12-0815 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application. Number: r 12-0.0.0008.15--'
Property Address:. 47610 VIA MONTANA
APN: 643-120-040-268 -26152 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5600
Applicant: IJ Architect or Engineer:
4
BUILDING &SAFETY DEPARTMENT
BUILDING -PERMIT
v
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 Pro ssionals Code, and my License is in full.force and effect.
Lice se Class: C20 License No.: 686310
Date: ntractor:
ER -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, 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 sale3.
(_ 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.). -
(_ 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
Owner:
SLAUGHTER JUDITH MAE
C/O ROBERT N SLAUGHTER
47610 VIA MONTANA
LA QUINTA, CA 92253
Contractor:.
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE '
THOUSAND PALMS; CA 92276
(760)343-7488 .
Lic. No.: 686310
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
-------------------
WORKER'S COMPENSATION DECLARATION
Date: 7/23/12
JUL 2 3 2012
OF LA
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain acertificate 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�/1 have and will maintain workers' compensation insurance, as required by Section 3700 of the ;Labor
—i'_ Code, for the performance of the Work for which this permit is issued. My workerscompensation
insurance carrier and policy number are:
Carrier ZENITH INS CO Policy Number Z071741501
I certify that, in the performance oft a work for which this permit is issued, I shall not employ any
person in any manner so as to be me subject to the workers' compensation laws of California,
and agree that, if I should becorubject to the workers' compensation provisions of Section3700 of the Labor Code, I shallwi omply with those provisions.
ate: 7 PPlicant:
WARNING:'FAIL RE TO SECURE W OMPENSATION 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 ofissuance of such permit, or ssation of work for 180 days will subject
permit to cancellation.
I' certify that I have read this application and state that the above info tion is correct. I agree to comply with all
city and county ordinances and state laws relating to building constr t n, and hereby authorize representatives
of this county to enter upon the bove-mentioned property for inspe i n pur oses.
igna re (Applicant or Agent): "
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
47610 VIA MONTANA La Quinta, CA 92253
City of La Quinta
Jul 23, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP .
❑ HSPF
❑ R 6 (CZ 10-13) .
Served by system
® Setback
If not already present, must be
® Condensing Unit
[3EER
❑ Resistance
[I R 8 (CZ 14-15)
1600 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1 R-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-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 CF-11R
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-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-411 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:
p 1:"Duct system was documented to have been previously sealed and confirmed through HERS verification, or
._
❑ 2. Duct systems with less th9h.40 linear feet in unconditioned space, or
0 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑'4.. The,Zyrstem�will not be Ducted'.(ie:,Ductless„flmSpt Sysfem(A1soExemptfro Refnger nharge)
112. 0WwjHVAC System
,.-
Requijed,,Fo
. Cut in or'Cti'angeout with
M
CF,�6i2- form ECH-04, MECH=20 HERS and ('for split systems) MECH-22 HERS, wand
new d Y;(all new.
ducts " d.all new
�.
MECH 25*HERS � � �” M
+
CF 4RfoMECH- O,.and (fors its stem MECH-2 ME H 25;
,
equipment). µ
,and
It i
For Split S.ystems:TDuct 12akage < 6 percent,7RC CCAa� 350�CFM/ton;�FWDfTMA'FI,�STMS, and either HSPP or PSPP: "
y.
For Packaged Units. Duct leakage < 6 percent
❑ 3 New.Duetswfth/or withoui"
Required Forms:
Replacement
. Includes replacing or installing :d1l'i iew
ducting and/or outdoor copdensing 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-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Dud leakage < 6 percent; RC, CCA z 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-4111 forms: MECH-21
For split system or packaged units: Dud 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: Danielle Garcia Signature: Danielle Garcia.
Company: HARRISON ENTERPRISES INC Date: Jul 23, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0038991A-00000000-0000 Registration Date/Time: 2012/07/23 09:56:00 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
i4in.#
of r of La Quinta
BuiWg 8[ Safety Dfvisfon
P.O. Box 1504,78-49S Calle Tampico
La.Qufnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1
Project Add[ess:1 O V .� q �t 1 Q
Owner's Name:.
A. P. Number.
Address:
Legal Description:
City, ST, Zip: 2%5 2
Contractor i✓c t_�c-a
Telephone: x
Address: 3 I
Project Description: ��h C
City, $T, o�CAI Z 2,7 6
o JT�,
Telephone:(7 6 0 34 1488
State Lic. # : 6 g 6 *�) 1 0 City Lia #:
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft : O #Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Stmetural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Tress Calcs.
Called Contact Person
Platt Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood pisln plan
Plans resubmlited
Mechanical
Grading plan
Za6 Review, ready for correctiouslissue
Electrical
Subcoatactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN $OUSE:-
'^' Review; ready for eorreetionsAssue
Developer Impact Fee
{
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees
I