12-0896 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-iht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MICHAEL BROWN.
54900 AVENIDA DIAZ
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
9/12
Application Number:
12=M_0 0896
Property Address:
54900 E IDA DIAZ
APN:
774-291-008-17 -000000-
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
6500
T-iht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MICHAEL BROWN.
54900 AVENIDA DIAZ
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
9/12
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: r+
LQPERMIT
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 inf orrect. I agree to comply with all
city and county ordinances and state laws relating to building c , and h eby authorize representatives
of this nt enter upon the above-mentioned property ec
te: - , nature (Applicant or Agent):
Contractor:
Applicant: Architect or Engineer:
BEST IN THE WEST
255 N. EL CIELO, 140-125
PALM SPRINGS, CA 92262
(760)343-1002
LiC. No.: 826714
--------------------------------------------------------------------------------------------
UCI SED CO TOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am Iiiprovisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business anro i als Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 -C38 'cen� a No.: 826714
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Data:ntractor:
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 permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I a empt-from the Contractor's State License Law for the
Carrier GUARD INS GRP Policy Number BEWC337354
following reason (Sec. 7031.5. Business and Professions Code: Any city or county that requires a permit to
I certify that, in the performance of the o which This permit is issued, I shall not employ -any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
_
person in any manner so as to be to the workers' compensation laws of California,
permit to file_a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, i�Ishou'd bec ect to th workers' compensation provisions of Section
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
3700 of the Labode, I h mpl with those provisions.
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date: � pplicant:
(_) 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 avid Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' CO -ION COVERAGE IS UNLAWFUL, AND SHALL
' Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees; provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&P.C. for this reason -
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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: r+
LQPERMIT
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 inf orrect. I agree to comply with all
city and county ordinances and state laws relating to building c , and h eby authorize representatives
of this nt enter upon the above-mentioned property ec
te: - , nature (Applicant or Agent):
Application Number . . . . . 12-00000896
Permit MECHANICAL
Additional desc . .
Permit Fee . . . . 40.50 Plan Check Fee .
Issue Date . . Valuation . . . .
Expiration Date . . 2/05/13
10.13
0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50
-------------------------------------------------------------------7-7------
Special Notes and Comments
HVAC CHANGE -OUT: INSTALL NEW 3 TON HEAT
PUMP FAU & CONDENSER. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN.(SB1473) 1:00
Fee summary Charged Paid Credited Due
---------------=-----------------------------------------
Permit Fee Total 40.50 .00 .00 40.50
Plan Check Total 10.13 .00 .00. 10.13
Other Fee Total 1.00 ,00 .00 1.00
Grand Total 51.63 .00 .00 51.63
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency:
Date:
Permit #:
54900 Avenida Diaz La Quinta, CA 92253 City of La Quinta
Aug 4, 2012
Dud insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
0 Furnace
❑ Indoor Coil
❑ AFUE
2 SEER 13.0
0 COPE3
® HSPF 7.7
R 6 (CZ 10-13)
Served by system
8 Setback
If not already present, must be
(3 Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-I5)
1200 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 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 fad 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 -111
and CF -611 shall also be on site for final inspection.
m 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 -611 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:
❑ 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 Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. Now HVAC System
Required Forms:
. Cut in or Changeout with
new ducts: (all new
CF -6R forms: MECH-04, MECH-20-HERS; and (for split systems) MECH-22-HERS, and
ducting and all new
MECH-25-HERS
CF -4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
equipment)
For Split Systems: Duct leakage < b percent; RC, CCA ? 35D CFM/ton, FIND, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing 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 -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA -2 300 CF141ton, Ti AH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 fleet 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 -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 intormation documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Richard C Weaver Sr Signature: Richard C Weaver Sr
Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: Aug 4, 2012
Address: 255 N ELCIELO ROAD #140-125 License: 967982
City/State/Zip: PALM SPRINGS / CA / 92262 Phone: (760) 343-1002
Reg: 212-A0042129A-00000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2012/08/04 14:13:42 HERS Provider: CalCERTS, Inc.
July 2010
r,
s
Bin #
City of La Quinta
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 # n �
��-
Project Address:
Owner's Name: 7 66,�C)
A. P. Number.
Address: 6- v *,s—;-
Legal Description:
City, ST, Zip; �3
Contractor.�S
141e,
Telephone!
Project Description:
Address: ;2S'5;4J, gL
City, ST, Zip: l
4�
p
Telephone:• C) 3 —/OOZ
State Lie. #
Arch., Engr., Designer:
City Lie. #:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Telephone # of Contact Person:,
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
V Review, ready for correctionsrrssue
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 cor•rectionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees