13-0327 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT.
Application Number:
13-00000327 -
Property Address:
48514 VIA AMISTAD
APN:
646-122-052-
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
6000
Applicant: Architect or Engineer:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -. - - - - - - - - - - - .
LICENSED ONTRACTOR'S DECLARATION
I hereby affirm under penalty of per' y that I a ensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the usiness Professionals Code, and my License is in full force and.effect.
license /nass: C20 Li
Date:'- Contractor:,
{// \ OWNER -BUILDER DECLARATION
eby affirm under penaaperjury that 1 am exempt from the Contractor's State License Law for the
following reason ISec. 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 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.).
(_ I 1, 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. , 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:
Lender's Address: _
LQPERD1IT .
Owner:
BURKHOLDER
48514 VIA AMI STAD
LA QUINTA, CA -92253
(949)706-55
Contractor:
AIR EXPER
PO BOX 94
LA QUINTA
(760)777-
Lic. 'No.:
725283
VOICE (760) .777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
C0%'BRT21&C2 V1
FINANCE
Date: 3/20/13 -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
WORKER'S COMPENSATION DECLARATION
I here —irm 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
r for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�t
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 NORGUARD INS Policy Number PAWC334856
I 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 b ubject to the workers' compensation laws of California,
and agree that, if I should rr u ject to the workers' com en n
3700 of the Labor Cod sh forthwith co se provisions.
Dat#ING:
Applicant;5MAILURE TO -SEC RE WORKE S' COMPENSATION 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 permitissued 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 1 have read this application and state that the absformation is correct. I agree to comply with t
city A
nances and state laws relating to buil ' g�fi constdiction, and hereby a saves
ofthter upon the above-mentioned proper) for inspecti
DateSignature (Applicant'orIAgent):
1
Application Number . . . . 13-00000327
Permit MECHANICAL
Additional desc .
Permit,Fee 42.50 Plan Check Fee
10.63
Issue Date Valuation
0
Expiration Date 9/16/.13
Qty Unit Charge -.Per-
Extension
'BASE FEE.
15.00
1.00' 11.0000 EA MECH-FURNACE >100K
11.00
1.00`""' 16:5000 EA - MECH B/C'>3-15HP/>100K-500KBTU
16..50
Special Notes and Comments
HVAC CHANGE -,OUT - REPLACE AIR
CONDITIONER WITH CONDENSOR & HEATING
UNIT 5 TON:, 100K BTU FURNACE. 2010
CODES.
-- - - - - - - -- - - - - - - -_ - - ------------------- - - - - -- --
Other Fees . . . BLDG STDS ADMIN (SB1473)
1.00
: Fee summary--- Charged Paid Credited
Due
Permit Fee Total .42.50 .00 .00
42.50
Plan Check `Total 10.63 00 .00
10..63
Other Fee Total 1.00 .00 .00
1.00
Grand Total 54.13 .00 00
54.13
- LQPERMIT,
Simplified Prescriptive Certificate of Compliance: 2008 'Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15 -
Site Address: j
48514 Via Amistad La Quinta, CA 92253
Enforcement Agency:
City of La Quinta
Date:
Mar 19, 2013
Permit #:
—(
Duct insulation
Conditioned Floor
Equipment Typel`
List Minimum Efficiency2requirement
Area
°' Thermostat
p Package Unit
-
® Furnace
® Indoor Coil
® AFUE 7.8%
® SEER 3.0
p COP
❑ HSPF
0 R 6 (CZ Io -13)
Served by system
® Setback
If not already
y present,,must be
® Condensing Unit
p EER
❑ Resistance
D R 8 CZ 14 -IS
( )
2000 sf
installed)
0 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.
® 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 -411 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
CF74R forms: MECH-21 and (for split systems) MECH-25 •
For Split Systems: Duct leakage ,< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if: .
`,❑ 1: Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. Th esystem:will not be Ducted'(ie�,Ductless-Mini-Split System)-(Also:Exempt-fromlRefrigerr t—Charge)
17 2. Nevi HVAC System
Requieed,Forms: y..,,; �, �► F ^ = +d ( ,
. Cut inlor Changeout with;
newducts. (all new
ducting and
" , 1. r ---.-....,._
CF 6R forms:,MECH 04, MECH ' 0AERS' and (for split systems) MECHw-22 HERS and
HER_ rt• «-,-' w t M
MECH.-'25 S
p
all new
t
•
CF 4R forms: MECH 20, and (for split systems) MECH=22, and'MECH=25 t
equipment)
For Split Systems: Duct leakage•<'6'percent; RC, CCA >_.350 CFM/ton; FWD,'.TMAH STMS, and either HSPP orPSPP "--"'
For Packaged Units: Duct leakage < 6 percent ,
❑ 3. New Ducts with/or without
Required Forms:
Replacement j-
. Includes replacing or installing allnew
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 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 -611 forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -411 forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
p 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: Luis M Lira Signature: Luis M Lira
Company: AIR EXPERTS AIR CONDITIONING -HEATING Date: Mar 19, 2013
Address: PO BOX 94 License: 725283
City/State/Zip: LA QUINTA / CA / 92247-0094 Phone: (760) 777-1724
eg: 213-A0016783A-000000000-0000 .Registration Date/Time: 2013/03/19 20:10:51 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
I
Bin. #City
Of ic7 QilIIZtd
Budding 8r Safety Divfslon
P.O. Box 1504,78-495 Calle Tampico
La.Wita, CA 92233 -:(760) 777-7012
Building Permit -Application" and Tracking Sheet
Pemillf
/ � 7
l�
Project Address:/ y Ji�ir✓%�S i
Name:.
A P. Number.
rAdd,=.s . VIA AM rS 7">
Legal Description:
Contractor.
T, Zip: LA 9Z22S
Telephone: 0
Address: r,— &D X 2
Project Description:
City. ST, zip, LA ( 9 zz it 7
Telephoner -I`B0 777/72 ,
N t r IJ C_
State Lia #: '%Z!�_Z Q City Lic. #:
Ard , Eagr., Designer:
Address:
City., ST. Zip:
Telephone:
State Lia #:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: 2=�� #Stories: #Unit$
Name of Contact Person: ��; l E�
ex
Telephone # of Contact Person: _(p v .�7'
41
2Estimated Value of Projoctr �QQpp •"
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Redd
Recd
TRACKTltIG PERMPTFEES-
Pias Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit_ .
Truss Cala.
Called Contact Person Pian Cheek Balance
Title 24 Calc$'.
Plans picked up Construction
Flood plain plan
Plans resubmitted MechanicalGrading
plan
Z`! Review, ready for correetiouslissuc Electrical
Lis
Subeontactor t
Called Contact Person Plumbing
Grant Deed
Plans picked cep MLH.O.A.
Approval
Plans resubmitted Grading
IN HOUSE:-
''` Review, ready for oorrectiooslLtsue Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr "
Date of permit issue
School Fees
Total Permit Fees