12-1016 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00001016
Property Address: 60959 FIRE BARREL DR
APN: r 764-280-999-63 -300235-
Application description: MECHANICAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 5000
Tiht 4 4 Q"
Applicant: Architect or Engineer:
Pik
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am lice ed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prof ionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
Date: S Contractor:
OW ER -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 _ 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.).
(_) 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.).
(_) 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:
LQPERD1IT
Owner:
LARSON RESIDENCE
60959 FIRE BARREL DR
LA QUINTA, CA 92253
Contractor:
GENERAL AIR CONDITIONI
31170 RESERVE DRIVE
THOUSAND PALMS, CA 922
(760)343-7488
Lic. No.: 686310
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/05/12
11:,P Q 0
SEP 05 2012
76
CITY OF LA QUINTA
FINANCE DEPT.
-----------------------------------------------
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 ZENITH INS CO Policy Number Z071741501
1 certify that, in the performance of the o for which this permit is issued, I shall not employ any
person in any manner so as to beco subject to the workers' compensation laws of California,
and agree that, if I should become lect to the workers'. compensation provisions of Section
3700 of the Labor Code, I shall fo ith omply with those provisions.
Date: 4tL51, Applicant:
WARNING: FAILURE TO SECURE WORKBRtAebMPENSATION 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 sJabove"
ssation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that thion is correct. I agree to comply with all
city and county ordinances and state laws relating to buil, and hereby authorize representatives
of this county to enter upon the above-mentioned propertpurposes.
Date: 9/i /f Signature (Applicant or Agent):
Application Number . . . . . 12-00001016
Permit . . . MECHANICAL
Additional desc . .
Permit Fee . . 33.00 Plan Check Fee
8.25
Issue Date Valuation . . .
. 0
Expiration Date 3/04/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 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
HVAC CHANGE OUT 2 TON DUCTLESS MINI
SPLIT IN GARAGE. REPLACING EXISTING.
----------------------------------------------------------------------------
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
1.00
Grand Total 42.25 .00 .00
42.25
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
7City
Enforcement Agency:
Date:
Permit #:
60959 FIRE BARREL DRIVE La Quinta, CA 92253
of La Quinta
Sep 5, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
❑ Indoor Coil
❑ AFUE
® SEER 13.0
❑ COP
® HSPF 7.7
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
[I EER
❑ Resistance
El R $ (CZ 14-15)
800 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-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. 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-611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R forms: MECH-04, EXEMPTED and (for split systems) M=9w ;is u=oG
replaced
EXEMPTED
CF-411 forms: M=, ,I,21 EXEMPTED and (for split systems) p4u;w-wr. EXEMPTED
. Condenser Coil and /or
CF-6R forms: MECH-04, ^4_C;l4;t+ W_Rr EXEMPTED and (for split systems) MC! LJ_ 1G_uCOC
. Indoor Coil and /or
EXEMPTED
. Furnace
CF-4R forms: MEr, , 1 EXEMPTED and (for split systems) 9+=i;;l4-x9 EXEMPTED
For Split Systems: Duct leakage:< 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
..r
Ler Passaged URNA061 Puet leakage 15
; p
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
[33. Existinn.g-"duct�'systems are.,constructed, insulated or:sealed with asbestos 17*"0
4. The system will not be Ducted,(ie.'Ductless Mini-Split Systeme) (Also)Ezempt from Refrigerant Charge)
❑ 2. New HVAC System,
Required Forms: —4
. Cut in or Chan eout,withr
CF-6R forms: MECH-04 •^_igm -,o m=oG"EXEMPTED and) fors lits stems Mr-cw ;p
new ducts: (all new" f %
� .+i '
EXEMPTED and o4rc44 EXEMPTED �i
f L _6 � -� - i
`,c
ducting%M all ;new
e-
CF-4R forms: M= EXEMPTED, and (for split systems) M=,�� EXEMPTED,,and ^^=r, 1,
equipment)
EXEMPTED `
For`Split Systems:.Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged'Umts: Duct leakage < 6 percent
❑ 3. New Ducts
Required Forms:
with/or without
Replacement
i
• Includes replacing or
installing all new
ducting and/or outdoor
CF-611 forms: MECH-04, N+=c;H_-,g_w=o9 EXEMPTED, and (for split systems) Mr=c;H -5-m=o= EXEMPTED
condensing unit and/or
indoor coil and/or
CF-4R forms: p4EG14Tg EXEMPTED and (for split systems) A^=g,g EXEMPTED
furnace. No or some
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
114. New Ducting over
Required Forms:
40 feet
. Includes adding or
replacing more than 40
CF-6R forms: MECH-04, M=l" lJ 2 uE EXEMPTED
linear feet of duct in
CF-4R forms: ^^_G,1 EXEMPTED
unconditioned space.
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 on 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
Reg: 212-AO04899OA-00000000-0000 Registration Date/Time: 2012/09/05 09:46:14 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
e,rt.#
.0ty, Of La QuInta
BulkUpg ar Safety DW6n
P.O. Box 1504,78-49S Calle Tampico
ta.Qulnta, CA 92253 - (760) 777-7012
Building pp Permit A lication and TrackingSheet
Perini
Project Address: 5 MOM
DY.
Owner'sName:.c60
A. P. Number. '1645100 Z
Address: CAW
Legal Description:
City, ST, Zip:
Contractor.
Telephoner
Address: 3— I D14—s LYU
` r,
Project Description: V a C C Q : znn
City, ST, Zip:
Telephone: 660 -34 3— S a 1.w
C q,?- 2- 6
0'
'In MYAO
State Lic. #: ( l O City Lic. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
- y V
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft : #Stories:
# Unity:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
q
Submittal
Req'd .
RecId
TRACMG
PERMIT FEES
Plan Sets
Plan Check sabmiued
Item Amount
Structural Calls.
Reviewed, ready for corrections
Plan Check Deposit. .
'buss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calls.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Zid Review, ready for correcGonsrmue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review; ready for correetionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
AXP -P -
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees