13-0828 (MECH)�. P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000828
Property Address: 55441 FIRESTONE
APN: 775 -151 -008 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 14389
c&ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CLIFF GANT
55441 FIRE
LA QUINTA,
(760)771-4
9225 U
JUL 03 2013
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor: I I
Applicant:Architect or Engineer: GENERAL AIJj CON 99&GQUINTA
31170 RES VE DRIYMANCEDEPT.
�ERTHOUSAND PALMS, CA 92276
A4__
(760)343-7488
Lic. No.: 686310
LICENSED CONTRACTOR'S DECLARATION
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 Professionals Code, and my License is in full force and effect.
j License Class: C20 License No.: 686310
Date: 13 Contractor: crwt/d�
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.).
1 _ 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. , 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
Date: 7/03/13
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 are:
Carrier ZENITH INS CO Policy Number Z071741502
I 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 to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date:% 3 Q) 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 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 county to enter upon the above-mentioned property for inspection purposes. ,1
Date: 3 Signature (Applicant or Agent):
1>
LQPERMIT `\
Application Number . . . . . 13-00000828
Permit . . . MECHANICAL 2013
Additional desc . . 2.
Permit Fee . . . . 143.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 12/30/13
Qty, Unit Charge Per
Extension
2.00 35.7500 EA MECH FURNACE
71.50
•
2.00 .35.7500 EA MECH CONDENSER/COMP
71.50
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Special Notes and Comments
HVAC CHANGE OUT FURNACE & A/C UNIT 15
SEER 4 TON 15 SEER & (2) FURNACE
110,000BTU 2008 ENERGY CODES CARBON
MONOXIDE ALARMS(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION 2010 BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged Paid Credited
----------- - - - - ------ - - - - ------ - - - - ------ - - - - ----
Due.
-- - - - - --
Permit Fee Total 143.00 .00 .00
143.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 139.23 .00 .00
139.23
Grand Total 282.23 .00 .00
282.23
1>
LQPERMIT `\
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Perinfc
P.O. Box 1504,'78- 95 Cie Tlff*o
14 Qdnt4 CA, 92253 -1760) 777-7012
Building Pem* Applicadon' and Tracking Sheet
55441 FIRESTONE
Owncesmmc. CLIFF G.ANT
ABdress; 55441 FIRESTONE
n:
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City,s mp: LA QUINT -A, CA 92253
NERAL A/C & HEATING Telepboae
0 RESERVE DRIVE
Ciry. Sr, gyp: THOUSAND PALMS, CA 92276 CHANGE OUT A!C (2) 4 TON 15 SEER
Tdgho= 760-343-7488
&-(2) FURNACE 110,000 BTU
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'falai Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC
Climate Zones 10 -15
Site A.ddr'essc Enforcement Agency: Date! Permit #:
55441 FIRESTONE La Qulnta, CA 92253 City of La Quinta Jul 3, 2013
Duct Insulation Conditioned Floor
EqulpmentTypel List Minimum Efficiency2 requirement Area Thermostat
❑ Package Unit
® Furnace H AFUE _Myo ❑ COP p R 6 (CZ 10-13) Sewed by system ® Setback
* Indoor Coil Cl SEER _15.0 ❑ HSPF Q R 8 303], sf If not already present, must be
(CZ 14-15)
Irk Condensing Unit [3 EER [I Resistance installed)
C] Other
1. Equipment Type: Choose the equipment being Installed; I more than one system, use another CF-1R—ALT—HVAC for each system.
2. HinlmVM Equipment EffrcleneleS. 13 SEER, 78% AFV,-, Z7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Llsted elow 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 verlfles 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. Beginning October 1, 2010, a registered copy of the CF -IR
and CF -6R shall also be on site for final Inspection.
® 1. HVAC Changeout Required Forme:
. All HVAC Equipment CF -6R forms; MECH-04, MECH-2I-HERS an (for split systems) MECH-25-HERS
replaced CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or CF -611 forms: MECH-04, MECH-2I-HERS and (for split Systems) MECH-25-HERS
. Indoor Coll and /or
CF -4R forms: MECH-21 and (for split systems) MECH-25
Furnace
For Split Systems: Duct leakageic415 percent; RC, CCA s 300 CFM/ton (Minimum Air Flow Requirement), TMAH
qepeeeA
Exempted from duct feakacje testi&—,
;Q 1 ief systern'was dQ.curiiefi .fid to have been previously sealed and confirmed through HERS verification, or
..Duetsystern with less:th41i 40 linear feet In unconditioned space, or
3 'V is ducf systems are.e?tS' ikructed, Insulated or sealed with asbestos
:. :.
Cj4: Tfi@: all not be Uu "d::(ie:<:Dcl :.!: ' y ��G Ste : ' . e e ire., rge)
O 2."N SyF11 Requl Rf�f.:,." :,:f?i <,;-, ..t l;�ab:
a
. Cut Ih ngeout wi' ECH-04, 0 {ERS ht sy ' sj MEC ° ERS, -1€td
new (ail new -,
,nn t
p
; nen _
ducti all n s t .t
f 0, br s
ECH ;:2 >fYIE •,
t t1
equip
'16g�
For S fit rii� (.. )f �c ,. Mjgi : V t " 1 .... �j�`7 ' " ri HM� ' -,e. ' 7 :anU
'-
Por Packaged lln�Fa:. uct leakag2�:�a'6':percent
C1:3:, K 7tC¢ ii�t /o.r..wlthoti> ` Required Forms.
Rep)aC��'ti�'::'
. includes replacing or installing.dl3pew
ducting and/or outdoor coiitlen5riig unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
4•
and/or indoor coil and/or ft,tn`ec,$::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, TM.AH
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-21-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
E3 EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responerble Designer's Declaration Statement
• i certify that this Certificate of Compliance documentation Is accurate and complete.`
. i am eligible under Division 3 of the Callfomia 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: Jul 3, 2013
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
.Reg: 213-A0049144A-000000000^0000 Registration Date/Time: 2013/07/03 1.1:57:55 HERS Provider: CaACERIS, xnc.
2008 .Residential. Compliance Forms July 2010