13-0502 (MECH)ll:t:iii� 414
P.O. BOX 1504 1 VOICE (7 60) 777-7012
78495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT �J INSPECTIONS (760) 777-7153
- BUILDING PERMIT -
_ Date: 4/22/13
Application Number_: 13-00000502 - Owner:
Property Address: 7.9435 "TORONJA STUBBS TERRY J
APN: 772-340-047- - 7225 W STANFORD AVE
Application description: MECHANICAL COLUMBINE•VALLEY, CO 80123 e
Property Zoning: LOW DENSITY RESIDENTIAL D
Application valuation: 8200
Contractor: APR 422-2013
Applicant: Architect or Engineer: GENERAL AIR CONDITIONING
.31170 RESERVE,DRIVE
CITY OFLAQIJINTA
THOUSAND PALMS; CA 92276 �INA,NC�nPT,
(760)343-7488
Lio. No.: 686310
-----------------------------------------
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 ' / LicenseNo.: 686310 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�� issued.
Date:' 13 Contractor: �• - - •^ - +••Z,�� _ 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 workerscompensation
(/J{ OWNER-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 Z071741502
following reason ISec.. 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
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 subject to 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 1 should become subject to the 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' comply 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 not more than five hundred dollars ($5001.: ,,"Date:f .-Applicant-. Sd�2
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and '
the structure is not intendedoroffered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 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 (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 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 information 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 construction; and hereby authorize representatives .
_ of this county to enter upon the above-mentioned property for inspection purposes.
Name:
-
'Lender's Ne _
• - - * Date:�'4 Q; Signature (Applicant or Agent):
Lender's Address:r
e
LQPERMIT
Application Number 13-00000502
Permit . . MECHANICAL
.
Additional desc ..
_
-- Permit"Fee :. 70.00 - Plan Check Fee
17.50
Issue Date Valuation
0
Expiration Date 10/19/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 11.0000 EA MECH FURNACE >100K
22.00
2.00.. 16:5000 EA MECH B/C >3-15HP/>100K-500KBTU
33.00
Special Notes and Comments-
ommentsHVAC
HVACCHANGE -OUT (2) UNITS - (1) 3 TON
UNIT,. (1) 3:5 TON -UNIT (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 70.,00 .00 00
70.0.0.
P1an.Check Total 17.50 00 00
,17.50,
Other Fee Total 1.00 00-' .00
.1.00
Grand Total 88.50 .00. .00
88.50
" LQPERMIT •.
Bin. #
City of La Quinta
Budding 8t Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet
Permit # /n
GJI�/
Project Address: '7. ci y 35 F Opp c
Owner's Name:. Pic' S� ibb S.
A P. Number.
Address: 'Gy 35 1.Or 'C-
7
Legal Description:
Contractor.
City, ST, Zip: f_c. iY� a CA q�53
(, Telephone:-�0- -7 7')- g,qv 3
Address: i
Project Description:
City, ST, Zip: Jho V5C,Y\ r~, Ci 2.Z'7�.
Telephone: 7(00. -3g3 -7y $b'.:
State Lic. # : (o $ 6 3 i() City L9c. C
Arch, Engr., Designer.
e 1GGGi i 3.S} r
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Univ
Telephone # of Contact Person: Estimated Value of Project: g Zoo
APPLICANT: DO NOT WRITE BELOW THIS UNE
N Submittal Req'd 'R=,d TRACKIIVG PERMrFnES
Plpn Sets
Plan Cheek submitted Item Amount
Structural Calcs
Reviewed, ready for corrections Plan Check Deposit, .
Truss Cala.
Called Contact Person Pian Check Balance
Title 24 Calm
Plans picked up Construction
Flood Plato plan
Plaus resubmitted.'. Mechanical
Grading plan
2" Review, ready for correctioasliissue Electrical
Subcontactor list
Called Contact Person Plumbing
Grant Deed
Plana picked up
H.O.A. Approval
Plans resubmitted Grading
IN ROUSE:-
''a Review; ready for correetionslissae Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr -
Date of permit issue
School Fees
,
Total Permit Fees
4
Simplified. Prescriptive Certificate -of Compliance:, 200.8 Residential HVAC'Alteiations- ` , CF, -IR -ALT -HVAC
Climate Zones 10 15 - z
Site Address:
Enforcement Agency: r - Date:Permit.#:
,-
79435 TORON]A'La.Quinta, CA.92253_ - _
City of La Quints.', .. Apr 18, 2013; .
Equipment Type1
List Minimum Efficiency2
-Duct insulation •
`- requirement;'-
Conditioned Floor
Area
ThermostitV
.
.
Q Package Unit • ,
"
*, -
z'
3 Ti,
❑Furnace . <
0 Indoor Coil
p AFUE
® SEER 413.0
p COP
p HSPF .If
p R,6 '(CZ 10=13)
Served by system
`'
® Setback, r - `
not already present;' must tie
,.
8 Condensing Unit
0 EER+.
p Resistance
0 R 8 (CZ -14-15)
1416 sf • '
installed) ' i
p Other
,.
1. Equipment Type: Choose the equipment being installed; if more than one system, use. another CF IR -ALT -HVAC for each system. - ?_S• ,
I
2. Minimum Equipment Efflciencies:.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'CF41t
and CF -6R shall also be on site for final inspection. ` I- - {
8 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -611 forms: MECH-04,-MECH-21-HERS and (forsplit systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25,...,..
Condenser Coil and /or
CF -6R forrrrs: MECH-04, MECH-2I-HERS and (for split systems)•MECH-25-HERS
.Indoor Coil and /or
CF -4R forms: MECH-21 and (for split stems) MECH-25 , r .
sy
,.Furnace
For Split Systems: Duct leakage_< IS -percent; RC, CCA <_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH .. �•
:rte
Exempted from duct.leal'age.teshgn
p 1;1DucIsystem'Was documented to have been previously sealed and confirmed through:HERS verification,_or •
ti ,
p2; Duct systems with less than 401inear feet in unconditionedspace°or
::...
0-3. Existing duct systems are constructed, insulated or sealed with asbestos .
The. ystemn ill not be Ducted (Ie: D etless lmi,Sptit,Systerrr)g,{Als Exempt{#Foto Refrdgerant barge)
Re fired>:F r.•tiis: n= ":<€`': ,
O 2. iHev�-k1V 1C System qy. ...,. �:' �r;r;:::. •. _ �s,�..
. Cut m dt .GhangeouI wrth :, .:_: "; `.... ::: :. tic., '>:.:. :::.. _
:;' CF 6 farmsl�IECH-04, Nt!~Ck-4T=F1ER5, nd. (iar_spTif sys ears) MECtf. 7Z: ERS;:and
::.: . :.>..
�new dcts . (all new-
CM_ ERSx=:..
duct+:rlg�a,�d alFnew....:;>:_::.,
.a.., . - ' �F-�iZ for s;. MECH-30,.an`�(f�r. trt�s, ir�s),MECH 2 ani MEGFf=ZS . c�•-.:;;...
For Split. -Sy s>letqu
iis ' 3crct IeaYc;'i e O5 7 M � `tt
9 percent, RC„CA 350 CFM/L'o_FSfdDYNCAH, 5fi1N5; aril ejther 157P'or P5PP
r
For Packaged U6ts:;Duct leakage < 6 percent:::'::.'.'::':.:.:
13 3.: New Dgctswrith/or withoat:::::.• •
Required Forms: r
Re
. includes replacing'or installing S'ff-hew
, •, . '
ducting and/or outdoor'conden5iiig::'unit
CF -6R forms:,MECH-04, MECH-20-HERS, and,(for split systems)'MECH-25-HERS'
and/or indoor coil and/oe furnac"a or some
CF -4R forms_ MECH-20 and (for split systems) MECH-25 c:•
.equipment changed.
For Split Systems: Duct leaka9e < 6 percent; RC; CCA 2:'300 CFM/ton, TMAH +. t - . R y, `•'
For Packaged Units: Duct leakage < 6• percent ' • - ” ,` ,,. ,
E3 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 . a
' 3 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 perforrnance specifications for the design.identifed on this Certificate of Compliance'eonforrn to the'
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations:
. The design features identified onthis 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,perrnit application. ;
Name::Danielle Garcia a: Signature' Danielle Garcia
Company: HARRISON ENTERPRISES•INC a + Date: Apr 18, 2013 i r
Address:.31-170 RESERVE DRIVE STE A, _ -, + ..; License: 686310
City/State/Zip: THOUSAND PALMS/, CA / 92276, .t_ '+ - - ., / : Phone: (760),343-7488!
Reg: ,213=A0023184A-000000000-0000 Registration Date/Time: 2013/04/18 17:34:24 • HERS Provider: Ca10ERTS, Inc. -
2008 Residential Compliance Forma t' { , r - 'July 2010