13-0664 (MECH)P.O. BOX 1504 ' -' ='� •• 1 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: 5/28/13
Application Number `.---1-3'=0'0-0'0-0"664
Owner:
Property Address:
48543 VIA'AMISTAD
MCDERMOTT THOMAS J
APN:
646-122-013-
-
48543 VIA.AMISTAD
Application description:
MECHANICAL
,
LAQUINTA, CA 92253
Property Zoning:
LOW DENSITY
RESIDENTIAL ..
(760) 464-1025
Application valuation:
3600
'
Contractor:
Applicant:
Architec or En n er.
PALM DESERT AIR COND CO I
42081 BEACON HILL
28 2013•PALM
FC'Zrly
DESERT, CA 922116J
J(760)346-0677
No.: 374937
Q(0NTALic.
.___
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I 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.
�Cicense Class: C20- Licens : 374937
Date:^�j Contractore: 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 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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.).
( 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: _
Lender's Address:
LQPERMIT
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 Section 3700 of 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 MID CENTURY Policy Number A09454905-12
_ 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 become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3.700 of the.Labor Code, I shall forthwith comply lose provisions.
Date::— 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 ($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 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. 1 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 purpo
Date: �� L? Signature (Applicant or Agent): < < 6
e :.Application Number . . . 13-00000664
'Permit MECHANICAL 2013
Additional desc .
Permit .Fee 35.75 Plan Check Fee
00
Issue Date`.: Valuation
0.
Expiration Date 11/24/13-
Qty Unit Charge Per
Extension
1.00: `" 35.7500 EA MECH CONDENSER/COMP
35.75
Special Notes and Comments
REPLACE (1) AIR CONDENSER 13 SEER PER
2010 CODES.
-----------------------------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
.-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'. 91.57 .00 .00
91.57
Grand Total 127.32 .00 .00
127.32
LQPERAIii - - -
40aig1ra
GE, -,/d. DESERT _..
P.O. Box -'1504.78,495 Calle Tampico, • La Quinta, California 92211
Tel: (760)777-7012• Fax: (760) 777-7112--
Website: www.La-Quinta.Org • Email- Building@La-Quinta.Ocg
Bin #: Permit #: �- '
3 Building Pet it.Application &Tracking Sheef
Project Address: 48-543 VIA AMISTAD
Owner's Name: MC. DERMOTT, THOMAS -
AP:- Number:'
Address:48-543 VIA AMISTAD
'Legal Description:
City, State, Zip: LA QUINTA, CA 92253
Contractor: Palm Desert Air Conditioning & Heating Company
Telephone: (760) 464-1025
Address: 42-081 Beacon Hill
Project Description:
City, State, Zip: Palm Desert, CA 92211
REPLACE (1) AIR CONDITIONING CONDENSER.
Telephone No:: (760) 346-0677
�u�kg7� i ty'.TMe, "�kk♦..
State: Lit. #: 374937
City Lic. #: 100886
A.rch:YEng'r./Designer:
Address:
.City, State... Zip:
�.
State:'Lic. #5 �
Waiaie' of Contact Person: KARL BROWN
onstruction Type:
YTelephone%No::.
Occu ane
Project -Type: 0 New• ® Add'n -.0 Alter •'0 Repair' O Demo
Sq. Ft.:
#'Stories:
#Units:
Contact Telephone No.: (760) 346-0677
Estimated Value of Project: $3,600.00
APPLICANT: MNOT WRITE
BELOW THIS LINE
Submittal
Req'd
Recd
Tracking
Permit Fee's
Plan Sets
Plan Check Submitted
Item
Amount
Structural Celts_
Reviewed, Ready for Corrections.
Plan Check Deposit
Truss talcs.
Called; Contact Person
Plan Check Balance:
Title,24 Calcs.
Plans Picked Up
Construction
Flood Plain Plan
Plans, Resubmitted
Mechanical
Grading Plan
2nd'Review, Ready for Corrections
Electrical
Subcontractor List
Called Contact Person
Plumbing
Grant Deed
Plans PickddL Up
S.M.I.
H.O.A.,Approval
Plans Resubmitted
Grading j
IN HOUSE
3n° Review, Ready for Corrections
Developer Impact Fee
Planning.Approval
Ca[ledPerson
A.I.P,P,
Pub. Works Appr'I
Date of Permit Issue
,
School Fees
Total Permit Fee's
N
Simplified Prescriptive Certificate of Compliance: 20 08 Residential HVACAIterations` ;:. CF -IR -ALT
Climate Zones 10 - 15
Site Address:
48-543 VIA AMISTAD, La Quinta; CA 92253
Enforcement Agency:
City of La'Quin
Date:
May.28,, 2013 '
Permit:
EquipmentTypei
List Minimum Effidency2•
Duct insulation
requirement ;
Conditioned Floor
r
-,Area,.Thiermostat;.
p Package Unit
❑:Furnace
❑ Indoor Coit .
❑ AFUE -
® SEER 13.0
❑ COP
❑-HSPF
❑ R 6 (CZ 10-13)
Served by. system[installed)
Setback
not already'present; must be
®-Condensing Unit
❑ Other
E3 EER
❑Resistance.
❑ R8 (CZ 14-15)
_
2000.'sf
., i'" ._
1. Equipment Type: Choose the equipment being installed; if`more than one systern use another CF-IR-ALT-HVAC:for each system.
2. Minfrrium Equipment Ellfciencies: ' 13 SEER; 78% AFUE, 7.7HSPF for typical residential systerns.
'
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 onsite for final inspection and a copy'glven 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 Octoberj, 2010, a registered copy of.the CF-1R .
and CF-611 shall also,be'on site for final inspection. -
«
® 1. HVAC Changeout
Required Forms: '
All HVAC Equipment
CF-6R forms: MECH-04, MECH-2.1-.HERS and (for split systems) MECH-25=HERS '
.replaced
CF-4R forms: MECH `21 and (for split systems) MECH-25
Condenser-Coll and /or .
Indoor Coil and /or
CF-611-forms: MECH-04, MECH-2I-HERS ancI for split systems) MECH-25-HERS
.furnace>�'w
CF 4RVf5rms: MECH-21 and split systems) MECH725 ."
For Split Systems: Duct leakage z�151percent; RC, CCA 5 300 CFM/ton. (Minimum Air flow Requirement); TMAH
�
FAr R�FIr in ,� n sa�E i x r rr Esc -
4
v aee ieauege G r��a-reere� `
Exempted�from duct leakage testlngif -
❑ Duct system wasxdocumeh c ,to have been-previously sealed and confirmed through HERS verification, or
®U Du2t systems w tl less thi 40 lwinear feet in unconditioned space, or
❑� Ez(stingrductsystems
areconstructed, Insulated or sealed witli asbestos
syst'ern
❑ 4�Ttie will iiot be Ducted (Ste Duchess Mtrn"SplIt,Sy`stem) (Also Exempt from�Refrtgetant Charge)
arraz ,.- r,� #.c Taxa z r m:r + r� LTi
❑<2'1VewHVACSystem Requited Fom►�sra��;yFE4 x :a�a
.Cutlno[Chan`geout�wlthz`�, �^ > ,x r.tt?'Ptrrr ..,.-r
new duyts (all new ME`CF 25 HERSE MSE H=20 HERS and for spat sy etns) MCCH 22�-HER5P� AW
ducting��d�allnew S � � � �.fi������������� 3` �
� ,��N�..«.,� •, r �� a�� �;� .'�
�25q `'�"�"�'
;� CFh4R forms MECH�O and (f splitTsystems3 MECc,�HF`22 andMEGRat!",1'�r �; '"
�� �a
•% Ar � �T�4&x.•'14 $ - 'Ka ��« Gam'? ~ b}?r�
NO
-9
For Spl t Sjrstems kDuct Leakage 6 percent RG CGA >�350 CFNI/ton; FyUD; TMAH'; STMS and efther3tiSPP or PSPP a .
For PackagedUmts Ductleakag'ec�6percent r " `.x"p .
O'Newducis with/orvwth o N Required Forms:
`I'nc ludas replingor[nllingallnew i
ducting and/or outdoorcOrdensingunit CF-6R forms:`MECH-04, MECH-20=HERS, and (for split systems) MECH-25-HERS
aqd/p r i�nldt ohangednd%or�sa or some .CF-4Rwforms: MECH720 and (for, split systems) MECH-25
e ut m
For Split Systems: Duct ieakgd'4�_ 6 percent; RC, CCA 2 300 CFM/ton, TMAHJ ,
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 21=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 /Responsible Designer's Declaration Statement).
• 1 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 idenbfied.on this Certificate of Compliance conform to the
requirements of Title 24,'ParIS 1 and 6 of the California Code of RegLdaUorts. r' , "
• The design features identified on this Certificate of Compliance are consistent yvith the information documented on other applicable compliance
forms, worksheets, calculations, plan's and specifications submitted to the enforcement'agency for approval with the permit application.
Name: Karl Brown Signature: Karl Brown -
Company: PALM DESERT AIR-CONDITIONING CO INC Date: May 28, 2013 '
Address: 42-081 BEACONHILLLicense:'374937
City/ Stat%Zip: PALM DESERT/ CA[ 92211 Phone: (760) 346=0677,
+