13-0969 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number: 13-00000969
Property Address: 44440.4E SUNDOWN CREST DR
APN: 604-110-036,- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL,
Application valuation: 10770
Applicant:
Architect or Engineer:
t \
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business anrofessionals Code, and my License is in full force and effect.
License Class: C20 -C43 LicenseNo.: 276586
Date, ,f� �• Contractorir
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'sState 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 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 nob 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, 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.). -
( 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:
4,4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LQPERMIT
Owner:
MOSHER FRED ,
" 44440 EAST SUNDOWN CREST
.f LA QUINTA, CA 92253
(760)345-6592
Contractor: '
DESERT AIR CONDITIONING,
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/02/13
(760)323-3383
Lic. No.: 276586
• 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.
•,yJ.; J1 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 EVEREST NATL. ' Policy Number '7600007908121 .
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
` personin any manner so as o become subject to the workers' compensation laws of California,'
and agree that, if I should ecome subjec the workers' compensation provisions of Section
3700 of the Labor Coe she rt h comply with those provisions.
-
Date: Q 1 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 ishereby 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 p formation is correct. I agree to•comply with all
city and county ordinances and state laws relating to building c struc ion, and reby authorize representatives
of this county to enter upon the above-mentioned property f ms io oses.
Date �"��gnatu re (Applicant or AgenU:�.
• i
+ Application Number-,. . . 13-00000969,
Permit'. MECHANICAL 2013
Additional desc
,-
Permit -Fee 71.50 Plan Check Fee
.00
Issue. Date . . . . Valuation
0
Expiration -Date 1/29/14
Qty Unit.Charge Per
1 Extension "
1:00 35.7500 EA MECH FURNACE
35.75
00` 3'5.7500 EA MECH CONDENSER/COMP '
35.75
Special Notes and Comments
HVAC CHANGE OUT - (1) 3 TON
17.7SEER/9.50 FURNACE & CONDENSING UNIT
' [2008 ENERGY] CARBON MONOXIDE`ALARM(S)
TO BE INSTALLED PRIOR,TO FINAL
'
- INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
Other Fees BLDG STDS ADMIN (SB1473)
1.00
" PERMIT ISSUANCE'M/P/E
90.57 ,
r Fee summary- Charged --_Paid--- Credited
r
Due
Permit Fee Total 71:50 .00, .00
71.50
Plan Check Total .00 .00 .00
.00 .
Other Fee Total 91.57 .00, -.00
91.57
Grand Total 163.07 .00 .00 ..'
163.07
s
- LQPERMIT
Bin. #C1t}/
Of La QL1111td
Building a Sarety Division
P.O. Box 1504,78-495 Carte Tampico
la.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Perrnit #
/� ��
11bJ`' l
Project Address: .y .. 9Q f, 5I•C AOS n -c�eS; Owner's Name:. 2 4&:�D - YW d
A. P. Number. 1D 0- •. Address: _t, k(Q C4(,— S C) r
Legal Description: City, ST, Zip:
Contractor. DESERT AIR CONDITIONING, INC Telephone:'%&O'3�$-�e
Address: 590 WILLIAMS RD Project Description:
City, ST, Zip: PALM SPRINGS, CA 92264 Yet lace.• 3 +0 in
Telephone: 760-323-3383
�' �''• tem• o � ror.�� d
City Lia #:. 363 '
State Lic. # : 276586
Arch., Engr., Designer: NA
Address:
City., ST, Zip:
Telephone: Construction Type:. MECH Occupancy:
gra •
State Lic. #: jam" Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: JACQUELINE RATLIFF Sq. Ft.: #Stories: #Univ:
Telephone # of Contact Person: 760-323-3383: Estimated Value of Project: Q . "'� 70
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACICTIVG i PERMU FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit, .
Truss C21cs.
. Called Contact Person Pian Check Balance,
Title 24 Cala.
Plans picked up Construction
Flood plain plan
Plans resubmltted, , Mechanical
Grading plan
Review, ready for correctiionsfissue Electrical
Subcoatactor List
Caped Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'^` Review', ready for correctionsRssue Developer Impact Fee
Planning Approval
Called Contact Person AJ.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-111-ALT.-HVAC
Climate Zones 10 - IS
Site Address:
Enforcement Agency:
Date:
Permit #:
44-440 E. SUNDOWN CREST DRIVE LA QUINTA, CA 92253
City of La Quinta
Jul 11, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat i
❑ Package Unit'
-
,
® Furnace -
❑ Indoor Coil
❑ AFUE
® SEER 17.7
❑ COP
® HSPF 9.50L3
❑ R 6 (CZ 10-13)
P 8 (CZ 14-15)
Served by system
1200 sf
® Setback
If not already present, must be
® Condensing Unit
13 EER '
[3 Resistance
installed)
❑ Other
,
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-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-1111
and CF-61% 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
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• 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 <_ 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. The system will not be.Ducted (ie Ductless„Mini75plit.System) (Also Exempt.:from�Ref�riger�aot=Charge)
w.
❑ 2 New HVAC System
Required Forms:` S' . �jJ '” �; °„ - '.
. Cut in�or&Changeout with
f r A � � r �` �� "" �
CF 612 forms MECH-04, MECH 20,-HERS, and (for split systems) MECH-.22 HERS, and
new u new
ducting alI newt
x
M0H :'25:HERS � 2 V 0' k , ; ")
MECH-25 „
P ). .(alI
equi meat
SCF 4R`forms `MECH-20, anfifor split systems) MECH-2.2�and
d.I_tx 'mow, _, .: :_ .: k�w-.t
For Split Systems: Duct leakage <- 60ercent;;RC; CCA'>'350:CFM/ton; FWD;'.TMAH, SIMS, and'either HSPP or`PSPP.
For Packaged Units: Duct leakage <.6 percent
113. 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. Noor 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: Jacqueline Zabik Signature: Jocqueline'Zabik
Company: DESERT AIR CONDITIONING INC Date: Jul 11, 2013 i
Address: •590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
Reg: 213-A0051917A-000000000-0000 Registration Date/Time: 2013/07/11 19:14:15 HERS Provider: CalCERTS,-Inc.
2008 Residential Compliance Forms ' July 2010