BMCH2015-020578-495 CALLE TAM PICO
LA QUINTA, CALIFORNIA,92253
Application Number:
Property Address:
APN:
BMCH2O15-0205
CO 4 VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/16/2015
Owner:
78234 HACIENDA LA QUINTA
646280004
Application Description: FOSTER/ CHANGE OUT (1) 13SEER CONDENSOR AND COIL*
Property2oning:
Application' Valuation: $4;000.00
Applicant:
CAVANAUGH ELECTRIC DBA,CAVANAU
83=231 HIWAY 111
iNDiO, CA 92201
LICENSED CONTRACTOR'S DECLARATION
I hereby "affirm under penalty of perjury that am licensediundee provisionsof Chapter
9 (commencing with Section 7000) of Division 3.of.the Business and,Professions Code,
and my License is in full force and effect.
License Class:. C20, C10 License No.: 286936
Date: "' 4 Contractor:: - / n(
OWNER -BUILDER DECLARATION
I hereby affirm under penalty ofperjury that am,exemptfrom the Contractor's State
License Law for the following reason(Set. 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 thatlhe or,she is licensed!pursuant tothe provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 700%of Division3
of the Business and Professions Code) or that he or sheJs exempt therefrom°andthe
basis for the alleged exemption. Any violation of Section 7031:5 byany applicant for a
permit subjects the applicant to a civil penalty of�not more than five hundred dollars
(_),J, as owner of the,property, or my employees: with wages as their sole
compensation, will do the work; an&the structure is not intended & 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 herselfthrough his ocher own employees; providedthatthe Improvements
are not intended or offered forsale. 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 salei.
(_,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.).
( f:am,exempt under Sec. B.&P.C.,for this reason
Date:
Owner:
CONSTRUCTIOMLENDING AGENCY
I .hereby affirm under penalty of perjury thatthere is a construction lending agency for
the performance rof the work forwhich'this'permitisissued (Sec. 3097, Civ. C.).
Lender's
Lender's Address:
JOHN.FOSTER '
78234 HACIENDA DR
LA QUINTA, CA,92253
Contractor:CAVANAUGH
ELECTRIC DBA CAV83-231
17M�1�3s
HIWAY 111
INDIO, CA 92201
(760)347-3608
Llc.ft.:286936 rte_, S
WORKER'SCOMPENSATION DECLARATION
I hereby affirm under penaltyof perjury,one of the following declarations:
I1have and willanaintain;a certificate of consent to self -insure for workers'
compensation,,as,provided for by Section 3700 of the LaborCode,, for the performance
ofa ork.forwhich this permit is issued.
9!� I have and will maintainworkers' compensation insurance, as required by
Section''3700 of the Labor Code, for the performance of the work forwhich this permit
is issued. My workers' compensation insurance carrier, and policy number are:
Carrier:_ Policy,Number.._
_ I certify that In the performance of the work for which this permit is issued; I
shall not employ any, person inanymanner so as to become subject,tothe workers'
compensation'lawsof•California, and agree that, if I should becomesubject to the
workers' compensation provisions, ofSection3700'of the Labor'Code, tshall forthwith
complywwiith those provislons..
Date: ” � M r A5_ Applicant: AV(
WARNING: 'FAILURE TO SECURE'WORKERS' COMPENSATION COVERAG UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL. PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND' DOLLARS (5100;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 herebymade to the Building Official 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 asa result.of this application, the owner, and the,applicant, each agrees to; and
shall'defend; indemnify and holdiharmless the City of La'Quinta,.its officers, agents, and
employees:for any actor omission related rtothe work being performed' under or
following issuance of this permit.
2. Any permit issued asa result-ofthis application becomes null and Void if work is
not commenced within 180 days from date of -issuance of such permit, or cessation of
work for180 days will subject permit toea"ncellation.
I certify thai,l;have readAhIs 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 city to enter upon the.above-
mentioned'property.for inspectlonpurposes.
bate: .f/" Signature (Applicant:or.Agent):
INFORMATION
DESCRIPTION._, _ ACCOUNT QTY IAM' :: _ ._•.
OUNT. _ PAID' PAID DATE'
BSAS SB1473 FEE
101-0000-20106 0 $1.00 $0.00
- PAID4Y,,
METHOD RECEIPT'# CHECK # CLTD BY
Total:Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION'
ACCOUNT
QTY_
AMOUNT
PAID:
PAID DATE -
.HVAC CHANGEOUT -CONDENSER ONLY
101-0000-42402
0
$36.26
$0.00
PAID::"BY;
METHOD
'';RECEIPT # `
CHECK:#
CLTD'BY
DESCRIPTION.
-, ACCOUNT`
QTY
, ,. AMOUNT' -...-_
PAID
PAID. -DATE
HVACCHANGEOUT -CONDENSER ONLY'PC
101-0000-42600
0
$24.17
$0.00
D, EW
METHOD
RECEIPT#
CHECK
CLTD.BY,
Y ;DESCRIPTION: ` :=
ACCOUNT ''
QTY
AMOUNT;
PAID r -'
PAID`'DATE,
HVAC..CHANGEOUT-:REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
PAID'B,Y_=METHOD
.: _
RECEIPT'#'
CHECK;iI'
CLTD' BY `
v. 7 ;' .-DESCRIPTION:, _ ` . _
...., ACCOUNT
Q
= . AMOUNT• ; : a
_ . -PAID; •
PAID D"ATE
HVAC CHANGEOUT - REPAIR/ALTERATION
PC
101-0000-42600
0
$4.83
$0.00
PAID'BY"..
METHOD' >-
REC EIPT'#
CHECK=#
C .
LTD;BY-
Total Paid forCHANGEOUT: $77.35 $0.00
DESCRIPTION
"," ACCOUNT
QTY
:'AMOUNT ' _
PAIb
'PAID.DAT.E
PERMIT ISSUANCE
101-000042404
0
$91.85
$0.00
B
PAID`'Y'
- METHOD
RECEIPT #
CHECK; .
CLTD: BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
• �0
Description: FOSTER [CHANGE OUT (1)13SEER CONDENSOR AND COIL
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 6/16/2015 SIM
Approved::
Parcel No: 646280004 Site,Address: 78234 HACIENDA LA,QUINTALA QUINTA,CA.92253
Subdivision: TR 8792-1 &,INT IN COMMON AREA Block: Lot: 16
Issued:
Lot. Sq. Ft: 0 Building'Sq Ft: 0 Zoning:,
Finaled:
Valuation: $4,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings:0 No. Stories: -.0 No. Unites: 0
Details: HVAC CHANGE OUT - (1)13SEER CONDENSOR AND COIL [2013u ENERGY] ] CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO
FINAL INSPECTION..2013 CALIFORNIA BUILDING CODES.
F -
INANCIAL IN
Printed: Tuesday, June.,16, 2015 10:28:27 AM 1 of 2
CRWIYSTEMS
'ADDITIONAL
•• • •
CONDITIONS.
,.:CONTACTS
NAMETYPE°NAME'''
ADDRESS
Clfilf
STATE =ZIP PHONE: 4 EAX" EMAIL
APPLICANT
CAVANAUGH ELECTRIC DBA
83-231 HIWAY`111
INDIO.
CA
92201
CAVANAU
CONTRACTOR
CAVANAUGH.ELECTRIC DBA
83-231 HIWAY 111
INDIO
CA
92201
CAVANAU
OWNER
JOHN FOSTER
78234 HACIENDA DR
LA QUINTA
CiA
92253
F -
INANCIAL IN
Printed: Tuesday, June.,16, 2015 10:28:27 AM 1 of 2
CRWIYSTEMS
.:
DESCRIPTION
{ ACCOUNT
QTY
AMOUNT
PAID
PAID: DATE
RECEIPT t(
CHECK,#
METHOD
:., PAID BY
A•
'
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
CONDENSER ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
CONDENSEWONLY PC
HVAC CHANGEOUT -
101-0000-42402
0
$12.09
$0:00
REPAIR/ALTERATION
HVAC CHANGEOUT -
101-0000-42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid forCHANGEOUT: $77.35 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: WAS $0.00
00
_ -BOND INFORMATION
ATT
AC.HMENTS
Printed: Tuesday, June 16, 201510:28:27 AM 2 -of 2 EmAr
CRsrsreMs
Bin
City of La Quinta
Building ex Safety Division
P.O: Box 1504, 78-495 Calle Tampico
Lai Quinta, CA 92253 -•(760) 777-7012
Building Permit ApplicationandTracking Sheet
Permit #
ProjectAddress:` 17 h�7GKaA.,Vr
OwncesName:.✓4ph/l/ fcr*l-
A. P. Number:
Address:
Legal Description:
Contractor: a `j Nt 15� f -
City, ST, Zip: La.
Telephone:
Project Description:
Address: �?
City, ST, Zip: n G' O I
e lace . �N A =
Telephone: dd -3 r
State Lica# : City Lica0- a,
Arcb., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lk. #:
Construction tion Type: Occupancy:
Project (circle one)_: New Add'n Alter Repair Demo
Sq. Ft:: #Stories: #units:
Name of ContactTcrson: �0 CaVanal.:
T, Telephone #sof Contact Person:
Estimated Value of Project: coo
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal.
1"9d _
Reed
TRACIMG .
PERMIT FEES
Plan Sets
Plan Cheek submitted
Item
Amount
Structural;Cdcs.
rady for correetioos
Revlewed, ready'.
Plan CheckDeposit
Truss Cala.
Called ContactTerson
Plan Cbeek Balance
Energy Caks.
Plans'ldcked ap
Construction
Flood plain plan
Plans resubmitted
Meehanicd;
Grading plan'
20' :Review, rady for correctiooslissue
Electrical
Subcontactor List
Caned Contact Person
Plumbing:
Grant Deed
Plans picked up
SALL
Ii.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
''':Review, ready for,correctionsr ae
Devdoper Impact Fee
Planning Approval
Called Contact P,ersou
A.U.P.
Pub. Wits. Appr
Dattof permit issue
School.Ftes
TotalPermitFen
Simplified. Prescriptlre Certificate of Compliance: 200S.Res/dendel HVAC A/t coition CF -1R -ALT -MVAC
Cilmate.Zones 10 - 15
Slte.Address:
Enforcement Agency,
Date_e
PennWill:
78234 hacienda La Quinta; CA 92253r
City of La Quanta
Jun 15, 2015
Equipment Typel
List Minimum Efndency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat'
O Package Unit
E3 Furnace
® Indoor Coll.
p AFUE
® SEER 13.0
i] COP
E3 HSPF
p R 6 (CZ 10.13)
O 8
Served by system
2000 9f
® Setback
If not already present~must be
® Condensing Unit
p:EER
p'ReMstance.
R (CZ 14-15)
Installed)
O Other
1. t?9u4wwntType: Choose, the equipment being Installed, rif more than one system, use another Cr-M-ALT-HIAAC for each system.
2: Mlnknum'R9ulpmegt RfAdendes: 13 SEER;: 78% AFUE, Z7NSW for typical resldenda/ 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.Optlons. Each Option Iists.the HERS measures thaCmust be condutted.,A copy of the fonns,shall
be IeR!on site for final irispectlon and a copy given to the homeowner:,At.flnal, the'.Inspedor verlfles that the ,workiilsted on this
form was -In -fact the work completed by the Installer. The Inspector also verifies that each appropriate CF -6R and neglstered CF -411
forms,,(no hand filled CF -411s allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R
and CF -SR shall also be on site for flnel Inspection.
® 1. HVAC changeout
Required Forms:
• All HVAC Equipment
CF -611 forms: MECH-04, MECH-21=HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for'splitsystems) MECH-25
• Condenser Coll and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-21-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 5 300 CFM/ton (Minimum Air How. Requirement), TMAH
te'Exempbed
--
nom ductleakage testing if:,,
E3 1. Duct system was documented to have been, prevlously:sealed and confirmed through HERS verification, or
p 2. Duct systems with less than 40 linear feet In unconditioned. spacie, or
Q 3. Existing duct systems are constructed, insulated or sealed with asbestos
E3.4. The system will not be Ducted (ie; Ductless Mini -Split System) (Also. Exempt from Refrigerant Charge)
13 2. New HVAC System
Required Forms:
. Cut In or Changeout with
CF-6111orms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
new ducts:((all new
ducting, all new
MECH,:25-HERIS
equipment)
CF-4R,forms: MECH-20, and (for split systems),MECH-22,'6nd MECH-25
For Split Systems: Duct leakage <'6. percent; RC, CCA 2 350 CFM/ton, FWD, TMAH, SiMS, and either,HSPP orPSPP: .
For Packaged unitsi Duct leakage c 6 percent,.
133. 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 -411 forms: MECH-20:and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct.leakage <, 6 percent; RC, CCA 2 300 CFM/ton, TMAH
For Packaged Units Duct leakage < 6 percent
134. New Ducting over 40 feet Required Forms:
• Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-21-HERS
linear feet of duct in unconditloned.space. CF -41k forms: MECH-21
For split.system or packaged. unib:. Duct leakage ,< 15 percent
E] EXCEPTION:, Existing duct systemsmonstructed, Insulated or sealed with asbestos..
Contractor (Docurnerrbatlon Author's /Responsible Designers Dedareftn Statement).
• I certify thatthis Certificate of Compliance documentation ivaccurate and'complate.
• 1 am eligible under Division 3 of the California airsiness'and Professiafa 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 Informatlondocumented on other appikable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Rod Cavanaugh Signature- Rod
Company: CAVANAUGH ELECTRIC Date: Jun 15, 2015
Address: 83=231 HIWAY Ill License: 286936
CttyLState/Zip: INDIO / CA / 92201 Phone: (760) 347-3608
Reg: 215-A0159909A-000000000-0000 Registration Date/Time: 2015/06/35 17:•16:39 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
/- 949- (�5O 7709