14-0692 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 922
Application Number: 14-00000692
Property Address: 78235 CALLE FORTUNA
APN: 770-154-007-7 -000000-
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6900
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LONG STAN
78235 CALLE FORTUNA
LA QUINTA, CA 92253
(
A licant:
��if�`���/'�4
Architect o Engineer:
L
�
Contractor:
AIR SOLUTIONS OF
42335 WASHINGTON
THE DESERT
STREET F41
PALM DESERT, CA
92211
(760)275-4919
Lic. No.: 862106
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th icensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s nd Pr fessionals Code, and my License is in full force and effect.
�'. License CI ss: 20 License No.: 862106
Date: + / Contractor:
N - UI6� om DECLARATION
I hereby affirm under penalty of perjury that I am exempt from ntractor'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).:
(_) 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.).
(_ 1 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 I am exempt under Sec. , BAP.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: 5/27/14 ,
MAY 2;.3 201:14
CITY OF LA QUINTA
a FINANCE DELT.
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 WAWC528304
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manZastoe subject to the workers' compensation laws of California,
qFAI
gree that, .bject to the workers' compensation provisions of Section
o the borwith comply with those provisions.
Date:Applicant:
WARNTO SECURE WORKERS' COMP N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL S UP TO ONE HUNDRED THOUSAND
DOLLARS ($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, findemnify 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.
1 certify that I h e read this application and state that the above information is correct. I agree to comply with all
city and county ordina ces and state laws relating to buildin construction, and hereby authorize representatives
of this coun . o ant/ u n the above-mentioned prope ori ection purposes.
Date: ` gnature (Applicant or Agent): ��
Application Number . . . . . 14-00000692
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee . . . . 83.42 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/23/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 11.9200 EA MECH APPL REP/ALT
11.92
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------------
Special Notes and Comments
5 TON
REPLACE TON FURNACE INDOOR COIL UNIT
780 13 SEER 2013 MECHANICAL CODE2008
ENERGY) CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES
DESCRIPTION
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
52.43
Fee summary Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 83.42 .00 .00
83.42
Plan Check Total .00 .00 .00
.00
Other Fee Total 144.00 .00 .00
144.00
Grand Total 227.42 .00 .00
227.42 .
LQPERMIT
1101
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 -.15
Site Address:
Enforcement Agency:
Date:
Permit #:
78-235 Calle Fourtuna La Quinta, CA 92253
City of La Quinta
May 23, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP[3
[3HSPF
R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
®Condensing Unit
❑
❑Resistance
[3 R 8CZ 14-15)
(
1800 sfEER
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. 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 -IR
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 -411 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
[13. 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�Changeout with
x N.
CF-6R'forms: MECH-04''MECH-20-HERS, and (for split"systems) MECH-22-HERS, and
new ducts: (all new.MECH
ducting hA all new
2.5 -HERS � s�.' f F'
a : ;
CF-4Wforms:�,MECH-20, and (for�y split systems);MECH-22,iand MECH-25 se
equipment
:Fk Our° .ld Z' �, f . '° Li' f .i• ..�F 0,"" 4,'12:<.
For Split 5ystemsd Duct leakage<, 6'pgcent; RC, CCAI2: 350 CFM/ton, FWD, TMAH,'STMS; and, either, HSPP, or' PSPP
For Packaged Units' Duct leakage < 6pereent yy'
❑ 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.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct 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 -411 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 specificatlons 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: Walter W Nellis Signature: Walter W Nellis
Company: AIR SOLUTIONS OF THE DESERT Date: May 23, 2014
Address: 42-335 WASHINGTON STREET License: 862106
pity/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 275-4919
Reg: 214-A0037506A-000000000-0000 Registration Date/Time: 2014/05/23 14:23:47 HERS Provider: Ca10ERTS, Inc.
July 2010
�� r
Bin #
,.
City of LQ Quinta
Building 8T Safety Division
P.O. Box t SO4, 78-49S Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
R'
permit #
Project Address: 7$-235 Ca e Fourtuna
Owner's Name: Stan Long
A. P. Number:
Address: 7 8 - 2 3 5 Calle Fourtuna
Legal Description:
Contractor: Air Solutions of the Desert760.
:<;:>:::>:>::::;:;;;:::;:;>:..•;:y;
Telephone:
Address: 42.335 Washington St F 418
project Description:
City;ST,zip: Palm Desert CA 92211
Replace existing.HVAC Split systeme
Telephone: 760.275.4919
x,«,,::.;,. • r «.::..:...:< >_
r '''`.>
;:.r,•.::•;,,� ` ��> r�;�•,•.:a,.•r:.
Kitchen side of house
State Lic. # : 862106
City Lic. #-. 107288
Arch., Engr., Designer:
�g(_
Address:
City., ST, Zip:
Telephone: :..:w>::..ti:;.
State Lic. #:^'{fi "'^ `:??<'°'%% h i'
Name of Contact Person: Walter Ne 11 i s
Construction Type: Occupancy: cy
Pro'ect type circle one): New Add'n -f Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: .$6900
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
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
Tide 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
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
LToal Permit Fees