10-0822 (MECH)4 a4P Qum&
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: 8/31/10
Application Number: -.10-00000822 Owner:
Property Address: 80390 WEISKOPF RENDINO DANIEL
APN: 762-090-017- - - 80-390 WEISKOPF
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1685 D j
Contractor: AUG
Applicant: Architect or Engineer: DOVE AIR INC 1 20410
69749 RISUENO ROAD
CATHEDRAL CITY, CA 92234 I LITYOFLAQUINTA
/�/ (760) 327-1890. I FWA N�-E1)EP
I^ Lic. No.: 794315
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 rofessionals de, and my License is in full force and effect.
License Class: C220 L' se No.: 794315
Dater �' ��/ ontractor:'!
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).:
(_) 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.).
(_) 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
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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.
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 E} MPT Policy Number EXEMPT
1114 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 be me subjeto a workers' compensation provisions of Section
,3``700 of the bor Code, I 'all forthwithct c ly wit those provisions.
/e:FlUg pplicant:
WARNING: FAI URE 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 ar)d county ordinancesand state laws relating to building nstruction, Ind hereby authorize representatives
7D.t,'.
s ccounty to enter u n the above-mentioned prope finspection poses.
{ ' 3►-� oignature (Applicant or Agent):
Application Number . . . . . 10-00000822
Permit . . . MECHANICAL
Additional desc .
Permit Fee . .
30.50
Plan Check Fee
7.63
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/27/11.
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
1.00 6.5000
A
EMECH
OTHER MECH EQUIPMENT
6.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE CONDENSER AND
COIL IN SAME
LOCATION. 2007.CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1-.00
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total
30.50
.00 .00
30.50
Plan Check Total
7.63
.00 .00
7.63
Other Fee Total
1.00
.00 .00
1.00
Grand Total
39.13
.00 .00
39.13
LQPERMIT
Sim _lifted Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 to 15
Site Address:
Enforcement Agency:
Date:
Perm!! #:
Equipment
List Minimum Efficienc a
Duct insulation requirement
Conditioned Floor
Area
Thermostat
❑ Packaged Unit
❑ Furnace
❑ AFUE ❑ COP
Over 40 ft of ducts added or
❑ Setback
WgIndoor Coil
❑SEER ❑ HSPF
replaced in unconditioned space
Served by system '
(Ijnot already
§kCondensing Unit
❑ EER ❑Resistance
❑ R 6 (CZ 10-13)
sf
presen[, must be
❑ Other
❑ R 8 (CZ 14-15)
installed)
1. Equipment Type.• Choose the equipment being installed; ijmore than one system, use another CF -1 R -ALT --HVAC for each system.
2. Minimum Equipment Efyteiendes: 13 SEER. 78% AFUE, T WSPF or
j 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 CF4R forms
(no hand filled CF4Rs allowed) are filled out and
signed. Beginning October 1 2010 a rellistered copy of the CF -4R and CF -6R shall also be on site for final Inspection.
ill.. HVAC Changeout Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems).MECH- 25=HERS
CF -4R forms: MECH- 21 and fors lit stems MECH-25
• Condenser Coil and/or
• Indoor Coil and /or
CF-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
CF4R forms: MECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA 2:300 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 ducts stems are constructed,insulated or sealed with asbestos
❑ 2. New HVAC System
Required.Forms:
with new
• Cut s: al Chang outducting
ducts: (all new ducting all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF -4R forms: MECH 20-, and fors lits stems MECH-22 and MECH 25
( split Y )
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 Kreent
O 3. New Ducts with .Replacement—
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 pent, RC, CCA > 300 CFM/ton, `fMAH
For Packaged Units: Duct leakage <6 percent
❑ 4. New Ducting over 40 feet
R uired Forms:
• Includes adding or replacing more than
linear feet of dud in unconditioned space.
e
T-611forms: MECH-04, MECH-21-HERS CF -4R forms: MECH-21
For split system or packaged unitsi Duct leakage < 15 percent
❑ EXCEPTION: Ekistin duct systems constructed insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• Lam 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 I 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 nerjni,t applicatkp.
Name: Gr G
Signature:
Company:
�V AIVA, Z�
Date: 2
7 0
Address:
L 64
License: 3
,City/State/Zip: C _4eC4 9 LL 3
Phone: 6 0gi? -7 _ , fj O
2UU6 Residential Compliance Forms March 2010
lir �icvvo rvry o:1• L, PIA ua tluinta uuitai.ngiijarty 1&JUut!UUt
Bin !f
City of La Quinta
Building at Safety Division .
P.O. Box 1504, 78-495 Calle Tampico
La Qutnta, CA 92253 - (•760) 777-7012
Building Permit Application and Tracking Sheet .
Permit # ^ _�
D C��
Project Address: Wei
Owner's Name: / C" 1 -A
A. P. Plumber:
Addrms; F03? 0 r
Legal Description:
Contractor: 6 v C.
City, ST, Zip 14 CA 511,53
I'elcphoue: %�
Address; (b�' 7 p U
l'rojest Description: A d l0 CA -Le J , w\
City. ST, Zip: `tA e •
Telephone: a 2� _
C tD
A 0 1
State Lie. # : y City Lia #:
Arch., Engr., Designer:
Address:
City, 91', 'Lip:
i elepltutre:
",tate Lic. #:
Constriction Type: Occupancy:
Project type (circle ane): New Add'n Alter Repair Demo
Name. of Contact Pera-on: 710 D 0 0 P 3oZ7
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: At
Estimated Value of Project:. o �
APPLICANT: DO NOT WHITE BELOW THIS UNE
ti
Submittal
Plan Selo
Req1d
Reed
TRACKING .
Plan Check submitted
PERMTC FEES
Item Amount
Structural Calm,
Reviewed, ready for corrections
Plan Check Deposit
Tress Calea.
Called Contact Person
Plan Check italafce
Energy Calea.
-Plans picked up
Constrvetian
Flood plain plan
Plans rcaubmitted
Meebanieal
Grading.plan,
r' Review, ready for corrections/issue
Electrical
Subcoutactor List
Called Contact Person
Plumblat
Grant Deed
Plaus picked up
S.M.I
H.O.A. Approval
Plans resubtuitled
Gradikig
IN HOUSE:-
r"' Review, ready for correctionslissno
Developer Impact Fee
Planning Approval
Called Contoct Person
A.I F.I'.
Pub.1'i'ks. Appr
Date of permit issue
Sehoot Fees
_
Total Permit Fees