10-0397 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,.CALIFORNIA 92253
Application Number:
10-00000397'
Property Address:
50425 SPYGLASS HILL DR,
APN:_
770-060-015-85 -25389 -
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
9800
Applicant !^ ^ Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
WALSH MARCY
50425 SPYGLASS HILL ROAD
LA QUINTA,•CA 92253
(760)564-1891
LICENSE NTRACTOR'S DECLARATION -
I hereby affirm under penalty of p r t it I a i n d under provisions of Chapter 9 (commencing with
Section70 01 of Division 3 of th Bus an Pr fe rsionals Co e, and my License is in full force and effect. '
License
6 ss C20 ice o.: 595145
Date: S 12
-0/0
Contractor: /
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 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 .
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.).
( 1 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.).
( 1 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's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 5/05/10
Contractor.: _......... -
DCS HEATING/AIR CONDITOINC
72078 CORPORATE WAY, #10
THOUSAND PALMS, CA 9227
(760)343-5566 M 0 5 2010
Lic. No.: 595145
CITY OF LA 46I TTA
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
1 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.
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
'insurance carrier and policy number are:
Carrier HARTFORD INS Policy Number 72WECLS7131
_ I certify that, in the performance of th ork for which this permit is issued, I shall not employ any
Person in any manner so as to b ome ubject to the workers' compensation laws of California,
and agree that, if sh beco e s j ct to the orkers' compensation provisions of Section
3700 of the Labo h fort th compl those provisions.
Date: 5 IO Applicant:
WARNING: FAILURE TO, SECURE WORKERS' 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 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 h ve read this application and state at abov nfor tion is correct. I agree to comply with all
city and c unt ordinances and state laws relati to mg c nstr n, and her authorize representatives
of this co my /o enter upon the above-mentioned p y o nspe ti purpose
Date: / D. Signature (Applicant or Age t): I
Application Number . . -10-00000397
Permit MECHANICAL
Additional desc .
Permit Fee 31.50 Plan Check Fee 7.88
Issue Date Valuation . . 0
Expiration Date 11/01/10
Qty Unit Charge. Per Extension
BASE FEE 15.00
1.00 16.5000 'EA MECH B/C >3-15HP/>100K-500KBTU 16.50
------------ -- ------------------------------------=---=-------------
Special Notes and Comments
REPLACEMENT OF HVAC EQUIPMENT 5-TON 16
-- - -- ----- -- :._..— -- — - -- --- --SEER"13-'EER""COMPLETE"-80s
o _............ ........ _ ....-......... _ ......._ _ ._.. _.. - ...:.... .... -.._ .. .
------------
Other Fees BLDG STDS ADMIN .(SB1473) 1.00.
Fee summary Charged Paid Credited Due
Permit'Fee Total. 31.50 .00 .00 31.50
Plan Check Total 7.88 .00 .00 7.88
Other Fee Total 1.00 .00 .00 1.00
Grand Total 40.38 .00 .00 40.38
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -
Climate Zones 10 to 15
Site Address: t;
v
+
l
Enforcement Agency:
Dates' 6 2t , /�
Permit #:
—Equipment T e'
List Minimum Efficiency Z
Duct insulation requirement
Condhio ed Floor
Area
f
Thermostat
❑ Packaged Unit
FF mac
p
FUE 0b o o
❑ COP
Over 40 ft of ducts added or
replaced in unconditioned space
S, s stem
R<etback
7� Indoor Coil
SEER 110
❑ HSPF _
p p
❑ R 6 (CZ 10- 13)
g (y
(/f not already
be
lis? Condensing Unit
EER
❑Resistance
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% 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
instal r. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF -411s allowed) are filled out and
_496d. Beginning October 1, 2010,1a registered cop 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' -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/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 ducts stems are constructed, insulated or sealed with asbestos
❑ 2. 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-25-14ERS
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 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
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.
• 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 I and 6 of the Cal ifomia Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the infqRationAqcomented on other applicable compliance forms, worksheets,
c lations, pl and cifications submitted to the enforcement a enc for approval N6th le pp"t1appliciltion.
Name:
'
Signature
Company: �� ��n„ 3 `� 1
J`
Date:., 2p0
Address: S+1
License: L�
V�
City/State/Zip:jj�AlI l 1,PPhone: IM
2008 Residential Compliance Forms March 2010
Bin #
City of La Quinta
Building 8L Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application 4nd Tracking Sheet
Permit #P.O.
Project Address S� 5 �� I
Owner's Name: RM
MW
A. P. Number: U
Address:
Legal Description:
City, ST, Zi
Contractor:
Y
Telephon % D
Address` O
Project Description:
.'
City, ST, Zip__kW0,\W
VIO 1A
, ` v I QWJA
Telephone 5
5l� �
State Lic. # :
City Lic. #..
OLo'kFac_
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Con
Construction Type: k_j Occupancy:
State Lic. #:
Project le one):: New, Add n
` Alter
type circRepair Dem o
Name of Contact PersonSq.
Ft.: O
# Stories:
#Units: I
Telephone # of Contact Perso •
Estimated Value of Project:
I
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 Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
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:-
'"' 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