14-0838 (MECH)P.O. BOX 1504
i 78-495 CALLE TAMPICO
'LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
1 BUILDING PERMIT -
Application Number:
14-00000838
Property Address:
5,1301 AVENIDA VALLEJO
APN:
773-083-015-3' -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
7000
App' on . Architect or �Engineer:
Owner:
CURIEL JORGE MACIEL
51301 AVENIDA VALLEJO
LA QUINTA, CA 92253
(760)485-7243
Contractor: I
MENDEZ AIR COND & HEATN
PO 'BOX 871
THOUSAND PALMS, CA 92276
(760)348-5041
Lic. No.: 791437
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/12/14
U
Civ`. E F 4 OUKTA
LQPERMIT
1
` LICENSED CONTRACTOR'S DECLARATION.
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 Profen ' nd 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
License Class: C20 License : 791437
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Date: ontractor:
issued.
_ • I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
OWNE - UILOER DECLARATION
Code, for the performance of the work for which this, permit is issued. 'My workers' compensation
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 FARMERS INS Policy Number B09242175
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 to its issuance, also requires the applicant for the
person in any manner so as tobecomesubject 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
rkez9mpensation provisions of Section
and agree that, if I should become subject try orY
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel or
3700 of the Labor Code, I sha cUawitA-e�rrtg ywwith t - a 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 thanfivehundred dollars ($500).:
Date: 2 Applicant:
(_ 1 1, as owrier 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 S CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property whobuilds 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, DAMAGESASPROVIDED 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. f
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 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 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
- r
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 permitissued 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
- - 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 i e to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1•
city and county ordinances and state laws relating to building construction and hereby authori representatives
'
of this cou to enter upon the above-mentioned property for ' n p
Lender's Name:
-
Date Signature (Applicant or Agent):
Lender's Address:
LQPERMIT
1
' Application Number . . . ... 14-00000838
Permit MECHANICAL 2013
T' Additional desc ..,
Permit Fee 83.42 Plan Check Fee
.00
Issue. Date Valuation . . .
. 0
Expiration Date 12/09/14
" Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 11.9200 EA MECH APPL REP/ALT
11.92 A
_ 1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE 3 1/2 TON FURNACE CONDENSING
UNIT COIL UNIT 80% 15 SEER 2013
MECHANICAL CODE2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE'INSTALLED PRIOR
TO FINAL INSPECTION. 2013 CALIFORNIA
BUILDING CODES DESCRIPTION.
---------------------------------------------------------------
------------- -
Other.Fees . . . . . BLDG STDS ADMIN (SB1473)
Other.Fees
------------
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
52.43
Fee summary Charged Paid Credited
Due
Permit Fee Total 83.42 .00 .00
83.42
Plan. Check Total .00 00' .00
.00
Other Fee Total 144.00 .00 .00
144.00
Grand Total 227.42. .00 .00
227.42
LQPERMIT
Bin #
City of La Quinta
Building 8t• 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: C>(&O(\Jbj
Owner's Name: G�A- r
A. P. Number:
Address: 5� w it (da V0,1 Tz
Legal Description:
City, ST, Zip: LA- 1K
Contractor: L
Telephone !&a � 1 2 '-f
Address: _ Q ` G
Project Description:
City, ST, Zip: •
CLCD C U
Fz-
Tele ho (G�
p X43 �o�
:<:<.:..,....,::.::.:�.::,::::,..,,.;:,:.:
��<»�<;;;>::>...f:::«>>.>:<:�:.>::<.:::->�tytA
State Lic.
City Lie.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
w Add'n Alter Re
Project type (ci rcle one): Ne pair Demo
State Lic. #: '_:«:€ :`^':%g:;•:.:::.:::.;:r..;;;;{:;;:;.
:.<::: > .:.•;: •:,:>;,::«::,->:::,:<::..;;•.
Name of Contact Person: WL a.Sq.
Ft.: y
# Stories:
# Units: '
Telephone # of Contact Person:', 77
'Estimated Value of Project: (�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Pian Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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 If OUSE:-
'"' Reyiew, ready for correctionstiissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�J
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
51301 Avenida Vallejo La Quinta, CA 92253
City of La Quinta
]un 12, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
IM
® Furnace
® AFUE
❑ COPy
13 R 6 (CZ 10-13)
Served b
b system
® Setback
® Indoor Coil
® SEERZ13
HSPF
13
❑ R 8 (CZ 14-15)
1400 sfinstalled)
If not already present, must be
Condensing Unit
[3® EER
Resistance
❑ 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 Efficiencles: 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 -411
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 -6R forms: MECH-04, ""_�� =D= EXEMPTED and.(for split systems) NEGH 2-5 HER&
replaced
EXEMPTED
r.�rru -�+ ( p systems) 44c4u -ir EXEMPTED
CF -4R forms: ,.,�� EXEMPTED and fors lits stems
• Condenser Coil and /or CF -6R forms: MECH-04, MECH 21 W=DF, EXEMPTED and (for split systems) M=Gw 2g urDr,
. Indoor Coil and /or EXEMPTED
. Furnace CF74P. farms: M •4=Gu
EXEMPTED an or split systems) _ _..... _�.....2�. EXEMPTED
For Split Systems: Duct lez ; .percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
peFrseRli
_5
Exempted from duct leapt
i w p r— taihave been previously sealed and confirmed through HERS verification, or
€ inear feet in unconditioned space, or
sited, insulated or sealed with asbestos
^�ir•NPsc
. '• Mini -Split System) (Also Exempt from Refrigerant Charge)
R "�-x-•R "!
new :+ '° fi &
ducti� .� fir` '� � � f �. .�-�.-•�*-�^'
equ k ;
For S'� ,as
r
For Or`
~ . � r '4 •' ,., :.r,(' : �.. ` ..�2 �y�tp�'rf��uf� ice$ 4V'�?_ ..'S • 5...5 :��� ; :y�.a,, l
_
•i�
11 c- 14 �� ..
t..
W{$
i+
installing all news
r` '
ducting and/or outdoor MECH-04, EXEMPTED, and (for split systems) M=r u ,r uCDr
EXEMPTED
. ..__.. .._.
condensingunit and/or CF .::.. ' . M__._ r._g EXEMPTED and (for split systems) mEGm 25 EXEMPTED
indoor coil and/or ~��"•>s�< -' � �--• • --
furnace. No or some
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting
Required Forms:
over 40 feet
. Includes adding or
replacing more than
CF -611 forms: MECH-04, EXEMPTED +
40 linear feet of duct in
CF -411 forms: M=C-.._ -a3 EXEMPTED
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 agency for approval with the permit application.
Name: Enrique Mendez Signature: Enrique Mendez
Company: MENDEZ AIR COND & HEATING Date: ]un 12, 2014
Address: P 0 BOX 871 License: 791437
2001 Residential Compliance Forms July 2010
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