11-0911 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
- -A.
Application Number: 11--00000911
Property Address: 78150- CALLE--TAMPICO
APN: 770-020-024-1 000000 -
Application description: MECHANICAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 7.000
T-ih
4 4Q"
BUILDING &' SAFETY DEPARTMENT
BUILDING PERMIT '
Owner:
SMITH FAMILY TRUST
78150 CALLE TAMPICO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Dated 8/24/11
Contractor: J
U� /A
Applicant: Architect or Engineer: PALM DESERT AIR COND CO INC,r! I F, rn
42081 BEACON HILL P t i "' 7 ?� j
' PALM DESERT, CA 92211 x L.J
(760) 346-0677-•-�_.e _�.
Lic. No.. 374937 - QF6°a/�
Illi P 1:�.��,
– – – – – – – – – – – – – – – – – – – – – – – – - --------------–----------------------------------------- –– – – – – – – – – – – – – – —
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 Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 ense No.: 374937 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
.�.�� issued.
Date: �- / Siontor: 1 f' Si%% I have and will maintain workers' compensationinsurance, as required by Section 3700 of the Labor
/ Code, for the performance of the work for which this permit is issued. My workers' compensation
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).:
(_) 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ 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: '
LQPERA1IT
insurance carrier and policy number are:
Carrier FIRST COMP INS Policy Number 010111WC
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 1 should become subject to the workers' compensation provisions of Section _
3700 of the Labor Code, Ishall forthwith com/pi i those provisions.
pale: –J�: ' ! /A plicant: ��
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 building construction, and hereb authorize representatives
of thisQco�unty to ter upon the above-mentioned property for inspectionnp pos
Da V '2 Signatu�Applicant or Agentl:�G- (r
Application Number
11-00000911
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
48.00
Plan Check Fee
12.00
Issue Date . . .
Valuation . . . .
0
Expiration Date
2/20/12
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2`.00 16.5000
EA MECH
B/C >3-15HP/>100K-50OKBTU
33.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE (2)HEAT PUMP
CONDENSERS:
2010.
CODES.
----------------------------------------------------
Other Fees . . .
.Other
------------------------
--------
. . . BLDG STDS ADMIN (SB1473)
- -------
1.00
Fee summary Charged
----------
----------
Paid Credited
--------------------
Due
-----------------
Permit Fee Total
48.00
.00 .00
48.00
Plan Check Total
12.00
.00 .00
12.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
61.00 .
.00 .00
61.00
LQPERMIT - -
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
78-150 CALLE TAMPICO.(SYSTEM 1) La Quinta, CA 92253
Enforcement Agency:
City of La Quinta
Date:
Aug 24, 711
Permit #:
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
O Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
p SEER 13.0
❑ COP "
p HSPF 7,7
❑ R 6 (CZ 10-13)
Served by system
If
2 Setback
not already present, must be
p Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
2000 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-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF-111
and CF-6111 shall also be on site for final inspection.
0 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-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 d fors MECH-25
and plits systems)
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 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 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.-,Ductless •Min i-Split, System) -(Also Exempt from Refrigerant Charge)
Elw 2. Ne'HVAC System Required Forms:f+;
t
. Cut in!r Changeout with* I t ,.
new ducks: (all new ; CF 61cforms: MECH-04, MECH-20-HERS; and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducting and all n w CF-4R forms: MECH 20, and (for split systems) MECH-22', and. MECH.25 ry I }
egwpment) ' I I/ t f s`
.. ." :�' ,� J rr
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP o'r PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New�Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new ducting
and/or outdoor condensing unit and/or indoor
CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
coil and/or furnace. No or some equipment
CF-4R forms: MECH-20 and (for split systems) MECH-25
changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 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-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: Karl Brown Signature: Karl Brown
Company: PALM DESERT AIR CONDITIONING CO INC Date: Aug 24, 2011
Address: 42-081 BEACON HILL License: 374937
City/State/Zip: PALM DESERT/ CA / 92211 Phone: (760) 346-0677
Reg:12ll-A0043672A-00000000-0000 Registration Date/Time: 2011/08/24 11:07:18 HERS Provider: Ca10ERT_S', Inc.-
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
78-150 CALLE TAMPICOa(SYSTEM 2) La Quinta, CA 92253
City of La Quinta
Aug 24, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
LJ Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
p SEER 13.0
❑ COP
2 HSPF 7,7
❑ R 6 (CZ 10-13)
Served by system
2 Setback
If not already present, must be
Q Condensing Unit
[jEER
U Resistance
El R 8 (CZ 14 IS)
2000 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 -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -611 shall also be on site for final inspection.
D 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 -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -611 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
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
1713. Existing duct systems are constructed, insulated or sealed with asbestos
❑4. Thesystemw:ill not be Dui d (ieDuctless Mini-Split.-Systemj(Also Exempt fromr,Ref�rigerant Charge)
❑ 2. NewHVAC System
Required Forms: " (e t�M lx
. Cut in;rb-r ,Changeout wit#i'(�
new ducts: (all new
CF-6R?forms: MECH-04 MECH-20-HERS; and ;(for split systems) MECH 22=HERS and MECH-25-HERS
ductiA and all new '
CF 4R forms: MECH 20, and (for split systems) MECH-22,'and MECH 25
equipment)
3'.
1.For
Split Systems: Duct leakage < 6 percent; RC, CCA >! 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or'PSPP. "
For Packaged Units: Duct leakage < 6 percent
113. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new ducting
and/or outdoor condensing unit and/or indoor
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
coil and/or furnace. No or some equipment
CF -4R forms: MECH-20 and (for split systems) MECH-25
changed.
For Split Systems: Duct leakage < 6 per RC, CCA >_ 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 -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: Karl Brown Signature: Karl Brown
Company: PALM DESERT AIR CONDITIONING CO INC Date: Aug 24, 2011
Address: 42-081 BEACON HILL License: 374937
City/State/Zip: PALM DESERT/ CA / 92211 Phone: (760) 346-0677
Reg:°211-A0043673A-00000000-0000 Registration Date/Time: 2011/08/24 11:14:58 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
T
a
4a
P.O. Box 150:4 -78-495 Calle Tampico, ! La Quinta, California 92211
qui Tel: (760) 777-701'2 • Fax: (760) 777-7112 .
Vl pbsite: www:La-Quinta.Org Email: Building:@La-Quin#a.OrgOF
in #. Rer;Intt # ��,Q O B`Uilding Permit Application &.Teackirlg Sheet
ProjectAddre"ss:- 78-150 CALLE TAMPICO
Owner's'Name: SMITH FAMILY TRUST
A.P. Number: _
Address: 78-150 CALLE TAMP.ICO
Legal Description: a
City, State, Zip: LA QUINTA, CA 92253
Contractor. ,Palm Desert Air Conditioning & Heating Company
-Telephone; • (925) 679-1935 • r
Address: 42-081 Beacon Hill
Project Description: ,
City -State. Zip: Palm Desert, CA 92211
(REPL''•ACE-(-2)-4EAT- PUMP GONDE—NSERS
• '
, ..
Teleph`gne No; (760) 346=0677
• 4. "N'
~
State: Lie: #- 374937
'City: Lie. #: 100886
ArchaEngr/Designer
Address:
'City, State; Zip: M .
Telephone No :
k
m`
fi ",�
Construction Type:.
Occupancy:
State: Lica##;
4 q
. ` t,
4 ,_
,
Project Type: 0 New -'0 Add'n •.O Alter • p Repair,, -El Demo
Narrie:of ContaetPersort: KARL BROWN
Sq. Ft.:`
# Stories:
# Units:
Contact Telephone No.: (760) 346-0677
-
Estimated Value of Project: C$7,000-00=11.
APPLICANT:`DO NOT WRITE
BELOW THIS LINE
#
Submittal
Req'd
Recd
Tracking
Permit Fee's.
Plan Sets
Plan Check.Submitted
Item
Amount '
Structural:Calcs:
Reviewed;_ Ready forrCorrection's
Plan Check Deposit
,
•TnimCalis: ,
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans Picked Up
Construction
Flood Plain P)an
Plans: Resubmitted
G•
Mechanical
Grading Plan
2'Aeview; Ready for•Conlections
Electrical
5ubcontracior`tast
Calle&Contact Person 1
Plumbing
Grant'Deed
Plans Picked Up
=
S.M.1
H:O:A. Approval
Plans Resubmitted
Grading
'
IN HO.USES
_ 3`0 Review, Ready for Corrections
Developer Impact Fee
Planning.Approval •
Called=Contact Person
Pub. Woks Appr'I
Date of Permit Issue,
,
School. Fees
Total Permit: Fee's