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
Other Fee Total 1.00
-00• .00
1.00 -
Grand Total 51.63
.00 .' .00
51.63
LQPERMIT
- - .
Sim lifted Prescriptive Certificate of Com liance:".2008.Residential HVAC Alterations CF -.IR -ALT -HVAC
Climate Zones 10 to 15
_vun tcestctenuot t.vnrplianc'e Porins )1n1n
Site ,4ddress:
4:
Enforcement Agency:
[.G�-
Date. p
-7-1 p �
Permit #:
11--7-751
Equipment T et
List Minimum Efficienc z
Duct insulation re requirement
Conditioned Floor
Area
Thermostat
❑ Packaged Unit
Furnace
❑ AFUE80TCOP
Over 40 ft of ducts added or
Setback
Indoor Coil
❑SEER 13 HSPF
replaced in unconditioned space
Served by system
(lf•not already
Condensing Unit
❑EER / /Resistance
❑ R 6 (CZ 10-13J
sf
present, mast he
❑ ther
❑ R 3 (CZ 14-15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -F_ VAC 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 four 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 CT -411s allowed) are filled out and
signed. Beginning October 1, 2010, a registered copy of the CF -1 R and CF -61R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
C F -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- 2541:=RS
• 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 ReclLirement), 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 veri5cation, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
I
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new a ui meat)
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
❑ 3. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for spfit systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF -4R forms: MECH-20 and (for split systems) MECH-25
-—coii-and/or-fima'ce:--Nbraft equipment dtianged`
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 ofduct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -411 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 idrntified on this Certificate of Compliance.
• f 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 I and 6 of the California Code of Regulations.
• 'rhe design features identified on this Certificate of Compliance are consistent with the orm tion documented on othe,itpplic• ompliance forms, worksheets,
calculations, lams ands
ecifications submitted to the enforcement a enc for a to •al with ennit a lication.
Name: I.(ee,-, kj�56
Sig lure:
Company:
67 erl •era.( 411 r C0�1 cl a f -,`o rt ,''
Date:
Da -7
Address:
31 / %d /Z>oServe �rt` ��
License_
6006,5(6)
City/State/Zip:-T-%ot�5u�x�( Pa_LmS, G ���7{0.
Phone: 760-3'1.3-%4ffP
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CaICERTS - CF -1R Registration
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CONGRATULATIONS
Your CF -I R -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Site Address: 79262 CALLE PALIv)ETO
La Quinta, CA 92253
CEC Registration: 1211-A0035540A-00000000-0000
CF -I R -ALT -HVAC: I CLICK 14ERE TO DOWNLOAD
Assigned Company:IHARRISON ENTERPRISES INC
Do you know your HERS Rater?
If you do, you may want to send this CF -IR to them.
Ca10ERTS Rater ID:
OR
My Rater Quick Select: Energy Driven Solutions, Inc. _
Every Ca10ERTS rater has a license number.
if you need to find the rater by name [Click HERE] to search ou.- directory.
I SEND CF -1R TO HERS. RATER j
[CLICK HERE] to do another
Copyright 02010 CalCf.I.R -S. Inc. All rights reserved. Revised: January 11. 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Po -icy].
CAICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-778-)
Fax: 916-985-3402 Contact Us
BBB Find us onFacebOOhQ
p,n vc� m,v
https://www.calcerts.com/public_cflR.cfm?project_id=1255.75 7/18/2011
Dill tt
Permit #
Project Address: 71 � ,
City of La Who
Building &' Safety•Divislon
P.O. Box 1504, 78-495 Calle Tamplco
La Quinta, CA 92253 (760) 777-7012
Building Perm -it -Application and. Tracking Sheet
• 1
- Z G�
Owner's Name: -y {� e y
A. P. Number:
Address: p
Legal Description:
City, ST, Zip: ��--
Contractor: -60,
Telephone: 3.
P t'�D
"``t: <::'•
Address: ✓1 RD
City, ST, Zip:
4-��J�/^`'-'
Project Description: T �rn
Telephone:
r :: ; `...`•:>;:
State Lic. # : 3
City Lic. #;::.,
Arch.,. Engr., Designer:
Address: .
City., ST, Zip:
Telephoner
State Lic.
f,�:::��<:3:>:<:::,>:>•>'::x••:•:�r::.#
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�'
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s :> f::> ,:;:;>:<.;; .;;r;•<.::.;N�.< , <
:>>- "" ••• • •.....• .....x.;":::::>:<:> :<•.ProJect
- . _
Construction Type: Occupancy:
.
type circle one): New Add n .Alter Repair Demo
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
TRACMG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cates.
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
Mec'aanicai
Grading" plan
2"" Review, ready for, corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plu&bing
Grant Deed
Plans picked up:
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review,.ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub, Wks. Appr
Date of permit issue
School Fees
Total Permit Fees