13-0915 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000915
Property Address:
54814 TANGLEWOOD
APN:
775 -052 -010 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
15000
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT r
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
Date: 7 I� Contractor:
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 ($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
Owner:'
BAYARD CARROLL
54814 TANGLEWOOD
LA QUINTA, CA 92253
(760)564-4533
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/23/13
Contractor: U "
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE JUL �3 ZU13
THOUSAND PALMS, CA 92276
(760)343-7488
Lic. No.: 686310 CITY OF LA QUINTA
---------------------------=-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
' 1 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 ZENITH INS CO Policy Number Z071741502
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, I shall forthwith comply with those provisions.
Date:% � � 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 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 building construction, and hereby authorize representatives
of this c uy to enter upon the above-mentioned property for inspection purposes.
Date: I3 Signature (Applicant or Agent)
LQPERMIT
Application Number 1340000915
Permit . . . . . . MECHANICAL 2013
Additional desc `
Permit Fee 71.50 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 1/19/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA • MECH FURNACE
r- 35.75
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----- -
Special Notes and Comments
HVAC CHANGE OUT (1) 3 TON
3.5SEER/78AFUE SYSTEM (2008 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2010
CALIFORNIA BUILDING CODES.
------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
Fee summary Charged Paid - -Credited
- - - ------ - - - - ------ - - - - ------ - - - - ---
Due
--- - - - - - -
- -----------
Permit Fee Total 71.50 .00 .00
71.50
Plan Check Total .00 .00 .00
00
Other Fee Total 91.57 .00 .00
91.57
1 r, -4 n7 nn nn
1 ti'A n,7
LQPERMIT
Bin #
Qty Of La Quinta
Building 8T Safety Division
Box 1504, 78-495 Calle Tampico
r La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet.
Permit #P.O.
q6'
Project Address:5y 21 LI Cr 1 \ewt a
Owner's Name: Cir roll
A. P. Number:
Address: Sq g li4. 10,h
Legal Description:
City, ST, Zip: L A Q�� y �� a GA ci ZZ 53
Contractor: G��r�Gr'c..� �r ��
Telephone:
Address:
Project Description:
City, ST, Zip:�ovSo. CA CtZZ7C�
�e ��ce 4rA � �O �TV
Telephone: 760 -3t13- 7L18f?
�vt Y1GG�
State Lic. # : (oFS(o31
City Lia #•:
Arch., Engr., Designer:
Address:
City., ST; Zip:.
Telephone: p
Construction Type: Occupancy:
YP P Y
State Lie.
Project one): New Add' n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: IS QpO , CnC�
APPLICANT: DO NOT WRITE BELOW 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 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°1 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 HOUSE:-
'"' 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
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
54814 TANGLEWOOD La Quinta, CA 92253
City of La Quinta
Jul 23, 2013
Equipment Type1
List Minimum Efficiency2
Dud insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
INSEER 13.
❑ COP
❑ HSPF
[3 R 6 (CZ lo -13)
Served by system
® Setback
If not already
Y Present, must be.
® Condensing Unit
❑ EER —�
❑Resistance
❑ R 8 (CZ 14-15)
2400 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 fad the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4k
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 -611 sha11 also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -611 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 -611 farms: MECH-04, MECH-2I-HERS and (far split systems) MECH-25-HERS
. Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
cor. split Sys�ems` Dud leakage:<j15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
peFeeRt
Exempted from duct leakage testirig f:
.0 i Duct. -system. ivas documented: to have been previously sealed and confirmed through HERS verification, or
0'2.*Duct'systems with less than :40 linear feet in unconditioned space, or
0_3; Existing duct systems are eQiistructed, insulated or sealed with asbestos
❑;4: Thesystemwill not be Ducted (le'.L?uc#iessMmSplltk4ystem)(Alsa�Exempt frnrn RefCiger�anC C#Iarge)
'.:
❑ 2 N e -HVAG S ste
�.:...,:... v ....
Re r
u red>: rms:: y+
..... _ ...... ,.. r�............. _ter.. �:A -
. Cut rnzoY,G an eou
z� h 9 t`
new ducts :(all new �`
L hors MECH-04, MECH 2OHERS {f� r split systetrts) MEC ki2�2HERS and
ductrnewequ
��� �
MECH 25 -HERS- L
�F--4Rfartns:�MECH-ZO,:anff�fior s_ tts �l'?iECH Z2� and INEC-i� ZS. z<=r�*�::;':J° 5:�°�:�?c:•'::'.::''*%
I
:stems
For Split Systems Ductteakatie 46'percent; RL CCA 350 C) M/tonr FVJD m S°TMS; and eilh:erH9PP PP PIP
For Packaged tliiits. Dud leakage
❑' 3.: New: Duets>wlth/or withot& :: '
Required Forms:
RepQacerttenti`?3`:`:
. Includes replacing or installing gill.:new
ducting and/or outdoor condensFrrg unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/orfj..ehai a -.No or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Dud 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 -411 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)
e 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: Danielle Garcia Signature: bonielle Garcia
Company: HARRISON ENTERPRISES INC Date: Jul 23, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 213-A0055040A-000000000-0000 Registration Date/Time: 2013/07/23 00:49:05 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010