11-0891 (MECH)TihtP.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253, BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING .PERMIT
Date: 8/'18/11.
._ �- .
Application Number: -°^-7 000. 00891 = Owner:
Property Address: 50280 'VALENCIA!"CT LYNDA LOUGHEED
APN: 773-390-018- 50280 VALENCIA COURT
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOWDENSITY RESIDENTIAL
Application valuation: 3,000 _
` Contractor:
Applicant: Architect or Engineer: J ANTHONY PLUMBING HEAT/AIAUG
w 72216 NORTH SHORE STREET, yTHOUSAND PALMS, CA 92276 1�9 E
(760)343-2121
LiC. No.. 777794 Ei13i
---------------------------------------------------------7-
• ` • - LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of peri fy 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 siness and Pr essionals CodsO ' i full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided
License Cass: C20 C36 License No.: 777794 -for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
/issued.
1 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:
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 1932451-2011 ��__
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county thatrequiresa'permit to - _ I certify that,, in the perfor ante of the work for which this permit is i , 1 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 o as to become subject to the workers' mpensation 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 s uld become suTom'to the workers' mpensation 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 I shall fortcply w' hose provisions.
that he or she is exempt therefrom and the basis,for the alleged exemption. Any violation of Section 7031.5 by �/ P/'��
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.: - ate: 7j icant:
y ) .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: FAIL RE TO SECUR 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 intendedor offered for sale. If,-however, the building or improvement is sold within . -SECTION 3706 OFTHELABOR 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 forthepurpose of sale.). APPLICANT ACKNOWLEDGEMENT - -
(_) I, 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 Lawdoesnot 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,-
( ) 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 issuan4such
erm't.
Date: Owner: + . 2. Any permit issued as a result of this, b comes null and void if work is not commenced
within 180 days from date of issuaermit, or cessation of work for 180 will subjectCONSTRUCTION LENDING AGENCY _ permit to cancellation.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 statbove information is correct. I ree to com y with all
work for which this permit is issued (Sec. 3097, Civ: C.1. - city and county ordinances and state laws relatinonstruction, and hereb thorize represe tatives
of this ty t enter upon the above-mentionef r i pecti purposesLender's Name:e (Applicant or Age -
Lender's Address:
LQPERMIT
�Application'Number 11-00000891
'
Permit - . . . MECHANICAL
Additional desc .
_ - Permit• Fee, -31.50 -
Plan'Check.,Fee
7.88 -
-Issue Date
Valuation
0
Expiration Date .'. 2/14/12•
'
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 '
CHANGE OUT CONDENSER, 13 SEER,•2010
CODES..
----------------------
-----------------_-_---
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
.. - • `. •. ..
4•
Lam. :'e
LQPEEN11T r _,
I
•• _ -
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency_ :
Date: APermit
#:
50280 VALENCIA CT La Quinta, CA 92253
City of La Quinta
Aug 13, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
. Thermostat
❑ Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
Q'SEER 13.0
❑ COP
(:1 HSPF
❑ R 6 (Cz 10-13)
Served by system
0 Setback
If not already present, must be
0 Condensing Unit
C3 EER
E) Resistance
❑ R.8 (� 14-1S)
1600 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 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-4111
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-6111 shall also be on site for final inspection.
D 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-411 forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and./or
• Indoor Coil and /or
CF-611 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 < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
..V
C..- Paelfaged Units- Pidw-F leakage 4 19
p
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
❑ 4. The system4 ill not be Ducted (ie.WDuctless: Mini; Split System)-AIsoaEkempt.fcom�Refrigerant;Charge)
❑ 2. New HVAC System
Required Forams: y
. Cut in or'Changeout with,:
ducts: (all new
� �4
CF 6R:forms MECH-04 MECH-20-HERS, MECH 227HERS, MECH-25-HERS
new
andl(for split systems) and
ductmg and all new,/I'
CF-4R forms: MECH 20 and (for split systems,) ME CH-22, and MECH 25
�
m
equipent)
For Split Systems: Duct leakage < 6 percent; RC,-CCAI> 350 CFM/tori, FWD; TMAH, SIMS, and`either HSPP orPSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
• Includes replacing or installing all new ducting
and/or outdoor condensing unit and/or indoor
CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
coil and/or furnace. No or some equipment
CF-4R forms: MECH-20 and (for split systems) MECH-25
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-611 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 accurateand 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: Kevin Robinson Signature: Kevin Robinson
Company: I ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Aug 13, 2011
Address: 72216 NORTH SHORE ST #101 License: 777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: 760-343-2121
Reg: 211-A0041555A-00000000-0000 Registration Date/Time: 2011/08/13 16:08:11 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
i
Bin #
City'Of La Qulnta
Building & Safety Division.
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application'and Tracking Sheet
Permit #
-`�
Project Address:�� Gl
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor•.
City, ST, Zip: -7.
Telephone: �� C U 03l �,., .: :
Address: J ANTHONY SERVICES
City, ST, Zip: THOUSAND PALMS, CA 92276
project Description:
Telephone'?i66.3 L43 Z
State Lic. # :—� -7 q
City Lic. 05094
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone..
P
� A • y
Construction Type:. Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: C-7
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 Cales..
Called Contact Person
Pian Check Balance
Tide 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Z" Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready, for correctionstissue
Develope' Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
t�
O�