13-0580 (MECH)10
T4&f 4 4 a
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
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
13-00000580
80610 WEISKOPF
762-100-009- -
MECHANICAL
LOW DENSITY RESIDENTIAL
14789
Architect or Engineer:
------------------
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.
License Class: C20 License No.: 686310
�.
Date: 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.).
(_ 11, 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
Date: 5/06/13
Owner:
VIENT DOUGLAS & DARLENE
P O BOX D
MODESTO, CA 95352
(209)996-5270
Contractor: D
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE MAY 00 X013
THOUSAND PALMS, CA 92276
(760) 343-7488 C"ryBFLA
Lic. No.: 686310 FINAt�CF '!t11.rA
-----------------------------------------------
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.
lie 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 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:Applicant:
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 J$1 00,000). 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
P•to_3enter upon the above-mentioned property for inspection purposes.
Date: r l Signature (Applicant or Agent):—
1 '
!,ib
Application Number . . . 13-00000580
Permit MECHANICAL
Additional desc . .
Permit Fee . . . . 42.50 Plan Check Fee
10.63
Issue Date . . . . Valuation . . . .
0
Expiration Date 11/02/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
11.00
1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE -OUT - 13 SEER/78 AFUE, (1) 5
TON SYSTEM [2008 ENERGY) CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
-------------------------------------------------------7--------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
------------------------------
e
Due
---------------------------
Permit Fee Total 42.50 .00 .00
42.50
Plan Check Total 10.63 .00 .00
10.63
Other Fee Total 1.00 .00 .00
1.00
Grand Total 54.13 .00 .00
54.13
LQPERMIT
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armpnnea rrescripttive Certificate of Compliance; 2008 Residential HVAC Alterations CF -IR -ALT -HVA
NimatQ Zones 10 - 15
Site Address: Enforcement Agency; Date: Permit #:
806i0Ii WEISKOPF La Quinta, CA 92253 City of la Quints May 6, 2013
Equiprrient Type' List Minimum Efficien 2 Duct Insulation Conditioned Floor
cY requirement Area Thermostat
O Packoge Unit.
® Fum ce ® AFUE ,z8% Q COP Setback
® Indogr Coll ®SEER 13.0 ❑ HSPF ❑ R 6 (CZ,10-13) 11 Setb
0-13) Served by system
®Condensing Unit p 1f not bEER [I Resistance 0 R 8 XZ 3579 sf already present, must bea
3 Other installed)
be lef
form i
forms
and t
® 1,
• All I
reps
•Cor
• Ind,
• Fun
Exerrpte
011
IZ
a3.
0
. Cut i
new
ducti
equip
For SOM
Por Pad
❑3;:,e
Replai
• Inciudl
ductinc
and/or
0 4. Ni
. Incluc
linear
For soli
• I ceml
. I am e
Compl
• I certil
requln
The de
forms,
lCompany;
Reg: 213-
2008 Res:
wu,p,,,=„� .ucrny msraueo; it more rllah one system, use another CF -1 R -ALT -HVAC for each system,
Equ/pmt EfYfc/enc;es: Z3 SEER, 78°1. AFUE, 7.7HSPF for typical residential systems
7r an
RIFICATION SUMMARY Listed be are FOUR HVAC alteration Options. The installer decides what work is being done
one of the appropriate Options, Each Option lists the HERS measures that must be conducted. A copy of the forms shall
site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
In fact the work completed by the installer. The inspector also verifies that each appropriate CF -611 and registered CF -4R
hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-iR
R shall also be on site for final laspecdon.
C Equipment CF -611 forms; MECH-04, m1:1 -1 -1 -21 -HERS and (for split systems) MECH-25-HERS
d CF -4R forms: MECH-21 and (for split systems) MECH-25
ser Coil and /or CF -6R forms: MECH-04, MECH-21-HERS and fors lit
Coll and /or CF -4R forms: MECH-21 and (for split systems) MECH-25 MECH-25-HERS
Systems,, Dud leakage-rc>15 percent; RC, CCA 5 300 CFM/ton (Minimum Air now Requirement), TMAH
from duct leakage testirirf;.
7Ud :systerP:.was documented .to have been previously sealed and confirmed through HERS verification, or
5uct systems.wlth• less thi 40 linear feet In unconditioned space, or
=kisting&1ct systems are •2"ortstructed, Insulated or sealed with asbestos
ll,not be Du 'd (fe:•. M.. era} ! e
k>: rge)
•.IL3'a1<:� �'?i�t �=C�3u'' to !labliiaL�[I
repladng or inl;talling.alltnew
Ind/or outdoor coYlgenst.-ha' unit CF -6R forms: MECH-04, MECH-20-HEPand (for split systems) MECH-25-HERS
door coil and/or• fu ace No or some CF -4R forms: MECH-20 and (for split systems) MECH-25
it changed.
ystems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
led Units: Duct leakage < 6 percent
Ducting over 40 feet Required Forms:
adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HER5
t of duct In unconditioned space. CF -4R forms; MECH-21
Warn or packaged units: Duct leakage < 15 percent
MON::Existing duct systems constructed, insulated or sealed with asbestos.
it this Certificate of Compliance documentation is accurate and Complete,
e under. Division 3 of the California Business and Professions Code to accept responsibility for the design Identified on this Certificate of
it the energy features and performance specifications for the design identified on this Certificate of Compliance Conform to the
is of Title 24, Parts 1 and 6 of the California Code of Regulations,
features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
;sheets,: Calculations, plans and specifications submitted to the enforcement agency for approval with the permit aoplicatlon.
!Ile Garcia Signature: Danielle Garcia
A
> / 92276
: May 6, 20
-- ....... ncq�ecracion mate/Time: 2013/05/06 12:26:41 HERS Provider- CalCERTS, Inc.
1 Compl,j annce Forms
July 2010
a.