14-0812 (MECH)P.O. BOX 1504
78-495 CALL TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14`00000812'fi'
Property Address: 61620 TULARE LN
APN: 764-280-999-112 -300237-
Application description: MECHANICAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 4864
Applicant:
Architect or Engineer:
pi
9mm
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JIM BREWER
61620 TULARE LANE
LA QUINTA, CA 922531
I1
Contractor:
GENERAL.AIR CONDIT
31170 RESERVE DRIV
THOUSAND PALMS, CA
(760)34-3-.7488
Lic. No.: 686310
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)777-7153
CIiyop. �, r<
Fi° Ai Iln �r
Date: 6/10/14
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 Division3 of the Business and Professionals Code, and my License is in full force and effect.
I have and_will maimain�a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 License No.: 686310
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
//
/Date. IO IZF /ontractor. Ste'��
issued.
I have and will maintain workers' compensation .insurance, as required by Section 3700 of the Labor
'
_
Code, for the performanceottheuvoPk for which this issued.' My workers compensation
OWNER -BUILDER DECLARATION
insurances carrier and policy number are: -
I hereby.affirm under penalty of perjury that) am exempt from the Contractor's State License Law for the
Carrier ZENITH INS- CO --. Policy Number Z071741503 -
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 sublemto the workers' compensation provisions of Section
License Law (Chapter.9'(commencing with Section 7000) of Division 3 of the. Business and Professions
3700 of the Labor'Code 1 shalj bnhwith comply with those provisions.
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).: Date:
- -
plicant: S,,.;,r� -
1 _ 1 1, as owner, of the property, or my employees with wages astheir. 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' COMPENSATIONCOVERAGE IS UNLAWFUL, AND SHALL
. 'Contractors' State License Law ,doesnot apply to an owner of property.,who builds orimproves [hereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP'TO ONE1iUNDRED 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 oroffered for 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-buildei will have the burden of proving that he or she did not build or-
iniproveforthe purpose of sale.). - -
- APPLICANT ACKNOWLEDGEMENT
(_) I, as owner. of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director.of Building and Safety fora permit subject to the
7044; Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and -restrictions set forth.on this application. '
property who buildsor improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each personuponwhose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued•as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason
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.
Date: Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
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 inspection purposes.
Lender's Name: I F
kfa
te:� 10 I nature (Applicant or, Agent):
Lender's Address:
LQPERMIT
Application Number . . . . . 14-00000812
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee . . . . 35.75 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/07/14
Qty Unit Charge Per Extension
1.00 35.7500 EA MECH CONDENSER/COMP 35.75
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 14.5SEER CONDENSER
ONLY [2010 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
June 10, 2014 2:54:15 PM AORTEGA
---------------------7------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
PERMIT ISSUANCE M/P/E 90.57
PLAN CHECK, MECHANICAL 23.83
Fee summary Charged
Permit Fee Total 35.75
Plan Check Total .00
Other Fee Total 115.40
Grand Total 151.15
LQPERMIT
Paid Credited Due
.00 .00 35.75
.00 .00 .00
.00 .00 115.40
.00 .00 151.15
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:Enforcement
Agency: Date:
Permit #:
61620 TULARE LANE La Quinta, CA 92253
City of La Quinta I )un 9, 2014
Dud insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
0 Furnace
[I AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
H Setback
(3 Indoor Coil
W SEER 14.5
p HSPF
❑ R 8 (CZ 14-15)
1806 sf
If not already present, must be
H Condensing Unit
[3EER
E3Resistance
installed)
0 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-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-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-411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF-611 forms: MEC11-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
CF-411 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
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 tti`ari:40 linear feet in unconditioned space, or
0-3i. 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 m or Changeout+rt�th
CF-SR forms MACH U4;�IECH ZD-HERS, and�(forspltt systems) MECH �2-HERS; and
new duds fait new
MECH 25 HERS ...
du ctin a ail new
9.:
a
GF-4R forms MECH-20, an(fo spit sysemsJ NFEGH 72„ane MECF! 25�
equiio� t).
For SptttSystems .Duct teakage < 6 percent; RC, CCAS 350-:CFM/ton FWD TMAH *S GMS';;and;either HSPP or PSPP-
-
,_a...z:> .... .,, �::.- -.parr.:
eruct: eaka e. 6< erteni.r.. .:��
For Pac -
_:::<,.
3. 'New aiucts iMrth}ot vitbai
rediFins
r❑
Replacement ::::..=.:. .
. Indudes:,replacing";or installing att'rtew
ducting: a;r dJor outdoor condens+rig;linit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil'and/or furnaci (N6 or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage'::<: 6 percent; RC, CCA 2 300 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-041 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)
o 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: Dayana Valdez Signature: boyana Valdez
Company: HARRISON ENTERPRISES INC Date: ]un 9, 2014
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 214-A0041782A-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2014/06/09 20:50:58 HERS provider: Ca10ERTS, Inc.
July 2010
I
Bin #
Permit #t�1�
\,,
1
Project Address:N
City of I q. Quinta;
Building.BzSafety'Didision. ;.
P.O. Box 1504, 78 495 Calie Tampico .
La Quinta, CA 9.22153:;'(760) 777 7012
Building Permit Application and Trading Sheet
O wner's Name:
A. P. Number:
Address: '—
�ol(D,Z'0 . .1 � arm: �h
Legal Description:City,
ST, Zip:. - ' CA - zz's-25
Contractor: t
Air-
Tele hone:
."7 hO-& I q., 39 Lea-
:;.:- .:.::.:...:.:.:....... .....:..:
Address: 'J �� ` �(
Project Description:
City, ST, Zip:
Qe ' I qCL o e e�f
Telephone:
P 7100- 343 -74 88
:?>:«:>::<:»::;<:>;:..>.;:"s:>.:;:>:::-:;:•;:::-:
State Lic. # : $6310
City Lie. #..
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
.:j.j?{�fiUy>^•v:i�:':Li=ii:::;{�>::::r;:;::�vvf v.:::i::i:
Construction Type: Occupancy:
State Lic. #
Project type circle.one : New Add'n Alter Repair De mo
Name of Contact Person:
r\% efe-r
Sq. Ft.:
# Stories:
#Units
Telephone # of Contact Person:_
Estimaied Value of.Project: 4 aped ,
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,CheckDeposit
Truss Cala.
Called Contact Person
PIan:Check Balance-
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
;Plans resubmitted
Mechanical
Grading plan
Zed Review, ready for corrcctions/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.L.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"''Revicw, ready for correctionifissue
Developer Impact Fee
Planning Approval
Called Contact Person
A'.I:P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees