12-0149 (MECH)a
P.O. BOX 1504. VOICE (760) 777-7012•
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253' BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
- Date: 2/17/12
Application Number: ;1249
=000001Owner:
-,Property Address: W9265"TORONJA WESTCOTT JOHN' A
APN: 7727340-031- - 79265 TORONJA -
Application description: MECHANICAL, y LA` QUINTA, CA •92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application' valuation: 6685 Q
Contractor: .
Applicant: Architect or Engineer: GENERAL, AIR CONDITIO1 FEB
1.7
2012'
O12rY
31170 RESERVE DRIVE
+, THOUSAND PALMS, CA 9'2.7
.(76.0)343-7488 CITY OF A�UIN
i
Li&. No'.: 686310 Et3aP
=-
--------'-------- -- - - - -- --------- ------------------=---=----_--------------------------_----------
4 'LICENSED CONTRACTOR'S DECLARATION - - .. ' . WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - -
Section 7000) of Division 3 of the Business and.Pro ssionals Code, and my License is in full force and effect. _ I have and will maintain a certificate ouconsent to self-insure for workers' compensation, as provided
Li nse Class:. C20 _ License No.: -686310. for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
t r - - - issued.
Contractor: -.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
r O ER-BUILDER DECLARATION - - -insurance carrier and policy number are:
•� - I hereby'affirm unifier penalty of perjury that I am exempt from the-ContractoPs State LicenseLawfor 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 which this permit is issued, I shall not employ any I -
' • 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 be ubject to the workers' compensation laws of California, pe 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 b-come's ct to the workers' compensation provisions of Section
• License Law (Chapter 9 (commencing .with Section 7000).of Division 3 of the BusinessandProfessions Code) or - 3700 of the Labor Code, I shall fort et
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 for a permit. subjects the applicant to a civil penalty of 6.110
ot more than five hundred dollars ($5001.: ate: z 'a- bZ. plicant: -
1 1 I,. as owner of the property, or my employees with wages as their sole compensation, will do the work, and //pr'{/
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The ' WARNIN�I RE7 TO SECURE WORT S• C04PENSATION COVERAGE IS UNLAWFUL, AND SHALL '
Contractors' State License Law does not apply to an owner of property who builds or improves thereon; SUBJECT ANEMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or'her own employees, providedthatthe .' DOLLARS ($.100,000).- IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN _ -
--_ _ improvements are not intendedoroffered for sale. If, however; the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, 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.). - APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec: • 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.
i 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,
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 .
+ 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for. the performance of the • I certify that I have read this application and state that the above infor ti n is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - _ city and county, ordinances and state laws relating to building construe and hereby authorize representatives
• - - /Date.1:s7-
ter upon a above-mentioned property for inspecti urposes.Lender's Name: -% 1 3/ L Z S' atura (Applicant or Agentl: .
Lender's Address: - _ TT--
LQPERMIT - ...
i
- Application Number 12-00000149
Permit MECHANICAL
Additional-desc .
Permit Fee 40'.50
Plan Check Fee
10.13.
Issue Date
Valuation
0
Expiration Date 8/15/12 -
Qty' Unit Charge, Per
Extension
BASE -FEE
_15.00
1.00 9.0000 EA'- MECH
FURNACE 2=100K
9.00
1.00`-. •16.5000•EA MECH
B/C >3-15HP/>100K-.500KBTU
Special Notes and Comments
HVAC CHANGE -OUT. 2•TON SYSTEM•AT
GROUND
LEVEL.. 2,010 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
LQPERAIIT , • -
,.
- - -
I Simplified Prescriptive Certificate of Compliance: -2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:. Ta 6 n^ G
Enforcement Agency:
Date: Permit k:
2I�IIZ
Conditioned Floor
Equipment T et
List Minimum Efficiency 2
Duct insolation requirement
Area Thermostat
❑ Packaged Unit
[]Furnace
L�AFUE 84 �0
❑COPSetback
Over 40 ft of ducts added or
Vindoor Coil
ErVER 13
❑ HSPF
replaced in unconditioned space
❑ R 6 10-13)
Served by system (If not already
2r33, be
®'Condensing UnitEER
//
❑Resistance
(CZ
sf present, must
13Other I
❑ R 8 (CZ 14-15)
installed)
i. Cqurpmenr type: unoose the equipment oetng instatted; ty more than one system, use another CF -1 R-ALT-HVACjor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFjbr 0ypical 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 -611 and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
LM!ed. Beginning October 1, 201.0, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection.
1. HVAC Chan2eout Required Forms:
-All HVAC Equipment replaced 1CF-6R forms: MECH-04, MECH-2I-HERS and (for split.systems) MECH- .25 -HERS
j '.CF4R forms: MECH- 21 and (for split systems) MECH-25 w
• Condenser Coil and/or
• Indoor Coil and/or CF-611forms: 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 > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
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
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems) MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment 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 -611 forms: MECH-04, MECH-2I-HERS CF -411 forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems 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.
• 1 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 ' orrn tion documented on other Pplic ompliance forms, worksheets,
calculations, plans ands specifications submitted to the enforcement a enc fora ro al with t e permit application.
Name:It een Wo -;6's -m Si lure:Ajj_/ -,
Company: nn Date: —
P y: 4
G -ell -era. 1 r Gondt.�-.`Onr`
Address: License:
3070 P seroe int` �� /,3iv /
City/State/Zip:-��DG��SG � Pa,(— ►-S, G,} '2,2 -7� Phone: 760-3`f_ -�'7F9
Bin # - Cr 0� La ty QIunta
Building &r Safety .Muton
Permit P.O. Box 15.04, 78-495 Calle Tampico � La Qulnta, CA 92253 - (760): 777-7012
Building Permit-Application and Trad.1 S1�eet
Project Address: 'I q 2 k05. -�-� �� Owner's Name: ohn este
,
A. P. Number:
Address: '1 g 21p5 'rp r Q j� Gi
Legal Description:
City, ST, zip:
Contractor:
Telephone:
Project Description:
5 -- u. d�Or • i ` s�
Address:
City, ST, Zip: 7. �'7
-Telephone-76'6
state Lic. # :
s :. •.� •r:{Tfr y%Y% ..j .%
r.>` "tel "�ys?:i ✓�s.• .,
3 City Lic.
Arch., Engr., Designer:
Address:
tp , ST. 7ip..
'Construction
Telephone:.?'
State Lic. #:
�"'' �•
y��lfs,<i.�#"•`
Type: Occupancy:
Project type circle one Neww Add'nAfter Repair w Demo
Sq. FL: '283 3 #• Stories: # Units:
Name of Contact•Person:
�p (,(;' e-dl
Telephone # of Contact Person: —7&0 31-1-6 % � �' $ Estimated Value of Project: U �Q O J • VV
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Recd
TRACING
Plan Checksubmitted
PERMIT FEES
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
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:-
7rd 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