13-1471 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001471
Property Address:
80154 HERMITAGE
APN:
762 -230. -032 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
22185
Applicant:
T-Ifwf
��
VOICE (760) 777-7012_.
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT 4?r INSPECTIONS (760) 777-7153
Architect or Engineer:
BUILDING PERMIT
LICENSED TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am ' nsed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business rofessionals Code, and my License is in full force and effect.
LicenseClass:C20-C38 � LicenseNo.: 661464
Date:Contractor:
OWNER -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).:
(_) 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
Owner:
DAN CALLAHAN
80154 HERMITAGE
LA QUINTA, CA 92253
(
Contractor:
CHAFFIN AIR
36345 BARKSIDE DIRVE
CATHEDRAL CITY, CA 9223
(760)328-3400
Lic. No.: 661464
Date: 11/20/13
D�
No o��
CITY 6F LA QUINTA
FINAPICE DEFY
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 ar -
Carrier PREFERRED EMPLY Poli N mber WKN1367555
I certify that, in the performance of e w k for which this permit is issued, I shall not employ any
person in any manner so as to co subject to the workers' compensation laws of California,
and agree that, if I should b m bject to the workers' compensation provisions of Section
Date_))700�0of the Labor Code orthwith comply with those provisions.
4.4pplicant:
WARNING: FAILURE TO SECURE WORKERS' 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 applicationespeclion
d void if work is not commenced
within 180 days from date of issuance of suction of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ais correct. I agree to comply with all
city,and county ordinances and state laws relating to buildind hereby authorize representatives
of this, county {o enter upon the above-mentioned propertposes.
Dater Signature (Applicant or Agent),.
Application Number . . . . . 13-00001471
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee 214.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 5/19/14
Qty Unit Charge Per
Extension
3.00 35.7500 EA MECH FURNACE
107.25
3.00 35.7500 EA MECH CONDENSER/COMP
107.25
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 16SEER/78AFUE, CHANGE
OUT (1) 3 TON SPLIT SYSTEM AND (2) 5 TON
SPLIT SYSTEMS [2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . .. BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
142.98
Fee summary Charged Paid Credited
=------------------------------------
Due
--------------------
Permit Fee Total 214.50 .00 .00
214.50
Plan Check Total .00 .00 .00
.00
Other Fee Total 234.55 .00 .00
234.55
Grand Total 449.05 .00 .00
449.05
LQPERMIT
City of La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Fermi[ if
• Submittal
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: - b
Owner's Name:l
A. P. Number:
Address: o is `
Plan Check submitted
Legal Description:
Contractor: (?—JrA 4111 yx
Item
City, ST, Zip: Lj*QLUAAk34q-'*A-"
Telephone:
1
Address: 3" 3e4$'
Project Description: 4
Vk-
City, ST, Zip: C wj
Plan Check Deposit
Tele e
P hon . `7 d 3 �
c<f
-4
-r 3
State Lic. # : ( 4 V 4
City Lic. #.
Plan Check Balance
Arch., Engr., Designer.
Title 24 Cala.
Address:
Construction
City., ST, Zip:
Flood plain plan
Telephone:
State Lic. #:"?<'
nstruction Type: Occupancy:
Project a circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Grading plan
Sq. Ft.: y TDJ
# Stories:
god Review, ready for corrections/issue
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ��Lj
Subcontactor List
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
• Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Reyiew, 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
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-1R-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date: 7Permit
#:
80154 HERMITAGE La Quinta, CA 92253
City of La Quinta
Nov 19; 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
IM Furnace
[3 Indoor Coil
® AFUE 78%
®SEER 16.0
❑ COP
®HSPF 7,7
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
4200 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-ZR-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-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-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-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
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
04. The system will not be Ducted (ie yctlesst,Mini-,Spli6System) Alsox�Exempt,:from�Refrigerant,Gbargej
..4{- _.
❑ 2. New HVAC S item Reii redlF•orms `,:` Y: *
.Cut inor,Changeout with .� +�,�.,T V.
CF 611forms IMECH-04, MECH 20 HERS;�and `(for split systems) MECH=,22 HERS, and
new ducts •(all new MECH 25'iHER'S tt fr �"
ductin and all new ' s ..
9— CF4R forms:jMECH-20 and (for split systems) MECH_22,�and�MECH'25:'
equipment) ._• lx-: to ;ra:r
For Split Systems 'Duct 1eakaget<16 percent„RC`CCA?> 350;GFM/ton FWD '-TMAKISTMS, and either” HSPP of PSPP.
For Packaged Units: Duct leakage<;6'percent
❑ 3. New Ducti.—With/or without r.
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-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 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: Signature:
Company: CHAFFIN AIR Date: Nov 19, 2013
Address: 36-345 BANKSIDE DRIVE License: 661464
City/State/Zip: CATHEDRAL CITY/ CA/ 92234 Phone: (760) 328-3400
Reg: 213-A0087112B-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2013/11/19 15:13:52 HERS Provider: CalCERTS, Inc.
July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
80154 HERMITAGE La Quinta, CA 92253
City of La Quinta
Nov 19, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
IN Furnace
® AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
® Setback
❑ Indoor Coil
® SEER 16.0
® HSPF 7.7
❑ R 8 (CZ 14-15)
4200 sf
If not already present, must be
® Condensing Unit
[3EER
[3Resistance
Installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -SR -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 -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 -1111
and CF -6111 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 -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
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. Thesystem-will not be Ducted (ie,Ductless,Mini-Splitr5ystem),(-Also,Exempt,from;Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut Wor Changeout with+,'
new ducts: (all new
' / 3 '
CF 6R forms`. MECH-04, MECH=20 HERS, and (for, split systems) MECH=,22=HERS, and
MECH-25ME'PS ix 'Nt `
ducting and all new
.. a .�4 * --,
CF forms: MECH-20 MECH-25 J
equipment) k.:
-4R and'(for split systems).MECH-22 Hand
: «'$ • .r' '". rf ! �.„--, ;' y i . J� . .j
For Split Systems: Duct leakage < 6 percent;,RC, CC -A'> 350 CFM/ton, FWD,-.TMAH, STMS, and either HSPP or'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 -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 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: Patrick L Chaffin Signature: Patrick L Chaffin
Company: CHAFFIN AIR Date: Nov 19, 2013
Address: 36-345 BANKSIDE DRIVE License: 661464
City/State/Zip: CATHEDRAL CITY/ CA/ 92234 Phone: (760) 328-3400
Reg: 213-A0087119A-000000000-0000 Registration Date/Time: 2013/11/19 15:23:42 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
7
Permit #:
80154 HERMITAGE La Quinta, CA 92253
City of La Quinta
I Nov 19, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
❑ Indoor Coil
® AFUE 78%
® SEER 16.0
❑ COP
® HSPF 7,7
❑ R 6 (CZ 10-13)
Served by system
sf
® Setback
If not already present, must be
® Condensing Unit
❑ EER
[3Resistance
[3R 8 (CZ 14-15)
4200
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-1111
and CF-61Z 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-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
F9F Packaged UR:tSe Duet leakage i 15 ..4
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
[13. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie Ductless •Min i-Split-System)-(Also.Exempt:frompRefrigerant Charge)
❑ 2. New' HVAC System
Required Forms:
. Cut in,or Changeout with,
' ° '; " # '- I
CF_6R forms`. MECH-04, MECH-20-HERS,and (for split systems) MECH,2�2-HERS, and
new ducts: (all new
ducting and all new
MECH-25-HERS 1 t', �• rq ,
CF 4R for`ms: MECH-20, and (for split sy terns,) MECH-22, and_MECH-25 `
,
equipment)
_
For Split Systems: Duct leakage < 6 percent; RC, CCA:>_•350 CFM/ton, FWD, TMAH;-STMS, and either HSPP or'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-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-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.
• 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: Patrick L Chaffin Signature: Patrick L Chaffin
Company: CHAFFIN AIR Date: Nov 19, 2013
Address: 36-345 BANKSIDE DRIVE License: 661464
City/State/Zip: CATHEDRAL CITY/ CA/ 92234 Phone: (760) 328-3400
Reg: 213-A0087117A-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2013/11/19 15:21:46 HERS Provider: Ca10ERTS, Inc.
July 2010