14-0490 (MECH)�s
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000490
Property Addressi 80769 SPANISH BAY
APN: 775-310-045- -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1400
Tiht 4 4Q" -
Applicant - Architecit or Enineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Business and Professionals Code, and my License is in full force and effect.
)6
cense Class: C20 C36 L• icense No.: 818759
aJContractor:
za ,
OWNER -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 1$5001.:
(_ 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.).
I_ ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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
Owner:
MARVIN SEGAL
80769 SPANISH BAY
LA QUINTA,- CA 92253
(760)771-9108
Contractor:
(r
PREC H & A INC
P.O_ BOX 11090�i
PALM DESERT, CA
92Vi
(760)776-1550
Lic. No.: 818759
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
r•
W" n5 ld\ WIN th
Date: 4/23/14
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.
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 TRUCK INS EXCHN Policy Number N 2008 71 19
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 become subject to the workers' compensation provisions of Section
��3700 of the Labor Code, 1I shall forthwith comply with those provisions.
Date: V>)—/t- Applicant:•.////!�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 of 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
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 building construction, and hereby authorize representatives
of this county
to enter upon the above-mentioned property for 'nspection pu oses.
Date: �+' / Signature (Applicant or Agent):
Application Number . . . . . 14-00000490
Permit MECHANICAL 2013
Additional desc .
Permit Fee 11.92 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 10/20/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA, MECH APPL-REP/ALT
11.92
Special Notes and Comments
REPLACE EVAP COIL CHANGE.OUT 2013 CMC
2008 ENERGY] CARBON MONOXIDE ALARM(S) TO
BE INSTALLED PRIOR TO FINAL INSPECTION.
----------- ------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE'M/P/E
90.57.
PLAN,CHECK, MECHANICAL
4.77 .
Fee summary Charged Paid Credited
-----------------
Due _
----------------------------------------
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 96.34 .00 - .00
96.34
Grand Total 108.26. 00 .00
108.26
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-1111-ALT-HVAC
Climate Zones 10 - 1S
Site Address.: -
Enforcement Agency:
Date:
Permit #:
80769 Spanish Bay La Quinta, CA 92253
City of La Quinta
Apr 23, 2014
insulation
Conditioned Floor
Equipment Typel
List Minimum Efficlency2
_Duct
requirement
AreaThermostat
.
(3Package Unit
❑ Furnace
® Indoor Coil
❑ AFUE
[3SEER
❑ COP®
[IHSPF
13R 6 (CZ Io-13)
Served by system
Setback
If not already present, must be
❑ Condensing Unit
E3EER
E3 Resistance
0 R 8 (CZ 14-15)
2000 sf
installed)
Cl 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, 7.7HSPF 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-411
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-6111 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-411 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 <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
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 duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut in or Changebut,with
:+
CF-6WfF .^" `' "w�-.• ".. '" ^,=+r ."^ rs "� ~' '`.:.'
orms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
new duct's (all new
ducting and all new
MECH 2.5 HERS S. '• Y
+ # i f `� t
CF 4R for4_C MECH-20, and (for split systems) MECH-22, and MECH-25
N
equipment),
<,.4 i r , 1, f >r ^ ; t * _ � •
For Split Systems; Duct leakager< 61percent; RC, CCAj>_ 350 CFM/ton, FWD TMAH; SIMS, and either HSPP or'PSPP. ter'
For Packaged Units Duct leakage�< 6 percents
❑ 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 systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some CF-4R 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-6R 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: Gerald Dobbins Signature: Gerald Dobbins -
Company: PREC H & A INC Date: Apr 23, 2014
Address: P O BOX 10991 License: 818759
City/State/Zip: PALM DESERT/ CA/ 92255 Phone: (760) 776-1550
Reg: 214-A0028308A-000000000-0000 Registration Date/Time: 2014/04/23 16:11':28 HERS Provider: Ca10ERTS, Inc..
2008 Residential Compliance Forms July 2010
F
Bin #
City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheen
Permit #
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Project Address: �,
Owner's Name: V
A. P. Number:
Address: (j_ S G ,7'
Legal Description:
City, ST, Zip: %
Contractor:
Telephone: 41dP
............ .
Address: ok Ild- V
Project Description:
City, ST, Zip: t�S�
Telephone:C%:::#�<?.>::•.::
::..:::::.::..:.::::..:.:..,...
State Lic. # : /�i City Lie...#
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. .
Name of Contact Person: / t
Construction Type: c u c•
Project hPa (circle one): New Add'n Alter Repair Demo
0
Sq. Ft.: # Stories: # Units:
Telephone #,of Contact Person: 7 6"- 1 Iff d
Estimated Value of Project:
APPLICANT: DO NOT WRITE 13ELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
''u Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees