13-1139 (MECH),r
P.O. BOX 1504
78-495 CALLE'TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001139
Property Address:
52825 AVENIDA VALLEJO
APN:
773-323-017-4 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3000
Tiht 4�� ',\`
/ = � VOICE (760) 777-7012
1 FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT ��--�
Applicant: -Architect or Engineer:
I r a
hereby affirm under penalty, of perjut I am
Section 7 0) bf Division 3 of the 136siness and
Date:
RACTOR'S DECLARATION
rider provisions of Chapter 9 (commencing with
ils Code, and my License is in full force and effect.
License No.: 725283
V OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires.the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State --
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
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$500).:
(_) 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
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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 sate.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , BAP.C. for this reason
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:
LQPERMlIT
Owner:
SUSAN FOSTER
52825 AVENIDA VALLEJO
LA QUINTA, CA 92253
Contractor:
AIR EXPERTS AIR CONDITI
PO BOX 94
LA QUINTA, CA 92247
(760)777-1724
Lic. No.: 725283
Date: 9/10/13
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
PI
have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
fqp y Section 3700 of the Labor Code, for the performance of the work for which this permit is
ssued.
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
insurance carrier and policy number are:
Carrier GUARD INS GROUP Policy Number PAWC446733
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
PG:FAILUR�ETO
on in any manner so as to om?bit.
ject to the workers' compensation laws of California,
agree that, if I should b come suthe workers"compensation provisions of Section
0 of the Labor Code, I shall f omply with those provisions.
Date:pplicant:WAR SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application. -
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall deferio, 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.
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 have read this application and stat at ithea i formation is correct. I agree to comply with all
city and cou ty o finances and state laws relatin tong construction, and hereby authorize representatives
of this y to3ter upon the above-mentioned pr purposes..
Date: f �^� Signature (Applicant or Agent):
LQPERM IT
Application Number . . . . . 13-00001139
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee . . . 35.75 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date .` 3/09/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH AIR HANDLER
35.75
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - REPLACE AIR HANDLER
[2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
-------------- --------------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
' PERMIT ISSUANCE M/P/E
90.57
• PLAN CHECK, MECHANICAL
11.92
Fee summary Charged Paid Credited
Due
Permit Fee Total 35.75 .00 .00
35.75
Plan Check Total ..00 .00 .00
.00
Other Fee Total 103.49 .00 .00
103.49
Grand Total 139.24 .00 .00
139.24
LQPERM IT
Bin #
City of La Quanta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Per is #7
��
Project Address: '' I �%fe (�E
Owner's Name: SL&S94Af
A. P. Number:
Address: c -'Z• `cam r Q,4 1 ��
Legal Description:
Contractor:Telehone:
City, ST, Zip:
P €»>:;>>.>:r::.: •: :.:...:..
Address: X
Project Description:
City, ST, Zip: c &-U rj rx —7
Telephone: o Z
77
State Lic. # : %-�3
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
onstruction Type: Occupancy:
dd'n Alter Repairait Demo
P roJ'ect type (circle one): New A
State Lic. #:
Name of Contact Person:
Sq. Ft.:Q('
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
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
Plan Check Balance •
Title 24 Cales.
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 HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations ' CF -IR -ALT -HVAC'
Climate Zones 10 - 15 ,
Site Address:
Enforcement Agency:
'Date:
Permit #:
52825 Avenida Vellejo La Qu.inta, CA 92253
City of La Quinta
Sep 10, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficdency2
requirement
Area
Thermostat
0 Package Unit
i® Furnace
E3AFUE
1:3 COP
❑'R 5 (L'Z 10-13)
Served by system
N Setback
Q Indoor Coil
❑SEER
❑ IiSPF
R 8 (Q 14-15)
1400 sf
If not already present, must be
(3 Condensing Unit'
Q EER
p Resistance
installed)
❑ Other
I
I I,
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC foreach system.
2. Minimum .Equipment Efficiencies: 13 SEER, �78% AFVE, 7.7HSPF,for typical rresidential 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 linspector 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 -511 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 -11R
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 forms: (MECH=21 and (for split systems) ME -CH -25
. Condenser Coil and Jor
CF1611 forums: MECH-04, MECH-21-HERS and (for sprit systems) MECH-25-HERS ,
. Indoor Coil and ,9or
CF -4R fmrms: MECH-21 and for split
(systems) MECH-25
. furnace
For Split Systems: Dudt leakage,< 15 percent; RC, CCA <_ 300 CFMJton (Minimum Air flow Requirement), TMAH
Exempted from duct leakage t!esun6 if: 5
El A. Duct systiam was aixxiuri ented in have been previously sealed and confirmed through HERS verification, or
® 2. Duct sysbNns vtritih less than 40 linear feet in unconditioned space,, or
® 3. Ex�sfing duct sVsbNns am &nstru clbed, insulated or sealed with asbestos .
® 4. The sys vriill not be ®andi>i Que.: Dpi s N9eaua-S�t S py (Agsm etaaaut +irno?aa;ltefvagaraent Q mge)
_ µ
r?'.l.a.. Y-4'. �. 4.F�•' i :v:.'. .ry.s:'-k.......-:: ta.: •..e.- v. . .." a -r4> Y'... -p
fl 2. Nevii� Sykim
Required;F�r
. Cut in ®r CMngeout with:
.�aR
',.roc i-•ec;,�e��. ✓, 1c `n.�.,.. �. .,�tt"a-
fo7Yrns MECH�4, MECH-2� 3iElE5,aaad (ffr split si') Q�ECh4c22'1-1ER5, bead
new dirdts; (all new
anar va
ductin ; ll
�"JEiJFi 25°HERS
< a'
CF -4&t forrm� H48-2®, and (for s serras� I'IZ� l 22, ar�d tl�i-25'
egiuipnt) r
_B
For S 0 rtfsaMage
�;pe rcem?p Rco,"C >3s�d Jdiorw F9T�e TU9q SiIMS, ai�i3hosr l�Si ®;'I'SP3'.
For Packaged limits: ®un7�
1»al . < b pame nt
E3 3. l+f _w,:Durrfis,vjft/or vwithout ..
Required Forms:
Replaaeri ent '
. b clu des meplarin!g or installing all, new
dudting andJor outdomr cohdansi uj a,nit
CF -6R foams: MECH-04, MECH-20-HERS, and (for split system s➢ MECH-2��HERS
andJor indoor coil andjbr fumaee. No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed:. .
For Split Systems: Putt leakage < fi percent;, RC, CCA >_ 300 CFM/ton, TMAH
For Packaged units: Duct leakage < ii ;percent
E3 4. New Ducting ever 40 feet
Required Forms:
. Includes adding or •replacing ,,ore than SID
CF7R_ forams: MECH-04, MECH-21-HERS
linear aeet of d.udt !in a,ncondit9oned space".
CF -4R forms: HEOH-21 {
For split system or packaged units: Duct leakage < 15 ',percent
El EXCEP71ON: Existing duct systems eoinstru,rted, insulated or sealed with ,asbestos.
Cor actor (Dacum>ertati'on Author's /Responsible Desigrsees DeclaraVon Statement)
srbif;� tj!r 1 t t:S C- cor".. lis 3.'D0" elm emd co�i:u;�iEL'k: .
e 5, z'•,iu 2I :;3inlE lu idarIip.� Gi^ S. Cr t h'a c l"rl'aEa'�5U5:. u'r �' znzd Code tro zFi;IIejj(^ili•c -S u1l�Ci'x�i11;'i: L/i ''�li�.c �i'.Ic=.` I.u"�rFi�u�lill' .FiiT 'nlh'ie���d 7�i1� c 6"ii6
x 1 _"_Jlu1r L 4..hal t henmpy ole , r s a'r.-Ti, perubrInw!ne fo.r klhe d: sizm IfO'B 7tlf iad or, I.!'€IS Y'-erdfG.'Cele of :: ordann to aha
If sAq.wti rznts Sir Y tlz 24,P?^:[_'S :. emd s cf -the CaGfiQT a rcDl��'_
e ;[ a +G'?Sign x `hi�`:r� li'rc:i �iTtE, Lr,!r,!':itfi:i: C ST!!i= Gr �7Tr.K:[ �'= '_ x: S:�t i•1'! iTuii% I`r i?' 4 .iR. 13':E:r:eY', Vail erner C,;'t"n,'r IJ'c C ::ee ftc:es
a--.^: u:.v5, :1i�"�`�.'ri.''q�, .'T -C �'u'�"J!1', r,b+p- �'Y '5�:'Ccy✓'J.^i.5 �'�f :BiSi��� V ��; V:P.`fu�'rr':li�,':L^� ��i:�3ri*¢.''il',Y7t rv�3:::SiH[`'i. �:�' ;^µ�� w']iF•i c�,Nt:E.��"-_'?'i:e.
:J'L'rz + jS4'gT-,@1W're. g-jis M !&PC
Ccornapan:: Ral'ut+Z. EXPERTS ATR CONDY 7111-21 N !vG-HEAT1 �a'j;G
dress: 80.X X LiT rnse: pySy
G 'Stzte;,ZPiu^,: LA Q'.;Rc A- /' iw /' '922-4.7-4 91-�'o& iGG2: ���yN i 6'ca-172
-------- ____ F .., ________ _-__, "•_C._: _ '��nn _: _ ne:__. __ Tic"= _.____ _...__- _.
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