12-0997 (MECH)P
4 P.O. BOX 1504 / __ \ VOICE (760) 777-7012
787495 CALLE TAMPICO , FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT_ INSPECTIONS (760) 777-715.3
- BUILDING PERMIT
_ s A D el/12
Application Number: 12-00000997 Owner: 70FINANCE
Property Address:, 55433 WINGED FOOT DOUGLAS CELLA G2 Q 20APN: 775-182-023- - - ,: 55433 WINGED FOOT UApplication description: MECHANICAL BERMUDA DUNES, CA 92203Property Zoning: LOW DENSITY RESIDENTIAL OF4.�+�6lWApplication valuation: 10364 DEP
Contractor: _
Applicant: Architect or Engineer: DESERT -AIR CONDITIONING, INC.
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
(760)323-3383
Lic: No.: 276586
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION .
I hereby affirm under penalty of perjury that I am licensed under provisions 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 and Profession ode, 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—C43 is tsE No.: 276586 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ,
Gissued.
Date omractor: • 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am'exempt from the Contractor's State License Law for the Carrier EVEREST NATL - Policy Number 7600007908111 -
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 work for 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 become subject 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, if I should become subject the workers' compensation provisions of Section T
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 37Q0 of the Labor C90er{ shat fo with ply with hose provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by /L/ C6//
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - , ate: C. F / A leant: ri \
(_) 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 I, 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
A 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,
( 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnity 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.
Date: - Owner: 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
CONSTRUCTION LENDING AGENCY - permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above informatio is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). , •city and�caunty ordinances and state laws relating to building co structio d hereby authorize representatives e _
• of thi ounty to enter upon eabove-mentioned pro y fo s ctio roses. '
Lender's Name: Q % �.
a ate: t+ S' ature (Applicant or Agent(:
Lender's Address: -
.r -
LQPERMIT _ - -
Application Number . . . . . 12-00000997
Permit MECHANICAL
Additional desc
Permit Fee . . . . 40.50 Plan Check Feer.
10.13
Issue Date Valuation
0
Expiration Date 2/25/13
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
Special Notes and Comments
HVAC CHANGE -OUT: REPLACE 4 TON SPLIT
SYSTEM AT GROUND LEVEL. 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
r
LQPER I[T .. ..
.
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations, , CF-lR-ALT-HVAC
Climate Zones 10 - 15t - r
Site Address:
Enforcement Agency:
Date: ,
Permit #:
55-443 WINGED FOOT La Quinta, CA .92253
City of La Quinta
Aug 24; 2012
Duct insulation
Conditioned Floor
Equipment Typel
= List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit-
® Furnace ,
® Indoor Coil
® AFUE _78%
® SEER 13.0
❑ COP
[1HSPF
[I R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
[I EER
[3 Resistance
❑ R 8 (� 14-15)
1600 sf
instalted) r
❑ 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, 7801b AFUE, , 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decide=- 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 onsite 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 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. -
®1. HVAC Changeout '.
Required Forms: .
. All HVAC Equipment
CF -611 forms: MECH-041 MECH-21-HERS and (for split systems) MECH-25-F-.ERS
replaced `
CF -4R forms: MECH-21 and (for split systems) MECH-25 h "
. Condenser Coil and /or,
. Indoor Coil and /or
CF -6R forms: MECH-04 MECH-2I-HERS and (for split systems) MECH-25-F ERS
~. )
- f
. Furnace
CF -4R forms: MECH-21�and (for split systems). MECH-25
1
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 systemmill not be Ducted (ie',,Ductless-Mini-Split _System),(Also_-Exempt fromIRefrigerant'�-harge)
❑ 2. New HVAC System
Required Forms: F
. Cut inror Changeout with,l
new ducts:
- -- :.
CF 6R forms:;MECH .04, MECH-20-HERS, and,(forsplit systems) MECH-22+IERS; and -
(all new
ducting and all new
MECH=25°HERS _ �r
CF-4R'forms:, MECH-20, and (for, split systems) MECH-22 and MECH-25 1 ��
equipment
For Split Systems: Duct leakage <'6 percent; RC; CCA:>_ 350 CFM/ton, FWD,•TMAH, STMS, and eil: erHSPP 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 -6R 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:
u_ ,
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
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. s: -
• 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 Com Aiance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. L
. 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: Jacqueline Zabik Signature: Jacqueline Znbik
Company: DESERT AIR CONDITIONING INC Date: Aug 24, 2012 -
Address: 590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383 ;
i Reg: 212-AO04679OA-00000000-0000 Registration Date/Time:.2012/08/24 14:18:13 HERS Provider: CalCERTS,..Inc`'.
2008 Residential Compliance Forms July 2010
Bin. # j
CII}/ Of La QUICK
BLdkgng 8r Safety D10sion
P.O. Box 1504,78-495 Calle Tampico
LR.Qtrhlta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ProjectAMmm: 55-433 WINGED FOOT
Owner'sNamm. DOUGLAS CELLA
A-P.Number.
Address: 55-433 WINGED FOOTk.�
Legal Description:
City, sT, zip: LA QUINTA, CA. 92253
Contractor. DESERT AIR CONDITIONING, INC
Telephone:
Address: 590 WILLIAMS RD
Project Description: REPLACE 4 TON SPLIT
City, sT, Zip: PALM SPRINGS, CA 92264SYSTEM
ON THE GROUND LIKE FOR LIK
Telephone: 760-323-3383
State Lia #: 276586 City Lic. .363
Arch., Fag., Designer: NA
Address:
City, ST, Zip:
Telephone:
f
State Lic. #:
Name of Contact Person: JACQUELINE RATLIFF
Construe ion Type:. MECH Ot�xpancy:
Project type (circle one): New Add'a Alter Repair Des no
Sq.' Ft:
#Stories:
#Unit;;
Telephone # of Contact Person: 760-323-3383
Estimated value of project: 10, 364.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACiCY1VG
PERMUFEFS
Plan Sets
Pian Cheng submitted
Item Amount
Strgdaial Coles.
Reviewed, ready for corrections
Plan Chect Deposit. .
Truss Calcs.
Called Contact Person
Pias Check Balance
Title 24 CalciL
Plans picked up
Constrnetion
Flood plain plan
Plans resubmitted..
Mechafik-I
Giading plan
2'" Review, ready for correctionshssue
Electrical
Subcontactor Lid
Called Contact Person
Plumbing
Grant Deed
Pians packed up
S.M.I.
Ii O A. Approval
Plass resnbmitbed
Grading
IN HOUSE-,
'id Reylew, ready for eorrectionslissue
Developer Iiuliaet Fees,
Planning Approval
Called Contact Person
A1P.P.,
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Pwmit Fees