13-0501 (MECH)4 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: 4/22/13
Application Number:0000050-1 Owner:
Property Address: 54961 LP;UREL VALLEY GOODING DAVID
APN: 775-120-058-- - - 54961 LAUREL VALLEY
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (
Application valuation: 27336
Contractor: W
Applicant: Architect or Engineer: GENERAL AIR CONDITIONING D
31170 RESERVE DRIVEAPR 22, 013
�✓�/ :/�� � %� THOUSAND PALMS, CA 92276
v (760)343-7488
Lic. No.: 686310 CiVOFLp, 101A S^
raW04CF 1]F.
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 ofthe Business and Professionals Code, and my License is in full force and effect.
License Class: C20 .wry License No.: 686310
Dte:
f a1p '-'pC-ontract—or:
�� 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).:
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.). ' e
(_ 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 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:
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.
1 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 permiris issued. My workers' compensation
insurance carrier and policy number are:
Carrier ZENITH INS CO Policy Number Z071741502
I certify that, in theperformance 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
_3700_of,.the-Labor Cowl shall forthwith comply with those provisions.
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. I 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 purposes.
.Date:"f 4 Signature. (Applicant or Agent):i�
LQPERMIT ,.
Application Number . . . . . 13-00000501
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 51.00
Plan Check Fee
12.75
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 10/19/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
•2.00 9.0000 EA MECH
FURNACE <=100K
18.00
.2.00 9.0000 EA MECH.B/C
<=3HP/100K BTU
18.00
----------------------------------------------------------------------------
_ Special Notes and Comments
REPLACE (2) 5 TON HVAC SYSTEMS 13
SEER
2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
-- - - - - - - - - - - - - - ------ - - - - -
Paid Credited
Due
---
Permit Fee Total 51.00
-- - - - - ------ - -- - ----
.00 .00
-- - - - - - -
51.00
Plan Check Total 12.75
.00 .00
12.75
Other Fee Total 1.00
.00 .00
1.00
Grand Total 64.75
.00 .00
64.75
LQPERMIT ,.
Bin. #
Permit #
jcctAddcrss: Sy �(oj
City of* La Quinta
BufWg & Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92233 - (760) 777-7012
Building Permit Application and Tracking Sheet
Lolvice) 1%o.��e OwneesName:. UC�vic� GoCic�:
A. P. Number.
Address: .ELI 96) L0.vrc l �0•�1 e
Legal Description:
City, ST, Zip: L0. 1.11 G C ctZ2
Contractor.
;
Telephone:
Address: JA 1-7 0
ProjectDescription:
S V A C
Telephone: -76 3t{-3- i4$ $ .
State Lia #: (0863) O
City Lia C
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:Sq.
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Dano
Ft: #Stories: #Univ
Telephone # of Contact Person:
Estimated Value of Project 2 7 3 &0 o Lx)
APPLICANT: DO NOT WRITE BELOW THIS UNE
M Submittal Req'd Rec'd TRACKING PERMITFEES
Plan Sets Plan Cheek submitted Item Amount
Structural Calm
Reviewed, ready for eofrections Plan Check Deposit. .
Truss Calot.
Called Contact Person Plan Check Balance
Tide 24 Calm
Pians picked up Construction
Flood Pula plan
Plans resubmitted.'. Meeba"
Grading plan
V Review, ready for correctionsftaue Metrical
Subeontactor List
Called Contact Person Plumbing
Great Deed
Plans picked up SMd.
H.O.A. Approval
Plans resubmitted Grading
IN ROUSE:-
3" Review; ready for correedonvUsue Developer Impact Fee
Planning APpro, al
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
System Z
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-1R-A1LT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
54961 LAUREL VALLEY La Quinta, CA 92253
City of La Quinta
Apr 18, 2013 '
Dud insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement'
Area
Thennostat
❑ Package Unit
® Furnace -
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
[3HSPF
[3 R 6 (CZ 10-13)
Served by system
® Setback
If not already present must be
® Condensing Unit
❑ EER
❑Resistance
❑ R 8 (CZ 14-15)
1686 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 Elirclencles: 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 fad 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 -IR
and CF -6R shall also be on site for final inspection.
® 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 -611 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 leakage=: <:15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from dud leakage testing'if: -
❑ 1: Duct system:v✓as docurriented to have been previously sealed and confirmed through HERS verification, or
0'2 : Duct systems with less than.40 linear feet in unconditioned' space, or
03. Existing dud systems are`coinstructed, insulated or sealed with asbestos
04: The systerxf will not 6e Ducted (ie. Ductdess.Mloi SFItt System` A1sa Exem tzfrarit Re erantAChar e )
`�.i:.•i%r
. ...:. ,�.;c:.�C .. .... ' .. ,._.9
�
❑ 2. Newv.H;Re en refo'011 �-
..
Cut in orCFeangeout with •-: X�__ .... I
:.. �CF�-6�k forms MECH-04 ME,�!y 20f11ERS, or it: systems} MECt z HERS,
new ducks .;(a11 new :.:,:,:
ductenewt MECH 25HER5 . ��
,�' CF-412f�rms�MECH 2-0 anti' �� �' `�-
equipment) 2 t� (for spilt syste3nMEki 22 and MECH 25
,
..a,v�,... :..i�Ae.:.»"v � . _� � -X}�a�KS : arF3id:- ..�_'t� .: �"+3'�,'- _, •K "vlt�'�..'. '�i �.. _. �� ''L �
For S tet p /
p Systems .Doc[ 1'eakage «6 ercertt RC CCA 2 350 CSM ton; FWL7 MAH SIMS; arid: either NSPP of PSPP. `' '
For Packaged Units. Duct leakage; < 6. percerrt
❑'3::New: D.0 ,ft with/or without*; ; ::
Required Forms:
Replacement:::'`"`.`.'.::;; .
.Incudes replacing or iiistalling.alf new
ducting and/or outdoor:condenstng;'unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or 'fuinace 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 2 300 CFM/ton; TMAH
For Packaged Units: Duct leakage < 6 percent
0 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 oertify 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: Danielle Garda Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Apr 18, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 213-AO02319OA-000000000-0000 Registration Date/Time: 2013/04/18 17:47:26 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
_�_i_em i
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACA/terations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
54961 LAUREL VALLEY La Quinta, CA 92253
City of La Quinta
Apr 18, 2013
Equipment Type1
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
0 Package Unit
8 Furnace
8 Indoor Coil
8 AFUE %
8 SEER❑
13.0
❑ COP
HSPF
17 R 6 (CZ 10-13)
Served by system
® Setback
Ifnot already present, must be
8 Condensing Unit
0 EER
❑Resistance
17 R 8 (CZ 14-15)
sf
installed)
Q Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each
2. Minimum Equipment Ef iclenciew 13 SEER, 78%_ AFUE,, 7. 7HSPF for typical residential systems.system.
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 -611 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 CIF-IRand
CF -6R shall also be on site for final inspection.
8 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
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage-KA5 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For. P-skaged U fti..... f -0-- .1::-. 1..: '.:..: : 1 C
Exempted from duct leakage testiriy'if::
❑l1 Duct system: .was docurriented to have been previously sealed and confirmed through HERS verification, or
0'2 Duct systems with less thA40 linear feet in unconditioned space; or
'03.
Existing duct systems are constructed; insulated or sealed with asbestos
Q'4: The systerrl rill not be Du wed (ie:�Ductleess Mini Split SystemeiAlsoEExeml, Af.tom Refrigerant Charge)
. .
❑ 2 New='- Requi -
dAG: Sj►st em q
.Cut tn�orxChangeout with i�-61fotms MECH-04 ME>t#29HER5 ��a or tit St M
syerris) MEC *HERS, and
new duns (all new : MECF25
ductrngFSi all new HERS ..:
equip merit�7formsMECH 20, ans# (for split systemsEGti 2�atl MEC%f=25 �:
For Split' $jrstems bttct leakagezz46 percent RC CCi4 z X50 CFM/tan FWD h1AH fMS and'elther H!5pP or PSPp.
For Packaged`Units• Ouct leaka' i%6%,.:.ercent ` ..::..;:`' ::.;..:::.:::: c, :,.>.,.: ..:. ....,.................
g `...:.:..P
13-3.-.:New.;;D.ucfs°°:with/or withouf':``;:.`:
Required Forms:
Replacement:`.;i<'''r:.:::.
. Includ.es replacing or instalfing. sal new
.ducting and/or outdoor condensin'g::unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or fumace,No .or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Dud leakage < 6 percent; RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Dud leakage < 6 percent
D 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 dud. in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
Q EXCEPTION: Existing dud 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: Danielle Garcia Signature: DaWelle Garcia
Company: HARRISON ENTERPRISES INC Date: Apr 18, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA/ 92276 Phone: (760) 343-7488
Reg: 213-AO023187A-000000000-0000 Registration Date/Time: 2013/04/18 17:43:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010