12-1014 (MECH)k7 n4
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX.(760) 777-7011
LA QUIN.TA, CALIFORNIA 92253 4BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT.
_ 1 Date: 9/04/12
pjcation-Number: - 12-00001014 Owner:
Property Address: 52435 AVENIDA VALLEJO MATA RESIDENCE `
APN:' 773-262-020-9 -000000- 52.435 AVENIDA VALLEJO
Application description: MECHANICAL LA 'QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 12737
Contractor:
Applicant: Architect or Engineer: GENERAL AIR. CONDITION
+ !" 31170 RESERVE 'DRIVE SEP O -21
12
THOUSAND PALMS, CA 922
(760) 343-7488-
Lic. No::' 686310 CITYOFLAQUI.NTA
FINANCE DEPT:
------------------- ---
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION `
-I hereby affirm under penalty of perjury that I am licsed 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 Pr ' ssionals 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 '
License Class: C20 License No.: 686310 for.by Section 3700 of the Labor Code, for the performance of the work for which this permit is .
,t - - issued:.
Date: 4 Contractor: ^ _ 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 DECLARATIONinsurance 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 ZENITH INS CO PoJwr
er Z0.71741501
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 thr which this permit is issued, Ishall 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 becct 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 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, I shall fomply 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 ($500).: Date: 0'14Z1- Applicant:
(_ 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: FAILURE TO SECURE WORK RS' 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 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. _ - -
r 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 (Seca 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. - -
Y - 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
_ 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: T Owner: 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 -
• - 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 infyi,
is correct. 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 constnd hereby authorize representatives
of this county to enter upon the above-mentioned property for inspeposes.
Lender's Name:
- -Date: ?—Signature (Applicant or Agent):
Lender's Address: -
• LQPERMIT .
LQPERMIT
Application Number
. . . . 12-00001014
.Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
33.00
Plan Check Fee..
8.25
Issue'Date'
Valuation
0
Expiration Date .•
3/03/13
Qty Unit Charge
Per
Extension
BASE
FEE.
15.00
1.00 9.0000
EA'. MECH
FURNACE <=100K
9.00
1.00 9.0000
EA MECH
B/C <=3HP/100K BTU
---------
9.00
--------------
--------------------------------------
Special Notes and Comments
---------------
HVAC CHANGE OUT'4"TON
SPLIT SYSTEM.
--------------------------
Other Fees .
------------------------------------
. . . . BLDG STDS ADMIN-(SB1473)
-- - - - - -- - -
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total
33.00
.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 HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #: y
52435 AVENIDA VALLEJO La Quinta, CA 92253
City of La Quinta
Sep 4, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat !
❑ Package Unit
• Furnace
p Indoor Coil
0 AFUE 78%
p SEER 13.0
'❑ COP[I
[1HSPF
R 6 (CZ 10-13)
Served by system
0 Setback
If not already present •must be
• Condensing Unit
❑ EER •
❑ Resistance
❑ R 8 (CZ 14-15)
1550 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 -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.
0 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -6R forms: MECH-04, MECH-21-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
.
z•F, ,
For Split Systems: Duct leakage:z<,>15 percent; RC, CCA _< 300 CFM/ton'(Minimum Air Flow Requirement), TMAH -
••
Exempted from duct leakage testing;if:
qj "Duct system was documented;to have been previously sealed and confirmed through HERS verification; or r
❑ 2. Duct systems with less than`4:0 linear feet in unconditioned space, or
`' ❑ 3. -Existing duct systems are 'constructed, insulated or sealed with asbestos 1
`'❑ 4. The system will not be Ducted'(ie Ductless*Mini-S lit S stem)+ Also-Exem t from "f rig erant Char e
F ;
112. New HVAC. System
Requied;Forms ,,. •;µ-rfi
. Cut infor. Changeout with'
new ducts.: (all new
.. w....
CF 6R forms:.MECH-04 MECH-20 HERS and'(for split systems) MECH 22 HERS rand
4
ductii nd all ne �
me
MECH; 25'HERS ` t� 6
, -s y � � '
CF 4R forms: MECH 20, and (for spliE systems) MECH=22, and MECH-25,
equi P ) `�'
fes;, i?� _./`, >.1 +�r'`�7 s +�,_ i .'... '•J 4 r _.,`�
For Split Systems: Duct leakage,< 6'0ercent; RC, CCA 24350 CFM/ton, FWD; TMAH, STMS, and either HSPP o"r PSPP9"'�-'
For Packaged.Units. Duct leakage <,6 percent
❑ 3.. New Ducts with/or without. 4"
Required Forms:
Replacement`
M.
. Includes repladng or installing all new
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 2_ 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 Sig nature:'Donielle Garcia
Company: HARRISON ENTERPRISES INC Date: Sep 4, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310.
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0048762A-00000000-0000 Registration Date/Time: 2012/09%04 12:58:20 HERS Provider: Ca10ERTS,'.Inc.
2008 Residential Compliance Forms • July 2010
Bin .#
CIS Of Lc? QUInta
Bultdng a Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Qulnta, CA 92253 - (760) 7,77-7012
Building Permit Application and Tracking Sheet
Permit #
4..
Project Address: GJ2.45G.
V� q I
Owner's Name:. !
A P. Number. 3
Address:*.
Legal Description:
Contractor.
`�,
City, ST. Zip.
:x mor
Telephone:
Address:3 1 _ O 4-
h .
Project Description:
City, ST, Zip:-Tk
g Z Z7
Telephone: �-j a� Vis` -a
4 75 —�
State Lic. # : Kgrn Q City Lie. #:
Engr , Designer
ss:
p
ST, Zip:.
Telephone:
1
Construction Type:. Occupancy:
State Lie. #:
Project type (circle
(circle one): New Add'n , Alter Repair
Demo
Name of Contact Person:
Sq.•Ft.: `rowbO # Stories: # uniw
Telephone # of Contact Person:
Estimated Value of Project ,2_75
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Stmetural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plana picked up
Construction
Flood plain plan
Pians resubmitted
Mecharilcal
Grading plan
2i1 Review, ready for correctionsiissue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans #icked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.-
'^' Review', ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees