13-0057 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA. 92253
Applicant: Architect or Engineer:
A { 1
tN
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FOSTER
53545 AVENIDA VELASCO
LA QUINTA, CA -92253
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.
License Class: C-2207) C36 License No.: 818759
Cont `ctor: v
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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Btisiness 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 ISec. 3097; Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
PREC H & A INC
P.O. BOX 11090'
PALM DESERT, CA 9225
(760)776-1550
LiC. No.: 818759
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/17/13
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
,i/ issued.
t 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 T CK 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, I✓shall
fforthwii ply with those provisions. "
D APP nt:
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 1$100,0001. 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 untyy to enter upon the above-mentioned property for in ction pur oses. '
Dat / ✓ Signature (Applicant or Age
Application Number:
13-x00000057 3
Property Address:
53545 AVENIDA VELASCO
APN:
774-124-015-3 _000000 -
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1400
Applicant: Architect or Engineer:
A { 1
tN
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FOSTER
53545 AVENIDA VELASCO
LA QUINTA, CA -92253
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.
License Class: C-2207) C36 License No.: 818759
Cont `ctor: v
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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Btisiness 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 ISec. 3097; Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
PREC H & A INC
P.O. BOX 11090'
PALM DESERT, CA 9225
(760)776-1550
LiC. No.: 818759
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/17/13
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
,i/ issued.
t 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 T CK 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, I✓shall
fforthwii ply with those provisions. "
D APP nt:
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 1$100,0001. 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 untyy to enter upon the above-mentioned property for in ction pur oses. '
Dat / ✓ Signature (Applicant or Age
Application Number, 13-00000057
Permit MECHANICAL
- -
Additional desc
Permit Fee . . . 31.50,
Plan Check Fee
7•:88 y
Issue Date
Valuation'
0
' Expiration Date 7/16/13
`
Qty -Unit Charge. Per
Extension
BASE
FEE
15:00 *,
1.00 16'.5000 EA MECH
B/C >3-15HP/>100K-50OKBTU
16.50 ;
-- --. ----- - -----------------
Special Notes and Comments
----------
_
CONDENSOR CHANGE -OUT, ,2010 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
a
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
�
s
1
Date:
Permit #:
53545 Avenida Velasco La Quinta, CA 92253
City of La Quinta
]an 15, 2013
Equipment Typel
List Minimum Efficiency2
Duct insulation,
requirement
Conditioned Floor
Area
Thermostat
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15 ,
Site Address: +
Enforcement Agency:
Date:
Permit #:
53545 Avenida Velasco La Quinta, CA 92253
City of La Quinta
]an 15, 2013
Equipment Typel
List Minimum Efficiency2
Duct insulation,
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
❑ Indoor Coil .
®SEER 13.0
1@ HSPF 7.7
❑ R 8 (� 14-15)
1400 sf .
If 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, 7.7HSPF 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 -611 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 -1R
and CF -6R shall also be on site for final inspection.
i
® 1. HVAC Chang.^.^.L•:
Aa'.liruri Firma. Q
. All HVAC Equipment
CF -6R forms: MECH-04, MECH-21-HiEkS and (for spilt systems) MtLrH-t5-MtKb
4CF-4k
1 replaced,
forms: MELCH-2i and (Tor sant sys-Mms rEi r-23
• 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 -411 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
'
Cw- Paiskaged Unite.. Due# leakage ; 15
p ;# 1 Z
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;DuctlessGMini-Split_System),(Also Exempt_from[Refrigerant Charge)'
❑ 2. New HVAC System
Required Forms: I IF .-y f k `
. Cut inlor, Changeout with',
new ducts: (all new -
'' ' ' •fi $ + t{ f k
CF -6R forms: MECH-04, MECH-20�HERS, � d'(t r split systems) MECH,22-HERS, and -
ducting and all ne w
MECH=25HER5 - J
CF -4R forms: `MECH-20, and (for split systems) MECH-22, and MECH-25
equipment)
For Split Systems: Duct leakage < 6`percent; RC, CCA _> 350 CFM/ton, FWD, TMAH, STMS; and either HSPP oe'PSPP.
For Packaged Units: Duct leakage <•6 percent
❑ 3. New Ducts with/or without 's-
Required Forms:
eplacement.
Replacement.-
Includes replacing or installing all new
Includes
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: Duct leakage < 6 percent
• lnciucies adding or repiacing more than 4U' •CF -6K forms: IvIrUl-U4, Mtk-rl-2l-liEKJ ,
linear feet of duct in unconditioned space. CF -4R forms: MECH-21 4
For split system or packaged units: Duct leakage < 15 percent
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
. i cer �ify that Lhe energy gy 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.
Company: PREC H & A INC Date: ]an 15, 2013
Address: P 0 BOX 10991 License: 818759
RAI 11�/ nCCCI`T i f7A r 12?SS., .Phnne- !7601, 776-1,.55171
Reg: 213-A0002967A=000000000-0000 Registration Date%'Time: 2013/.01/.15 19:05:42 HERS Provioer. CaiCEP.TE, inn.
2008 Residential Compliance Forms Julv 2010
b
r
Bill #
Perink #P.O.
/.�
Project AM=.
Oty., of La Quth ta.
RulklZrog &r saky Division
Box 1504,78-4915 Cage Tampico
La.Qufnta, CA 92233 -:(760) 777-7012
Building Permit -Application: and Tracking Sheet
. Owner's Name:.
A. P. Number.
Address:
C. 2
Legal Description:
!v
City, ST, Zip.
Contrwur rl,
Telephone:
Address: dr�_7d /M
Project -Description:
City, ST, Zip; 1-451412
Telephone:
City Lic. k
State Lie. # 1_7
ArdL.. Eag, Designer.
Address:
City., ST, 4:
Telephone:
State Lie. 0:
Name of Contact Person:
Construction Type:. occ'upan't -y:
'
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL. # stories.
9 ufti4:
Telephone 9 of Contact Person:
Estimated
timatet! Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc,d
TRACMG
PERMrrFEES -
Plea Set:
Plan Cltc& sabmitted
item Amon at
S"clural Cates.
Rtyl—ed, ready for corrections
Plan Check Deposit.
Truss Cates.
Called Contact Person
?[aft Check Rdance.
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans rembmitted.'.
Mech2fkll
Grading plan
2`'RrAtw.ready for correcdoftsrwuc
Electrical
Subcostactor List
Called Contact Person
Plumbing
Grant Dew
Plans lilcktd up
S.KL
ILO.A. Approval
Plans resubmitted
Grading
ER HOUSE-.
Review; ready for correctionsrissue
Developci Impact Fee
PlantaniApprovat.
Called :- Cot . itact Person
Pub. Wks. Appr
Date Of permit Issue
Scko4l Fees
Total Permit Fees
!v