12-0264 (MECH)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:. 3/21/12.
Application Number: X12-00000264
Owner:
Property Address: 56087 WINGED—FOOT
JANICE BROWN
APN: 775-300-013- - -
56,087 WINGED FOT
Application description: MECHANICAL
LA QUINTA, CA 92253 �__._____
Property Zoning: LOW DENSITY RESIDENTIAL
n 0 (j
Application valuation: 11767
J! III t�
p
Contractor: MAR L�IL
2
Applicant:. Architect or Engineer-
GENERAL AIR CONDITIONI
31170 RESERVE DRIVE
THOUSAND PALMS, CA 922 6 CITY OF fLA QUINTA
(760)343-7488 FIN�4!tlCF (l�PT.
Lic. No.: 686310
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of'perjury that I am lic sed under provisions, of Chapter 9 (commencing with .
.1 hereby affirm under penalty of perjury one of the following declarations: ,
Section 7000) of Division 3 of the Business and Pro sionals 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
• Licens •Class: C20 License No.: 686310
ntractor:
_
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
OW ER -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 ZENITH INS CO Policy Number Z071741501
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 f 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 su t to theworkers' 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 subjec the workers' compensation provisions of Section- '
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall fonhwit mply with those provisions. '
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).: -
ate.- ppftant: "
1—) 1, 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' SATION 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
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-
.
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 ssation of work for 180 days will subject
• CONSTRUCTION LENDING AGENCY
permit to cancellation.
Thereby 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 in r ation is correct. I agree to comply with all
work for which this permit is issued (Sec: 3097, Civ. C.1. -
city and co my ordinances and state laws relating to building cons ion, and hereby authorise representatives
. -
of this unty to enter upon the above-mentionedproperty for insp ion oses. ,
"Lender's Name:
-
ate: ure (Applicant or Agentl:
. Lender's Address:
- -
LQPERMIT -
Application Number . . 12-00000264
Permit- . . . . MECHANICAL
Additional desc _.
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date Valuation
0
Expiration Date,. .9/17/12
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/>100K7500KBTU
16.50
- Special Notes and Comments
HVAC CHANGE -OUT: 3 TON HORIZONTAL
SYSTEM IN ATTIC, FURNACE, COIL,
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 ..
.. .
Ca10ERTS.., CF -1R Registration~ t�I
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CONGRATULATIONS
Secure Home �.
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Your CF -IR -ALT -HVAC Registration is complete!
�• About Us
You may want to print this page for your records. ,.
Site Address:
56087 WINGED'FOOR
t ,
Training
La Quinta, CA 92253
a
CEC Registration:
212-A0013986A-00000000-0000
• Rater Directory
• .
—
CF-lR-ALT-HVAC:
—
CLICK DOWNLOAD
•
- Forms
Assigned Company:IHARRISON
_HERE _TO_
ENTERPRISES INC
Membership Benefits
Do you know your HERS Rater?
4
If you do, you may want to send this CF -111 to them.
Events
CaICERTS Rater ID:
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OR
Industry Partners
M Rater Quick.Select: Select From List
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Every CaICERTS rater has a license number.
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11 SENA CF IR TOXHERS',R/�7ER �
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our monthly
newsletter,
[CLICK HERE] to do another
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please click here.
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Copyright Oc 2010 CaICERTS, Inc. All rights reserved- Revised: January 11 2010
[Terms and Conditions] [Privacy Statement) [Class Cancellation Policy']
r •'
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
•`
Office: 916-985-3400,TollFree: 877-HERS-R8R,(877-437-7787)
Fax: 916-985-3402 Contact Us `
BBB Ewa uS o Fac aokQ
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https://www.calcerts.com/public_cf1R.cfin?project_id=176.['94
3/20/2012
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
56087 WINGED FOOR La Quirita, CA 92253
City of La Quinta
Mar 2-0, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
❑ R 6 PCZ 10-13).
Served by system
® Setback
® Indoor Coil
® SEER 13.0
❑ HSPF
❑ R 8 (CZ 14-15)
1250 sf
If nit already present, must be
® Condensing Unit
❑ EER
❑ Resistance
insMIled)
❑ Other
.
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor 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 decices 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 -61k 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 -IR
and CF -6R shall also be on site for final inspection.
® 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 -4R forms: MECH-21 11 INOand (for split systems) MECH-25
• Condenser Coil and /or
. Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage,<i15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
FGF Parakaged Un- E
Exempted from dud leakage testing. -if:
❑ 1. Ductsystem was documented to have been previously sealed and confirmed through HERS verification, or
.❑ 2. Dud systems with less than 40 linear feet in unconditioned space, or
p 3. Existing dud systems are constructed, insulated or sealed with asbestos
❑ 4. Th,�ystem:will not be Ducted`(ie. Ductless Mini -Split S.ystem)v(Alla=Exempt.from,Refrigerraet Charge)
�.a.Sh .wt! .c_ ....9 .. ei:
❑ 2 New'HVAc'System
Required Forms s" ; .' j `
t ;4-, 3.. •'� �.
. Cut mor=Changeout with"
new ductsr`(all new
ductin
1 + y' ' * �
CF 611 forms MECH-04 MECH 20 HERS and �(for split systems) MECH r2 HERS and
r a �•
MECW
, all new
g>
CES 4Ftforms: MECH 20, and fors lits stems MECH_.,22, and MECH-25 1 '
equipment) a.
i ., _„ a? .,� _ Yx_ rV2"r .
For Split Systems .DuetaeakageA<
6y percent,' RC; CCA+> 350 CFM/tpn6FWD,-T,MAH, SIMS, and'eitr,& HSPP'orPSPP.
For Packaged Units: Dud
leakage <>6 percent'
❑ 3 New -,Ducts with/or without;;
Required Forms:
Replacement f '.
• Includes replacing or installing 611 new
ducting and/or outdoor condensing`vnit
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 -4R forms: MECH-20 and (for split systems) MECH-25
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 -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 information documented 3n other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: Mar 20, 2012
Address: 31-170 RESERVE DRIVE STE A Litense: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0013986A-00000000-0000 Registration Date/Time: 2012/03/20 19:40.:49 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin #
Cr 0� La � T
ty Qrcunta
Building iii' Safety Division
P.O. Box 15.04, 78.495 Calle Tampico
La Quinta, CA 92253 - (760): 777-7012
Building Permit -Application and Tracking Sheet
Permit #
Project Address: (p09-2 w M(Nd F •
�QnCQ 6w n .7w
A. P. Number:
Address: S10 0 ,n I foot
Legal Description:
F
City, ST, Zip: L q 5
Contractor:11
Address -3
City, ST, Zip: �'7
Telephone: �r;�
1111
Project Description: v Ve Nti �3.
s WL. IL .
Telephone:
v •.. v •, r.4 ,ter ri ti r�rM1 ��
O f<•''.0{1,.1lji-",
State Lic. # :
3 City Lic. #: loC7 {2
'
Arch., Engr., Designer:
-
Address:
C;!, ST Zip.
Telephone:
State Lic.
,�" , : . •;. �;.
. ri:�• ,��...�:.i�f �r:�.. }}• �*,...
� Construction Type: Occupancy:
Pro '
Project type. (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
•
CC) U4? e-4 OYU
Sq. Ft
#Stories:
#Units:
Telephone # of Contact Person: 0 3 V -j %' 4 �' $
Estimated Value of Project:
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
tt
Submittal
Req'd
Recd
TRACKWG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cales.
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
Schodl Fees
Total Permit Fees