13-0615 (MECH)Tii!t 4
P:O. BOX 1504 !/
78-495 CALLE TAMPICO r
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT ����.••''
BUILDING PERMIT
Application Number: 13-00000615, Owner:
Property Address: 81125 SHINNECOCK HILLS WEIL DAVID & MARSHA
APN: 762-340-010- - - 81125 SHINNECOCK HILLS
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (
Application valuation: 10389
Contractor:
Applicant: Architect or Engineer: MAY 9 � ^ GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
C1 THOUSAND PALMS, CA 92276
FHgN�AQ(�la�liq (760) 343-7488
E10) Lic. No.: 686310
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: C20 License No.: 686310
Dat %ST 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 ($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.).
(_ 1 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.).
(_) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/15/13
—----------------------------7-----------------
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 ZENITH INS CO Policy Number Z071741502
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 forthwith comply with those provisions.
Date • Applicant: =-�Lo;5 .
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 hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
t
Date: Signature (Applicant or Agent)_: �,..Q...c/:f•
Application Number . . . . . 13-00000615
Permit MECHANICAL
Additional desc .
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date Valuation
0
Expiration Date 11/11/13
Qty Unit Charge Per.
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
f
1.00 16.5000 EA MECH P/C >3-15HP/>100K-500KBTU
16..50
Special Notes and Comments
REPLACE ONE (2) TON a/C AND 70K BTU
FURNACE.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
Fee summary Charged Paid Credited
Due
----------------- ---------- ----------
Permit Fee Total 40.50 .00. .00
40.50
Plan Check Total 10.13 .00 .00
10.13
Other Fee Total 1.00 .00 .00
1.00
Grand Total 51.'63 .00 .00
51.63
. . LQPERMIT
Bin #
City Of.La Quinta
BulkUpg 8T Safety Division
P.O. Box 1504,'78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application' and Tracking Sheet
Pe It #
'
Project Address: (ZS S i r\ e. C.1'— ,H i 1 I s
Owner's Name: Dc,, i d E M ar's �C- Lie -Jt
A. P. Number.
Address: a 1 l 25 S1.i hr `C oc Imo— i I
Legal Description:
Contractor. (���er�\ A�,c- r iQ
City, ST, Zip: LQ. QU, V- G CA R ZZ 53
Telephone: - M Y
Address: 3\1-70 e5ec v ve-
ProjectDescription:
City, ST, Zip:�11ov5Ck-YN A MS q?2_77(o
P—c iac.4-. 2+c> c- 70J:�,
Telephone: -7(,0-3'43-'74438
City Lic. #,
State Lie. # :
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:Construction Type:. Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft.: # Stories: # unit;;:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
'Rec'd
TRACKING
PERMfrFEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit...
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Calls.
Plans picked up
Construction
Flood plain plan
Pians resubmitted..
Mechanical
Grading plan
2'! Review, ready for correction&rwue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7n° Review; ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance. 2008 Residential HVACA/terations CF-iR ALT -HVAC
Climate Zones 10 - 15 ;
Site Address:
Enforcement Agency:
Date:
Permit #:
81125 SHINNECOCK HILLS La Quinta, CA 92253
City of La Quinta ,
May 14, 2013
Duct insulation
Conditioned Floor
^
Equipment Typel
List Minimum Efficiency2 ,
requirement
Area
Thermostat
17 Package Unit ..
s
® Furnace
® Indoor Coil' •
® AFUE 78%
® SEER 13.0
COP
❑ HSPF
0 R'6 (CZ 10-13)
R 8
Served by system
4961 sf
® Setback
If not already present, must be
® Condensing Unit
0 EER
p Resistance
O (CZ 14-I5) .
,
installed)
p 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 onsite 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-ARs 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 -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
I
.Furnace.
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage::<; percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct.leakage testing f:,
i [j is Duct: systiam'was docum6'...0 to have been previously sealed and confirmed through HERS verification,'or .
p 2. Duct systems with less thee; 40 linear feet in unconditioned space, or
0.3. Existing duct systems are:con_structed, insulated or sealed with asbestos
❑'4: The systeennvil] not be Du�fed (te: DucUess Mini plit Systeip) Als xen tfio{ tehigerant:€l�ar e
:::..., ,..g )
Re 'u
O'2, iVe VX1�� teen q Q . .._
:=ibb`.., a>%. -' .'..;d,.. .'. :�;. .
. Cut in d Giangeout w th<:CF 6R forms ,MEGH-04, MECyMm2kT�HERS,�nd { split systerrts) MECH 22i`iERS,':aiid
new ducts tall new %`;
duct itt �a all new - - '-' _ '
.� .C�. :R-fo tns.,;MECH-0;.an ar split's:
r �. d• :f eln �f�CH-Z2 a'rtd�iKECk1�25�`:.-
(.. --
3 ..-_.. .
euimint.... ..... _ � : _
..�-..l•J�.:� ...�_...F .:::_v.:z'�%�.`�� ���, •r:7"h�.c�_'`�'.-s??i``�`::ci�,��1iL.• '�:d`•45+._:.:...v. �� F�m::� r
For S lit' dti t* : vc#leak ` e,:<..6 percents iTC CA "35b CI 1NJto#% FV1D TMAH 5TN15; ani) either ]i pP or""'PSPP. - `'
iii
For Packa ed Units:
9
O 3.'N 0 ts v rith/or wit trot t =:-;?:: '
Required Forms:
^
. Includes replacing or installing ai( iiew
ducting and/or outdoor condens n.j -unit
CF -611 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.
t
For Split Systems: Duct leakage < 6 percent; RC, CCA z 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 -411 forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
E3 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: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: May 14, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276: Phone: (760) 343-7488
Reg: 213-A0029187A-000000000-0000 ,Registration Date/Time: 2013/05/14 18:36:48 HERS Provider: Ca10ERTS, Inc_
2008 Residential Compliance Forms July 2010