13-0024 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA— 92253
Application Number:
tY3=000060 4 -
Property Address:
7B'SVO—SPYGLASS
APN:
770-060-001-71
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY
Application valuation:
7500
Ap/plicant:
�v
^� 4
VOICE (760) 777-7012
_ FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT INSPECTIONS (760) 777-7153
Date: 1/07/13
Owner:
HILL DR PLOTE DON
-25389,- 78840 SPYGLASS HILL DR
LA QUINTA, CA 92253
RES (760)771-511
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Lic-e+nsse Class: C20 raw Lic a No.: 686310
Date: fi-7-�3
Convector.
-BUILD RATION
I hereby affirm under penalty of perjury th exempt from a Contrac 'l State License Law for the
following reason (Sec. 7031 .5, Business rd 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 Codel 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).:
1 _ 1 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 saleJ.
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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.).
(_) 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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I 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 ZENITH INS CO Policy Number Z071741502
_ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the rkers' compensation provisions of Section
.�.�.fC 3700 of the Labor Code all forthwith c ply th those provisions.
•-Dater!-2 0 Appl_- i�cant
WARNING: FAILURE TO SECURE WORK PENSATI RAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA ALTIES AND 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 holdharmless 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 state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby aut representatives
of this county to enter upon the above-mentioned propert pection purposes.
,
``Date,te:
/ _743 Signature (Applicant or Agent
tic
q
Contractor:
Architect o�gineer:
GENERAL ANG
31170 RES
O'7 Z01�
V
THOUSAND76
(760)343-r.
Li C . No .:QI1IRlr
IJ
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Lic-e+nsse Class: C20 raw Lic a No.: 686310
Date: fi-7-�3
Convector.
-BUILD RATION
I hereby affirm under penalty of perjury th exempt from a Contrac 'l State License Law for the
following reason (Sec. 7031 .5, Business rd 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 Codel 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).:
1 _ 1 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 saleJ.
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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.).
(_) 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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I 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 ZENITH INS CO Policy Number Z071741502
_ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the rkers' compensation provisions of Section
.�.�.fC 3700 of the Labor Code all forthwith c ply th those provisions.
•-Dater!-2 0 Appl_- i�cant
WARNING: FAILURE TO SECURE WORK PENSATI RAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA ALTIES AND 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 holdharmless 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 state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby aut representatives
of this county to enter upon the above-mentioned propert pection purposes.
,
``Date,te:
/ _743 Signature (Applicant or Agent
tic
LQPERMIT
Application Number . . . . 13-00000024
Permit . . . MECHANICAL
Additional desc .
Permit Fee 33.00 Plan Check Fee
8.25
Issue Date . . . . Valuation . . .
. 0
Expiration Date 7/06/13
Qty Unit Charge Per
'Extension
BASE FEE
1.5.00
2.00 9.0000 EA MECH FURNACE <=100K
18.00
---------------------------------------------------------------
Special Notes and Comments
------------
CHANGE OUT (2)FURNACES (1) 70,000.BTU
AND (1) 90,000 BTU 2010 CODES.
----------------------------------------------------- -----------------------
Other Fees . . . . BLDG STDS ADMIN (SB1473)
1..00
Fee summary Charged Paid Credited
Due
Permit Fee Total 3.3.00 .00 .00
33.00
Plan Check Total. 8.25 .00 .00
8.25
Other Fee Total, 1.00 .00 .00
1.00
Grand Total 42.25 .00 .00
42".25
simplified Prescriptive Certificate of Compliance: 2008 Residential HVA CA Iterations CF -IR -ALT -HVAC
Climate Zones 10 to 1S
Site Address: 78840 SPYGLASS HILL DRIVE
Enforcement Agency:
Date:
Permit #:
LA QUINTA B&S
01/07/2013
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
® Furnace
o
E AFUE 80%
❑ COP
Over 40 ft of ducts added or
M Setback
❑ Indoor Coil
❑SEER
❑ HSPF
replaced in unconditioned space
P
Served stem
by
not already
❑ CondensingUnit
❑ EER
_
❑ Resistance
❑ R 6 (CZ 10-13)
❑ R 8 (CZ 14-15)
sf
2424_ sf
present must be
r
installed)
❑ Other DUCTS
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, 7.7HSPFfor 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 CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
signed. Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also bean site for final inspection.
1. HVAC Changeout
Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• All HVAC Equipment replaced
CF -4R forms: MECH-21 and fors lit stems MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH-25-HERS
• Indoor Coil and/or
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 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 A!ld 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 now 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
Re uired Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-21-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ 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 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 information documented on other applicable compliance forms, worksheets,
calculations, plans and specifications submitted to the enforcement a enc fora roval with the permit application.
Name: ALLEN JACOBY Signature:
Company: GENERAL AIR CONDITIONING & HEATING
Date: 01/07/2013
Address' 31170 RESERVE DRIVE
License' 686310
City/State/Zip: THOUSAND PALMS, CA 92276
Phone: 760-343-7488
2008 Residential Compliance Forms
July 2010
Bin.l3 Ct 0 Quanta
Budding ar Safety Duron
pelt q P.O. Box 1504,78.495 Cage Tampico
4.Quirlta, CA 92253 • x(760) 777-7012
Building Permit ApPlicadon' and Tracking Sheet
ProjectAdd=. : 78840 SPYGLASS HILL DRIVE Owner's Name:. DON PLOTE
A. P. Number 770-060-001-5
Address: 7.8840 SPYGLASS HILL DRIVE
Leap Description:
sr, zip: LA QU I NTA, CA 92253
Contractor GENERAL A/C & HEATING
Telephone: 760-771-5111
Address: 31170 RESERVE DRIVE
HANGEOUT(2) FURNACES.
ProjeaDeseription: CHANGE-OUT(2)
City, $T, Zip: THOUSAND PALMS, CA 92276 70,000 & 90,000 BTU
Telephone: 760-343-7488
State Lia # : 686310. City Lic, ti;
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: Construction Type:. Occupancy:
State Lia #: Project type (circle one): New Add'n Alter Repair Demo
Name of ContAct Person: PATRICK Sq: Ft.: 24f [ f 1' # Stories: # Unity:
Telephone # of Contact Person: 760-343-7488 Ewroatod. Value of Project —75VO. �'
APPUCANT: DO NOT WRITE BELOW THIS UNE
R
Submittal
Rcq'd
Recd
TRACKNG PERMIT FEES
Plan Sett
Plan Check submitted Item Amount
Structutal calea.
Reviewed, ready for corrasion Plan Check Deposit.
'frust Glu.
Called Contact Person Plan Cheek Balance
We ZI Cates.
Pians picked up Conatractlon
Flood plain plan
Plans resubmitted Mecbarilnl
Grading plan
Z`! Review, ready for corrections!nsue Electrical
Subeontaetor Idst
Called Contact Person Plumbing
Grant Deed
Plans pteked cap S.&LL
H.O.A. Approval
ses
Plans ubmitted Grading
IN HOUSE:.
''' Review; ready for correctionvisaue Devdoper Impact Fee
Approval Planning Appal
Called Contact Person A.IP.P.
Pub. Win. Appr
Date of permit issue
School Fees
Total Permit Feu