12-1157 (MECH)P.O. BOX 1504^� VOICE (760) 777-7012
I -
78-495 CALLE TAMPICO FAX (760) 777-70.11
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/02/12 "
.Application Number:~ -12-000011571-- Owner:
Property Address: 47445 VIA CORDOVA STEVEN DOUGLAS
APN: 643-100-028-207 -26152 - 47445 VIA CORDOVA
Application description: MECHANICAL LA QUINTA, CA 92253,
Property Zoning: LOW DENSITY `RESIDENTIAL
Application valuation: 4107
. Contractor: D� a
Applicant: Architect or Engineer: AIR PRO SERVICES rt 7
P.O. BOX 1120,r�. i 212
CATHEDRAL CITY, CA 92235
(760)34 ' 3-5502 CITY OFLA QUINT`
LiC. NO.: 780198 1A%1CFr3F>, I
LQPERMIT
- LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
.I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals -Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
• Lice Class:.. C20 License No.: ' 780198
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Date: �O-:l-/i rive -
`p,C� issued.
f ' 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier NORGUARD INS Policy Number A-IWC346635
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any, -
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he'or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become sub] to the workers' compensation provisions of Section -
' License Law (Chapter. 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
, . 3700 of the Labor Code, I shall fortlj h com ly with those provisions.
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)•:
,
ate:/a -.2 *0L ,k plicant:
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, Business and Professions Code: The
WARNING: TAILURE TO SECURE WO S.COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMIN PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND - -
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT -
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. -
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
- 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a.contractor(s) licensed
_ 1.. Each person upon whose'behalf this application is made, -each person at whose requestand for - -.
- -- pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application, -
(_ )" I am exempt under Sec. , B.&P.C. for this reason
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 tothe .work being
-
- performed under or following issuance of this permit.
- Date: Owner:
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 -
- CONSTRUCTION LENDING AGENCY
- permit to cancellation. -
.. - I hereby affirm under penalty of perjury that there Is a construction lending agency for the performance of the
I certify that I have read this application and state that the above informa 'on is correct. , I agree to comply with all '
work for which this permit is issued (Sec. 3097,. Civ. C:)•
city and county ordinances and state laws relating to building co ructi , and hereby authorize representatives -
.. -
of is county to enter upon the above-mentioned property for • i t purposes.
Lender's Name:
-
- Lender's Address:
Date: /U-2-/:7nature (Applicant or Agent): -
-
-
/J
LQPERMIT
Application Number 12-00001157
Permit . . MECHANICAL
Additional desc
Permit Fee . . . . 31.50 Plan Check Fee
7.88
Issue Date- Valuation . . ,
0
Expiration Date' 3/31/13
Qty Unit Charge Per
Extension
BASE FEE
15.00 ,
1.00 -16.5000 EA MECH B/C.>3-15HP/>100K-500KBTU
16.50
-----Special Notes and Comments
HVAC CHANGE -OUT: INSTALL NEW 4 TON 13
SEER CONDENSER & INDOOR COIL. 2010
CODES:
------------------------ - --
Other Fees . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 31.50. .00 .00
31.50
Plan•Check Total 7.88 .00 .00
7.88
Other Fee Total 1.00• .00 .00
1.00
Grand Total 40.38' .00 .00
40.38
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement. Agency:
Date:
Permit #:..
47445 VIA CORDOVA La Quinta, CA 92253
City, of.La Quinta , _ -
Oct 2, 2012.
'
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ AFUE
'
❑ COP
❑ R 6 (CZ 10-13)
Served by'system
® Setback
® Indoor Coil
® SEER 13.0
❑ HSPF
❑ R 8 (CZ 14-IS)
1530 sf
If nc,t already present, must be
® CondensingUnit
❑EER•
❑Resistance ' .
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 thax the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate 0F-611R 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-6111 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-61R 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 (forsplit 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
leakage
wt 4 15 peF6WIt
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. The system will not be Ducted (ie pDuctless, Mini-Split-System).(Also,Exempt•fromrRefrigerant Charge) ,
❑ 2. New'HVAC System
Required Forms:
. Cut in or Changeout with'
new ducts: all new
(all
` '+ " r.r
CF-6R forms. MECH-04, MECH-20-HERS, and'(for split systems) MECH-22 IHERS, and ,
'�.), `'
ductiri 9 new
MECH-25HERS }' )1
CF-4R forms`. MECH-20 and (for split systems) MECH-22 and MECH-25 Wiz' W.
equipment) 41r`1
--'t# IV '- �.e
� •ar ✓'r;, #� s .; 1" a a # • 4 ..
,%:171We
For Split Systems: Duct leakage < 6'percent; RC,-CCA >_ 350 CFM/ton, FWD; TMAH, STMS, and either >iSPP.oe'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 z 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 8n this Certificate of Complience 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 otter applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the p=_rmit application. '
Name: Joe Priest. Signature: Joe Priest
Company: AIR PRO SERVICES CORPORATION Date: Oct 2,.2012
Address: P 0 BOX 1120 License: 780198
City/State/Zip: CATHEDRAL CITY / CA / 92235 Phone: (760) 343-5502
Reg: 212-A0054772A-00000000=0000 Registration,Date/Time: 2012/10/02 12:08:35„ HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance`Forma July 2010
Bin # :
i
,�•
" ` r City of La Quinta �r.
t� r
Building & Safety, Division
P.O..Box 1504, 78-495• Calle -Tampico xiv
`�: �'.��
Permit #
.
La Quinta,•CA 92253 (760) 777=7012 "
Building Permit Application and Tracking-Shee6teveN�Fl 34t
Project Address: �7 S ��
Owner's Name:T_ to 5
A. P. Number:
Address. 7 tE 15 ✓' Co A6 cv
` -
Legal Description`. -'
c
City, ST, Zip: L '14 -r A Q d a-S 3
tr t
Con ac or. •/1o .G
Ft R s
� e
Telephone: hone: Z S_38_ t
Address:7��g� N44�/► S�io/te 5y�eecf' 5,, V.-
Project Description:
City, ST, Zip: T �,.�( Q �iA s C.4 9 Ida 7 C.
Ctia,v 0q e'ow ervS F"eo, .
,. `#,
.r '�,
Cµ ��
`t4..
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Telephone: e �
P a
7 .
6 - —
0 S5
3 43
.._ t' '{
w
YT12 See
State Lic. # : 7 pD g
City Lia #; 30 7 �'
Arch., Engr., Designer:
• .:
Address:
44 ,
City, ST, Zip:` . t
�.
Telephone:
Construction Type: Occupancy:
ancY• ,
State Ltc.
r J'e ct type (circle one):: New Add n Alter Repairair Demo
Name of Contact Person: J e ?A.; os t
Sq. Ft.:
#Stories:
#Units: '
Telephone #.of Contact Person: 7 (pp - 3 3 —SSoi
Estimated Value of Project: 19Y G o0
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount"
Structural Cald.
'Reviewed, ready for corrections
Plan Check E-eposit
.Truss Calcs.
Called Contact Person
Plan Check Ealance_
Title 24 Calcs.' -
.s_
Plans picked up
Construction ,
r
rFlood plain plan'
rr `.
Plans resubmitted
Mechanical
Grading plan,
2"' Review,-ready for corrections/issue
Electrical
Subcontactor.List
Called Contact Person
.t
Plumbing
Grant Deed '_
Plans picked up
S.M.1.
H.O.A. Approval
s y
Plans resubmitted
Grading ,
IN HOUSE:-
'rd Review, ready for corrections/issue
Developer Impact Fee'
W
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr.
-
Date of permit issue - •
t,
School Fees
•
Total Permit Fees
A)
I
•
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