14-0667 (MECH)P.O. BOX 1504
78=495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applic'ation,Number:000667 ►�
Property Aldd ess: 57895 SEMINOLE' DR
APN. 762 -380 -020 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY .RESIDENTIAL
Application valuation: 8874
Appl' an
Ta�v 4 4 Qum' � - e
Architect or En 'neer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
0
Section 7001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
Dater. Lc� 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 ($5001.:
(_) 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, 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 contractorls) 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:
LQPERMIT
Owner:
YOUNG LEE
57895 SEMINOLE DR
LA QUINTA, CA 92253
(714)747-3652
Contractor:
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488,-
LiC. No.: 686310
-VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
N
Date: 5/20/14
MAY 20 2014
-------------------------------
WORKER'S COMPENSATION DE
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, ZENITH INS CO Policy Number .Z071741503
I certify that, in the performance of the work for which this permit is issued, 1 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.
S�
Date: S �% Applicant:; vt.t,t.if� �•� �"
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 FORIN
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 requestandfor
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 co my to enter.upon the above-mentioned property for inspection purposes.
DAte: i Signature (Applicant or Agent):
Application Number . . . . . 14-00000667
Permit MECHANICAL 2013
Additional desc .
Permit Fee 83.42 Plan Check Fee
.00
Issue Date . . . .` Valuation . . .
0
L Expiration Date 11/16/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 11.9200 EA MECH APPL REP/ALT
11.92
1.00 35.7500 EA MECH CONDENSER/COMP
-
35.75
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Special Notes and Comments
(1)HVAC CHANGE OUT 3.5 TON (1) 90,00 BTU.
FURNACE & COIL - 78AFUE,14.-5 SEER [2008
ENERGY] CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION.2013
CBC.
-----------------_-_--------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
52.43
Fee summary Charged Paid Credited
-------------------------------------
Due
--------------------
Permit Fee Total 83.42 .00 .00
83.42
Plan Check Total .00 .00 .00
.00
Other Fee Total 144.00 .00 .00
144.00
Grand Total 227.42 .00 .00
227.42
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency:
Date-,
Permit #:
57895 SEMINOLE DRIVE La Quinta, CA 92253 City of La Quinta
I May 19, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
p COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
® Indoor Coil .
® SEER 14.5
❑ HSPF
[3 R 8 (CZ 14-15)
2611 sf
If not already present, must be
® Condensing Unit
[3EER
[3 Resistance
installed)
0 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 -411s allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1111
and CF -611 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
. 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 :s,300 CFM/ton (Minimum Air Flow Requirement), TMAH
Per. Paskaaed Units. Duet leakage 19
; per-eeAt
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 t6.":40 linear feet in .unconditioned space, or
0-3i. Existing duct systems arecoristructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted '(ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
1:12.: .New HVAC System
Requir'ed:._Forms:
Cu r
. o Chan eouf 1lth
' in g- • •";.:.:. �
:•""`
CF 5R forms MECH- 04,-MEGH 20 HERS, and jfor split systems) MECH- �2��H�RS; and
new
MECH15HER5::::
.., ,:..
ducting artd all new��
farms i+ifCH-20,. and (for split systems) fNELH 22, and MFCfi ZS
e ui ment
For Split Systems ,.Duct Leakage < 6 erpent; RC, CSA 35U GFM/ton, FIND;; TMAH SIMS artd either # (SPP
�.F ,.:., _.... .
ct:te ka e . t: i"
erten -
For Pack�:'.::...�.
a U
ed .nets .:...
..
t_r.
3. NewDusvitloti"
R
i<dFin::.e❑
Replacemerit :..::... ": .
W.
Indudes:.ceptazing:Ar installing a0new
ducting. ardor oufdaor eondensirig- unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or'indoor coil'and/or furnace N6 or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage'.' -,:z!6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leaka4:`<' 6 percent
114. 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 -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: Dayana Valdez Signature: boyona Valdez
Company: HARRISON ENTERPRISES INC Date: May 19, 2014
Address: 31-170 RESERVE DRIVE STE A License: 686310.
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760)'343-7488
Reg: 214-A003575SA-000000000-0000 Registration Date/Time: 2014/05/19 16:11:30 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Din #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1 LL J�1
Project Address: 57 �5S SeMiho�e
Owner's Name: Your Lee-
eeA.
A.P. Number:
Address: 5789,5 5 e—vr I Yl O e ilk
Legal Description:
City, ST, Zip: L c Qv,kc * CA 9 2253.
Contractor:Tele
G'✓rer �1 � Lor ;
hone: lLl -
P •l%y -7- 3(652
Address: 3117p �eServ� -
Project Description:
City, ST, Zip: S c. YY CA 9z2 -A-
' e l ac c 3. S "tbr A C e!'O Opp
Telephone:
P 3
v F�� mace
State Lic. # : $(0 34 tl
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
. -.
Construction Type: Occupancy:
YP P Y
State Lic. #: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
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 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'. 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