11-1261 (MECH)-
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA. 92253
Application Number:
11-00001261
Property Address:
78745 W HARLAND DR
APN:
604-232-001-130 -23268 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application Valuation:
7000
Applicant: Architect -or Engineer:
— ------------- I-.
LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of.the Business and Professio els Code,and my License Is in full force and effect.
License' lass: _ C20 License No.: 771,254
OWNER -BUILDER DECLARATION
I hereby affirm under penalty'of perjury that I am exempt fromahe Contractor's State License Lew for the
following reason.(See. 7031.5„Business and,Professlons Code: Any. clty or county that:requlres•a permit,to
construct,atter,'Inlprove, demolish; Or” `
repeir•any structure, prior to its Issuance; also requfre8.the applicant for the
permit to filea signed statement,that he:or she Is licensed pursusnt,to the provlsiom of the Contractor's State
License Law4Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
fhathe or she is exempt therefrom.and the basis for the alleged exemption. .Any violation of Section 1031.6 by
any applicant for a permit subjects,the applicant to a civil penalty of not more than five hundred dollars (6500)::.
( _.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, Buslness and Professions Code: The
Contractors' State License Lew: 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 rare not,lntended or offered for sale:If, however, the building or improvemem,is sold within
one-year of completlon,:the owner -builder will have the burden of proving. that he or she did not. build or
Improve forthe purpose of sale.).
(_)
[,as: owner'of,the property, am exclusively contracting with;licensed contractors to construct the project (Sec.
7044, Business. and Professions Code: The Contractors' Siete License Law does not apply:to an owner of
property who builds or improves thereon, and who contracts for the protects with a contractor(s) licensed
pursuant to the Contractors' -State License Law.).
(_) 'I sm,exempt underSec:. B.&P.C. for this reason
Date:
Owner:.
CONSTRUCTIOMLENDING 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 isassued (Sec. 3097, CW. C:).
Lender's Name:
Lender's Address: - -
LQP=MIT
Owner:
'PETER & ALICE NEELY
78745 WEST HARLAND DRIVE.
LA QUINTA, CA 92253
VOICE (760) 777=.7012.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/21-/11
Contractor: ilulir lALL KNIGHT HEAT & AIR COG n f.
FFd� / r iI
P.O BOX 5232 � k`.l: �! �=' 2a1� I
LA QUINTA, CA 92248 f
((760)7.72.=4947n
at<:NiA
tic. NO,.. `771254
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 Sect(om3700,of the Labor Code, for the performance of the'work for which this permit is.
�j issued.
QUI have and Will maintain workers'compensationdnsurance,'as required by Sectlon,3700,of'the'Labor
Code; for the performance of the'work for which this permlt'is Issued.. My workers' compensation
Insurance ' carrier and policy number are:
Carrier NORGUARD INS Policy Number BRWC910742.
I certify that, in thwperformarice.of,the work for which this permit is Issued; I shall not employ any
person In- ,any manner so Ise to become Bub to the workers' compensstlon laws of California;
and agree that, W1 should come subjectt he workers' compensation provisions of Section
370P of the ',LeborC hall with those provisions.
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 (6100,000). 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 fora permit subject to the
conditions and restrictions setforih 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, indemnityand hold harmless the City
of.La duima, is offieers,.agents and employees for any act or omission related to the work being
performed under or following.1ssuance of this permit.
2: Any permit issued.,es_a result of this appllcation.becomes null and v_dd if work isnot 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 have read this application'andstate thatthe above information I 4-6. l; agree to comply with all
city and county ordinances and state'laws relating to bulkti DostIon, and ebyauthorize.represemetives
ofthis�cou t enter up the above-mentioned pro insp ion pu - s.
Dat✓.' --/(gnature (Applicant or Agent):
Application Number . . . . . 11-00001261
Permit. .. . . . . MECHANICAL
Additional des*c
Permit Fee . . . . 40,50 Plan -Check Fee
10.13
Issue Date . . . . Valuation . . . .
b
Expiration.Date 5/19/12
Qty Unit Charge Per
Extension
BASE FEE
15.0'0
1.00 9.0000 EA FURNACE <=1.00K
9.00
IMECH
1.60 1:6. 5 0-6 6 ,EA MECH B/(f ->3--15HP/>100K--500KBTU
16. SO
------------------------------- ----
Special Notes, and Comments
IfVAC 'dftANGE6bT-. FURNACE CONDENSER,
INDOOR COIL- 2016 d6liES..
Other Fees . . . .. . . . . . BLDG SIDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
- - - --- - --- - - - - - - - - - - - - - -
Due
- - - - - -
7-
Permit Fee Total 40.50 .00 .00
40.i50
Plan Check Total 10-13 .00
10-.13
Other Fee Total 1.00 .00
1.00
Grand total - 51..63 .0'0 A0
.5,1.63
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Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-1R-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit !:
78745 West Harland Drive La Quinta, CA 922531,
City of La Quints
Nov 21; 2011
Duct insulation
Conditioned_ Floor
Equipment Typei
List,Minimum Efficiency2
requirement
Area
Thermostat
Package Unit
urnace
Indoor Coil
oil
[I
® SEER 13.0
' ❑ COP
E]HSPF
El R.6 (� i0-i3)
0 R 8 (CZ 14-1s)
Served by system
1400 sf
® Setback
If not already present, must be
CEJ Condensing Unit
p EER
p Resistance
installed)
p Other
1. Equipment Type., Choose the equipment being Installed; If more than one system, use another CF-1R-ALT-HVAC !Fu each system.
2. Minimum Equipment EfififtI ncles: 13 SEER, 76%.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: formsshall
for,
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 work completed by'the-installer. The inspector also verifies' that each appropriate CF-611 and registered CF-411
forms (no hand filled CF-4Rs allowed) are filled out and signed.8eginning October 1, 2010, a registered copy of the CF-1R
and CF-6R shall also be on site1dr final. nspection.
01. 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-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 <;;1'5 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
0'4.. The system will not be Ducted 0e.,D,uctless:Mini-Split;System) (AIso-Exempt.from Refrigerant°Charge)
❑ 2. Nevi HVAC System
Required 'Formsc
.Cut rn orChangeout with;
CF ,6 f017r15'l MECH-04, MECH-20`'HERS, and'(forapiit systems) MECH-22-HERS,.and
new ducts' (all new �)
MECH725 HERS j , ! '
ducting and all new r.
�f
. ; ,
CF-4R forms MECH 20, and (for split systems) MECH-22, and: MECH-25
equip*nt)
/! i �.
For Split Systems:. Duct;leakage < 6; percent, RC,4CCA >,350 ;CFM/ton;. FWD; TMAHi SIMS, and-either HSPP oe'PSPP.
For Packaged Units: Duct leakage •<, 6 percent
❑ 3. New Ducts,with/or without_. '
Required Forms:
Replacement
. Includes replacing or installing alit new
ducting and/or outdoor condensing .unit
CF-611 forms: _MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/of,indoor coil and/or furnace: No or some.
CF-411forms: 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 over40 feet
Required'Forms:
.Includes adding or replacing more than 40
CF-6R forms: MECH-04, MECH-21-HERS
1CF-4R.forms:
linear feet of duct in unconditioned space.
MECH-2T
Forspiitsystem or packaged units:, Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documento on 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 Califomia.Business and Professions code Eo 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.
rTheAesign features identifled.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: April Knight Signature: Awl Knight
Company: ALL KNIGHT HEATING & AIR CONDITIONING Date' Nov 21, 2011
Address: P O BOX. 5232 License: 771254
City/State/Zip: LA QUINTA / CA/ 92248 Phone: (760) 772-4947
Reg: 21140066462A-00000000-0000 Registration bate/Time: 2011/11/11 11:05:53 HERS Provider: CalCERTS, Inc.
2006 Residential Compliance Forms July 2010