13-0609 (MECH)4
P.O. BOX 1504
78-495 CALLE TAMPICO -
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000609
Property Address:
79680 DESERT WILLOW ST
APN:
649-470-050-81. -28601 -
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation: 6628
4
Ti'At 4 4 Q"
Applicant: Architect or Engineer:
C�Dti �
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under ovisions of Chapter 9 (commencing with
Sectio;70001Div1C43 sine an fessipnal C/ e, and 2 License is in full force and effect.
License�Cjass: C,O-C43 / i se No.: 2'x6586
Date.J 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 7b001 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.).
(_ 1 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
Owner:
LANKHAAR SHT
79-680 DESE.
LA QUINTA,
(
Contractor:
DESERT AIR
590 WILLIAM
PALM SPRINGS, CA
(760)323-3383
Lic. No.: 276586
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/14/13
92264
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 EVEREST NATL Policy Number 7600007908121
1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject t t e workers' compensation laws of California,
and agree that, if I 0��
'ct tot kers' co ensation provisions of Section
37 of the Labor
it co rovisions.
Date / • Applicant:
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 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.
I certify that I have read this application and state that the above infor4pesr
rect. I agreeJrp
ply with all
city and county ordinances and state laws relating to bu' nst ce y authorizentatives
of this
�rc-ount en upon the above-mentioned pro art r in ec
Dated / � Signature (Applicant or Agent)
Application Number . . . . . 13-00000609
Permit . . . MECHANICAL
Additional desc .
Permit"Fee . . . . 33.00 Plan Check Fee
8.25
Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/10/,13•
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
1.00 9.0000 EA MECH B/C <=3HP/100K BTU
9.00
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Special Notes and Comments
REPLACE 5 TON CONDENSER AND COIL GROUND
LIKE FOR LIKE 13 SEER CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
--------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
--------------
1.00
Fee summary Charged Paid Credited
---------- ------- - -- ----------
Due.
----------------- ----------
Permit Fee Total 33.00 .00 .00
33.00
Plan Check Total 8.25 .00 .00
8.25
Other Fee Total 1.00 .00 .00
1.00
Grand Total 42.25 .00 .00
42.25
LQPERMIT
sfi. #
Oty Of QL1lnta
Bulkling 8[ Safety Mimi
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application, and Tracking Sheet
Permit #
Zj` �bq
ProjectAddress:79-680 DESERT WILLOW ST
0wner'sName:SHEREE LANKHAAR'•
A. P. Number.
Address: 79-680 DESERT WILLOW ST
Legal Description:
City, ST, zip: LA QUINTA, CA 92253
Contractor. DESERT AIR CONDITIONING, INC
Telephone:
PmjeetDescription:
Address: 590 WILLIAMS RD
City, ST, Zip:PALM SPRINGS, CA 92264
REPLACE 5 TON CONDENSER AND COIL ON
Telephone: 760-323-3383
GROUND LIKE FOR. LIKE
State Lic. # : 276586 City Lic. #, 363
Anchi Engr., Designer. NA "
Address:
City, ST, Zip:
Telephone: Construction Type:. MECH Occupancy:
State Lia #: Project type (circle one): New Add'n Aher Repair Demo
Name of Con adPerson: JACQUELINE RATLIFF " Sq. Ft.: #Stories #Univ:
Telephone # of Contact Person:
Estimated Value of Project 6,628.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
d
Submittal
Req'd
'Pee'd
TRACKING
PERb=FEES-
Plan Sets
Pian Check submitted
new Amount
Strgctnral CalmReviewed,
ready for conwdons
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calls.
Pians picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
2" Review, ready for corrections/tme
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked op
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"° Review; ready for eomcdo'ns/issne
Developer Impact Fee
Planning Approval.
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - IS
Site Address:
Enforcement Agency:
Date:
Permit #:
79-680 DESERT WILLOW ST La Quinta, CA 92253
City of La Quinta I
Apr 23, 2013
Dud insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
W AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
[3 R 6 (CZ 10-13)
0 R 8
Served by system
2000
® Setback
If not already present, must be
® Condensing Unit
[3 EER
[3 Resistance
(CZ 14-15)
installed)
0 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 Effldencies: 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 -411
forms (no hand filled CF-4Rs allowed) are filled out and signed.8eginning October 1, 2010, a registered copy of the CF -IR
and CF -6111 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 -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:
p 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. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut in or Changeout with
CF -6R forms: MECH-04, MECH-20-HERS; and - (for split systems) MECH-22-HERS, and
new duds: (all new
MECH-25-HERS
dulling and all new
equipment)
,
CF -4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
I.
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 -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
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -61k forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Dud 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: Jacqueline Zabik Signature: Jacqueline Zabik
Company: DESERT AIR CONDITIONING INC Date: Apr 23, 2013
Address: 590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
f Reg: 213-A0023922A-000000000-0000 Registration Date/Time: 2013/04/23 12:49:29 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010