12-1477 (MECH)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 / BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
---
- -- .---� Date: 12/26/12
Application Number: x_12-00.0014-77 Owner:
Property Address: 79786 OLYMPIA FIELDS J CRAVELLO ALLAN
APN: 775-051-036- - 79786 .OLYMPIA FIELDS D
Application description: MECHANICAL .LA QUINTA,-CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 574-4612
Application valuation: 6612 ��'(+ rp 2,012
Yv Viv [U!C
Contractor:
Architect or Engineer: DESERT AIR CONDITIONING, INC C. CITY OF LA QUINTA
590 WILLIAMS ROAD F!NANCFnPOT,
PALM SPRINGS, CA 92264
(760)323-3383
Lic. No.: 276586
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
.1 hereby affirm under penalty of perjury that I am li ensed under
provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Divisi3 f the Busines an fessionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C-29-.&30 License No.: .276586 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�. - � / issued. - -
��:Oate:r V,�Contractor:-_ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EVEREST NATL Policy Number 7600007908121
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California_,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - - and agree that, if I should.bec a subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or -'�, 3700 of the Labor Code, I sl I f rth comply with those provisions.
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 ($5001.: Date:-
(_ 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 (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through 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 or improvement 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 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 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 fSec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
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 holdharmless 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 v Id if work is not commenced
within 180 days from date of issuance of such permit, or cessati of work for 180 days will subject
permit to cancellation. "
I certify that I have 'read this application and state that the abov informatio is correct. I agree to comply with all
city and county ordinances and state laws relating to building ruc 'o and hereby authorize representatives
of this county to enter upon the above-mentioned propert nspe purposes. '
DaTlen ,d Z ,Te gnature-(Applicant or Agent):
Application -Number . . . . 12-0000,1477
.
r
Permit . . . MECHANICAL
Additional desc .
Permit'Fee . . . . 40.50 Plan Check Fee..
10.13
- Issue Date Valuation
0
Expiration Date .. .6/24/13
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 >3-15HP/>100K-500KBTU
16,50
--- -----------------------
Special Notes and Comments
REPLACE 5 TON SPLIT SYSTEM FURNACE,
INDOOR COIL;.CONDENSING.UNIT ON ROOF, -
LIKE FOR LIKE 13 SEER.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
_ F
LQPERMIT _ •
- ..
tY ���M�T _vel' 'SMl'A .. .. 4 Y� •- r Y � * _._
implified•Prescriptive Certificate of Compliance: 2008 ,Residential HVAC Alterations CF-1R-ALT-Hlbe
Climate Zones 10 - 15 .
Site Address: Enforcement Agency: Date: Permit 79-786OLYMPIA FIELDS La Quinta, CA 92253 City of La Quinta ' . Dec 19, 2012
Dud insulation Conditioned Floor
Equipment Type1 List Minimum Efficiency2 requirementArea Thermostat
p Package Unit® Furnace ® AFUE 78% [3 COP® Indoor Coil E3 R 6 CZ 10-13 Served b s stem ® Serback
® SEER 13.0 ❑ HSPF ( )• yy If not alread®Condensing Unit .0 EER ❑ R 8 (0214 -IS sf Y Present must
[3 Other
O Resistance ) _ �-�� - installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC foxeach 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
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. The inspector also verifies that each appropriate CF -611 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.
® 1. HVAC Changeout . ` Required Forms:
. All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for,split systems) MECH-25-HERS -
replaced CF -411 forms: MECH-21 and (for split systems). MECH-25
. Condenser Coil and /or _ CF -6R forms: MECH-04, MECH721-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace CF
For Split Systems:. Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton,(Minimum Air Flow Requirement), TM.AH
Exempted from'dud leakage testing if: .. {
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS veri=ication, or
O 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
p'4. The system •will not be Ducted (ie Yu -Hess Mini Split -System) (Also>Exempt from;Refngeiant Charge) '
2. New HVAC System • Required Forms: Mi'
.Cut in:or Changeout with! _«W;v
CF -6R forms ?MECH-04 MECH,20=HERS Aand (for split systems) MECH'=22' H2RS and
new ducts: (all new r4i ;
ductin } MECH 25filiERS
g. all new K y r
equi meat 6µ r CF -4R forms MECH 20, and fors ht s stems YMECH 22a d MECH-25 ,0
P ) _ ,tir+r_ -p , ;yam ) Y+ .
For Split Systems:, Duct leakagef< 6 percent; RC, CCAZ> 350 CFM/ton, FWD,'`TMAH, SIMS, and either hSPP of'PSPP.
For Packaged Units: Duct leakage '< 6 percent
13 3. New Ducts,with/or-without Required Forms:
Replacement •;
• Includes_ replacing or installing all new !
ducting and/or outdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split' -sy's'tems) MECH-25-HERS -' -
and/or indoor, coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 y
_equipment changed: ', - _ _ -
For Split Systems: Duct leakage < 6 percent; RC, CCA 1, 300 CFM/ton, TMAH I
For Packaged Units: Duct leakage < 6 percent
O 4. New Ducting.over 40 feet Required Forms:
. Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS I
linear feet of duct in unconditioned space. CF -411 forms: MECH-21 {
For split system or packaged units: Duct leakage < 15 percent t
❑ 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. !
• 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 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 and specifications submitted to the enforcement agency for approval with the permit application. I
Name: Jacqueline Zabik Signature: Jacqueline Zabik .
f,
Company: DESERT AIR CONDITIONING INC -
Address: 590 WILLIAMS ROAD Date: Dec 19, 2012
City/State/Zip: PALM SPRINGS / CA / 92264 License= 276586
Phone:. E760) 323-3383
..
Of
}.
Reg: 212-AO071534A-000000000-0000Registration `
gistration Date/Time: 2012/12/19 14:24:57
2008 Resident . HERS Prov der: 'Ca10ERTS, Inca
ial Compliance. Forms - -• _ ,
-July 2010
Bin.#
City�f 1.Ci Quinta.
Building 8r Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit •Application and Tracking Sheet
Perinit #
i1
"t G
ProjectAddcess: 79-786 OLYMPIA FIELDS
Owner'SNwne:.ALLAN CRAVELLO
A P. Number.
Address: 79-786 OLYMPIA FIELDS
Legal Description:
Couftwtor. DESERT AIR CONDITIONING, INC
City, ST, Zip: LA QUINTA, CA 92253
Telephone: 760-574-4612
Address: 590 WILLIAMS RD
Project Description:
City, ST, Zip:PALM SPRINGS, CA 92264
REPLACE 5 TON SPLIT SYSTEM ON ROOF
Telephone: 760-323-3383 LIKE FOR LIKE .
State Lic. # : 276586 City Li, #; 363
Arch., Engr., Designer: NA
Address.
City., ST, Zip: '
Telephone:
State Lir. #:
Constructiontype, . MECH tq�upanqy:
Project type (circle one): New Addie Alter Repair Demo
Name of Contact Person: JACQUELINE RATLIFF'Sq.
Ft:
#Stories
#Unit
Telephone # of Contact Person: 760-32373383
Estimated Value of Project: $6612.00 .
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal ReWd Reed TRACMG PERMIT FEES
Plan Sets
Pian Cheek submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan CbccA Deposit. .
Truss Calan.
- Called Contact Person
Plan Check Balance
Title 34 Calcs.
Plans picked up
constrMer.ou
Flood plain plan
Plans resubmitteV .
MechafikA
Giading plan
2" Review, ready for corrections/issue
Electrical!
Subeontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE.-
3" WvLew, ready for correetionslissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr -
Date of permit issue
School Fees
Total Permit Fees