12-0678 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-0000067-8—. —J
Property Address:
53645 AVENIDA NAVARRO
APN:
774-134-017-7 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
46QQ
lw4t I oy�, 4 -14 Quil4m.,
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760)777-7011
INSPECTIONS (760) 777-71-53
Owner: -
CITY OF LA QUINTA
78495 CALLE T I -CC
LA QUINTA, CA.j)53
JJr
Contractor. It
Date: 6/19/12
Applicant: Architect or Engineer:
SPEEDY AIR CQND OWZNG r
54685 AVENIDF HERR9f 6Z.:_`p
LA QUINTA, CA"92�-53^�'?r s5,�r,•;
(760')567-0133 "�-- — _•
-n,
Lic. No.: 834471
- LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals 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: C20 Licens No.: 834471-
r/ '
�te: ' Z Z ntractor: IPP Gv l am
d/
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
J
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 EXEMPT Policy Number EXEMPT
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 become 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, shall forthwit omp��se 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 ($500).:
%
ate,/G_ plicant: �/
( ) 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 -
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 offeredfor 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.).
(_) 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.).
I—) 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
APPLICANT ACKNOWLEDGEMENT—
IMPORTANT
CKNOWLEDGEMENT—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. I agree to comply with all
city and county ordinances and state laws relating to buildi;conp,ruction, andhereby authorize representatives
is county to enter u on the above-mentioned propertyction purpo5
/ K
Dated Z//Z ignature (Applicant or Agenty. -
" Application Number 12-00000678
Permit MECHANICAL
Additional desc '.
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date Valuation
0
Expiration Date 12/16/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA- MECH FURNACE <=100K
9.00
1.0.0 16.5000 EA_ MECH B/C >3=1.5Hp/>1nnx-SnnxRTT.T
1ss; i50
----------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT: INSTALL 4 TON 13 SEER
SPLIT SYSTEM, HEAT PUMP, 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 .b0 .00
51.63
LQPERMIT -
.
Y
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 30 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
53645 AVE NAVARRO La Quinta, CA 92253
City of La Quinta
Jun 21, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
❑ Indoor Coil
❑ AFUE
® SEER 13.0
❑ COP
® HSPF 7.7If
❑ R 6 (CZ 10-13)
❑ R 8 (CZ 14 -IS)
Served by system
1500 sf
® Setback
not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being Installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.714SPF 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 -1111
and CF -6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -6R 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
unism, Q. .4 1pakagio, 4. 15
peizeei;k
Exempted from duct leakage testing4:
❑ 1 buct`systern was documented:.to have been previously sealed and confirmed through HERS verification, or
'::❑ 2. Duct systems with less thah'4.0 linear feet in unconditioned space, or
p 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The; system will not be Ducted (ieDuctless System) (Also -Exempt from Refrigerant Charge)
yMmi-Split
❑ 2. New HVAC System
Required Forms - *, „.?
. Cut in or Changeout with
new ducts. all new
(
' i .� x ,r -
CF 6R forms MECH-04, MECH 20 HERS,and (fog split systems) MECH 22 HERS, and ` "`" -•
� .--
ducting nod all new
MECH 25=HERS. --F
CF 4R forms MECH 20, and (for split.systems) MECH-22, and MECH-25 K t
equipment):
%�Crr''.f5
-
, _. .tr-
xyr-..e�y s-.rk 1i,, }.:s a• :
For Split Systems Duct leakage �6'percent;.RC;.CCA >;350 CFM/ton,,-FWD, ,TMAH,_,,,STMS, and either HSPP of>PSPP.Wit:
For Packaged`Umts: Duct leakage,`< 6."-"'
percent
❑ 3. New.Ducts with/or without
Required Forms:
Replacement°.
.
• Includes replacing or installing all new.
ducting and/or outdoor -co- ndensing .-u'nit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace,:;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
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -611 forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. "
CF -4R forms: MECH-21
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 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.
Name: DANIEL TORRES Signature: DANIEL TORRES
Company: SPEEDY AIR CONDITIONING Date: Jun 21, 2012 -
Address: 54-685 AVENIDA HERRERA License: 834471
City/State/Zip: LA QUINTA / CA / 92253 Phone: (760) 567-0133