11-0308 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000308
Property Address:
79620 CITRUS
APN:
772 -170 -004 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
12987
Applicant:
Architect or Engineer:
��wa�rw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BLOWER MICHAEL
79620 CITRUS
LA QUINTA, CA 92253
(
Contractor:
PREFERRED PLUMBING HTG A/C
P.O. BOX 5120
PALM SPRINGS, CA 92263
(760)322-3173
Lic. No.: 457554
VOICE (760) 777-7012
FAX (760) 777-7011
"INSPECTIONS (760) 777-7153
LL
Date: 3/28/11
------------------------------------------------------------------------------------------- - - - - -
—
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Businessd Professionals Code, and my License is in full force and effect.
License Class CIO C16 C2 // �ic�rrs� Ny.: 457554
Date:-�I-db-1 %_ Contractor:
?WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 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:
LQPERMIT
WORKER'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 workers' 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 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 EVEREST NATL Policy Number 7600006445111
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 bc me subject to the workers' compensation provisions of Section
2 3700 of the Labor Code, all forthwit A�wh provisions.
Date: J Applicant:w
WARNING: FAILURE TO SECURE WORKERS' C:OdPENSATION COVERAGE 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 AS PROVIDED FOR IN
SECTION 3706 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
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 1 have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building c ,nstructioon, and hereby orize representatives
of this county to enter upon the above-mentioned property fo spection pus o e
Date: Signature (Applicant or Agent):
Application Number . . . . 11-00000308
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 51.00
Plan Check Fee
12.75
Issue Date
Valuation . . .
. 0
Expiration Date 9/24/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH
FURNACE <=100K
18.00
2.00 9.0000 EA MECH
B/C <=3HP/100K BTU
.18.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE (2) EXISTING 4 &.5 TON FAV A/C &
COIL WITH SAME LIKE FOR LIKE 13
SEER.
2007 CODES.
--=-------------------------------------------------------------=
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
-----------
1.00
Fee summary Charged
--------------------
Paid Credited
--------------------
Due
-----------------
Permit Fee Total 51.00
.00 .00
51.00
Plan Check Total 12.75
.00 .00
12.75
Other Fee Total 1.00
.00 .00
1.00
Grand Total 64.75
.00 .00
64.75
LQPERMIT
Simplified Prescri :tive Certificate of Compliance: 2008 Residential NVACAllerations CF -IR -ALT -
Climate, Zones 10 to 15 .
Site Address: 1En
orcen�e t Agen
T/i
Date:
L �
Permit #:
ll�
Conditioned Floor
Equipment T el
List Minimum Efficiency 2
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
frr ace
15 UEi/
❑ COP
Over ft of ducts added or
e- rack
ndoor Coil
e
BS`EER
❑ HSPF
e
replaced 4n unconditioned space
Served by system
(If not already
fa'C o densin Unit
�'LR �L
❑Resistance
❑ R 6 (CZ JOJ3)
11R 8 (CZ 14-15)
sf
present, must be
installed)
11OtheOtherg
1. Equipment j pe: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC for each system.
2. Minimum tau ipntent-Efficlendes; 13 SEER, 78%AFUE, 7.7HSPFfor typical residential systems.
HN. SUMMARY Listed below are four HVAC alter,}tion Options. The installer decides .what work is being done and
ERS VEIFICATIO
picks one oft , heappropriate 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 -6R and registered!CFAR forms (no hand filled CF-4Rs allowed) are filled out and
si e e innin October 1, 2010 a rgigistered copy of the CF -1R and CF4R shall also be on site for final inspection.
:.HVAC Changeout
Required Forms: '
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace.
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For POckaged Units: Duct leakage < 15 percent
Exempted from duct ieakage testing if -
0 1. Duct system was documented to have been previously sealed anq confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
133. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2.'New-1RVACSY§tem Required Forms:
• Cut in or.Chengeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25'
now eq ui meat)
For Split Syetents: Duct leakage <6 percent; RC, CCA > 350 CFM/ton', FWD, TMAH, STMS, and either HSPP or PSPP.
For Nc:4agpd Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for 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 Spilt Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton: TMAH
For Packs ged Units: Duct leakage <.6 percent
4. New Du-itinj over 40 feet Required Forms:
6. Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For spilt system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems 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 andspecifications submitted to the enforcement agency for appro,4al with the permit BppliCWn.
Name: '
Signature
i
Company: ej;'_g � Az1,W?1NG %�f4I-Wd dF Ale-
Date: -?jZe,�Le ll
Address:p�
G
License:
Cily/State/Zip: �'1 _.. Cl (Q
Phone: Q_.31-7— 3173
2008 Residential Compliande Forms March 2010
Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
,20 e1 ,e�1� 5
Enforcement A ency:-
��
Dpte:�� �nI/
oma'
Permit #:
Conditi ned Floor
Equipment T e'
List Minimum Efficienc '
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
0"Furnace
ErAAFUE��
❑ COP
Over 40 ft of ducts added or
19-6ettink
L'_1Door Coil
1119EE R
❑ HSPF
replaced in unconditioned space
Served by system
(If not already
E Condensing Unit
C•3'EER L
❑ Resistance
❑ R 6 (CZ 10-13)
❑ R 8 (CZ 14-15)
sf
present, must be
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF-IR-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF 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 -6R 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 -6R shall also be on site for final inspection.
HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or
CF-411forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Ivlinimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
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
❑ 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for 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 Packaged 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 -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems 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.
• 1 am eligible under Division 3 of the Califoinia 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 fors, worksheets,
calculationsplans andspecifications submitted to the enforcement agency for approval with thpermit application.
Name:c�` / �„ /S/
C� CL �V
Signature:
Compan
ate. Z Z-0,
Address —7 / 6: aN 4 `z���
License:
City/State/Zip: �.� ,4j 6,y e�`/Z 2�YCPhone:
_ 3 Z —J
2008 Residential Compliance Forms March 2010
Bin #
City of La QU'inta
Building 81: Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:' YL96ZO e17AI S te-
Owner's Name:
A. P. Number:
Address: 7_96 go e%% XV5
Legal Description:
Coma eferred Air
Preferred
Conditioning dba
Plumbin Heatin &A'i
City, S.T, Zip: tk 0011 127�'
Telephone:
PG' �`
Address: p0 Box 5120
Project Description: ,4E2_r -9 kX/57_,,
City,ST,Zip-.Pa'1m Springs, CA•92263
OA( j'=�lrJ.r C�f/1
Telephone: ( 7 6 0) 3 2 2 —3 17 3j7�,j
State Lic. # : 457554
City Lic.
3 �GS'
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construotioa Type: Occupancy:
Project; type (circle one): New A:Mn Alter Repair Demo
Name of Contact Person: ���� /��'
Sq. Ft.;
#Stories:
#Units:
Telephone # of Contact Person:
?60 -�3z 2 - 3 / :7- 3
Estimated Value of Project: 99-7d.0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.:
PERMIT FEES
Plan Sets
Plan Check submitted
Ite
Amount
Structural Cities.
Reviewed, ready for corrections
Plar Check Deposit
Truss Cales.
Called Contact Person
Plar Check Balance
Energy Calcs.
Plans Dicked up
Can itructlon
Flood plain plan
Plans.resubmitted
Mechanical
Grading.plan'
2"1 Review, ready for'correctiooslissue
Elet trical
Subcontactor List
Called Contact Peron
Flur ibing
Grant Deed
Plans picked up
S.M I.
H.O.A. Approval
Plans resubmitted
Gra ing
IN HOUSE:-
'"' Review, ready for corrections/issue
Dev toper Impact Fee
Pianning Approval
Called Contact Person
A.I..F.
Pub. Wks. Appr "
Date of permit Issue
School Fees '
Total PermltFees