12-1313 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO_
LA QUINTA, CALIFORNIA 92253
Application Number: f --'12--00001313
Property Address: _-78329 TERRA COTTA CT
APN: 604-022-015- - -
Application description: MECHANICAL
Property Zoning: •LOW DENSITY RESIDENTIAL,
Application valuation: 5820
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LY,,TULIE
78329 TERRA COTTA COURT
LA QUINTA, CA 92253
r
VOICE (760) 777-12
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153 .
Date: 11/05/12
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
[,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 of improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ I 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
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 statAtheab
rmation is correct. I agree to comply with all
city -and county ordinances and state laws relatinction he y aut rize representatives
of�ttis county to enter uponth above-mentionedti pur DDate�%--Sign re (Applicant or Age
Contractor:
Applicant: Architect or Engineer:
PREFERRED PLUMBING HTG A/C [rte
P.O. BOX 5120
PALM SPRINGS, CA 92263
05
r
(760),322.-3173 2011
.
Lic. No.: 457554
Ciryo
FS UT
�cE QAlTq
DOPY.
----'---------------------------------------------------------------------------------------------
" LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that 1 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 d 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
Lice se Class: C10 C16 C2 i nse o. 45755 ,
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�3— ontractor:' -
� issued.
P"'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 ER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am a pt from the Contractor's State License Law for the
Carrier EVEREST NATL Policy Number 7600006445121
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
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant wthe provisions of the Contractor's State
and agree that, if I should come subject to the worker 'com ensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the L bor Cod shall forthwith com it t se rovisions.
- that -he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7631.5 by _
_
.any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate:�A icant:.
1 _ 1 1; 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
WARNING: FAILU E TO SE RE WORKERS' COQ ENS TION 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 A IVIL 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 3766 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.).,
( 1
[,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 of improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ I 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
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 statAtheab
rmation is correct. I agree to comply with all
city -and county ordinances and state laws relatinction he y aut rize representatives
of�ttis county to enter uponth above-mentionedti pur DDate�%--Sign re (Applicant or Age
LQPERMIT
Application Number . . . . . 12-00001313
Permit MECHANICAL
Additional desc .
Permit Fee . . 40.50
Plan Check Fee
10.13
Issue Date . . . .
Valuation
0
Expiration Date 5/04/13
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: REPLACE CONDENSER & AIR
HANDLER 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 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
Shri lified Prescriptive Certificate -of Com fiance: 2005 Residential HVA CAlteradons . CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
32 TEEP-A 601TA C -F
En orcement Agency:
MjMIA
Date:
z6iz
Permit #:
Conditioned Floor
E ui ment Type
List Minimum Efficienc. 2
Duct insulation requirement
Area
Thermostat
❑aged Unit
uroace
❑ AFUE_
❑ COP
Over'40 ft'of ducts added or
etback
❑ Indoor Coil
Zi!SnR 15
❑ HSPl
replaced in unconditioned space
❑ R 6 10-13)
'Served by system
7 3
(If not already
be
Condensing Unit
Z?V-ER I
❑.Resistance
(CZ
sf
present, must
❑ Other
❑ R 8 (CZ 14-15)
installed)
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%o 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
si Beginning October 1 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final ins ection.
1. HVAC Changeout
required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and/or
• Indoor Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/tori(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 ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut s: Changeout with new
ducts: (all
l new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
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:
o 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 CF4R 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.
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
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.
• I certify that the energy features and performance specifications for the design identified on this Cgrtificate of Complia4conrm to the requirements of Title 24,
Parts I and 6 of the California Code of Regulations.The
design features identified on this Certificate of Compliance are consistent with the inform on documentedonothle compliance forms, w s eets,
calculationsplans and specifications submitted to the enforcement agency for approval withermi ' ti .
Name: Te F: r-7 Q FM 5
Signature:
Company-�
c�
Date:. .I I,// 120f2_
Address:
S- Z C�
License:
'-�� -7 5 5--F
City/State/Zip: NGS n f� 1 _
Phone: '-+60 r ZZ - 3 ( 7
Big #
Cl/ of La QU'inta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Proj'et Addiess:".,,.`:.;:
Owner`s Name:
A. P. Number*... _.. `. ,,.`;: .:. ' :
Address:
tegal-Decziptiggi ? -3ti
City, ST, Zip: L/3 QC/,AIT c� �ao�S 3
ppre'€'fir ed A r dh'ditioriing db
Contractor.. ' ° T � �.;•. ;rs':.' `
:P>'e'ferr:e:: U, m-: Heatin &Ai
Addiess; }?Q::'B'Os.`.`5;?`Q.`
Telephone•
Project Description: e
City, ST:ZiPPam.pgs;::;CA, 9226
Ga'� Co5 /�HID
Telephone:.(!.7.6::)=x,32;=31`73..i2
State 16C
City Lic..#:
Arch,; Eigr: Designer :,..
Address:
City,.STT:
Telephone;..;
State,Lip # _ _ _ <.
Conslriietion Type: Occupancy:
Project type (circle one): New Ad&n Alter Repair Demo
Name of:, pip P_ - .L is r iyQ ytr�
Sq: Ft:
#Stories:
#Units:
Telepboi�e-'#>'oi wCQ itaerEersou . j�.Q j�a 3/ %.3
Estimaied Value of Project: ,S��p2
r; ;;. •.
APPLICANT: DO NOT WRITE BELOW THIS LINE
# .
$nbpitttal ; ::::i.,. • `-' ,::Reg'd:. . Beed TRACKING,,
PERMI<T FEES
YIan,S�ts::°<::
Plan Checkl;ellmltted
IteAmount
Stroetural'Cal�s..
Reviewed, ready for corrections
Plar Check Deposit
Tru s Calcs..',..... •
Called Contact Person
Flat Check Balance
E4ergy Cabs.'
Plans Dicked up
colAtruction
01ood,platn plaq%
Plans.resubmitted
M6C isinical
Grad[ng plan' ':.. .
2"d Review, ready for'correetionsrssue
EIe cal
,Su6eontactor.Itst
Called ContactPergon
No btng
Grant Decd .
Plans picked up
S.M
H.O,A Approval
Plans resubmitted
Gra ling
Review, ready for corrections/issue
Developer Impact Fee
Plannl.qg Apprbval:
Called Contact Person
p.
Pub. Wks. Appr '
Date of permit issue
Sebool Fens '
Tot YermltFees
r
city-of'a uin a
-495
78CALLE TAMPICO
LA*QUINTA, CALIFORNIA'
(760)-777-7012 {FAX] (760) 777-7011:
INSPECTION RECORD
Permit* 9808=002
STRUCTURAL RETROFIT OF UNIT
ADDRESS
DATE.
INSPECTION
[YES/NO]
78 - 52% _79. 4A
11-5-99
FRAMING/HARDWARE
PLAN TYPE:
/-,ter - 98
INSULATION
V/,/-
/LSHEAR
Contractor.
WERMERS MULTI -FAMILY CORP.'
SHEARNAILING
/- /Q - 9B
DRYWALL
mrZ ,(Q •.�
/2-/1- 98IOB
FINAL
,
COMMENTS/NOTES:
�4•) �QoF .&A,o1,e.5 6�,0,/ c 7-"=Z) to 98 4.,;r .
4)
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253