09-0467 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
~09=00000467 _
Property Address:
`- 52835 AVENIDA VILLA
APN:
773-333-018-5 -000000--
Application description:
MECHANICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2400
Applicant:
Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT'
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 License No.: 752180
r —
Date. - 17` Contractor:
NE BUILDER DECLARATION
hereby affirm under penalty of perjury that I am xem from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Profe s 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 ($5001.:
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 ovshe did not build or
improve for the purpose of sale.).
(_) 1, 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 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/13/09
Owner:
REDEVELOPMENT AGENCY CITY OF.L
78495 CALLE TAMPICO
LA QUINTA, CA 92253 O
(760)777-7000
Contractor:
PRIORITY ONE A/C &•EACDPNG CO
P.O. BOX 1681 ^fie f
PALM DESERT, CA 92261
(760) 773-0811
Lic. No.: 752180
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — \— sem_ — _ — — — — — — — --
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 NORGUARD INS Policy Number ROWC013690
_ 1 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' compensationprovisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
7
Date: K") 7 Z 7 /' Applicant:
-- J
WARNING: FAILURE TO SECURE WORKERS' C M ENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA' AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 1 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 to enter upon the above-mentioned property for inspection purposes.
'Date: 5- I1-09 Signature (Applicant or Agent):
- Application -Number 09-00000467
Permit MECHANICAL
-
Additional desc' •. . .
Permit Fee '33.00
Plan Check Fee
8.25
Issue Date . .
Valuation',
0
,. Expiration Date,..". 11/09/09
' y ' `Qty Unit Charge' Per.
'Extension
" BASE
FEE
15.00
.1.0 0 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 9.0000 EA MECH
B/C <=3HP/100K•BTU
9-00
-------------------------------------------------------
Special Notes and Comments
REPLACE HEAT PUMP CONDENSOR 13 SEER
OUTDOOR UNIT.
------------------------
Other Fees . . BLDG STDS ADMIN (SB1473)
1.00'
Fee summary Charged
Paid Credited
Due
Permit Fee 'Total. 33.00
.00.. .00
.33.00
Plan Check Total 8.25•
.00 .00
8.25
Other Fee Total 1.00
.00 .00
Grand Total 42.25
00 00
42..25
t
LQPERMIT - -
•EXCEPTIONS-
{ • If an 'of the following three"exce tions are ✓, the ducts stem .is exempt from sealed ducts
ry}
#
✓'
'Exce'tions ;
Sealed Ducts (climate zones 2 and' 9-16) (Installer testing and certification and HERS rater field verification_required.)
r ❑.
Duct systems that are documented to have been previously sealed'as confrmed through field
verification and diagnostic tesiti ing in accordance with rocedures in the Residential `ACM fival:~.Y
2
0
Existin ducts stems that are extended, which are constructed, insulated or,sealed witli asbestos.'
CERTIFICATE OF COMPLIANCE: _RESIDEN.TIAL *-,(Pa e.1 of 1 .•CF IRA
Project'Title
Date:
_EP
Refrigerant Charge'
C)
' CF-4Rpages'3and4of 8
ProjectA'ddress'
EER r� .- '
CF -6R page 8 of 1,2
K,Z .� A A , V it LA
l'in Check% Aate
_
EwaDocumentation
Author ;
Telephone-
ie15C ecln/ .at
Wma-
w"
t
Compliance Method (Prescriptive — HVAC and/or Duct,
System Alteration 152 I ]?,And
Climate Zone
nforeement Agency Uleofi`
n �
- § (b) C, E),'',
l
a
•EXCEPTIONS-
{ • If an 'of the following three"exce tions are ✓, the ducts stem .is exempt from sealed ducts
ry}
#
✓'
'Exce'tions ;
Sealed Ducts (climate zones 2 and' 9-16) (Installer testing and certification and HERS rater field verification_required.)
r ❑.
Duct systems that are documented to have been previously sealed'as confrmed through field
verification and diagnostic tesiti ing in accordance with rocedures in the Residential `ACM fival:~.Y
2
0
Existin ducts stems that are extended, which are constructed, insulated or,sealed witli asbestos.'
EER -as indicated in,Table`8-3 of Residential Compliance Manual'( climate zones2 and 9..16 only) (Installer testing
and certification and HERS. Rater field verificatioh required y _• F
CF-6R:pages 5 and 6,of'12, r
systemswith less than 40 linear feel bf ducts in unc6Aditi6ned-s ace;
. Cooling Equipment Type ' Minimum x * Configuration
and Ca aci A/C, heat Efficiency Duct Location K. >'
P h ( Duct.R Value' Thermostat Type (split or y.
a pump evap ,cooling) (SEER or, (attic, etc.) , ,
a ` ` EER .. Package) 1 n'
L 6
+ y
SEALED DUCTS, REFRIGERANT CHARGE (TWAND EER r ,
w • _, The prescriptive requirement for either a refrigerant charge or a TXV does apply� to packaged um s.X'.` K '
Before the. permit can be'-finalized,a'"sig ned CF -4R must be provided to the g p buildin department fortY''an of
.
�. , 4
` the folwio
complian
re uiremerits
o, ...
,
✓j
Compliance Requirements ' } . _',. F ; .+ . �i .' 4 "
•.
`
❑•,
Sealed Ducts (climate zones 2 and' 9-16) (Installer testing and certification and HERS rater field verification_required.)
r ❑.
TXV (climate zones 2 and 8-15 only,) (lnstaller testing and certification and HERS Rater field verification required )
i i .
Refrigerant Charge (climate zones 2 and 8-15 only) (lnstaller testing and certificafionandl,HERS Raterfeld
.verification, re uired: ' r� a r:
< ❑
EER -as indicated in,Table`8-3 of Residential Compliance Manual'( climate zones2 and 9..16 only) (Installer testing
and certification and HERS. Rater field verificatioh required y _• F
.J
� • SPECIAL FEATURES'REOUIRING HERS RATER VERIFICATION
A ✓indicates which:compliance requirements are:part fthis project'and need HERS rater verification:; r
✓ :'
`Compliance Requirements ' :
Installer -Forms (if;applicable)
HERS Rater Forms (if applicable)
p
Duct Sealing ;'
CF=,6R page 4 of l2 . ' , '
CF -4R a e l.of 8
P g
< ❑
Thermostatic Expansion Valve (TXV') ,:.
CF-6R:pages 5 and 6,of'12, r
CF -4R pages 3 of 8
_EP
Refrigerant Charge'
CF -6R pages 5 and 6 of 12 ,: ` r
' CF-4Rpages'3and4of 8
EER r� .- '
CF -6R page 8 of 1,2
CF=4R pages'S`of 8 .
r:yY-
'
Bin #
City Of La Quints
Building ff Safety Division
P.O. Box 1504, 78-495 Calle Tampico
b Quinta, CA 92253 - (760) Ile
Building Permit Application. and Tracking Sheet
pp
Permit #
Project Address:.
Owner's Name:
A. P. Number: i--- 3S AVe V). L4 '7
Address:
Legal Description:
City, ST, Zip:
Contractor:D 1 _
�i'(�'�
Address: P ��k (��
Telephone:
Project Description:
City,•ST, Zip:
Telephone:? 6 r77 -Q :<:::?`k''<:a:::>: :::;>;; ':'•.:;.::>:`:'r:
Lq cam. N PAk ?+/ M-0 CJ N D&S6
State Lic. # : -7 Z 1 Ci
City Lic. #:
Arch., Engr., Designer:.
Address:
City., ST; Zip:
Telephone: •..,.:::�r•s:r:�::� ::.::..;;w•:.,.-.:
State Lic. #: Y:':<:::;:`::>f:»
::: •;::.~>r>:'s:.<;r>;:::l,:•,.:::<t:;:::c;>
Name of Contact Person: .
Construction Type: Occupancy:
Project type (circle one): New. .Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project: Z L} 0 (D
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING -
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
-Plan Check Balance
Title 24 Calcs.
Plans picked upConstruction
Flood plain plan
Plans resubmitted
Mectanical
Grading -plan
2nd Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person' _
Plumbing
..Grant Deed
Plans picked up.
SAII.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review,.ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I..P:P.
Pub. Wks. Appr
Date of permit issue
School Fees
t
i
Total Permit Fees
1
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Perms #:
52835 Avenida Villa La Quinta, CA 92253City
of La Quinta
Apr 29, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
L3 Indoor Coil
® SEER 13.0
® HSPF 7_7
❑ R 8 (CZ 14-15)
1400 sf
If not already present, must be
® Condensing Unit
❑ EER.,
❑ Resistance
installed) .
❑ 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, 78% AFUE, 7.7HSPF 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.'F. 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 :he work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -5R 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 -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 < 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 s
❑ 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 Charge)-.
❑ 2. New HVAC System
Required Forms:
. Cut in or Ch'angeout'with
new ducts neve 1*
CF 6R forms MECH 04 MECH 20- HERS and �(foaplit Systems) MECH 22-H RS, and
,' r.�
:all
ducting aatl all new
a
MECH¢25 HERS tx �1axe` , r •.
CF 4R forms MECH-20, an'W(for split systems)�MECH 22,�and :MECH 25 I f`
equipment)
For Split Systems Duct leaka9e,< 6,percent RC CCA -,f>_;:350 CFM/ton; FWDL TMAH O'STMS and either FSPP onPSPP,
yy
For Pack a ed UnrtsEDuct. leakage'; 6 percent'
.9.:..... .. ..:u,<.. .. ... .. .! .¢_ •�.,..n :.....nes..,. a?e??Y:.'._,va .w....;y✓•.. n..r.. ;*, +' .s a:" o-.rtrz..✓n.. 2e ::anrs e.,r.,,y4' :x..iitF''` w...+yY..
El3. 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 -4R forms: MECH-20 and (for split systems) MECH-2 5
equipment changed.
For Split Systems: Duct leakage';c 6 percent; RC, CCA 2: 300 CFM/ton, TMAH
For Packaged Units: -Dud leakage < 6 percent
114. 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.
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. r; 1 •
. 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 on otter applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. -
Name: Brian Greenupi Signature: Brian 6reenup
Company: GREENUP AIR CONDITIONING AND HEATING Date:'Apr 29, 2014 _
Address:_P O BOX 7431 Licenser 985406
City/State/Zip: LA QUINTA / CA / 92248 Phone: (760) 625-6537
Reg: 214-A0029551A-000000000-0000 Registration Date/Time: 2014/04/29 14:42:02 HERS Prcvider: Ca10ERTS, Inc.
2008 Residential Compliance Forms ` July 2010 •'