11-0674 (MECH)f��tiw
P.O. BOX 1504 VOICE (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/20/11
Application Number: 11-•000006.7:4 Owner:
Property Addyess: 5'6468 LMS DR WENDELL & BETSY WHITE
APN: 764-020-011- - 56468 PALMS DRIVE
Application description: MECHANICAL LA QUINTA,' CA, 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application, valuation: .5810
Contractor:
Applicant:. Architect or Engineer: GENERAL AIR CONDITIONING D
31170 -RESERVE DRIVE
THOUSAND PALMS, CA 92276 JUN 26.
(760')34,3-7488.
Lic. No.: 686310 CITYOFlgQUINTA
---------------7------
UCENSED'CONTRACTOR'S DECLARATION - - - WORKER'S COMPENSATION DECLARATION .
I hereby affirm under penalty of perjury that I amhcensed under provisions of Chapter,9 (commencing with I hereby affirm under penalty of perjury, one ofttlie.foll6wing declaraiionsi: s
Se6tion,70001' o$Division 3 of the Business and rofessionals Code, and my License is in full. force and effect. I, have'and will'maintain a certificatenof consentto self-insurefor workers' compensation; has provided
Lic_ense Class: C20 License No.: .686310 '' .for by Section 3700 of the LaborCode for'ihe performance Of the work for which this permit is.
dfi issued" "
ate 7�c gntiactor. �J.have and will mamtaimworkers;compensafwn insurance,"as regwred by Secuon 3700.of.the Latior
. ,
_L/ r .. r, .Code-for!the performance of the work' ;for which -this permit is issued fv 'workers compensation.
OWNER-BUILDER'DECLARATION insurance:carnerands'policy number are +'" -
I hereby'affirm under penalty of. perjury,thai I am exempt from the Contractoi's State License Law for the Carrier EVEREST NATL' Policy Number 7600006147101]
following reason (Sec..7031 5;. Business and'Professions Code: -!Any city or,county that requges'a'permit to _ I certdy ihat;Iinthe performance of the work'for'which this permit is issued, I shall not employ any.
Construct; alter, improve, demoiiph, or repair any structure prior to its issuance, also requires the.ap0cant.for..tne person in any manner so as to become subject to the workers' compensation laws of California, .
.P permit to file a signed. statement that he or she is licensed,pursuent to the provisions'of the Contractor's State and agree that, if I sh' Id b 'me subject to the workers' compensation provisions of,Section r
License Law.(Chapter g;lcornmencing with Section 70001'of Division 3.6f;04 8usiness'and'Professions Cooel•or 3700 -of -the Laoor.Code, l Lforthwith comply with those provisions.'.
that he or'lhe i's exempt therefrom and the:basis for the alleged exemption._'•Any violation of Seciion_7031.5 by: _
any applicanffor a permit subjects the'applicant to a civil penalty.of not.more than five'hundred.dollars-($5001.: ate: 2t> / - /.'l5pliiccant:
l; as'owner of,the property; ;or my. employees with'wages"a'siheii sole compensation will do the work,. and ✓ ., .`! .
-the structure is not intended or offered for. sale -(Seo 7044 Business•and1Profession's Codei,The WARNING: FAILURE TO SECUREfWORK S'�COMPENSATION COVERAGE-IS.UNLAWFUL, AND:SHALL',r
Contractors State Ucense Law does not apply to an owner of property who, builds or improves thereon; SUBJECT AN,EMPLOYER,TO CRIMINAL PENALTIES!,N[Ii6 IVIL FINES UP;TO
ONE-HUNDRED'THOUSAND.
and who does the work himself or,herself'tlirough�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. orimprovernent 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 buildor
impro) a for,therpurpose of sale.).v.�'' - •APPLICANT ACKNOWLEDGEMENT
J'_ 1 1 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 owrier of • "' co4ti6hi and restrictions set'forth�on this' application:,,-+ ^•' r . ,+ia~-
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 benefitvvork is performed under -or pursuant to any permit issued as a result of this application,
I _ I I am exempt under Sec. , 8:&P.C..for this reason" .. 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.
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 such permit, or cessation 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 abov formation is correct. I agree to comply with all
work for which this permit is issued. (Sec. 3097, Civ. C.I. city and county. ordinances and state laws relating to building truction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for ecti purposes. '
Lender's Name: 't
ate: 2. 1ature (Applicant or Agent):
Lender's Address: _ '
LQPERMIT
Application Number . . . . . 11-00000674
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 30.50 Plan Check
Fee
6.00
Issue Date . . . . Valuation
0
Expiration Date 12/17/11
Qty Unit Charge 'Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
.1.00 6.5000 EA MECH AH <=10K CFM
6,:50
-------------------------------------------------------=--------------------
Special Notes and Comments
CHANGE OUT HEAT PUMP & AIR HANDLER. 2010
-CODES:
----------------------------------
Other Fees . . . . . . . ... BLDG,STDS-ADMIN.(SB1473)
1.00
Fee summary Charged Paid' Credited
Due
Permit Fee Total 30.50 .00; •'.
.00 .'
30.5'0
Plan Check Total 6.00 .00
.00
6.00
Other Fee Total 1.00 .00
00
1.00
Grand Total `37.50 .00
.00
37..50:;-;
s
LQPERMIT
Sim lined Prescri tive Certificate of-Coii ' liance :2008 Residentidl HVAC. Alterations.. CF -IR -ALT -HVAC -
Climate Zones 10 to 15
2008 Resiclential Compliance Forms n f„ ,•b 7n to
HERS VERIFICATION SUMMARY Listed below are four`HVAC alteration Options..'The installer decides what work is being done and
Site Address:
E4 gi2
En orcemei gency;
Date:
Permit #:
installer. The inspector also verifies that each appropriate, CF -6R and registered CF -4R forms,(no hand fulled CF-4Rs allowed) are filled out and
2
si ed. Beginning October 1, 201.0, a re istered co of the CF -IR and CF -6R shall_ also be on site for final inspection.
Conditioned Floor
Required Forms:
• All HVAC Equipment replaced
Equipment T
List Minimum Efficient
Ductinsulation re uiremerii.
Area
Thermostat
Furnace
❑ Packaged Unit
❑ Furnace
p
❑ AFUE 80 w
❑ COP
Over 40 ft of duct's added or
I. Duct system was documented to have been previously sealed and.conftrmed through HERS verification, or
Setback
❑ 3. Existing duct systems are constructed,, insulated or sealed with asbestos
C1 G�door Coil
❑SEER t 3
C] HSPF
placed space
rein unconditioned sa
S
. Served bt
y system
(lfnot already.
Required Forms: '
/❑
❑ Cfonden,mg Un'
❑.EER //
0. Resistance
R 6 (CZ 10-13)
sf.e
present, must he
For Split Systems: Duct leakage < 6 percent, RC; -CCA > 300 CFM/ton, TMAH
Other
/
Required Forms:
❑ R 8 (CZ 14-I5)
CF -6R forms: MECH-04; MECH-2I-HERS CF -411 forms: MECH-21
installed)
❑ EXCEPTION: Existing ducts stems constnrcted, 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 I and 6 of the Califomia Code of Regulations.
• .rhe design features identified on this Certificate of Compliance are consistent with the ' orm. tion iiocumented,on other tpplic ompliance forms, worksheets,
alculations, tans ands eci/fi'c/ations submitted to the enforcement agency for a rc al with t e permit application.
1. Eijkdpnrent Type: Ch se the equipment being installed; if more than one system, use another CF-,IR-ALT-HVACfor each syslem.
Sig lure:
2. Minimum Eattipment Efficiencies: 13 .SFFR TM AFr1F 7 79RPF M n.,,; ,.l ,•a ;do�ti I � ,��� ,�
2008 Resiclential Compliance Forms n f„ ,•b 7n to
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 inspectof 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 fulled CF-4Rs allowed) are filled out and
si ed. Beginning October 1, 201.0, a re istered co of the CF -IR and CF -6R shall_ also be on site for final inspection.
I. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
'MECH-25
CF -4R forms: MECH- 21 and forsplit sstems)
+ 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.❑
I. Duct system was documented to have been previously sealed and.conftrmed through HERS verification, 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: z.
with new . CF -6R forms: MECH-04', MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS-
• Cut s: al Chang outducting
new ducting and all
new(all
CF -4R forms: MECH 2O-, and (for split. systems)MECH-22, and-MECH 25
new a ui ment)
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-
ercent❑
73.
3. New Duets with Replacement
Required Forms: '
• Includes replacing or installing all new ducting
CF -6'R forms MECH-04, MECH-20-HERS,and,(f6r 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 Packs ed 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 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 constnrcted, 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 I and 6 of the Califomia Code of Regulations.
• .rhe design features identified on this Certificate of Compliance are consistent with the ' orm. tion iiocumented,on other tpplic ompliance forms, worksheets,
alculations, tans ands eci/fi'c/ations submitted to the enforcement agency for a rc al with t e permit application.
Name: Co Clem t�l/Q'cs6l]
Sig lure:
y.
Company. p G7eii-e_(at Ar Con,G 11_?10 r1 r`
De:
t
Address: 3!1.70 %2,e,se(ve
^ tt ✓�
License:
/
-_k
City/State/Zip:-ot�G,� PA,(Y%4Z, .Gid '�a-a 7�
Phone:
2008 Resiclential Compliance Forms n f„ ,•b 7n to
CaICERTS - CF -1R Registration Page 1 of 1
Pabtic Hoouc ,
Danielle Garcia logged in [Logout]
Seovre flome
[Home]
CONGRATULATIONS
Rbov: Us
Your CF -IR -ALT -HVAC Registration is complete!
rralnfog
You may want to'print this page for your;records.
Rater Dirrcc'oiy'Site
Address: 56468 PALMS DRIVE `
�� �
La Qui' ta; CA 92253
__• +E°mrs
,
CEC Registration: 2,1.1'A0029486A-00000000-0000 .
Membenhip
CF-1R-ALT-HVAC: CLICK�HERE TO DOWNLOAD.
... L veins
Assigned Company: HARRISON ENTERPRISES INC
.. .
tntE•osrryPrernen
' Do you know your' HERS Rater?
News
If you do, you may want to send this CF -1 R to them.
To register for our
CaICERTS Rater ID:
monthly
:OR'
newsletter, please
My Rater Quick,Select: Energy Driven Solutions, Inc.
click here.
_...._ .... _._.__.._.._.._-_..._...__.
Every CaICERTS rater has a'license number.
/fyou need to find the rater by name. [ClickHERE] to search our directory.
I ;SEND.CF-IR:TOtHERS,RATER •..� . , I
[CLICK HERE] to do another
Copyright cc, 2010 CaICHTS. Inc. All rig)its reserved. Revised:.lanuary 11.'010
[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-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us" '
BBB Ftntt us` op F6¢�ilOOk� ;
uen minmn _
https://www.calcerts:com/public_cfl R.cfm?project_id=119537: 6/17/201.1
Dill #
- y;
Ci ytof La Qcrinta
Building &''Safety :Division
P.O. Box 1504, 78 495 Calle Tampico
La. Quinta,,CA 92253 (760)..777-7012
Buildin�i Permit A'„„/n' [icatron and'Trackin Sheet
Permit #q
`
Project Address: p
do 0
r .
Owner sNair►e�/�s� S'LviT�
A. P. Number:
Address j(Drog' ” U�
Legal Description:
' ,—
City; ST, Zip:
Contractor:;r
:.Telephone -7f%OD ZS
><:•::.>: -:::.. f S ;n::
Fff• :r.;, ..c.:
Address: ✓
City, ST, Zip:
Project Description: '",` '
Telephone:
>x
CityLic. #
State Lic. # :
Arch., Engr., Designer:
Address:
City., ST, Zip:
:.`f:i:�::S•'.L;'Y.ii::
Telephone.` _ 4k 4y ,Y F ` F
Fi FJ
"gip•,`•.'::%i?�i?;:?:;:'r$:ti � r{�•y�;F�:: y:^
State Lic. #: 44,>
,...... ' .... , a,.
Name of Contact -Person:
Construction Type: Occupancy:
..
"Projecttype (circle one): New Add'n .Alter Repair . Demo
;Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: "Estimated Value -of Project: 58yo, o
APPLICANT: DO NOTMF(ITE BELOW THIS LINE .
H .
Submittal
Plan Sets
Req'd
Recd
TRACKING '�
Plan Check submitted
i PERMIT FEES
Item 1 Amount
Structural Calcs.
Reviewed, ready, for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person '
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construetion
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
1N HOUSE:-
'"' Reyiew,.ready for corrections/issue
Developer Impact Fee
Planning Approval.
'Called Contact Person
A.I.P.P.
Pub. Wks. Appr
`batebiliermit issue .
School Fees
Total Permit Fees