12-1232 (MECH)P.O. BOX 1504 .
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
Tityl 4 4-Qula
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect.or Engineer:
VOICE� NOF 7T/-- /i 12
FAX (7 X11
INSPECTIONS (760) 777-7153
Owner:
ROB SIEBERS D
54504 SHOAL CREEK- G
LA QUINTA, CA 92253
LA
Contractor: CIj'FLA
GENERAL AIR CONDITI Kliy fyyEp
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343=7488,
Lic. No.: 686310
Date: 10/16/12
LICENSED CONTRACTOR'S DECLARATION -
Application Number:
`12-00001232
Property Address:
-54504 SHOAL CREEK
APN:
775-071-078- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
8828
Tityl 4 4-Qula
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect.or Engineer:
VOICE� NOF 7T/-- /i 12
FAX (7 X11
INSPECTIONS (760) 777-7153
Owner:
ROB SIEBERS D
54504 SHOAL CREEK- G
LA QUINTA, CA 92253
LA
Contractor: CIj'FLA
GENERAL AIR CONDITI Kliy fyyEp
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343=7488,
Lic. No.: 686310
Date: 10/16/12
LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am license 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 Pro fess als 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 License No.: 686310
,
- for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate: l� C tractor. - -
k
'-
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
W -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier ZENITH INS CO Policy Number Z071741501
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for w ich this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
_ person in any manner so as to become subjec the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
` and agree that, if I should become subject to workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith co y with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by.
-
----------any-applicant-fora-permit-subjects-the-applicant to a -civil -penalty of -not -more -than five hundred dollars-($ 5001::------'
_
--D e:-�� t -G._ -_ - p"ant:- - --
(_ 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
Y
WARNING: FAILURE TO SECURE WORKERS' C�PENS ION COVERAGE IS UNLAWFUL, AND SHALL
' Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
• - - improvements are not intended or offered for sale. If, however, the building or improvement is sold within
-
SECTION 3706 OF THE'LABORCODE, INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
(_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application. • ,
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason '
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 inf tion is correct. I agree to comply with all
city and county ordinances and state laws relating to building const W n, and hereby authorize representatives
of this county to enter upon the above-mentioned property for insp ' n purposes.
6/ate: I gnature (Applicant or Agent): -
Applicatiori Number . . . . . 12-00001232
Permit . . . MECHANICAL
• Additional desc .
Permit Fee . . . . 40.50
Plan Check Fee
10.13
Issue Date
Valuation
0
Expiration Date 4/14/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -,OUT: INSTALL 4 TON COMPLETE
SYSTEM. 2010 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.Total10.13
.00 .00
10.13
Other Fee Total -1.00
.00 .00
1:.00
Grand Total 51.63
.00 .00
51.63
LQPERMIT -
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
54504 SHOAL CREEK La Quinta, CA 92253•
City of La Quinta
Oct 15, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF :
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
[3 EER
[3 Resistance
13 R g CZ 14-15)
(
154 sf
—�
installed)
E3 Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another, CF -1R -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AF'JE, 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.
® 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 oil 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
is
For Split Systems: Duct leakage,<"15 percent; RC, CCA _< 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage.;testing if R::
s❑ 1. Duct system was documentedto have been previously sealed and confirmed through HERS verification, or
,132Duct 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-twill, not be Duc'ted_(i �DuctlessYMini-Split System)=(Also Exempt fromlRefrigerant Charge)
❑ 2. New`.HVACSy'stem
Requ*r'ed Forms t ra .•
. Cut mfor Charigeout `with
� •� �
CF 6R forms MECH 04, MECH 20 HERS, and (for split systems) MECH-22 HERS,,.and
du tngcand(al1 new i
equipment)
p )
MECH 25HERS' `r'�{ :
CF -4R forms MECH 20,'and (for split systems) MECH=22, and MECH-25
Y,
"J,..'3' wt''%-+F.st w«[n.>,. j+rs" ?z+ .'t rz:!
For Split!Systems:`Duct leakage `<-6'percent - RQ CCA.2!.350 CFM/ton`,,FWD TMAH, STMS1 and either,HSPP or PSPP. w :^
For Pack" ae .Units: Duct leakage percent
,<`6
r..
13.3. New4Ducts with/or;without
Required Forms:
Replacements`'_,
. Includes.replacing or installing all new
ducting and/or outdo&icondensing,unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/6r•furna6e.,N6 or some
CF -4R forms: MECH-20 and (for split systems) MECH-25 .
equipment changed.
-
For Split Systems: Duct leakage°2 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 -61k forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF-41k1orms: 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: Danielle Garcia Signature: banielli Garcia
Company: HARRISON ENTERPRISES INC Date: Oct 15, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310 '
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0057548A-000000000-0000 Registration Date/Time: 2012/10/15 19:09:46 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
"ISI 11
City of La Quint'a
Building U Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
Buildin La Qulnta, CA 92253 - (760) 777-7012
g Permit A ppiica tion and Tracking Sheet
Project Address: Owner's Name: g
A. P. Number: Address: 54 S 014 5ftA(
Legal Description: City, ST, Zip:( c `''
, 1�
Contractor: ,y � ys=
Telephone: q �v"t >...",
Address:1w C 1Y-
-3Project Description: AW,
,)
City, ST, Zip:' y
ML�US)Y)4-7
SUS.
State Lic. # : 3� City Lic. #;C.�(j
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: _ s, � �, • �•� .�Y� wy.: ,
^i�"' ConshvctionType:
Occupancy:
State Lic.
Project type (circle one)- New Add'n Alter Repair Demo
Name of Contact Person: p L•(c .ems Z'Oec-t-5 zryu Sq. Ft : (5 #.Stories: #Units:
Telephone # of Contact Person "7& D l -b "7 4 $' Estimated-Vah;e f pr6j r.-.
- -
APPLICANT: DO NOT WRITE. BELOW THIS LINE
# Submittal Req'd Rec'.d TRACIUNG PERMIT FEES
Plan Sets - Plan Check submitted Item Amount
Structural Cales. Reviewed, ready for corrections Plan Check Deposit
Truss Calcs., Called Contact Person Plan Check Balance
Titre 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 Jrd Review,.ready for correctionsrssue Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
Pub. Wks. Appr Date of permit issue
School Fees
Total Permit Fees I
REQUEST FOR PROPOSAL
INSTALL POLYURETHANE FOAM ROOF SYSTEM
8 BUILDINGS (30 UNITS) _ --- - - –
Priori ,-_ _-----__ _--
4 S ., 1
Numbers•
55485, 467,.449, 431
Street
Phase
Units
Bldg Type
(0 0-0
80-575,
Southern Hills
17B
4
SM
587, 599, 611
Cherry Hills
11B
4
54-655,639,623,607
Riviera
17M
55-682,670,.6.58,646
Riviera
31B
4
SM
.,551070;.660
Riviera
35A
4.
9M—'
55-270, 258;_ 246, 234
Shoal Creek
37A
2
27M
14A
4
9M
54-732; 720, 708, 696
Shoal Creek
18A
q
24 �
54=516, 504, 492, 480
Shoal Creek
20A
9M
• �
q.
lOM
SCOPE OF WORK
Furnish all labor, materials, equipment and. services necessary for completion of
this document all roofing and related work as specified in
POLYURE=THANE FOAM ROOFING Vdrrff ACRYLIC AND GRANULES
1) All loose gravel; dust and residue shall be removed using power vacuum equipment, power sweeper,
air blowing or other suitable means.
2) Grind all loose paint from Z -bar metal, solvent wipe and prime with metal primer before application of
foam roofing. Install new Z -bar metal (will be identified at job walk) as needed and solvent wipe and
Prime with metal primer before application of foam roofing.
3) Remove two (2) courses of tile and cut 3" water blocks where slope meets flat roof areas.
4) All surfaces shall be primed with neoprime primer at the rate of not less than %a gallon.
feet prior to foam application. per. 100 square
5) Urethane foam shall be sprayed – applied to a minimum thickness of 1.5". Additional' foam shall be
aPPhed in Ponding areas to help disperse the staiiding water.
6) Coating shall be applied in a minimum of two (2) separate coats. Acrylic coating to be 55% solids.
a) The base coat shall be applied at a rate of 2.0 gallons per 100 square feet.
b) The topcoat shall be applied at the rate of 2.0 gallons per 100 square feet, with a combined
thickness of 32 total dry mils. Ceramic granules shall be embedded into the final coat while the
coating is wet