14-0760 (MECH)T3
ce000000, 4
•
P.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: 6/03/14
Application Number: 14-00000760 Owner:
Property Address: 54105 AVENIDA VALLEJO ANDREW AND MARJORIE PATTERSON
APN: 774-212-016-5 -000000- 54105 AVENDA VALLJEO
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL (760) 777-8195
Application valuation: 7000
Contractor:
Applicant: Architect or E gineer: GENERAL AIR CONDITIONING n
31170 RESERVE DRIVE u
,THOUSAND PALMS, CA 92276 D'
(760)343-7488 sr ��E'�
Lic. No.: 686310 JUN � 3 E
i
Circ a 1-&.04INTA
-----------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that.] am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
Date: ---111 Contractor: s__�Z�_
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 ($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 soldwithin
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.). K . -
(_) 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 anowner 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.). _ -
1 ) I am exempt under Sec. , B.&P.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.).
Lende'r's Name:
Lender's Address: ^
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
SSI 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 ZENITH INS CO Policy Number Z071741503
1 certify that, in the performance of the.work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions. -
� �e
Date:6 36 11} Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
'DOLLARS 0100,000). 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.
.11 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 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.
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 I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
.Date: 1 Signature (Applicant or Agent):
Application Number . . 14-00000760 -
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration -Date 11/30/14..
Qty Unit Charge, Per
Extension
1.00 35.7500. EA MECH FURNACE
35.75'"
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
Special Notes and Comments
HVAC CHANGE OUT - 135SEER FURNACE.AND
CONDENSOR [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL_
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . PERMIT ISSUANCE`M/P/E
90.57
PLAN.CHECK, MECHANICAL
59.58
Fee summary Charged Paid Credited-
Due
Permit Fee Total 71.50 .00 .00`
71.50
Plan.Check Total. .00 .00 - .00
.00
Other Fee Total 150.15 .00 .00
150.15
Grand Total 221.6.5 .00 .00
22-1.65
.LQPERMIT
-
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations, CF -IR -ALT -HVAC
Climate Zones 10 - 15 -
Site Address: -
Enforcement Agency:
Date:
Permit #:
54105 AVENIDA VALLEJO La Quinta, CA 92253 _-
City of -La Quinta
Jun 3, 2014
= ; Duct insulation
Conditioned Floor'
Equipment Typel'
List Minimum Efficiency2
requirement
Area
Thermostat
p Package Unit
® Furnace
O AFUE
Q COP
❑ R 6 (CZ 10-13)
Served by system
® Setback '
Indoor Coil
® SEER 13.0.
8 HSPF 7,7
D R 8 (CZ 14-15)
658- sf
If not already present, must be
8 Condensing Unit
❑ EER
❑Resistance
installed) ,
p 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 Efirclencies 13 SEER, 78% AFUE, Z7HSPF tar typical -residential systems.
HERS VERIFICATION SUMMARYListed below are fOU.R'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 -4R1'
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 -6R shall also be on site for final inspection: -
® 1. HVAC Changeout
Required Forms:.
. All HVAC Equipment
CF -6R .forms: MECH-04, ,MECH-21-HERS and (for split systems) MECH=25-'HERS ,
replaced r
CF -4R forms: MECH=21 and'(for split systems) MECH-25
. Condenser Coil and /or
CF -6R -forms: MECH-04, 'MECH-2I-HERS and (for split system_ s) MECH-25-HERS
01 Indoor'Coil and /or
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA`s 300 CFM/ton (Minimum Air Flow Requirement), TMAH
FeeAt
Exempted from dud leakage testing;if: {
❑ 1. Duct system was-docurnen ed to have been previously sealed and confirmed through HERS verification, or
❑ 2• Duct.systems.with less tfian:40 linear feet in unconditioned. space, or
0- 3; -.Existing duct.systems are con struded,'insulated or sealed with asbestos
❑ 4.'The :system will not be Dotted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2i! New HVAC System Requited_.Forms:
. Cut in or Ci#attgeoui<with � �"_ MEC
:. CF 61�forms MECH 04s MECH-20-1{ERS, auki jiospuf sySCemsj. :h1=22-1 fERS, and
v -=
new, dud=(a11'TFewt:;:: MECH 25.:RSS=:::' + _::.. -'�
ductin d`all new'.-:- ..
gam--'
=. C i;ARAorms MECH-20, ans) for spl►t systems MECH 22, ancf MECii-25 ;-:::::..
....:
e u i meat. �; ..�.�.::....:. �. �
For SO, ems:, Dtsctleal a percent; RC, CCA> 350 CFMJ.;ton, F11i1p, TMAH; a'" S;:and;eithei
N_< 9
For Pac Unats, g. --,•�-_:_:- -
kaged
❑ 3. New=Ddeti: niriih/or wiithoitt s ; =
.. eq tied Fotms _::_..
_ .
Replacement::..:: . _ ..
. Incudes:replaci*4 or installing altnew
diicEing :an i/ar.:oiitiloor condensi" . unit'
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor .coil and/or furnaceNo or. some
CF -4R forms; MECH-20 and (for split systems) MECH-25; +
equipment changed.
For Split Systems: Dudteakage�<;..6:percent; :RC, CCA _a 300 CFM/ton, TMAH
For Packaged Units: Duct -lea- 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: Dud leakage < 15 percent
p EXCEPTION: Existing duct systems constructed, insulated or seated with asbestos.
Contractor (Documentation Author's /Responsible Designer's Decllaration Statement) t
. I certify that this Cert`if'icate of Compliance documentation is accurate and complete. '
. I am eligible under Division 3 of the Califomia 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: Dayana Valdez i Signature: Dayan Valdez
Company: HARRISOWENTERPRISES INC ; Date: Jun 3,, 2014
Address: 31-170 RESERVE DRIVE -STI= A - ' 'License: 686310
City/State/Zip: THOUSAND ?AIMS / CA /'92276 'Phone: (760) 343-7488
<.
Reg:.214-A0039949A-000000000-0000,,Registration Date/Time: 2014/06/03 11:36:08 HERS provider: Ca10ERTS, Inca
2008 Residential Compliance Forms , July 2010'.
Bin #
Permit #
Project Address: Sy I v t
A. P. Number:
Legal Description:
Contractor:
cher q_\
Address: 3 1 -7 0 1<e Se�v
City, ST, Zip: i'ho1�s ahc� c
Telephone. �(op- ��i3_%i�r'�
State Lic. # :
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
City of La QUinta
"Building 81' Safety Division
P.O. Box 1504, 78-495 Calle Tampico . ,
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
181M V e.1 1 D Owner's Namc: A,,Are-\J M QN- i o �c a
Address: ,5L4) os AYe l V O -11 i o
City, ST, Zip: 1r, .+. CA gZ-LS
- 7 r
Telephone: r% (00 �- g 14 ..r<>.
l
�r Project Description:
Construction Type: Occupancy:
tyP. air Demo
�
Project a circle one): Now Add'n Alter Re
J ) P
Name of Contact Person: �� c Sq. Ft.: # Stories: # Units:
Telephone #,of Contact Person: —7(*0- 3213- 7L4 $& Estimated Value of Project: %, CCZ)
APPLICANT: DO NOT WRITF RFl OW THIS l INF
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss C21cs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
[2*-dEReview, ready for corrections/issue
Electrical
Subconlactor List
ontact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN I10USE:
'"' Reyiew, 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