12-0685 (MECH)P.O. BOX 1.504 _
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
Application Number: _-12_0 0 0 0 0 6 8 5 -"
Property Address: 54979 TANGLEWOOD
APN: 775 -152 -055 -
Application description: MECHANICAL
Property Zoning: ' LOW DENSITY RESIDENTIAL
Application valuation: 3800
Applicant:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
-- --�. BILL PARK
K4979 TANGLEWOOD
QUINTA, CA 92253
€f 2012
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor,
Engineer: lib►
Architect or Eng f ��, � � . J ANTHONY PLUMBING HEAT/AIR
�:Ivt
72216 NORTH SHORE STREET, #101
THOUSAND PALMS, CA 9227
(760)328-8096
Lic. No.: 777794
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury hat 1 am licensed under f Chapter 9 (commencing with j
Section 7000) of Division 3 of the Busi a nd Professional ode, and my arise is in full force and effect.
License lass: C20 -C36 icense No.: 777
ate:"I!!�/Rbn'uactor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury hat 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 _) 1, 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 _ 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 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: P.
LQPERMIT
Date: 6/20/12
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty ofrperjury 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 GRANITE STATE Policy Number WC065255599
_ I certify that, in the perfor nce of the work for which this permit is issued, I shall not employ any
person in any manners as to become subject to the workers' compensation laws of California,
and agree that, if I s Id become subject to the w on provisions of Section
3700 of the Lab e, s all forthwith c with those provisions.
ate: V►.. f ►/ plicant: '
WARNI—NG: FFAA"IL—RE 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 THELABORCODE, 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 personuponwhose 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, eachagrees'to, and shall defend, indemnity 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 pplication becomes null and void if work is not commenced ,
within 180 days from date of iss nce of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this applicati and ate that the above information is correct. I agree to comply with all
city and county ordinances and sta s re ing constr tion, and hereby authorize re resentatives
of 's c my t �e-nterr upon the ab - en oned property for insp tion purposes.
Date:
6118 Pry nature IApp cant, r Agent):
LQPERMIT
Application Number . . . . . 12-00000685
Permit . . . MECHANICAL
Additional desc .
Permit Fee 31.50
Plan Check Fee
7.88
Issue Date
Valuation . . . .
0
Expiration Date 12/17/12
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 CHANGE -OUT: REPLACE'5 TON 13'SEER
UNIT,CONDENSER, INDOOR COIL, 2.010
CODES.
" -----------------_-_---------------------------------------------------.-----
Other Fees . . . . . BLDG STDS 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
F
Simplified Prescriptive Certificate of Compliance: 2008 Residential. HVAC Alterations CF -111 -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:.
Permit #:
54979 Tanglewood La Quinta, CA 92253
City of La Quinta
Jun 20, 2012
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
0 SEER 3.0
�—
❑ COP
[1HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not alreadyresent must be
p
0 Condensing Unit
[3 EER
❑ Resistance
[3R 8 (CZ 14-15)
1800 sf
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, 7.7HSPF 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 -1R
and CF -611 shall also be on site for final inspection.
0 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 -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:
' 0'1`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 dud systems are constructed, insulated or sealed with asbestos
❑'4. The system will not be Ducted 1 (ie.�Ductless Mini-Split;System-) (Also �Exempt- from ,Refrigerant=Charge)
❑ 2. New HVAC System Required Forms:',.;"` <t • i., +� T
• Cut m or,Changeout with'' CF -6R formsf'MECH-04, MECH-2 RS,and (fo`r split systems) MECH-22-HERS, and
ducts:;(all
new new , ,� ..
dudmg and all new MECH=25�HERS
CF 4R forms:'MECH-20, and (for split systems) MECH-22, and
-,"tequipment),. _ �Wl f:,s�' ". , 4,. J L . 7to I- r t - % %, 1.:f • t �.
For Split Systems:,Duct leakage <,6'percent;'RC, CCA >_ 350 CFM/ton, FWDTMAH, SIMS, and.'either HSPP'or PSPP
For Packaged Units: Dud leakage < 6.percent
❑ 3..New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing 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 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: Dud leakage < 6 percent
114. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS s
linear feet of dud in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
❑ EXCEPTION: Existing dud 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: Kevin Robinson Signature: Kevin Robinson
Company: J ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Jun 20, 2012
Address: 72216 NORTH SHORE ST #101 License: 777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121
Reg: 212-A0032027A-00000000-0000 Registration Date/Time: 2012/06/20 12:47:19 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010.'
Bin #
City of La Quinta
Buildings 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: % �/>+�/ Lo ttJ 9,0 '
Owner's Name:
A. P. Number:
Address: dL
Legal Description:
Contractor:.............
City, ST, Zip:
:::.: c:;.r:�:;
....
Address: J ANTHONY SERVICES
Project Description:
City, ST, Zip: 72216 NORTH SHORE ST. STE 101
THOUSAND PALMS, CA 922�(7�6
S7-7-0 N LO IVO -OM 4A - >� .
Telephone: 7`D„,;:r:;.:%3'>'::<
State Lic. # : 777?6'I cl
i;•j: \i�: :i'n ":�Oh3+'}•��M4:':�:v:'}3:ti}n
\.r•:,i:;'Lyy'itii?':•irr
City Lic.
•�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:€
v... ..Z'r.;�: v..' •.qtr 1v,{.y
£,:, • • �c,µ:w;v>«,;.fi:;ycts:�c�:. ;<� �, ."�
Construction O p cy:
ype: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Pian Check Balance ”
Title 24 Cities.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2i° 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 corrcctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees