13-0414 (MECH)P.O. BOX 1504
787495 CALLE TAMPICO
LA QUINTA,:,CALIFORNIA 92253
Application Number:
Pro0erty Address:
APN:
Application description
Property Zoning:
Application valuation:
13-00000414
56708 PALMS DR
764-020-003- - -
MECHANICAL
LOW-DENSITY RESIDENTIAL
6500
DEPARTMENT-
BUILDING PERMIT
Applicant:. 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 70001 of'Division 3 of the•6usiness and Professionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310'
'o
Date:: y` N 'l3 Contractor:
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracfor'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 (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).:
(_ 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 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 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 contractors) licensed
pursuant to the Contractors' State License Law.).
I 1 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:
LQPER1A11T
Owner:
MARION STEINMANN
56708 PALMS DRIVE
LA QUINTA, CA 92253
(760)564-2192
Contractor:
GENERAL AIR CONDITI
31170'RESERVE.DRIVE
THOUSAND PALMS,. -CA
(760)343-7488
T.in TT- 9z 0r 110
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/04/13
WORKER'S COMPENSATION DECLARATION
1 hereby affirm urider 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.
155 I•have and -will maintain workers' compensation insurance, as -required by Section 3700.of.tfie Labor
Code, for the performance of the work for which thispermit is issued. My workers'' compensation '
insurance carrier and policy number are:
Carrier ZENITH INS CO Policy'Number Z071741502 1
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
1�3700 of the Labor'CCoode, ( shall forthwith comply with those provisions.
Date'�TI 411 S APPI�.--
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 1$100,000). IN ADDITION TO THE,CO ST OF COMPENSATION, DAMAGES AS PROVIDED F6R IN _
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS, 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to upon the above-mentioned property for inspection purposes.
Date: y Signature (Applicant or Agen,101<
t)': .e>•
Application Number .
. . . . 13-00000414
Permit . . . .
MECHANICAL
Additional desc .
Permit Fee ..
40.50 Plan Check Fee
10.13
Issue Date . . . .
Valuation . . . .
0
Expiration Date
10/01/13
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-ISHP/>1.00K-S00KBTU
16.50
Special Notes.and Comments
HVAC `CHANGE OUT . (1).-2
TON 3SEER/78AFAU
[2008 ENERGY] 2010 CALIFORNIA
BUILDING.
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
Gtand Total
51.63 .00 .00
51-:63
LQPERMIT
04/04/2013 01:42PM 8187353575
IPERMIT ERATERS
PAGE 06/11
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04/04/2013 01:42PM 8187353575 IPERMIT ERATERS PAGE 07/11
Simplified Prescriptivei'Certificate of Compliance: 2008 Kesidentlel HVAC A
teratlons CF -IR -ALT -HVAC
Climate Zones 16---15
Site Address:
Enforcement Agency:
are.
Permit #:
56708 PALMS DR La Quinta, CA 92253
City. of La Quinta
Apr 4, 2013
Duct Insulation
Conditioned FI
or
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
p Package Unit
Cl Furnace
Indoor Coll
E3 indoor
® AFUE 78%
® SEER i
'❑ COP
® HSPF �•
n R 6 (L•Z 10-13)
R 8
Served by sy
2493
m
H Setback
If not already present, must be
® Condensing Unit
--.
❑EER
[3installed Reststance
p (CZ 14-15)
)
❑ Other
1. Equipment type: Choose the,equipment being installed, i 'more than one system, use•anotherCF--IR-
LT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SFER, 78%-AFUE, Z7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed elow are FOUR HVAC alteration Options. The insta
ler decides what work is being done
and picks one of the appropriate Options- Each Option lists the HERS measures that must be
nriducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner.W final; the Inspector.,
erifies that the work listed on this
form was in fact the work completed by the Installer. The inspector also. verifies that each apI
ropriate CF -6K and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and slgned.Beg inning October 1, 2010,:a
registered copy of the CF -IR
and CF -6R shall also be on site for final inspection.
�1 1. HVAC Changeotlt
Requi Forms:
Ml HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS •and (for split systems):.
ECH-25-HERS,
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF -611 forms: MECH-04, MECH=21-HERS and (for split systems)
ECH-25-HERS
. Indoor Coll and /or
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct leakage -j<:15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow
equirement), TMAH
Exempted from dud: leakage testiriif:
;❑ 1:.Dct uct-system..was docufl Oted to have been previously sealed and confirmed throw
HERS verification, or
M.2. DusystemS:With less thakl; 40 linear feet In unconditioned space, or
.Q3: Existing duct systerns:areOgstructed, insulated or, sealed with asbestos
❑'4:The all not be Duct •, (ie: it te' e
e nom' rge)
O 2. He ' `S m Requi 5^t " _ K:.
. Cut i bngeout :wl H_ it s)
F9ERS pl � sY
EC 04, M ,
MEC ER d
S, An
„
new !(all new ..'
duds all n !` ECH 0,
L ��....
equip a. ay;
For Split= F ' :,
For Padcagetl Unitse' Oct lea kagiq.m_, :15Wrertt
❑ 3:_N'e /or without.'.' •
Required Forms:
Regia �4 n. "-.7
. Indudes•replacing or Insertstalling all; new
ducting and/or outdoor•condrig unit
CF -6R forms: MECH-04, MECH-ZO-HERS,
d (for split systems) MECH 25 -HERS
and/or indoor coil and/or furnace; 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 Padtaged Units; Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet Required Forma:.
. Includes adding or replacing more than 40 CF -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: Dud leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, Insulated or sealed with asbestos.
Contractor (Documentation Author's. /Responsible Dealgner's, Declarat olf Statame
t)
• 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 fa
r the design identified on this Certificate of
Compliance.
■ I certify that the energy features and performance' specifications for the design Identified on this Certifi
to of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features identlfied on this Certificate of Compliance are consistent with the information do
mented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the'enforcement agency,for approval
with the permit application.
Name: Danielle Garda ISignature. bnnidle Garcia
'
Company: HARRISON ENTERPRISES INC
Date: Apr 4, 2013
Address: 31-170 RESERVE DRIVE STEA
License; 686310
City/State/Zip: THOUSAND PALMS / CA / 92276
Phone: (760) 343-7488
Reg: 213-A0020124A-000000000-0000 Registration Date/Tim; 2013/04/04 16:11:13 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forma July 2010