12-0384 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t�t440"
BUILDING" &'SAFETY DEPARTMENT
BUILDING PERMIT -
Application Number: 12-000.00384 Owner:
Property Address: 52650 DEL .GATO DR GARNER RESIDENCE
APN: 770-290-007'- - - 52650 DEL GATO DR
Application description: MECHANICAL LA QUINTA, CA :92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 13192
Applicant: Architector Engineer:
----------------- �
LICENSED CONTRACTOR'S DECLARATION -
Thereby affirm under penalty of perjury that:Tam Ij nsed under-provisionaof Chapter 9 (commencing with
Sectiori,7000) of Division 3 of'the Busi_n_ eWand,P essionals Code, _and'my Ucense`is In full force'anil:effect.
License. Class: C20 License No.: 686310
Data: • f O[A 7,Contractor:
OWNER -BUILDER DECLARATION
Thereby affirm under penalty of perjury that I am exempt from the Contractor's State License'L•aw for'the
following reason (Sec:. 7031.5;;Business and Professions+Code: Any city or'county -that requires,a permitto,
construct, alter; improve, demolish, orrepainanystructure, prior to its .issuance,,also requires.the applicant for the.
permit "to file assigned statement that he or she is Iicensed,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. exemptytherefrom and.the basisiforthe alleged+exemption. Any wolation;of Section 7031.5 by
any applicant for permit subjects the applicant to a civil' penalty of notmore•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 workhimself or herself through 2his or her own employees, provided,that the
improvements are not intended or offered for sale. If, however, the,buiiding•orimprovementis sold within
one year of completion„the owner -builder will have the burden otproving that he or she did,not build or
Improve for the.purpose of sale.);
G_ 1 1; as owner of the property;,am exclusively contracting with licensed.contractors--toconstruct 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 contractsftor.the projects with alcontractor(s) licensed
pursuant to the'Contiactors' State License Law.);.
(_) I am exempt under Sec. ,,B.&P.C. for this reason
'Date: __ - -
CONSTRUCTIOMLENDINO AGENCY
Thereby affirm under penalty of perjury thaCthere is a:constructionlending-,agenyy,for'the performance of the
Work for which permit is issued (Sec. 3097, Civ. C.):
Lender's. Name: _
Lender's Address:
WPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/10/12
Contractor:
GENERAL AIR 'CONDITIONI 0
31170 RESERVE DRIVE
D
THOUSAND PALMS, .CA 91271
(760)3'43-7488 p�p ZO 20��
Lia. No.: 686310 /i R
U
WORKEA'.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 worke& compensation, as provided
for by Section 3700 of. the Labor Code, for the performance.of the work for Which this permit is
Issued:
I have and'wlll 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 policynumber are:.
Carrier ZENITH INS CO Policy Number
I`Certify that,.in thwperformance of the work.forwhich this permit is Issued, I shall not employ any
person in any:manner so as,to becom
e. bject to the workers'�compensation laws of California,
and agree that, if I should become sub t to the workers' compensation provisions of Sectioq
3700'of the, Labor Code; I shall forth comply with,those, provisions.
Date: a" 1 Applicant: - -
WARNING; FAILURE 70SECURE WORKE _ _ - NSATION COVERAGE IS UNLAWFUL, AND SHALL.
SUBJECT AN EMPLOYER'TO CRIMINAL PENALTIES.AND CIVIL FINES UP TO ONEHUNDRED THOUSAND
DOLLARS ($100;000). IN ADDITION TO THE'COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTERE_ST,,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 issperformed under or pursuant to any permit issued.as a result of this application,
the owner, and the applicant, each;agrees to, and shall defend,:indemnifyand hold harmless,the City
of: La Quints, 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 H work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days willsubject
pernitt to cancellation.
I Certify that I -have read this application and state".that the above i mation Is. correct. I _agree 10 comply with all
cityend county,ordinances and state laws relating to building co ction, and hereby.authoriierepresentatives
of this county to enterupon•the above-mentioned property for ion purposes.
Date: a (�- Signature (Applicanvor Agent)
Application Number . . . . . 12-00000384
Permit.
MECHANICAL
Additional�desc
.
Permit ;Fee . .
. 31.50
Plan Check Fee ..
7.8.8
_
Issue Date . .
.
Valuation.
0
Expiration Date
10/07/12
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 16.5000
EA MECH
B/C >3.-15HP/>100K-500KBTU
16.50
-----------------------------
Special Notes and
Comments
HVAC REPLACEMENT 5
UPFLOW SYSTEM;
OUT
DOOR UNIT ON GROUND. 2010,CODES
-------------------------------------------------------------------------------
Other Fees
. . . . BLDG SIDS ADMIN (SB1473)
1.00
Fee summary
Charged
-------
Paid Credited
Due
-----------------
Permit Fee Total
-----------
31.50
.00 .;00
31'.50
'Plan Check Total
7.88
..00 .00
7.88
Other Fee Total
1.00
.00 .00
1.00
Grand Total
40.38
.00 .00
40.38
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC'A/terations CF -1R -ALT -HVAC
Climate -Zones 10 - 15'
Site Address:
Enforcement Agency:
Date:
Permit #:
52650 DEL GATO DRIVE La Quinta, CA 92253
City of La Quinta
Apr 9, 2012
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ PackageUnit
® Furnace
® Indoor Coil
®AFUE 78%
® SEER 13.0
❑ COP
❑; HSP.F
OR 6 (CZ 10=13)
❑ R.8
Served by system
2000 sf
® Setback
If not already present, must be
® Condensing Unit
❑ EER
p Resistance
(CZ 14-15)
installed)
❑ Other
1. Equipment Type: Choose the equipment' being installed; if more than one system, use another CF -IR -ALT -HVAC thr each system.
2. Minimum Equipment EHldendese 13 SEER, 78% AFUE; 7.7HSPF for typical resldendal.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 -411
forms (no hand filled CF-411sallowed) are filled out and signe_d.Beginning October 1,. 2010 a registered copy of the CF -1R
and CF -611 shall also be on site for filnal Inspection.
® 1. HVAC Changeout
Required Forms:
.•All HVAC Equipment.
C -F-611 forms: �M,ECH-04,, MECH=21-HERS-and (for split systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split,systems) MECH-25
Condenser Coil and /or
• Indoor Coil and /or
CF -611 forms: MECH-04, 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 :5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if,:
❑ 1. -Duct system was:documehted to have'been previously sealed rand confirmed through HERS verification, or
❑ 2., Duct systems` with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are 2onsirucied, insulated orseaied with asbestos
04: The rstern.Lwiil not be Du d (ie. uctless Minl- its stem)-,( ,: em04Trn,,RefferanrCharge)
❑ 2. Ne~C System I Requir if . :!Mi
• Cut i �° angeout wl _. _.
ECH-04, M ERS it sy' j MEC . ERS, end .
new (all new
_ " 5 _.
ducti . aU new a R;fo MECH 0, >` �l _
ors lit s. H;2 5
equip _ )-
For Split Systenis:r DuetRjkW f k< 6 pi f t t�C CCPA . - 5 FM f FW .. .;H, STNIS, and itiier HSPP'on"PSPP.'-
For Packaged'Units: Duct leakage, <'& percent -
03New Ducts with/or without
Required Forms*
Replacement
.Includes replacing ormstalling all new
ducting and/or outdoor condensing unit
CF -.6R forms: MECH-04, MECH-20-HERS, and (for split.systems) MECH-25-HERS
and/or indoor coil and/or f6' ;-No or some
CF -411 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 Packaged Units: Duct leakage < 6 percent
134. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -611 forms: MECH-04, MECH-2I-HERS
linearfeet of duct in unconditioned space.
CF -411 forms: MECH''721
For split system or packaged units: Duct.leakage < 15 percent
❑ 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 inaccurate and complete.
• I am.eligible under Division 3 ofthe,Callfornia Business and Professiorns'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=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, calculations, plans and specifications submitted to the enforcement agency,for approval with the permit:application.
Name: Danielle,,Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Apr 9, 2012_
Address: 31-170 RESERVE DRIVEESTE A License: 686310
City/State/Zip:, THOUSAND PALMS. / CA / 92276 Phone: (760) 343-7488
Reg: 212-A001750A-00000000-0000 Registration Date/Time: 2012/04/09 20:14:38 HERS .Provider: Ca10ERTS, Inca
2006 Residential Compliance Forms July 2010
4
Ca10ERTS - CF -1R Registration
9arnW-
Page 1 of 1
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CONGRATULATIONS
Your CF -1R. -ALT-HVAC. Registration Is: complete!
You may want to print this page for your records.
Site Address: �� Qui DEL G�ATO'DRIVE
C:92253
.Assigned Company.IHARRISON ENTERPRISES INC
Do you know your HERS Rater?
Ifyou' do, you may .want to send: this CF -1R to them'.
CaICERTS Rater ID:
OR
My Rater Quick Select '--Select From List E
Every'CaICERTS rater has a license n_ umber,
If you need to,find the rater byname [Click Elft tosea_rch our directory.
[CLICK HERE] to do another
Copyright 0 2010 CaICERTS, Inc. All rights reserved. Revised! January .11,,2010
[Terms.and Conditions] [PrWacy'Statement) [Class Cancellatlon,'Policy]
CalCERTS, Inc:; 31 Natoma St Suite 120, Folsom, CA,,95630
Offlce: 916-985-3400,Toll Free:,877-HERS-118R, (877-437-7787)
'Fax: 916-985-3402 Contact Us
L v9
nups://www.calcerts:com/publ'ic_cfl,R.cfin?project id=18013.4
4/9/20.12
Bin #
Submittal
Plan Be to.
Clay 0 L QuInta
Recd
TRAM=
.Plan Check 'submitted
P)I RMFIE' FEES
Item Amount
1iu11mf� 8t Safety,Dly *n
StructuratCalcs.
Pe i #
Reviewed, ready for corrections
P.O. Box 1504, 78-495 Calve Farnpico
La Q*ta, CA 92253- E760j 777-7012
Plan Check Deposit
BurEdlng Permit..AppOdidon and Tracft Sh"t
ProjectAddress:
gel Owner's Meme: Windd &LIM
A P. Number:
Address: E;r2 4; 0 DAI (bM UNWO
Legal Description:
City, ST, Zip: LRI22
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Address:
Cite STI 7i .
Telephone:' .
Coasttua on Type- Oca�psnwy
Plumbing,_
State Lia #:
Pwjeettype (pircle one): Now Add•n Alter Repair 'Demo:
Name of Contact •Person: 6_0 u.., el FL: q $ ,3 #. Stories: #Units:
Telephone # of Contact Person: %'� t4;
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Bsdmatbd' Va�u�e ofProjed:
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Submittal
Plan Be to.
Req'd-
Recd
TRAM=
.Plan Check 'submitted
P)I RMFIE' FEES
Item Amount
StructuratCalcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Xalled:CodtactPireon
R[an Chock Balance.
tl& 24•CAlcs:
Planeplcicad up
Coueir dna
Plood plain plan
Planeresubmitted
Mechanical
Gradteg;plsu
Zr Revlew, ready for correctionwisme
Electrical
Subcontactor List
Called Contact Person
Plumbing,_
Grant Deed
Plane picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
'"' Review, ready for correctiononue
Developer Impact Fee
Planutng' APprovAl
Called Contaet Person
AXP.8.
Pub. Wks. Appr
Date of permit Issue
SchoOlFee;
Total Permit Fees