12-0345 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-i`4t 4 X�& Q"
Application Number:
12-00000345
Property Address:
50745 GRAND TRAVERSE AVE
APN:
770-320-027-27 -25389 -
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
13580
Applicant: A)
Architect or Engineer:
P1 A
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am'censed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and ofe
s
s
,
onals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
C or: I
— J WNER-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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/02/12
Owner:
MARLENE HARDESTYf Rr-nn
50745 GRAND TRAVERSE AVE , IJI
LA QUINTA, CA 92253 II
ri
, 202 i
Contractor: ` I--
CITY OFLA f+if IN i
GENERAL AIR CONDITIONING f,l+_ :Z
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488
Lic. No.: 686310
--------------- - - -
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.
Y_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
T 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
I certify that, in the performanceo the work for which this permit is issued, I shall not employ any
person in any manner so as to come subject to the workers' compensation laws of California,
and agree that, if I should bec a subject to the workers' compensation provisions of Section
3700 of the Labor Code, I sha orthwith comply with those provisions.
�Hte:4 A icon:
/WARNING: FAILU TUBE ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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, 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 per or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov i ormation is correct. 1 agree to comply with all
C
ity nd county ordinances and state laws relating to building truction, and hereby authorize representatives
o is county to enter upon the above-mentioned property for pectio rposes.
Date:_ Si a[ure (Applicant or Agent):
Application Number . . 12-00000345
Permit .. . . MECHANICAL
Additional desc . .
Permit Fee . . . . 66.00_
Plan Check Fee
16.50
Issue Date . . . .
Valuation
0
Expiration Date . . 9/29/12
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH'FURNACE
<=100K
18.00
2.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
33.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE (2) 3 TON SPLIT SYSTEMS LOCATED
IN ATTIC. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
--------------------
Paid Credited
--------------------
Due
-----------------
Permit Fee Total 66.00
.00. .00
66.00
Plan Check Total 16.50
.00 .00
16.50 .
Other Fee Total 1.00
.00 .00
1.00
Grand Total 83.50
.00 .00
83.50
LQPERb11T
CaICERTS - CF -1 R Registration Page 1 of 1
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Site Address: 50745 GRAND TRAVERSE AVENUE (SYS 1)
La Quinta, CA 92253
CEC Registration: 212-A0015708A-00000000-0000
_._—.---------------_.._.__....------..._....._._...---------- -- ---
CF-IR-ALT-HVAC: CLICK HERE TO DOWNLOAD
Forms Assigned Company: HARRISON ENTERPRISES INC
Membership Benefits
Do you know your HERS Rater?
If you do, you may want to send this CF -111 to them.
Events
CalCERTS Rater ID:
OR
Industry Partners
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News
If you need to find the rater by name Click HERE to search our directory.
_' SEND CF -,1R TO HERS RATER.
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[CLICK HERE] to do another
please click here.
Copyright 0 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy]
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,TollFree: 877 -HERS -11811, (877-437-7787)
Fax: 916-985-3402 Contact Us
on BBB
.w. aa. tom, erk'. .:&.atE
httns://www-calcerts.com/nuhlic cfl R-cftn?nrniect. id=179090 3/30/2012
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
50745 GRAND TRAVERSE AVENUE (SYS 1) La Quinta, CA 92253
City of La Quinta
Mar 30, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
2180 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.
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 mustbe 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 -611 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 -1R
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 -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF -411 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
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
[14. The�systemytill not be Ducted (ie. DuctlessMinSplit,Systemj�(A1soExemptrfromrRefrigeraC arge)
❑ 2. NewjH_ VAC System
Required&CMs: "AW '"""
• Cut in or Ghangeout with'
new ducts: (all new
""` '�f
CF=6R forms: MECH-04, MECH 20 HERS nd (VO split SY ems) MEC 22 -HERS, and
+�
ducting all new
-
MECH; 25 -HERS fix;
CF-4R,form`_ s :MECH 20, and (for s its, stems MECH=2_ ,and MECH-25'
equipment) ,.
_
�•il '+lig .i"._-
For Split Systems: Duct leakage'<_=percent;;-RC-; CCA't_�350<CFM/t_on;OFWD�TMAH STMS, and'either'HSPP &'PSPP.
For Packaged Units: Duct leakage;,< 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -611 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 responsibiNty 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: banielle 6arcla
Company: HARRISON ENTERPRISES INC Date: Mar 30, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0015708A-00000000-0000 Registration Date/Time: 2012/03/30 11:05:24 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
CaICERTS - CF -1R Registration�r�l
Page 1 of 1
Public Home Danielle Garcia logged in [Logout]
[Home]
CONGRATULATIONS
Secure Home
Your CF -IR -ALT -HVAC Registration is complete!
About tis You may want to print this page for your records.
Training Site Address: 50745 GRAND TRAVERSE AVENUE (SYS 2)
_ ILa Quintal, CA 92253
CEC Registration:l212-A0015709A-00000000-0000
Rater Directory _._..._..._..__._....._.__—.----- —
CF-lR-ALT-HVAC: CLICK HERE TO DOWNLOAD
Forms _.__.__.___Assigned Company: jHARRISON ENTERPRISES INC
Membership Benefits Do you know your HERS Rater?
If you do, you may want to send this CF -1R to them.
Events CaICERTS Rater ID: r---�
OR
Industry Partners My Rater Quick Select: ; —Select From List
Every CaICERTS rater has alicense number.
News If you need to find the rater b name Click HERE to search our directory.
SEND,CF!1 RMHERSRAT_ERAbli
To register for
our monthly
newsletter, [CLICK HERE] to do another
please click here.
Copyright 0 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 2010
(Terms and Conditions] (Privacy Statement) (Class Cancellation Policy]
CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
BBB
httvs://www.calcerts.com/public cflR.cfm?nroiect id=178091 3/30/2012
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
50745 GRAND TRAVERSE AVENUE (SYS 2) La Quinta, CA 92253
City of La Quinta
I Mar 30, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE _ 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
[3 EER
[3Resistance
❑ R 8 (CZ 14-15)
2180 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-611 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-611 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
Pop Paiskaged Units, Qw# leakage r. 15
per-reRt
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
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie.,,uctles�MinSpSy�yQarge)tnm
..
❑ 2. NewLHVAC System
:,
Required.,Fic[»s:
• Cut in o, riChangeout with;
new ducts: (all new
GF 6R�orms: MECH-04, MECH 2Q HERS, and oysptit sy t�l�m) MECH�22'HERS, and
r+
�r
�
all new
�r
MECHr25-HERS - +
CF dR;forms MECH 20 and (for split systems) MECH=22 and MECH-25
equipigT"
equipment) .+rrtr-,
��i
For Split Systems:'Ductleakages<<i6 percent;RC.CCA►>�350 CFM/ton;�FWD,%TMAH SIMS, and"eitFfer HSPP of PSPP.
For Packaged Units: Duct leakage'< 6 percent
❑ 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-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 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
Company: HARRISON ENTERPRISES INC Date: Mar 30, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0015709A-00000000-0000 Registration Date/Time: 2012/03/30 11:06:28 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
ein #
Qty Of La Q[.1rnta
Building 8r Safety Division
P.O. Box 15.04, 78-495 Calle Tampico
La Quinta, CA92253 - (760). 777-7012 '
Building Permit Application and Tracking Sheet
Permit #
Project Address: b014,5
OrmdGi
e AW Owners Name:
A. P. Number:
2
Z Address: 45
Legal Description:
City, ST, Zip: 2
Contractor:
Address:
Telephone: '' s' 't�'`. '•
y Project Description: CYQD1
Ci ST Zip:
Telephone:
3%�
7EVat C5:
State Lic. # :
Arch., Engr., Designer:
3
City Lic. (o
Address:
City ST Zip*
_.. _. _ .. .. ... _ ... .. __ , .. _. ._ ......,....... ._.
Telephone:
; , ^p>> Construction Type: Occupancy:
Project type (circle one): New Add'.n Alter Repair Demo
State Lic.
Name of Contact Person:
CO bl -e- evi Z,06t%;�S vyL; Sq. Ft.:
Stories:
#
/Units,:
Telephone # of Contact Person:. - Estimated Value of Project: 15 15
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
N Submittal Req'd Rec'•d TRACEING PERMIT FEES
Plan Sets . Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calm
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 correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Revlew,.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 .
Total Permit Fees