13-0766 (MECH)P.O. BOX 1504.. h•�� VOICE (760) 777-7012
" � � r'r
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA; CALIFORNIA 92253' BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
- BUILDING PERMIT
t j Date: 6/20/13
Application Number: 13-00000766 Owner:
Property Address: 47880 VIA NICE SHARON MILES
APN: 643-130-028-28 -26152 LA QUINTA, CA 92253
Application description: MECHANICAL (760) 564-1797
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3500
Contractor: D
Applicant: Architect or Engineer: J ANTHONY 'PLUMBING HEAT �{p,�
" 72216 NORTH SHORE STREE lO1 JU•N 2�:0 2013.
THOUSAND PALMS, CA 9227
1 1
(760)343-2121 CIS( OF LA (IU1NTis
Lic. No.: 777794 FINANCE DEPT.
LICENSED CONTRACTOWS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter cing with
Section 7000) of Division 3 of the Business and Profess, Is Code, and my Lic is in full forcAand effect.
License las : C20 -C36 LicenseNo.: 7 94 111
{ J
dDate: 6 Contractor
1�
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
LicenseLaw (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 155001.:
(_) 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
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. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penaltyof 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: 1 V\
I,QPERA1IT
WORKER'S COMPENSATION DECLARATION
1 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
ection 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
-'f 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 WESCO INS Policy Number 3051016
,_• I certify that, in the performance of the work for which this permit is issued, I shall not employ any
I person in any manner so as.to become subject to the workers' compensation laws of California, .
and agree that, if I shout become subject to the workers' compensation provisions of Section
j' 3700 of trie Labor C d , I shall forthwith comply with those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 p mit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ab ve information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil in construction, an ereby authorize representati
of this o my o enter upon the above-mentioned pro sp
on
pur os
Date: Signature (Applicant or AgenW,
4
Application Number . . . .
13-00000766
Permit . . . . . . MECHANICAL
2013
• Additional desc .
Permit.Fee'35.75
Plan Check Fee
:00
- Issue Date
Valuation
0
Expiration Date 12/17/13
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT (1)' 13SEER 4
TON
CONDENSOR (2008 ENERGY) CARBON
MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR
TO FINAL .
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
-----------------------------------------------------------------------------
Other Fees
BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
23.83
Fee summary Charged
Paid Credited'
Due
Permit Fee Total 35.75
:00• .00
35.75
_. Plan Check Total .00
.00 .0.0
..00
Other Fee Total 115.40
.00 .00
115.40
-.Grand'Total 151.15
00 .00
151.15
LOPE IL\1IT
Total Permit Fees
City Of La Quinta
Building 8i Safety Division
Permit #P.O.
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253
- (760) 777-7012
l v
Building Permit APPlication and Tracking Sheet
JC
Project Address:
t t
A. P. Number:
wner's Name:
0/1 l 'LeS
Address: '
Legal Description:
City. ST, Zip:
Contractor:
elephone: �� �_ �
4
J I�R.l 131-mi-V"' �r Project Description: �P %�c..c T "JtL
City,, ST, Zip: *-r�1lIGE$ -1
..,
Telephone: THOUSAND PALMS, CA 3 >:<>::<:':`'':`>>'-.<,
jC
State Lic. #
City Lic.:#:;:�i��6=>:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
_
C onstru h '
c on
Type: Oceu Pan c_v -
Name of Contact Person: ed �
Pro e ct type (circle one): New Add'n Alter Repair Demo
�
W (. `t hm S S Ft.:
Sq.
Telephone # of Contact Person: -7 to Q ^Z� �'t
#Stories:
#Units:
Estimated Value of Project: 3�0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
Plan Sets
Plan Check submitted
PERMIT FEES
Structural Calcs.
Reviewed, ready for corrections
Item
Amount
Truss Calcs.
Plan Check Deposit
Called Contact Person
Title 2� Calcs.
Plan Check Balance
Plans picked up
Flood plain plan
Construction
Plans resubmitted
Grading plan
,,
2 Review, ready for corrcctionslssue
Mechanical
Subcontactor List
Electrical
Called Contact Person
Grant Deed
Plumbing
Plans picked up
II.O.A. Approval
Plans resubmitted
S. IJ.
IN HOUSE:-
Review,
Grading
Planning Approval
ready for corrections<ssue
Impact Fee
Called Contact Person
Pub=APpr
4:"fe
Date of permit issue
School Fees
Total Permit Fees
Y
Simplified Prescriptive. Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 1S
Site Address:
Enforcement Agency:
Date:
7.
Permit #:
47880 VIA NICE La Quinta, CA 92253
City of La Quinta
Jun 20, 2013
Duct Insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
[3 Indoor Coil
❑ AFUE
® SEER 13.0.
❑ COP
❑ HSPF
p R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
H Condensing Unit
[3 EER
❑ Resistance
R 8 (CZ 14-15) 13
6 0 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.
1. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, Z7HSPF 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 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 -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 and (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, cc.15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if: -
ti❑ 1 `Ductsystem,ovas documented to have been previously sealed and confirmed through -HERS verification, or
❑ 2. Duct systems with less thans40 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 Char ell
❑ 2. New HVAC System Required: Forms
• Cut in or Changeout with' CF=6R forms: MECH-04, MECH-20fHERS, and (for split systems) MECH-22-HERS, and
new ducts: (all new MECH-25 HERS
ducting and all new CF -4R forms MECH,720, and (for split systems) MECH=22, and-MECH-25
equipment)
For Split'Systemsc;Duct leakage <6 percent; RC, CCA >_ 350. CFM/tong FWD, TMAH STMS and either,HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
0.3. ,New Ducts "with/or without
Required Forms:
Relacement
-
. Includes replacing or installing all 'new.
ducting and/or outdoor condensing unit
CF -6R forms: MECH704, MECH-20-HERS, and (for split systems) MECH-25-HERS
,and/or indoor coil and/or furnace, Ao 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 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 permit application.
Name: Kevin Robinson Signature: Kevin Robinson
Company: J ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Jun 20, 2013
Address: 72216 NORTH SHORE ST #101 License: 777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121
Reg: 213-A0045649A-000000000-0000 Registration Date/Time: 2013/06/20 11:35:30 HERS Provider: CaICERTS, Inc.
2008 Residential Compliance Forms July 2010