11-0885 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
117-00000888` __
Property Address: _'-79850-TANGELO-__
-79850-TANGELO---
APN
APN:
772-230-012- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1000
Applicant:
If, il4t 4
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT '
Owner:
KNUTSON
7985.0 TANGELO
LA.QUINTA, CA 92253
Contractor:
BEST IN THE WEST I �J
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 8/17/11
255 N. EL CIELO, 140-125gg 1� �
f
PALM SPRINGS, .CA 92262 f ��e 2�1�
�•� 1/ ^ (760)343-1002 P LiC. No.: 826714 l-j'�'(��;t� 4UjN
--------------------------------------------------------------------------------- -------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I ansa under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Busines nd fessio als Code, and my License is in.full force and effect.
License s: C20 -C38 License No.: 826714
ate: ^ f 7tractor:
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 nwner 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.).
I—) I am exempt under Sec. , BAP.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'sName:
Lender's Address: k
LQPERMIT
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.
Xhave 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 STATE FUND Policy Number 1932774-2010
_ I certify that, in the performance of t ork for which this permit is issued, I shall not employ any
person in any manner so as t ec u ) ct to the workers' compensation laws of California,
and agree that, if I should b e s ' t t the workers' compensation provisions of Section
�f( 3700 of the Labor Cod i h omply with those provisions.
crate: CJcant:
WARNING:- FAIL ETU SECURE W RKERS' 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 isnot 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 abo ' for ' n is correct. I agree to comply with all
city and county ordinances and state laws relating to build' c t n, nd hereby authorize representatives
oft
is nty to enter upon the above-mentioned propert insp pu poses.
Date: (L-ntF LL nature (Applicant or Agent):
Application Number . . . . . 11-00000885
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 21.50
Plan Check Fee
5.38
Issue Date
Valuation
0
Expiration Date _ 2/13/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.5000 EA MECH OTHER
MECH EQUIPMENT
=------------------------------
6.50
---------------------------------------------
Special Notes „and Comments -
REPLACE EVAP COIL ATOP FURNACE IN
_
CLOSET. 2010 CODES.
-----------------_--------------------------------------------------
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1.00 `
Fee summary Charged Paid
Credited
Due
Permit Fee Total 21.50
.00 .00.
21.50
Plan Check Total 5.38
.00 .00
5.38
Other Fee Total 1.00
.00 .00
1.00
Grand Total- 27.88
.00 .00
27:88
mplified Presc
Reg: 211-A0042258A-00000000-0000 Registration. Date/Time: 2011/08/17 13:28:07 HERS Provider; Ca10ERTS, Inc -
2008 Residential Compliance Forms July 2010
rip we Certificate of Compliance; 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15 '
Site Address: Enforcement Agency:
79850 Tangelo La Quinta, CA 92253 City La
Date:
Permit #:
of Quinta ,
Aug 17, 2011
Equipment Typel
List Minimum Efficiency2
Dud insulation
requirement
Conditioned Floor+,
Area
Thermostat
L] Package Unit
❑ Furnace..
+ii Indoor Coil
S3 AFUE '❑ C04
❑ SEER p HSPF
❑ R 6 (CZ 10-13)
Served by system
t '
Setback
❑ Condensing Unit
[],EER ❑Resistance
❑ R 8 (CZ 14-15)'
2000 sf
If not already present, must be
❑ Other
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system; use another CF•IR-ALT-ph for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 789/. 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: -verifies
At final, the inspector that the work listed on this
form was in fact the work completed by the installer_ The inspector also verifies that each appcopriate'CF-6R and registered CF
forms
-4R
(no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy ofthe CF -111
a nd CF -6R shall also, be on site for final inspection.
L� 1. HVAC Changeout Required. Forms:
. All HVAC Equipment CF -6R forms: MECH-04, MECH=21-HERS and (for split systems) MECH-25-HERS
replaced r
. CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or CF -6R forms: MECH-04, MECH-21-HERS and fors lits stems MECH-25-HERS
.Indoor Coil and /or � ( split y )
. Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage;:<:15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Row Requirement), TMAH
lser. Packaged unit. -r, s` I al og�` zr--pe
r�rrr
Exempted from duct leakage testing:>if:
.❑ 1. -Duct system was documehfed to have been previously sealed -and confirmed through HERS verification,
or
❑ 2• Duct systems with less than'40 linear feet in unconditioned space, orEj ,
3. Existing duct systems are constructed, insulated or sealed with asbestos
[].4. The system will not be Ducted(ie ess DuctlM#ni. Split. Syrstem) Also Exempt from Refrigerant Charge)
❑ 2. New IiVAC System Required Formss k L w
3
• Cut in or�Changeout with±` a , c
..' ..F'.r::
new ducts :(all new GF 6R forms MECH-04, MECE1` 20. HERS�artd} (mar=split systeri►s) MECH 2THERS and MECH 25 -HERS
ducting a:nd all new. f; CF -41 forms `MECH-22ard
x M11ECH 20 and�(for'sptt systems MECH»2.5. ::.:• N` xe`z
}f °r
t]t. ...._..,.r°::: -._... a... :..... .r >, •;.::. :ter._ :. N. a-.. - •t;' » <- N,tz;': t�'rd„::;;';;:;;<`•;,i':
�... ....... ......... ....: -..v ...... .-
... ...�,..... ..2 .. ..<�. - .J_ .. > .....:....?...
:. ,.
For Split Systems ' Duct.le`alcage o pereerir RC, CCA�> 35g CFP1/tah FIh1D TMAH Silvis and',either hISPP or PSPP
For Packa ed'tlnits: Duct leaka e.'_<:.;6> ercent< '"
03. - New Duets=:with/or
Required Forms: ,
Replacement:-
. Includes replacing or installing all'.new ducting
and/or outdoor condensirigit:iaTrtrjvr indVW
Cf-b7tivrms•. 10E ."-004, 9diiCri-20�r5ER5, and (fw split systems) MECH-25=HERS
coil and/or furnace. No or-some'e
: quipment
changed.
CF -4R forms: MECH-20 and (for_ split systems) MECH-25
-
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 feetRequired
Forms:
. Includes adding or replacing more than 40
CF -6111 forms: MECH-04, MECH-2I-HERS -
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21 {
For split system or Packaged units: Uuc Seakage < 1s WvU%*,
i.❑ 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. 1
. 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.
e The design features identified on this Certificate of Complianoe 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: Wendy Stewart Signature: Wendy Stewart
Company: BEST IN THE WEST
Date: Aug 17, 2011
Address: 1188 ADOBE WAY
License: 826714
City/State/Zip: PALM SPRINGS / CA / 92262
Phone: (760) 343-1002
Reg: 211-A0042258A-00000000-0000 Registration. Date/Time: 2011/08/17 13:28:07 HERS Provider; Ca10ERTS, Inc -
2008 Residential Compliance Forms July 2010
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
0
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: /yq-,4— ZZ�3
Contractor: /x 1 R &P -J
Tele honer7/Z O - Z-
4
Address: 2�,
Project Description:
City, ST, Zip: 1,44
Telephone:`? �"�OvZx�
State Lic. # : 9'Z6-7/(/1
City Lie. #:
Ar ., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Perso .-i
Sq. Ft.:#
Stories:��,�o
# Units:
Telephone # of Contact Person: %& C)Jf 3— / OU Z
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Cheek Balance
Energy Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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