13-1316 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
13-00001316
78292 CALLE LAS RAMBLAS
770-015-006- -
MECHANICAL
LOW DENSITY RESIDENTIAL
8455
Ti -ht 4 4 Q"
Architect o� Engineer:
tel\7,-�J
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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.
Licensre Class: C20 // License No.: 686310
Date:f L ll -5 Contractor,
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 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 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 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 a ency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: N \J
LQPERMIT,
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
.Date: 10/15/13
Owner: -
DALPORTO DONALD
78292 CALLE LAS RAMBLAS
LA QUINTA, CA 92253
(
W []
Contractor: D �
GENERAL AIR CONDITIONING
31170 RESERVE.DRIVE OCT 15 ryi3
THOUSAND PALMS, CA 92276 1
(760)343-7488
Lic. No.: 686310 CITYOFurEQrt'IA,3.
..uwr .:_.
-----------------------------------------------
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.
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 ZENITH INS CO Policy Number Z071741502
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
� 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: rQ 0 Applicant.' c4 J��
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 1$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 I.J' I3 Signature (Applicant or Agem)7_S_,7 t -n
4:;
t
Application Number . . . . . 13-00001316
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee . . . . 47.67 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 4/13/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA MECH APPL REP/ALT
11.92
1.00 35.7500 EA MECH AIR HANDLER
35.75
-----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - REPLACE 1 2TON HEAT
PUMP AND AIR HANDLER 7.7HSPF SPLIT
SYSTEM [2008 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
- ----------------------------------------------------------------------------
Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
35.75
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 47.67 .00 .00
47.67
Plan Check Total .00 .00 —.00
.00
Other Fee Total 126.32 .00 .00
126.32
Grand Total 173.99 .00 .00
173.99
1
LQPERMff
,
Din #
City of La Quihl,U
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
(2j(.
Project Address: "j fs Z9 Z Cc.� LAS amb
Owner's Name:
A. P. Number:
Address: '7 gZq Z
Legal Description:
Contractor: Cr�e m1 Ll - ,QN$
City, ST, Zip: CA Ci 7-Z53
Telephone: ...................:......:.............
Address: 3)\-7C) *—'e5exvc
Project Description:
City, ST, Zip: ho�0.hd CQ Ci ZZ7(o
'
Telephone: %(o0-343-7488
p....: ::::;:ir:?{r:
ii�?:M1.[.i ..: :..J: �� {:f: ;.; �.::..:: is •i
`<>.<::;:{:'s>;,:.;;:;:.;i:%:.::«;::i:.:{•i»
State Lic. # : (1%6_2110'
City Lic. #•:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
's.z'aj; :zi;:<r;>•:;>{:;;l:.<;;i;{:;;
��'�•' $Sill:•: is isv:•i:iii%•ii:{iti!{;:{y}:y;'ry;:�ry'v ���
:,';>:z?>:'<><;>f.»>s<>:s;z`:•::>:{?..,,<. '<;:<
Construction Type: Occupancy:
State Lic. #
Add'
n Alter tyPav:(circle one): New Repair Demo
Sq. Ft.: —# Stones: # Units:
Name of Contact Person:
Telephone #,of Contact Person:
Estimated Value of Project: [� 5
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Coles.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential RVACA&erations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:Enforcement
Agency:
Date:
Permit #:
7-SZzgZ Cr—Ile- L ,:,s �G���c.5
�� La. C�iiY1 c.
10IS 13
Conditioned Floor
Equipment T t
List Minimum Efficienc 2
Duct insulation requirement
Area
Thermostat
13 Packaged Unit
[3 Furnace
❑ AFUE
❑ COP
Over 40 ft of ducts added or
C9 Setback
Indoor Coil
❑SEER
11 HSPF %. "j
replaced in unconditioned space
Served by system
(if not already .
,N
JR Condensing Unit
13 EER
❑ Resistance
❑ R 6 (CZ 10-13)
E3R 8 (CZ 14-I5)
sf
present, must 6e
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 CF4R forms (no hand filled CF4Rs allowed) are filled out and
signed. BepAming October 1 2010, a re ' tered copy of the CF -1R and CF -6R shall also be on site for final inspection.
In 1. HVAC Changeout
Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH-21 and (fors lit stems) MECH-25
• Condenser Coil and/or
CF -6R forms: 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
For Packaged Units: Duct leakage < 15 percent
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
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF4R forms: MECH-20, and (for split systems)MECH-22, and MECH-25
new equipment)
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 peruent
❑ 3. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all 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 CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
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.
• 1 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 a enc forval with the permit application.
Name: <
!S;
Signature: �_ a
4F -\i GYM r
Company:
Ge�nGrc�I Air
Date:
Io' 15' 13
Address. 3\k_70 k*�eSPXvc_ \ �
License:
lc_il�/_State/ZID: \hovSGY� �cZ\vYIS C-Ao CtZZ7(o
Phone: %�p_3�i3-74$�
2008 Residential Compliance Forms July 2010
INSTALLATION CERTIFICATE CF-6R-ENS'-01
Envelope — Insulation; Roofing; Fenestration (Page I of 3)
Site Address: Enforcement Agency: Permit Number:
lV P 1'�)-0000 %SV o
If more than one person has responsibility for installation of the items on this certificate, each person shall prepare and sign a certificate
applicable to the portion of construction for which they are responsible, alternatively, the person with chief responsibility for construction shall
prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check boxes require to be checked to ensure
the mandatory measures have been met.
Description of Insulation
1. RAISED FLOOR
Material: Brand Name:
Thickness (inches): Thermal Resistance (R-Value):
❑ § 150(d): Minimum R-13 insulation in raised wood -frame floor or equivalent U-factor.
2. SLAB FLOOR/PERIMETER
Material: Brand Name:
Thickness (inches): Thermal Resistance (R-Value):
Perimeter Insulation Depth (inches):
❑ t 150(1): Water absorption rate for the insulation material alone without facings is no greater than 0.3%; water vapor permeance
rate is no greater than 2.0 penn/inch and shall be protected from physical damage and UV light deterioration.
3. EXTERIOR WALL
a. Insulation Type (e.x. Batt, Loose Fill, Spray Foam)
b.. Insulation Type (e.x. Batt, Loose Fill, Spray Foam)
Brand: {
a. Thermal Resistance (R-Value): /L - I
b. Thermal Resistance (R-Value):
Spray/Loose fill) Installed Actual Thickness Spray/Loose fill)
inches Contractor's min installed weight/ft 12.381b
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
04 ti 150(c): Minimum R-13 insulation in wood -frame wall or equivalent U-factor.
Exterior Foam Sheathing (rigid Insulation)
Material:
Thickness (inches) :
4. FOUNDATION WALL
Thickness (inches):
5. CEILING
Brand Name:
Thermal Resistance (R-Value) :.
Brand Name:
Thermal Resistance (R-Value):
Batt or Blanket Type: Brand Name:
Loose Fill Type: Thermal Resistance (R-Value):
Spray Foam Type: Brand Name:
Installed Actual Thickness (inches): Contractor's min installed weight/ft'`4 GI(a lb
Manufacturer's installed weight per square foot to achieve Thennal Resistance (R-Value):
U" § 150(a): Minimum R-19 insulation in wood -frame ceiling or equivalent U-factor.
6. ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER
Material: Brand Name:
Material: Brand Name:
Thickness (inches): Thermal Resistance (R-Value):
❑ `118(a): Insulation installed meets Standards for Insulating Material.
❑ $150(g): Mandatory Vapor barrier instal led in Climate Zones 14 or 16.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-ENV-01
Envelope — Insulation; Roofing; Fenestration (Page 2 of 3)
Site Address: Enforcement Agency: Permit� tum�ber:
—I 2q`z 1 `�i L.RS f-W P 3; .5 1 -�>—Lucl o 15l LD
Description of R ofing Products
CRRC Product ID
Manufacturer
Product
Root'
Roof
Product
Initial Solar
Aged Solar
'rhennal
Numbed
Intonation
Ili -and hLulel
INpe
Area
Sloe
Weidit3
Reflectance
Reflectance'
F.miltance
❑3
❑3
❑3
7. The CRRC Product ID Number can be obtained from the Cool Roof Rating ('ouncil's Ruled Product Director at
ww. coo Iroofs, org/products/search. php
2. The weight in /bs per square feet of the roofing product being installed
3. Check box if the Aged Reflectance is a calculated value using the equation below, footnote 4.
4. if the aged reflectance is not available in the Cool Rogf Rating C'ouncil's Ruled Product Directory then use the initial reflectance value from the
directory and use the equation (0.2+0.7(o,,,,(tat— 0.2) to ohluin a calculated aged value.
✓OCNFcK dPPLIC I BLE BOX eEZOIt IF E.YE.IIPT P RO:II THE ROOFING PRODUCT "COOL ROOF" RE_O('IRE.IIF:\'T
❑ The roof area emered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool
Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with it weight of at least 25 Ib/ft is exempted from the above Cool Roof
criteria.
To apply Liquid Field Applied Coatings, the coating must be applied with a minimum dry mil thickness of20 mils across the entire roofsurface and
meet minimum performance requirements listed in §778(i)3 and Table 118-C Select the a ficabto coatin
❑ Aluntinuni-Pigmented Asphalt Roof Coating ❑ Canent-Based Roof Coating
❑ Other
✓ ❑ CRRC-I Label Attached to CF-6R
(Note if no CRRC-1 label is available, this compliance method cannot be used and another method is required to meet compliance).
FENESTRATION/GLAZING
Item
Manutacturer.'Brand Name
(GROUP LIKE RODUCI'S)
Product
U-
factor
Product
SHGC'
#
of
Panes
NFRC
Certified' 2((Optional)
Total Quantity
of Like Product
Area
ft'
Add. Exterior
Shading Dev.
orOverhang
Comments
I.ocationi Special
Features
3
4
5
6
7.
s /iwwa feneshulion In oduetb AhRCCertified Label. For fenestration products without an NFRC label, use the default values from Section 116, Ta116-B of the 2008 Energy Efficiency Standards.
FNFRC
bel Certificates shall not be removed until the building inspector has verified the efficiency, Enter Yes or No.
❑ 1I16(a)1: Doors and windotes betwctn conditioned and unconditioned spaces designed to limit air leakage.
❑ §I I6(a)2 and 3: Actual fenestration products installed arc equiealent to or have a lower U-factor and'or a lower SHGC than that specified on
the Certificate of Compliance (Form CF-I R).
❑ § 116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U-Factor, certified Solar Heat Gain
Coefficient (SHGC), and infiltration that meets- the requirements of §10-I1 I(a)
❑ § 1 17: Exterior doors and windows weather-stripped: all joints and penetrations caulked and sealed.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-ENV-01
Envelope —Insulation; Roofin • Fenestration (Page 3 of 3)
Site Address: Enforcement Agency: Permit Number:
M S Pit 5
DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative
of the person responsible for construction (responsible person).
• I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation) conforms
to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement
agency.
• I reviewed a copy of the Certificate of Compliance (CF-111) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-IR that apply to the installation have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a
signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building
owner at occupancy.
Company Name: (Instplling Subcontractor or General Contractor or Builder/Owner
&. E 2FkL A i C
Responsible Person's Name:
-V
Responsible Person's Signature:
M
CSLB License:
Date Signed:
Position With Company (Title):
Residential Compliance Forms August 2009