13-0718 (MECH)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: 6/06/13
Application Number: 13-00000718 Owner:
Property Address: 48540 VIA AMISTAD WALLACE WILLIAM H & GLORIA
APN: 646-122-044- - - 78905 VIA TRIESTE
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760)7,71-2493
Application valuation: 6800
Contractor:
Applicant: Architect or Engineer: J ANT G HEAT/AIR
72216 RTH S E SS EET,
THOU 276
(760) -2121
Lic. o 7a�0406 2013
CITY OF LA QUINTA -
_____ FtNAN�EDEERi"----- -----=-----------
LICENSED CONTRACTOR'S DECLARATION ' . WORKER'S COMP LARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Cha ter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Busines and Professionals Code, and icense full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Licen�,C0-C36 License 777794 �•— f 'by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ssued.
DateContry_AA -'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 DECLARATION insurance 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 WESCO INS Policy Number 3051016
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 the work for which this permit is issued, I shall 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 become subject 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 agreethat, if I shout become subject to 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 od , I sh forthwith comp] rowsion .
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.r A -pl :
(_ 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 WORKERS' 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 ($100,0001• 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.
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 (Sec. 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.
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
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:
LQPERMIT
of La Ouinta, 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 a,,y4�,ve information is correct. I agree to comply with all
city and county ordinances and state laws relating touildfl construction, and hereby authorize representatives
of this coynty to enter upon the above-mentione4Lpr ert for inspection ourooses.
LQPEWMJT _
Application Number 13-00000718
Permit MECHANICAL 2013
Additional desc .
Permit Fee 71.50 Plan Check Fee ..
.00 -
Issue Date Valuation . . .
. 0
Expiration Date 12/03/13
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 - 16 SEER/AFUE 78 - HVAC
CHANGE -OUT 5 TON SPLIT SYSTEM. 2010
CALIFORNIA BUILDING CODES.
----.------------------------------------------------------------------------
Other Fees . . . . . . .BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57.
PLAN CHECK, MECHANICAL
47..66
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 139.23 .00 .00
139.23
Grand Total 210.73 .00, ..00
210.73
LQPEWMJT _
Total Permit Fees
City Of La Quinta
Building 8& Safety Division
Permit #P.O.
?Ileb
Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 -
(760) 777-7012
Building Permit Application and Tracking Sheet
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Project Address: Z -11'[/b
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A. P. Number:
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Description:Ci4.
AddresLegal
ontractor:
SCTHONY
Address: � 3
SERv9 eleph?% 1 7-
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^, Project Description: 5 /'�lA)
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Cit)-. ST, Zip: I MMSAND PALMS, CA 9227671
Telephone: M
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State Lic. # : -7-7� 9 �'
City
City Lic. #.
ic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Lic. #•
? C onstruction Type: Occup
ancv:Stato
Name of Contact Person: V 1IN
Project t}•pe (circle one): Ne%k' Add'n Alter Repair Demo
LUAC
A-YvL< Sq. Ft.:
Telephone # of Contact Person: ��t' (Z(
# Stories
#Units:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
Plan Sets
Plan Check submitted
PERMIT FEES
Structural Calcs.
readv for corrections
Item
AmountReviewed,
Truss Calcs.
Plan Check Deposit
Called Contact Person
Title 24 Cales.
Plan Check Balance
Plans picked up
Flood plain plan
Construction
Plans resubmitted
Grading plan
Mechanical
Review, readv for corrections<ssue
Electrical
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
II.O.A. Approval
Plans resubmitted
S.M.I.
Iti HOUSE:-
Review, ready for correctionsrssue
Grading
Planning Approval
Developer Impact Fee
Called Contact Person
:Pub. Wks. Appr
Date of permit issue
A.I.P.P.
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 #:
48540 VIA AMISTAD La Quinta, CA 92253
City of La Quinta
]un 6, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUEo/
® SEER 1
�Q
[3 COP
E3HSPF
13 R 6 (CZ 10-13)
Served by system
® Setback
If not alreadyresent must be
P
® Condensing Unit
[3 EER
[3 Resistance
❑ R 8 (CZ 14-15)
1800 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-1R
and CF-6R shall also be on site for final inspection.
ON 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-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
For Split Systems: Duct leakagew< 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
E3.2. Duct systems with less than 40 linear feet in unconditioned space,. or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie: Ductless Mini-Split System) (Also Exemptfrom Refrigerant,Charge)
❑ 2. New HVAC System
Required Forms::.
. Cut in or Changeout witha.
new ducts (all new
is
-
CF-6R forms: MECH-04, MECH-207HERS, and (for split systems) MECH-22-HERS, and
ducting all new.
equipment)
MECH-25-HERS
CF-4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
For Split Systems:. Duct leakage .<6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH,-STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3..,New Ducts with/or without
Required Forms:
Replacement
• Includes replacing 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 >_ 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: Kevin Robinson Signature: Kevin Robinson
Company: 3 ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Jun 6, 2013
Address: 72216 NORTH SHORE ST #101 License: 777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121
Reg: 213-AO03504OA-000000000-0000 Registration Date/Time: 2013/06/06 12:26:36 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010