13-0779 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,.CALIFORNIA 92253.
Application Number:
13-00000779
Property Address:
54421 AVENIDA VELASCO '
APN:
774-251-020-10 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2165
(01,07
4 VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Owner:
SPEAR VIRGINIA L
P O BOX 1672
PALM DESERT, CA 92261
Date: 6/24/13
Contractor:
Applicant: Architect or Engineer: DOVE AIR INC �y►
69749 RISUENO ROAD U
CATHEDRAL CITY, CA 92234 sof
(760)327-1890
Lic: No.: 794315 + �" 4
1 JWOTA
---------------------------------------------------------------------------------------
-
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. Busines and Professionals Code, and my License is in full force and effect.
License Class: C20 qq License No.: 794315
Dare: 61 IA 1 % Contractor: U
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 Cade) 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 ISec. 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, 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:
LQ1'I;RDI IT
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.
_ 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 EXEMPT Policy Number EXEMPT
_ 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
I 3700 of the Labor Cod(/EI shall forthwith comply with those provisions.
Date: l"' ` I> Applicant:
v
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 buildin onstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned property inspection rposes
Date: LL.9. , 1 / Signature (Applicant or Agentl:
Application Number 13-00000779
Permit . . . . . . MECHANICAL 2013
Additional desc .
Permit Fee° 71.50 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 12/21/13
Qty Unit Charge Per
Extension
1:.00 35.7500 EA MECH CONDENSER/COMP
35.7.5
1.00.. 35.7500 EA MECH`AIR HANDLER
3.5.75
Special Notes and Comments
HVAC CHANGE OUT - 13SEER - SPLIT 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
PLAN CHECK, MECHANICAL
35.75
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 71.50 .00 .00
71.50
Plan Check Total t00 .00 .00
.00
Other Feer Total 127.32 .00 .00
127.32
Grand Total 198.82 ` .00 .00
198.82
1.QPI"sltA-11T
Lei ei evuo rvr o: a a rhe► i+a �uiuea auiit�au�� �aL,y .r�--- .---
Bin tt
City sof La Qtainta
Building SL Safety Division
P.O. Box 1$04, 78-495 Calle Tampico
La Quanta, CA 92253.- (•760). 777-7012
Building Permit Application and Tracking Sheet
Permit #
1
'Project Address: 421Jt• j i g a S t)
Owner's Name: AY r
A. P. Number:
'Address: o. al 4 l C 0
Legal-Vescription:n/
Contractor: 0 Jam. A � S
City, ST, Zip: i 711 SJ
Telephone: % b 6 — ? J
Address -,Project
Description: A-( r
City, ST, Zip: �.t7.44 4&t C— TL j
Ca -44
Telephone: e
.o W- " YL%% r
State Lie. # : 3 City I.ia �k: 103s
Arch., Fsngr., Designer: "
Address:
City; Sf, 'Lip:
,"eiephoue:
State Lie. #:
Name of Contact Person: P
Contraction Type: Occupancy:
Project type (circle one): New, Add'n /Ater .Repair Demo
Sq. Ft.:!
Stories:
# Units:
'Telephone # of Contact Perso.: S �167 Fstirnated Value of Project:.
APPLICANT: D0. NOT WATE•BELOW THIS UNE
ii
Submittal
AeqV4
Recd
T1tACAINIG •
PERM F FEES
Plan Sets
Piaci ((]tech submitted
Ytem Amount
Structural.Calcs..
Reviewed, ready for corrections
Pian Check Deposit
Tress Cala.
Called Contact Person
Pian Check Mallet
Cates. Energy Cs.
Plans bieked up
Cowtnsetiou
Flood plain plan .
Plans resubmitted
Mechanical
Grading.pian'
E'` Review, ready [or eorrectionslissae
Electrical
Sabcouticlor List
C'ititid Contact Person
Plwnt[>Tng
Grant Deed
Plans picked up
SM L
H.O.A. Approval
d.Ians resubiuilted
C;radidg
IN HOUSE:-
s^' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.U.P.
Pub, Wks. Appr
Date of permit issue •
School Fees
_.....
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-1W-ALT-HVAC
Climate Zones 10 - 15
Site Address:
7City
Enforcement Agency:
Date:
Permit #:
54421 Avenida Velasco La Quinta, CA 92253
of La Quinta
Jun 24, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
® Package Unit
[3 Furnace
❑ Indoor Coil
[3 AFUE
® SEER 13.0
❑COP
® HSPF 7.7If
❑ R 6 (CZ 10-13)
Served by system
sf
® Setback
not already present, must be
13 Condensing Unit
[3EER
[3 Resistance
13 R B (CZ 14-15)
2000
installed)
❑ Other
-
1. Equlpment 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-4R
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 (99- Split systems) 04EGH 25_uEnc
replaced
CF-411 forms: MECH721
. Condenser Coil and /or
CF-6R forms: MECH-04, MECH-21-HERS ^a (a,.. ^:.,l,� systems) MEGH_2_5 WEEoS
. Indoor Coil and /or
CF-4R forms: MECH-21 MECH 2
. Furnace
For Packaged Units: Duct ieakage',<..15 percent
Exempted from duct leakage testirig�if`.
❑.!:.Duct system was documented to have been previously sealed and confirmed through HERS verification; or
2. Duct systems with less thM40 linear feet in unconditioned space; or
- ❑ 3. Existing-duct-systems-are onstr-ucted, insulated-or sealed with-asbestos-, 7- -- --
❑ 4. Thesystem`will not be D meted (ie ? uctlessMimSphtSyystem:)(Also+Eyxernpt�frotnRefrf"ger�antCharge)
❑ 2. NewH1fAC System
Regwredp�,Forms: f :'
. Cut in o(hbrigeout wit
new ducts:. (all new
' q -a " t ' ;, ' a
split systems) MECti 22 HERS and
¢ r-
CF 6R form! MECH-04 MK-H 20 HERHIEC
ductiii n all new ��
kM�ECH25HERS .
CF orms MECH-20, and {for 22--, i4-MEGM 25
,g
equipment%;
split systemH
'f''£ '.. ' QFt r te. `
For Split.5ystem5 Duct `leakage
6 e cent SRC, CCA z 350FCFM/ton FWD; TMAH, SIMS, aridEeith6PHSPP or'PSPP.,'
For Packaged Units: Duct
leakage< 6. percent
❑ 3 NewDucts with/or without S
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 some
CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed..
For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH
For Packaged Units: Duct-leakage-c6 piercent -� -'-- - - - --- -- - - �--
❑ 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: Gary Laster Signature: Gary Laster
Company: DOVE AIR INC . Date: Jun 24, 2013•
Address: 68-749 RISUENO ROAD License: 794315
City/State/Zip: CATHEDRAL CITY/ CA/ 92234 Phone: (760) 327-1890
Reg: 213-A0046526A-000000000-0000 Registration Date/Time: 2013/06/24 13:24:43 HERS Provider: Ca10ERTS, Inc.
2608 Residential Compliance Forms July 2010