12-0681 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
Application Number:
Property Address:
APN:
Application description
Property Zoning: .
Application valuation:
(12-00000_681
79425 STONEGATE
772 -040 -013 -
MECHANICAL
LOW DENSITY RESIDENTIAL
23616
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DONALD & JULIE JONES.PART
405 AVENIDA.GRANDA NO 504
SAN CLEMENTE, CA 92672
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
A
I
"W,,t J ` 2012 }
GB'sY . ?A
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
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 infor on is correct. I agree to comply with all
city and county ordinances and state laws relating to building constru ti , and hereby authorize representatives.
of this county to enter 10on the above-mentioned property for insp purposes.
ate: -Y-01L/Signature (Applicant or Agent):
Contractor: —""" '� ==": �f• 1
Applicant: Architect or Engineer:
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS,. CA 92276
(760)343-7488
Lic. No.: 686310
-----------------------------------------------.--------------------------------------------------
' LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION '
1 hereby affirm under penalty of perjury that I am lice d 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 Prof ionals 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
L' ense Class: C20 Lio nse No.: 686310
Date:(' Contractor:
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
y 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
' - ER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury th exempt from the Contractor's State License law for the
Carrier ZENITH INS CO Policy Number 2071741501
•_ 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 wor 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 became jact 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 I should become sub' 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, 1 shall forth,6i 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 1$5001.:
�_ )'
te: 1zcant:
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
WARNING: 'FAILU TO SECURE WORK ENSATION COVERAGE IS UNLAWFUL, AND SHALL
HHEE
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE 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
(_ 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. -
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 I 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
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
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 infor on is correct. I agree to comply with all
city and county ordinances and state laws relating to building constru ti , and hereby authorize representatives.
of this county to enter 10on the above-mentioned property for insp purposes.
ate: -Y-01L/Signature (Applicant or Agent):
4 Application Number . . . . . 12-00000681
Permit . . MECHANICAL
Additional desc .
Permit Fee - 66.00 Plan Check Fee
16.50
Issue Date . . . . Valuation
0
Expiration Date 12/16/12
Qty Unit Charge Per
Extension
BASE.FEE
15.00
2.00 9.0000 EA MECH FURNACE <=100K
18.00
2.00 •16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
33.00
Special Notes and Comments
HVAC CHANGE -OUT: 5 TON & 3 TON UPFLOW
SYSTEMS, FURNACES, CONDENSERS, INDOOR
COILS. -2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited -Due
Permit Fee'Total 66.00. >00 ..00.
66..00
Plan Check Total 16.50 .00 .00
16.50
Other Fee Total 1.00 .00 .00
1.00
Grand Total 83.50 .00 .00
83.50
� r
Simplified Prescriptive Cert
ificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency: • .
Date:
Permit #:
79425 STONEGATE (5 TON.SYS) La Quinta, CA 92253
City of La Quinta
Jun 18, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
.requirement
Conditioned Floor
Area.
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® 1 SEER 3, �
❑ COP
E3HSPF
❑ R 6 (CZ 10-13)
Served by system
®Setback
If not already present, must be
® Condensing Unit
[3 EER
[3Resistance
[3 R 8 CZ 14-15
� )
g sf
247,
installed)
❑ Other
'
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 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 -111
and CF -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R form's: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for.split systems). MECH-25-HERS ;
. Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage;;<F,15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testingif:
❑ 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 s
p 3. Existing duct systems are constructed, insulated or sealed with asbestos '
[3 1. The ;systen ill not be Ducted'(ie. Ductless,Mini-Split=System)g(A1sozE�xempt fro Refrgera charge)
_. , � - .,, . G.
132. Nevv.HVAC'S sfem
Re uired Forms
• Cut intor&hangeout withy= � #� l x
F;', 6 fornts MECH-04 tCHF20IHERS and• forsp litsy stems MECHr22 HERS and
new du',9"� (all new; "
MECH
,25
ducting all new CF 4R�forms. MECH--20 nd (for split systems) MECH-2 ,and MECH'25� ,�� w
equipment)_
For Split Systems aDuct leakage;- percent';RCi�CCM2* 350 CFM/t6h"-,FWD tTMAH, STMS, andeeither HSPP"or=PSPP. '
,...-
For Packaged Units: Duct leakage < 6 percent
❑ 3 NewFDucts with/or without,'-.
Required Forms:
Replacement `'�y;,•,
. Includes replacing or installing All: ';new
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and'(for split systems) MECH-25-HERS
and/or indoor coil and/or furnace -No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
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 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-,
❑ 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. • t
• 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 agency for approval with the permit application.
Name: Danielle Garcia Signature: Danielle "r-cla
Company: HARRISON ENTERPRISES INC Date: Jun 18, 2012 f.
Address: 31-170 RESERVE DRIVE STE A License: 686310 '
City/State/Zip: THOUSAND PALMS / CA /92276 , Phone: (760) 343-7488 -
Reg: 212-A0031600A-00000000-0000 Registration Date/Time: 2012/06/18 19:28:26 HERS,Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms - July 2010
. A
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations -.CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79425 STONEGATE (3 TON SYS) La Quinta, CA 92253
City of La•Quinta
Jun 18, 2012
- ' '
Equipment Typel
' -
List Minimum Efficiency2
- Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
i
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 3•
��
❑ COP
❑ HSPF
-
❑ R 6 (CZ 10-13)
Served by system
®Setback
If not already present, must be
® Condensing Unit
❑ EER',
Resistance.
❑ R 8 (CZ 14-IS)
2000 sf
installed)
❑Other
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 Efflclencles: -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 CF-1R
and CF-6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for. split systems) MECH-25-HERS
. Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakagelc,15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing'. •if:
❑ 1"Duct systemwas documented to have been previously sealed and confirmed through HERS verification, or -
❑ 2.,Duct systems with less than40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑'`4. The„system will not be Ducted `(ie,D�yctless Mint Split $ystem�-(AlsogExem t: from Refrigera, t char e
❑ 2 NeW,;HV.Ac System
Required Farms
x�,
. Cut m orChan eout with
new Ducts r(a0 new 0—
-,
J.=
CF 6R forms MECH-04, MECH 20 HERS ah&E(for split systems) MECH 22�H” ERS,-d`rid
ducting all new
MECH�25 HERS , 0, rste
� �os )MECH- -0 and (for split sms)iMECti 2 ,nand Mequipmecit)y�...�Lfi M %.'WtF'_�'•J !x.f ��"C.. -dvw
For Split Systems: Duct leakage <6kpercent, RG; CCA?350 CFM/ton, FWD,�TMAFI, SIMS, and either HSPPxor PSPP: ' ...
rt a...a . .
.x a...,
For Packf
aged Units: Duct leakage ••< 6_percent -' •
❑ 3 New-Ducts with/or without {'
Required Forms:
Replacement
. Includes replacing or installing allnew
-
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
.and/or indoor coil and/or furnace: No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25
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
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 -
❑ 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 agency for approval with the permit application.
Name: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Jun 18, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0031608A-00000000-0000 Registration Date/Time: 2012/06/18 19:36:43 ITERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
slR.#
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
1
Perrriit # `
1
Project Address: -11415 S nPa
Owner's Name:. J V' L V► tNS
A. P. Number.
Address: SUM l l
Legal Description:
Contractor.� . �}
City, ST, Zip: ,
Telephone
Project Description: bvt
Address:
City, ST, Zip:
3 nwi
Telephone: ' a �� s
State Lic. # : City Lic. #;
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone: P �., t
State Lic. #: »air
Name of Contact Person:
Construction Type: , Occupancy:
type . Add'
n. Pro a circle one New Addn Alter Repair Demo
.i )" ep
Sq. Ft.: 1441# Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project: 23 ID�
APPLICANT: DO NOT WRITE BELOW THIS LINE
N Submittal Req'd Reed 'TRACKING PERMITTEES-
Plan Sets
Plan Cheek submitted
Item Amonat
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
'Fuss Cales.
Called Contact Person
Plan Check Balance
Tide 24 Coles.
Plans picked up
Constractlea
Flood plain plae
Pians resubmitted
Mecharilcal
Grading plan
2'' Review, ready for correctionstiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'i° Review; ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees