10-1037 (MECH)P.O. BOX 1504 TVOICE ( 760) 777-7012
1
.78-495 CALLE TAMPICO FAX (760) 777=7011
LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT - INSPECTIONS (760) 777-7153
_
BUILDING PERMIT,
I _
. f BU M1 � -
_ Date: 10/05 /10
Application Number: /10=00001037] + Owner:
Property Address: C 78533-TORINO"DR _ AVERETT JERRY
APN: 609-5517005-9 -28458 - - 78533 TORINO DRIVE
-` Application description: MECHANICAL LA..QUINTA, CA, 92253 ? O
• Property Zoning: LOW DENSITY RESIDENTIAL (760) 200-2396 S
Application Valuation: 9380 NT O J 2G10
Contractor:
Applicant: Architect r Engineer: ESSER AIR CONDITIONING & • TG CITY OF LAQUINTA
P.O.' BOX 1636 'CE DEPT
CATHEDRAL CITY, CA 92235' '
(760)324-_0550
y:• Lic. No: 489046
-' • LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty of perjury that'l am licensed under provisions of Chapter 9 (commencingwithI hereby affirm under penally of perjury one of the following declarations: • "
Section 7000) of Division 3 of the Bud nd rofessionals 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: 20 nse No.: 489046' - - �1 • for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - • '
I issued.
'Date: ✓ 1 b Contractor: v/ - j _ 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
t - 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 STATE FUND Policy Number 1891568-2010.
- following reason (Sec.,7031.5, Business and Professions Code: Any city or county that requires a permit.tos_ 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 tothe workers' compensation, provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the labor e, I shall for with comply with those provisions.
r that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by �����,d/��ti1\) EEE1PPPhhhA 11t
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: Date: 7 (V' Applicant: — `• / VY -
t (_ I 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: 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 'of fer6d for sale. If, however, -the building or improvement'is sold within' SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.—
one year ofcompletion, the owner builder will have the burden of proving that he or she did not build.or - - - -
impiove for -the purpose of sale.). t• APPLICANT ACKNOWLEDGEMENT
1—) 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. - ' . r 1. 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,
(= 1 1 am exempt under Sec. , B.&P.C. for this reason. - t' - 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
• - .r performed under or following issuance of this permit. - -
' Date: - Owner: A ' ' 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
tr• + •-
-4- _ - CONSTRUCTION LENDING AGENCY - - - - permit to cancellation. - - - - • - - � _ *' - -
' r 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. al�gree to comply with all•
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to b ding ons r ction, and here authorize representatives -
' - - .of this county o enter upon the above-mentioned pr e�r m ti�,
Lender's Name: ' -
�� ` Imo`
• . � Date: � Signature (Applicant or'AgentY:'
Lender's Address:
LQPERHIIT
Application Number 1.10-00001037
-
` r •�
Permit MECHANICAL.
4 desc-
.0
.. .mss r —. - —Additional M
+ =.� = �•
Permit Fee '. 40.50 Plan Check Fee
10.13
4 Issue Date 'Valuation
0:
• Expiration Date— 4/03/11
� ~
• Qty- Unit,Charge .Per P
Extension
-� BASE FEE *
15.00.
11.00 ; 9.0000 EA MECH%FURNACE <=100K`
<
9."00•
• 1.00, 16:5000 EA MECH*B/C >3-15HP/>f00K-50.0KBTU'•
,.
16.50*•
Special Notes and.Comments • • �•
�^ INSTALL. NEW .5 .TON 16 SEER A/( �'V HEATING '
SYSTEM' TO REPLACE OLD SYSTEM IN SAME
,w'
'LOCATION 2007.CODES. -
••
----------------- - - - - - --- - - - - - - - - - - - - - - - -.- - - - - - - - - - - - - - ------------------------
♦ ' •,
.-
Other Fees. BLDG STDS.'ADMIN (SBi473)`
11.00 '.
Fee summary Charged Paid Credited :
----------
Due
------------------------------------- -----y ---
Permit Fee Total •- 40-.50 . 00• 00._-
4,0 .50
Plan Check' Total' 10213, 00 00
10.•13 "•
} Other Fee Total,, 1:00 .00 .00
`.51.63
1.00.
Grand - Total v .00 00"
51.63
- ,. { _ .•• � ' F • • • * -
1, i �-
. LQPERMIT • i .' .. - -
Sim lifted Prescriptive Certificate of Compliance: 2005 Residential HVACAIterations CF-IR-ALT-HVAIC
Climate Zones 10 to 15
2008 Residential Compliance Forms March 2010
Site Address:
Enforcement Agency:
Date:
Permit #: ,
Equipment Type'
List Minimum Efficient
Duct insulation requirement
Conditioned Floor
Area
Thermostat
Packaged Unit
® Furnace
J-AFUE b'J
® cop
Over 40 ft of ducts added or
Setback
Indoor Coil
Condensing Unit
JOSEER TT
EER_
HSPF _
laced in unconditioned space
R 6 (CZ 10-13)
ffR
d by
Served system(/f
z�6d sf
not already
present, must be
Mother
_
Resistance
8 (CZ 14-15)
installed
I. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER,.78% AFUE, 7.7HSPFfor 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 CFAR forms (no hand filled CFARs allowed) are filled out and
signed. Beginning October 1, 2010 a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF-61kforms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lit stems MECH-25
• Condenser Coil and/or
• Indoor Coil and/or
CF -6R forms:. MECH-2I -HERS and (for split systems) MECH- 25 -HERS
--..• ane_.. .__......
CFAR 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
E32. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all 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:
• 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 CFAR forms: MECH-20 and (for split systems) MECH-25
coil and/or firrnace. 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 mole than 40
linear feet of duct in unconditioned s ace.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
For splits stem 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 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 informa ' umented on other applicable compliance forms, worksheets,
calculations plans andspecifications submitted to the enforcement agency for approval with e t li
Name: DAVID WILLIAMS
Signature:
Company:
ESSER SERVICES INC.
Date:
Address:
P.O.BOX 1636
License:
489046
City/State/Zip: CATHEDRAL CITY,CA. 92235760
Phone:
124 nr%qn
2008 Residential Compliance Forms March 2010
r
Bin # Oty of La Quinta
Building &r Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: TY5 33 l7 (llv �1VL'� Owner's Name:
A P. Number Address:
Legal Description: City, ST, Zip: �,¢ v a',/} l 2 270
Contractor: S= P VIDES Inl C . Telenhane- 740_ L90. 7-1 G, /xs w
Address:. P z?. ZvX X63 6
Project Deseri tion: � - /7r.
City,ST,Zip: CA-%HrDRqL C1 -Ty
0,4, c11235~
Sz 1 I -AC— CS&r,A)4.5 c`mow(
Telephone: ( . 3'L 4. � ° .SO
7 a
�. 's , %�
-��
O S c.'f 1A) !�tlry
State Lic. # : y 8 `l o?t 6
city tic. c .
�r a �✓
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
w n
Construction Type: Occupancy:
State Lic. #:
AA��55 t "
Project type (circle one): New. Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person: DAVID .W i t-"I'4Ivi,5
Telephone # of Contact Person: 76 d 5-5-0
Estimated Value of Project: 3 fSV
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for.corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plaa Check Balance
Title 24 Cales.
Plans picked up
Coastrnctioe
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctiousrlssue
Electrical
Subcontactor Ust
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval Plans resubmitted Grading
IN HOUSE:- Review, ready for correctionsrL%uc Developer Impact Fee
Planning Approval Called Contact Person A.LP.P.
Pub. Wks. Appr Date of permit issue
School Fees;
0
Total Permit Fees