10-0650 (MECH)P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: i0-00000650
Property Address: 52620 DEL GATO DR
APN: 770-29.0-006- -
Application description: 'MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 11510
T4ht °F 4 Q"
Architect or Engineer.
A�lfk
BUILDING- & SAFETY DEPARTMENT
BUILDING PERMIT
- --
LICENSED CONTRACTO. R'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provislone'of Chapter9 (commencing with
Section 70. 00) of Division 3 of the Business and Professionals Code, and my Licenscl in full twee and effect.
License ass: C20 License No:: 686330
/bate: Tact rc
// OWNER�UILDFA D�LARATION
I hereby affirm under penalty of;perjury that I am exempt from the::;Contractor's;State License Law for the
fallowing 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,lioensed pursuam'.to the provislons of the Contra6for's State
Ucense' Lew (Chapter 9 (commencing with Section,7000) of Division 3 of the a Business: and. Professions Code) or
that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 70311.5'by
any applicant for a, permit subjects the applicant to a:cNll penalty of not more than five hundred dollars (8500).:
( _ ) I„as owner, of the property; or my employses'wlth wages at their sole compensation,. Willdo the work; and
the structure'la notintended or offered for (Sec. 7044,, Business and Profesaions,Code: The
Contractors' State License Law does nor -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
improvemetrte;are not,intended or offered fousale: if;.however,'the�building'or,improvement is sold within
one year of completion,'the owner-bWl_der will have'the,burden'bf proving thaf,he or she'did not build or
r
Improve'forthe purpose of sale.).
(_) 1, 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 Lew 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' Stete.Ucense Law.).
(_) I.am exemptunder Sec. , B.&P.C. forthis 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 permitis lasued'(Sec. 3097, Civ. C).
Lender's Name:
Lender's,Address:
LQP&RMIT
Owner:
HOPKZNS JOHN Sit
52620 DEL GATO'DRIVE
LA QUINTA, CA 92253
Contractor:
GENERAL AIR CONDITION
33170 RESERVE DRIVE
THOUSAND PALMS, CA 9r2--7:6
(760):343-7488
Lia. No.: 686310
VOICE (760)'1774012
FAX (760) 777-7011
INSPECTIONS (700) 777-7153
Date: 7/15/10
JUL 1 P 2010
WORKER'S COMPENSATION DECLARATION
I'hereby affirm under penalty of perjury one .ofthe following declarations:
_ I have and will maintelma certificate of consent to self-insure,for wwkeW compensation, as provided
for. by Section 3700 of the Labor Code; for the performance of the work for which this permlt,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 PREFERRED EMBL Policy Number
_ I certify that, in,the performance of the work for which this permit is issued, I shall.not empioy,any
person In.any manner so 881to become subject to the Workers' compensation laws of Callfornla;
and agree that; if I should become:subjectto the workers' compensation provislons of Section
9700 of•ths�Labor Code,1 shatLLrthwith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGE' 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 A&PROVIDED FOR IN.
SECTION:3705 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
e
conditions and' restrictions; sat 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 shell defend; indemnify and hold harmless the City
of La Quints, its officers, agents and employees foranyact or omission related to thcwork 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, orcessation of work for 180 days will subject
permlt to cancellation.
I.certify that) have read this'application and state that the above Information is correct. I agreeto comply with all
city and county ordinances and state laws relating:to,building construction, and hereby authorize representatives
of this cmy t enter upon the,above-mentioned property for in Iion:��}`(((rpoaea.
6.
ate: nature (Applicant or Agero�\
r
.Application Number . . . . . 10-00000650
Permit. . . .
Additional desc .
Permit Fee . .
Issue Date . .
Expiration Date . .
MECHANICAL
33.00 Plan Check Fee . . 8,.25
Valuation . . . . 0
1/11/11
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
B/C <=3HP/100K
BTU
9.00
Special Notes and.Comments
INSTALL NEW 4 TON 13 SEER SYSTEM,
200.7
CODES.
---------. BLDG ADMIN
Other Fees : . . STDS
-----
(SB1473)
-
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 33.00
..00
.00
33..00
Plan Check Total 8.25
..00
.bd
8.,25
Other Fee Total 1.00
.00
.00
1..00
Grand Total 42.25
.00
.00
42.25
LQPEmff
2008 Residential HVAC
15
Site Address•&&o
E force t.4ency.
D te•
Pertirlt#:.
Conditioned Floor
E ui ment T e'
List Minimum Efficien s
Duct insulationrequirement
Area
Thermostat
❑'P�,ckaged Unit
Ro�ndensina
❑ AFUE
❑SEER
❑-COP
❑ HSPF._
Over 40 ft ofducts added or,
replaced in unconditioned space
Served by system
(Ifnotalleady
Unit
O EER L
❑ Resistance❑
❑ R 6 (CZ 1043)
OR 8 (CZ 14--15)
sf
present; Aust be
installed)
Other
1. Equipment Type: Choose the equipment being installed, • if more than one system, ,use,another CF=IR-ALT--HVA C for each system.
2. Minimum Equipment,Efflciencies: 13 SEE$, 78.0 AFUE, 7..7HSPFfor typical residential systems.
HERS VERIFICATION SUMMARY Listed below are four HVA.Calteration 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 copyof the forms -shall be lefton site for final
mspection.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. a inspector also verifies that each,appropriate CF -6R and registered' CF-4R.fotms (no hand filled CF-4Rs,allowed) are filled outand
signe"eginning October 1 2010 a registered copy, ofthe CF -111 and CF-6R.shall also be on site for finatlns ection.
1:.HVAC'Changeout.
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04,.MECH-21-HERS and(for split systems),MECH- 25 -HERS
CF -411 forms: MECH- 21 an&(forsplit stems MECH-25
• Condenser Coil and/or
CF-6R;forms: MECH-21-HERS and (for split systems) MECH- 25 -HERS'
• Indoor! Coil and /or
CF -4R, forms: MECH- 21 and (for splitsystems) MECH-25
• 'Furnace
For Split Systems: Duct leakage < 15 percent; .RC, CCA >,300 CFMLton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct'leakage < 15 percent
Exempted from:duct leakage1esting if:
❑ 1. Duct system was documentedlo have been previously sealed andconfirmed.through,,HERS verification, or
❑ ;2. Duct systems with less than 40;linear feet in unconditioned space, or
❑ 3. Existing duct stems are'constructed, insulated or sealedwithasbestos
❑ 2. New HVAC System
Required. Forms:
• Cutin or Ghangeout with new
ducts: (all new ducting and all
CF. -6R forms: MECH-04, MIECH-20=HERS;and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF -411 forms: MECH'20-, and (for split.systems)MECH-22, and MECH 25
For Split Systems: Duct leakage <:6 percent; RC, CCA 2:350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with. Replacement
Required Forms:
4i Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH=20-11ERS,an&(for split;systems) MECH=25=HERS
and/or outdoor condensing un&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
❑A. New Ductln °over 40 feet
Required Forms:.
• Includes,adding or replacingmom than 40
linear feet of duct in unconditioned space.
C&6..R forms: MECH-04, MECH-21-HERS CF4R forms: MECH-21
For split system or packaged units: Duct'leakage <15 percent
❑_ EXCEPTION: Exis ' ,duct systems constructed, insulated or sealed withasbestos.
'Contractor (Documentation.Autl or's /Responsible Designer's,Declaradon Statement)
• I certify that this Certificate of Compliance,documentationIs accurate and complete.
• I am eligible under. Division 3 of the California,Business and'Professions Code to acceptresponsibility for the design identified on this Certificate of Compl iance..
• I:certify that the energy featuresand performance specifications for the design identified on this Certificate of Compliance�conform'to the requirements.of Title 24,
Parts 1 and 6' of the,Califomia Code of Regulations.
• The design features: identified on this Certificate of Compliance are consistent with the information documented on other, applicable compliance forms, worksheets;
caleulat` s,. plans andspecifications submitted to the enforcement agency fora roval.,with 1' tion.
Name:
Signature:
Company: C Date:
COTAD 14L_
Address: ) 1 License:.
',
City/State/Zip v _ Phone:
Work Order
Equipment:
1 1
I Assignments i
Employee TaskCodc Scheduled Time
JOi 1NNY 7:00:00 At:VI
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Modei #
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3.1170 RESERVE DR
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THOUSAND PALMS CA 92276
Loc:
760.343-7488 FAX: 760-343-7494
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LIC#:686310
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Service At: Customer # 107949
gilt To:, Customer # 107949
Rating:
HOPKINS, JOHN
760-77`1-4995 HOME HOPKINS', JOHN
760-7714995 HOME_
52620 DEL GATO DR
52620 DEL GATO DR
LA QUINTA CA 92253
LA QUINTA CA 92253
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Call Info
Job Info
HS260362P
Call.No.: 107832
Booked by: Estee Job No:: 107832
Taken: 7/14/10 10:55 AM
Ty:ue: G.ASAC
Booked Date: 7/16/10 Class: REPLACEMENT
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Di" it
City of La Qulnta
Building Br.Safety Dl+rlslon
'P.O. Box 1'504, 7- -495 Calle Tampico
Ca Qulnta, CA 92253 - (760) 777.7012 j
.. Buiidin Permit Application acrd. Tracking Sheet
Permit #
10 ;
PrcjectAddress: .- `sem MOwner's
A P. Number:
Name:
Address: W �• '. /.
Legal. Description .
City, ST. Zip: 111- n
Contractor: Q
Telephone.
Address: eCtic(Jf, Z
Project Description:
City. ST, Zip:
Telephone:? --
.�
State Lic. # : City Lic. #:
Arch., Engr.; Designer
Address:
City, ST, Zip:
Telephone:. Construction Type: Occupancy:.
State Lic. #: Project type (circle one): New- Add'n Alter Repair. Demo
--
Name.of ContactPerson: Sq.;FL: T#Storibs.: #Units:
Telephone* of Contact Person: " , Estimated Value of Prc j (7
APPLICANT: DO .NOT WRITE. BELOW THIS UNE
#
Submittal
Req'd'
ReeV
TRACENG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cale.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cale.
-Cailed;ContactPersou
Plan Check:Balance.
Titie 24 Cale.
Plans,picked up
Construction
Flood ptain,plan
Plans: resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsllssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctlonslinue
Developer Impact Fee
Planning -Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees.