12-1290 (MECH)4 .� P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 012-0 00 012 9 0—"'
Owner:
Property Address:
57795 SOUTH
VALLEY LN
SPADA
APN:
762-250-005-
- -
57795 SOUTH VALLEY LAN
Application description:
MECHANICAL
LA QUINTA, CA 92253 D
Property Zoning:
LOW DENSITY'RESIDENTIAL
Application valuation:
1200
Contractor:
Applicant:
Architect or Engineer:
BEST IN THE WEST
255 N., EL CIELO,. 140-112-5—
PALM SPRINGS, CA 92262
"
(760)343-1002
Lic..No.c 826714
--------------------=f--- \--------=--------------=----
S�TOR'i DECLARATION
I hereby affirm under penalty of perjury th I am ensed un provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine s an Pyo e s Code, and my License is in full force and effect.
a)�Licens lass:QC20-C38ense No.: 826714
2-' ✓.1 ntractor:
`�-IiIUILDER 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).:
1 _ 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
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 sale.).
(_ 1 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 thereori, and who contracts for the projects with a contractor(s) licensed
pursuantto 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.).
Lender's Name: l
Lender's Address:
LQPERMIT
7
- VOICE (760;-1�j
FAX (760)777-7011
INSPECTIONS (760) 777-7153
Date: 10/29/12
QCT 29 2011 ID
CITY OF LA
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section3700of the Labor Code, for the performance of the work for which this permit is
issued.
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
insurance carrier and policy number are:
Carrier GUARD INS GRP Policy Nu SEWC337354
I certify that, in the performRasome
or w 'ch this permit is issued, I shall not employ any
person in any manner so ect to the workers' compensation laws of California,
and agree that, if I should the orkers' compensation provisions of Section
3700 aft abor Codemp with those provisions.
"Ktio— cant:
WARNING: FAILURE TO SECURE W • N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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 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 d void if work is not commenced
within 180 days from date of issuance of such per cess tion of work for 180 days will subject
permit to cancellation.'
00
I certify that I have read this application and state that abo inf atio is correct. I agree to comply with all
city and county ordinances and state laws relating to tion, nd hereby authorize representatives
of this ounty to enter upo/the(Apove-mentioned pe "r i tion rposes.
plicant or e� k
Application. Number . . . 12-00001290
Permit . . . MECHANICAL
Additional desc .
Permit Fee •. . 40.50 Plan Check Fee 10.13
Issue Date Valuation 0
Expiration Date 4/27/13
Qty Unit Charge Per - Extension
BASE FEE 15.00
1.00, 9.0000 EA MECH FURNACE <=100K 9.00
1.00 16:5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50
----------------------------------------
Special
- --- -----------------------------
Special Notes and Comments
HVAC CHANGE -OUT: REPLACE 3 TON 'GAS PACK
ON ROOF. 2010 CODES. (HOME WARRANTY
CHANGE -OUT)
-------- -------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged Paid Credited Due
--- ------ ---------- ---------- ----------
Permit Fee Total 40.50 .00 .00 40.5 0,
Plan Check Total 10.13 .00 .00 10.13
Other Fee Total 1.00 .00 .00 1.00
Grand Total 51.63 .00 .00 51.63
LQPERMIT
5
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations, •CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency:
Date: '�
Permit #:
-57795.1•S Valley Ln La Quinta, CA 92253. City of'La Quinta
Oct 29, 2012 •
Equipment Typei
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
r. Thermostat
® Package Unit
.. •
-
"
.
❑ Furnace
❑ Indoor Coil
®AFUE 78GIo
®SEER 13.0
❑ HSPF
❑ R 6 (CZ 10-13) > j
t'
Served by system
®Setback
If not already present must be
❑Condensing Unit
DEER
❑Resistance
❑ R 8 (CZ 14-15)
1200 Sf
installed):"
[3 Other _•
� _
- ,
I: Equipment Type: Choose the equipment being instaNed; if more than one system, use another CF -1R -ALT -HVAC for each system. t
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 ofthe 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 CF7,6R and registered CF -4R
forms (no hand filled CF-411sallowed) 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: _ tr
. All, HVAC Equipment ;
CF -611 forms: MECH-04, MECH-2I-HERS
replaced
CF -411 forms: MECH-21 and (f8F split Systems) MECH 26 -
. Condenser. Coil and /or
.Indoor Coil and /or
CF -611 forms: MECH-04, MECH-2I-HERS ,-a rf i;� .•�� ' -� MC! LJ_7 G_LlCDC
`
.Furnace
' 4
CF-4R:forms:0MECH-21 ,_a rf_-...Ji... •�*� -� ------ 2FGF
splili Systems- P. -A lealQge---!�::.l r ------ — RGGGA 6 .399GFMAOR (MiRiFRUFn Air- Flew lkequi�em�eR�4,
For Packaged Units: Duct leakage,<;15 percent .,
Exempted from duct leakage
❑ 2: Duct'iystem was documehted:to have been previously sealed and confirmed through HERS verification, or
❑:2:: Duct systems with less tli' � 40 linear feet in unconditioned -space, or "
_ ❑ 3:. Existing duct systems are canstructed insulated or sealed with asbestos
❑:.4::The s�esk m �nrall not be Ducted (ie sAuctleSs�Nlth1 S'p1ipsystenl) {�4isd Exe pXfrom Ref�i a ant"G ar e e '
.. .:fes...
stem ..y. �._,.:.:..:. ...y -..
❑ 2. Ne.'3:•t
ft�\F.AC S
_.sem=:
Re u ired:.p,
.cut. m*o —C _ .'an eout witE�.1<•
9€
new duets::: ; .;
(all new ..:s,
-.. ,
a��f- ... :..:.: ; ::::; :::::r;. ...... ......W
.CF bRs> arm s c<MECH-D4 ME <2) MRS, a ;d� (frot split systetTFs).:MECH 22
f
_aew�a„- z:
ducting.n ll n
.e _<:=.F=4farrrrsECH
:
.O,.and'+fior:s"tit:ssterns=yMlwEf'2Z
For Split Systemsi...-muct,ieakag
6M".ercent,RR CGq> 358 CFM%ton, FWD TMAH, SIMS, ariczerther i ISPP br P5PP.
For.Packaged`Unitsc.:Duct
leakagert6;peT'ceiit:::: -- ::• :. .
❑:3'.: Flew Ducts with s`:':
Required
Required Forms:
Replacenieoyt
ti
i?
. Includes replacing or installing ig *i:ew
,
'ducting and/or outdoor conderising'unR
CF -6R forms: MECH-04; MECH-204fERS, and (for split systems) MECH-25-HERS
and/or.indoor coil and/or furnaces-Ao or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
4
For Split Systems: Duct leakage < 6,percent; RC, CCA >_300 CFM/ton, TMAH +-
Foi 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 -411 forms: MECH-21
For split system.orpackaged units: Duct leakage < 15 percent tf,.
❑ 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 i 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:. Richard C Weaver Sr Signature: Richard C Weaver Sr -
Company: BEST IN THE WEST'AIR CONDITIONING & HEATING INC Date: Oct 29, 2012
Address: 255.N ELCIELO ROAD #140-125 License: 967982
,City/State/Zip:, PALM SPRINGS / CA / 92262 Phone: (760) 343-1002 '
Reg::212-A0060399A-000000000-0000 Registration Date/Time:.2012/10/29`13:35:09 HERS•Provider_: Ca10ERTS,'Inc_
'2008' Residential Compliance Forms; .4 ' _ 'L' July, 2010•
Bin #
City of La Quinta
Building a Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # ;g°P.O.
Project Address:
G�
£ !
Owner's Name:
A. P. Number:
Address: S s✓ $
Legal Description:
City, ST, Zip:
Contractor:
Address:�Ss�J�L
/L
r
%
Telephone:
Project Description:
City, ST, Zip: J
/Z,, S e79' - �Z Z� -2—
6;,z %
Telephone:, v 3 '/OUZO
G2�a.. ,�24� Z- YU�G
State Lic. #:qAj&g
Arch., Engr., Designer:
City Lic. #:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
p cy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Stories: # Units:
Telephone # of Contact Person: tab 3 3 f o G 2—
lEstimated Value of Project: 12004'16
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 Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' Review, ready for correctionsrissue
Electricaly
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