12-1142 (MECH)P.O. BOX 1504 J ' VOICE (760) 77T-
78-495 CALLE TAMPICO t FAX (760) 777-7011
L"A QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS'(760) 777-7153
( BUILDING PERMIT
Date: 9/27/12
Application Number: 12700001142 Owner: `
Property Address: 5.5555 SOUTHERN HILLS PETERS '
APN: 775-200-011- - 55555 SOUTHERN HILLS
Application description: MECHANICAL LA� QUINTA; CA 92253
" Property Zoning: LOW DENSITY RESIDENTIAL ;
.=Application valuation: 10000 '
4 Contractor:- Q
Applicant: Architect or Engineer: PRIORITY ONE AIR CONDI ' HEA qry,
.•r r P.O. BOX 168116•'
PALM DESERT, CA 92261
(760) 773 *0811 _
Lio. No.`: 752180
1
LICENSED CONTRACTOR'S DECLARATION t WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am 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 and 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
- Licens�Class: C20 License No.: 752180 - - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ntractor. �' •• 1 + 1-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
OWNER -BUILDER DECLARATION, insurance carrier and policy number are: k ,
` I hereby affirm under penalty of perjury that I am -exempt from the Contractor's State License Law for the Carrier SOUTHERN INS CO Policy Number PWC00181212 -12
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 toitsissuance; 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 I should become subject 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 sh II forthwith 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 (5500).: - te: A icant''
(_) 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: FAILURE TO SECURE WORK ' C0 NSATION 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 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 non build or''
'improve for the purpose of sale.). , • . I - `• •. - . - APPLICANT ACKNOWLEDGEMENT -
(_) 1, as owner of the pioperty; 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 Piofessions 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 contractorls) 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.l•" - • 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
- 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. -
Date: - Owner: • ' - - 2. Any permit issued as a result of this application becomes null and void if work is not commenced
• • }� Y within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject r
CONSTRUCTION LENDING AGENCY - permit to cancellation. -
•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 incorrect. I agree to`comply with all - -
work for which this permit is issued (Sec- 3097, Civ. C.)• _ - city and county ordinances and state laws relating to building construction, and hereby authorize representatives
' - - - of this ounty to enter upon the above-mentioned prop or inspe ion purposes.
Lender's Name: a• -
10 1 P(ate: " r Signa re (Applicant or Agentl:
Lender's Address: - _ _ [
LQPERMIT -
f Application Number . . . . . 12-00001142
Permit MECHANICAL
Additional desc .
Permit Fee ,. 66.00•, Plan Check Fee
16.50
Issue Date -Valuation r.
0
Expiration Date 3/26/13`
Qty Unit Charge, Per
Extension
• -BASE FEE `.
15.00 '
2.00• 9.000.0'EA MECH FURNACE <=100K.
18.00
2.00 ra 16.5000 EA '-•MECHrB/C,•>3=15HP/>100K-500KBTU
33.00
Special.Notes and Comments
�+ HVAC CHANGE-OUT: INSTALL 2 NEW SYSTEMS,
,
FURNACES, CONDENSERS: 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- -i.00 .00 r .00'
1.00
Grand- Total_ 83.50. ".00 .•00
83.50'
LQPERMIT ..
..
Simplified Prescriptive Certificate of Compliance: 2008. Residential HVAC Alterations CF-111-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:71.
Permit #:
55555 Southern Hills La Quinta, CA 92253
City of La Quinta
Aug 30, 20
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat^
❑ Package Unit
p Furnace
Indoor
0 AFUE 78%
❑ COP❑
R 6 (CZ 10-13)
Served by system
[21 Setback
❑ Coil
p SEER. 13.0
❑ HSPF
[I R (CZ 14-15)
2800 sf
If not already present,, must be
0 Condensing Unit
[IEER
❑ Resistance
8
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-SR-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-611 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-1111
and CF-6111 shall also be on site for final inspection.
D 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;f6rms: 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
FGF aelpeFeeRt.
Exempted from duct leakage testing,if <_'.
❑ l p Duct system was docuinennted; to have been previously sealed and confirmed through HERS verification, or
❑ 2:;Duct systems with less tharil 0 linear feet in unconditioned space; or
❑ 3 .Existing duct systems are constructed, insulated or sealed with asbestos
014.'`-::.The systemwnot M�t frRef gerantCharge)mp
❑ 2 NewHYAC System'
Requir dForms 3WAS
. Cut in or Changeout:with
rte: , y� r.. ,� .V" �
OF formsMECH 04, MECH 20 HERS and (fo'r split systems)MECH 22 HERS and
new ducts (all new
ducting611 new .�
MECH 25tiERS > �r� 4� c .
a
split
equipment)C�orms
MECO`antl (for systems) EGH22, and MECH 25
For Split Sy r ms �Ductfleakage<�b percentRC CCA> 350CFM/ton FWD,TMAH,�STMS; andeitherHSPPeor PSPP. ='
For Packaged'Umts Duct leakage <;,6.perc6nt
❑ 3 New Ducts with/or without >R
`
Required Forms:
Re Acement h.
. Includes 'replacing or;i;nstaIli g 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'furna'+ Noor some
CF-4R forms: MECH-20 and (for split systems) MECH-25 +
equipment changed:;'
For Split Systems: Duct leakage ' 6'per1cent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. 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-4P 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: Roy Meghnagi Signature: Roy Meghnogi
Company: PRIORITY ONE AIR CONDITIONING AND HEATING Date: Aug 30, 2012
Address: P 0 BOX 1681 License: 752180
City/State/Zip: PALM DESERT/ CA / 92261 Phone: (760) 773-0811
Reg: 212-AO04831BA-00000000-0000 Registration-Date/Time: 2012/08/30 19:17:50 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms, July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
55555 Southern Hills (system 2) La' Quinta, CA 92253
City of La Quinta
I Sep 10, 2012
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
El Furnace
p AFUE 78%
❑ COP __[IR
6 (CZ Io -13)
Served by system
13 Setback
❑ Indoor Coil
p SEER 13.0
11HSPF
❑ R 8 (CZ 14-15)
1600 sf
If not already present, must be
2 Condensing Unit
❑ EER
❑ Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -Wand 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 -IR
and CF -611 shall also be on site for final inspection.
0 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 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS
. Furnace
CF4Riforms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct percent; RC, CCA'<_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Y
URitSR^le;akage^<415
peFeeRt
Exempted from., duct leakage testing f ;,`y
ap 1 Duct systemwas documented:ao have been previously sealed and confirmed through HERS verification, or
❑ 2: DucEaystems:'with less than 4Q. linearfeet in unconditioned space, or .
❑ 3:; Existing:duct'systems are constructed, Insulated or sealed with asbestos '
❑ 4 :The system will not be Ducted (ie Duc- ss N in�Spl t System) (SAlso;Exempt froRef gera�nt4Gharge)
a .:;." _. - ^....:
❑ 2 NewHVAC System:
Requ�reil
<. .:...-. ,., y ten..
. Cut in kfGhangeout `with
new ducts (all new .:
ductih.16.3 d all new
" � p�
CF -6R forms MECH 04; MECH 20 HERS; andz(for�spllttsystems) MECH 22 HERB, and
MECH 25 -HERS "�
=y
-�
equipment)_:.:.
CF-4Rforms MECH 20, and (eforspht systerns)�MECH22 Viand MECH25 h
r.: U, `
For Split Systems SDut leakages<�6 ercent; RC GCA > 350 CFM/ton FWD; TMAH SIMS, andfelther HSPP3or PS'PP >. .
a '
For Packaged Units Duct leakageLL.,<.,,6 per t r"
r A y;.'++r. .+tTKr wt ''?f .
❑ 3 NewDucts with/or without,'"'
Required Forms:
Replacement
-
. Inclddes replacing or;instaIli n'g all new "
ducting and/or outdoor condensmg�unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or Indoor coil and/or-furna�e _N,o or some
CF -411 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
114. 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 Certiflcate 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: Roy Meghnagi Signature: Roy Meghnagi
Company: PRIORITY ONE AIR CONDITIONING AND HEATING Date: Sep 10, 2012
Address: P 0 BOX 1681 License: 752180
City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 773-0811
Reg: 212-AO04990BA-00000000-0000 Registration Date/Time: 2012/09/10 12:31:02 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
C
Total Permit Fees
tttn n
City of La Quinta
Building 8T Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
�. •
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Y
Project Address: 55555 So kf h -ern H j' (15 wner's Name: -Dr, Re rS
Number:
-4e
Address: 55555 JCu4ke-v- 1
H( • ' 1 S
L
Lega
Legal Description:
l x- A �/n
City, ST, Zip: L& - G x!24 C
9 aaJ`3
Contractor: Priorrl ��
�1�+ L elephone-760-, _
3 32
Add re -
•Project
Description:
phon:
City. ST, Zip: P�.lm�eser�
C!q gZZlp l
-760-773-09
.�,..� ov
Telephone.
l
jC
State Lic. #:'715,Z ($Q
City Lie. #:ODD......—T3.....
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction rUC
ti on Type: Y
P: u an
Occupancy:
P c Y•
State Lie.
of Contact Person: �011
.... r oJe
c[ type (circle e one): Newv Add'n Alter
Repair DemoName
V
Sq. Ft.: #
Stories: #
Telephone # of Contact Person:%W•- Zi5- ioOpZ Estimated
Units:
Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted Item
Structural Cates.
Reviewed, ready for corrections Plan Check Deposit
Amount
Truss Calcs.
Called Contact Person Plan Check Balance
Title 2HCalcs.
Plans picked upConstruction
Flood n
Plans resubmitted
Mechanical
Grading plan
2"� Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.A1.1. .
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd Review, ready for correctionstissue Developer Impact Fee
Planning Approval
Called Contact Person
P.P.
Pub�Fees ppr
Date of permit issue
Sch
Total Permit Fees