13-0941 (MECH)P.O. BOX 1504
78-495-CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000941
-Property Address: 78863 VIA CARMEL
APN: 646-430-028- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Anolication valuation; 24305
4 VOICE (760) 777-7012 4
r .1 .
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760),7771-7153
BUILDING,PERMIT
Date: 7/29/13
Owner'
Applicant: / Architect gr Engineer.
-----------------------------—-----—---------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C20 License No.: 686310
Date: Z )3 Contractor�i
OWNER-BUILDER DECLARATION
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 (55001:
(_ 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
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.).
(_ 1 I am exempt under Sec.. _ , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPEPMIT
NORRED CHARLENE
78863 VIA CARMEL
LA QUINTA, CA 92253
(760)972-4473 fr--::z
Contractor:
GENERAL AIR CONE
31170 RESERVE DR
THOUSAND PALMS,
(760)343-7488
LiC. No.: 686310
f
)2 2013
A QUINTA
------------------
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.
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 Elie 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.
.. Ddte:B Z )3 Applicant :15 c�
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 Ouinta, 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 1 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 enterupon the above-mentioned property for inspection purposes.
Date 8, L 13 Signature (Applicant or AgenO:,-
f%
I
Application Number . . . 13-00000941
Permit MECHANICAL 2013.
Additional desc .
Permit Fee . . 143 00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 1/25/14
Qty Unit Charge Per
Extension
2.00 35..7500 EA MECH FURNACE
71.50
2.00 .35.7500 EA MECH CONDENSER/COMP
71.50
----------------------------------------------------------------
-----Special Notes and Comments.
REPLACE (1) 4 TON A/C UNIT &90 K BTU
FURNACE REPLACE -(1) 5 TON AC/ 80 K BTU
FURNACE 2010 CODES.
July 29, 2013 4:21:16 PM-pjuarez.
_ ----------------------------------------------------- -----------------------
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
t
'
•
LQPERMIT -
..
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
Project Address:
Owner's Name: �N ter f e -.A
A. P. Number:
Address: i $FSio 3 V � C, nne�
Legal Description:
Contractor: G' e-reraO X -c Cot^6,4�O
City, ST, Zip: L o;�. G, i n\ � ,, CA 9 ZZ S 3
Telephone: 4 Z �1y73
Address: 3l \ i 0 1Z a Se,ry �c, •
Project Description:
City, ST,Zip: `�novso.�nc� �G.`ms C+A Q'ZZ7�
y fior'A c j�_ QO l�V
ne•
TeleP ho O - -7
7 3 Za.
3 y
TVMG
State Lic. # : 6 963 t O City Lic. #•:
Arch., Engr., Designer:
cace-• 1 O A G h6 l�Tu
1'v rYIO.LG
Address:
City., ST, Zip:
Telephone: one:
ancY
Construction Type: Occupancy:
•
State Lic. #:ProJject
type circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:.
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
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 Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" 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:-
'^' Review, ready for correctionstissue .
'Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
mplified Prescrlptive:Certificaate of Compliance: 2008 Residential HVAC Alterations CF -111 -ALT -HVAC
-15
Site Address: Enforcement Agency: Date: Permit #:
78863 VIA CARMEL La Quinta, CA 92253 City of La Qui tai Jul 29, 2013
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efflciency2 requirement Area Thermostat
❑ Package Unit NSetback-
* Furnace ® AFUE 780)lo ❑ COP d R'16 CZ 10-13 Served by system
Indoor Coil N SEER ❑ HSPF not already present, must be
� �.� [3 R 8 (CZ 14-1 S) _ � � s4 installed)
® Condensing Unit ❑ EER ❑ Resistance
❑ Other
1. Equipment Type: Choose the equipment being Installs ; ff more than one system, use another CFIR-ALT-HVAC for eac system.
2, M/nimum 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.8eginning O"Ctober it 2010, a registered copy of the CT° Ilk
and CF -6R shall also be on site for final Inspection.
® 1. HVAC Cha.ngeout Required Forms:
. All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and, (for spilt systems) MECH-25-HERS
replaced CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil.and /or CP -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS
Indoor Coil and /o: CF-4it-forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Spilt Systems: Duct leakageU%,15 percent; RC, CCA:5. 300, CFM/tan (Minimum Air Flow Requirement), TMAH
Exe[rlptezifr4sn;duct.leakage testin���f:•.: • • .' -
�luct:5yskgfGga5ociJ�ne+ed.to have been previously sealed and confirmed through HERS veNflcatlon, or
:,CI2:.DUGt SySteiai5 wltlj Iess..th Tz40 linear feet In uncondltloned spat?, or
Ej3'. EX,i t r!g `duCC systems: Ye: f!strueted, .IRsulated or seated with asbestos r
Fl,
4 :tl.,h :sN iaUll not be.:by" d'.(C: M9 i Usai,' e! ?l mxe► ` k z �� ge)
TTRfIr:`„'��.'M�{1.`�Ser4G.��'�'+��'.•,ri�:,�''fC�'' i'nS�n��"�^'�'A�kA;:hM1�t•4l�Nii'.:��5J7r?��'�<•:71�hl6iii`uS���.:�'
new
ForSplit;
For; P,aek6
Rbplaf4R ..;:.._....
i
.Iriiduiii>feplacingrtir'lriLpllirig''.d �itiew
�iornnit
ducting and/or outdoor c-i"CF-6R forms: MECH-04, MECH-20-HERS, and (for spilt systems) MECH-25-HER5
and/or Indoor coil and/dr.fu41,i&h bi tVo.or some . CF=4R ferms: 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 DUtcting over 40 feet Required Forms:
. Includes adding or replacing -more than 40 CF -6R farms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. ICF -4R forms: MECH-21
For split system or packaged units: Duce leakage < 15 percent
13 EXCEPTION: Existing duct systems constructed., insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
. ['certify that this Certificate of Compliance documentation is accurate and complete.
. 1 am eligible under Division 3 of the California Business and Professions Code to accept responslblllty 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 COmDllance 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: bonielle Garcia
Date: Jul 29, 2013
70 RESERVE DRIVE STE A •
: THOUSAND PALMS / CA / 92276
Reg: 213-A.O056789A-000000000-0000 Regirstration.Dat:e/Time: 207.3/07/29 1.2-52:49 HERS Provides: Ca10ERT8, Inc.
2008 Residential Compliance Forma July 2010'
iirnplified Prescriptive Certificate of Compliance.
2008 Residential HVAC Alterations CF-IR-ALT-HVAI
�Ilmate Zones 10 - 15
Enforcement Agency: Date: Permit #:
site Address: City of La Quinta Jul 29, 2013
78863 VIA CARMEL La Quinta, CA 92253
Duct insulation Conditioned Floor Thermostat
EquipmentTVpel List Minimum Efflciency2 requirement Area
13 Package Unit ll Setback
* Furnace 11 AFUE 78% ❑ COP 0 R 6 CZ 10-13 Served by system
* Indoor Coil ®SEER 18.0 13 HSPF ( ) in not already present, mUSC be
®Condensing Unit Q EER ❑ Resistance R 8 (CZ 14-15) 2375 sf installed)
❑ Other
1. Equipment Typal Choose t e equipment being installed; if more than, one system, use another CF -1R -ALT -HVAC for each system.
2, MInImLm Equipment Ef/iciencles- 13 SEEP, 78% AFUE, 7.7HSpF for typical residential Systems.
HERS VERIPICATlON 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 HER$ 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.6eginning October 1, 2010, a registered copy of the CF -IR
and Cf -6R shall also be on site for final inspection.
13:L. HVAC Changeout Required forms:
. All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for spilt systems) MECH-25-HERS
replaced CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or CF -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Solit SV6tems: Duct leakages x:,15 percent; RC, CCA < 300 CFM/ton (Minimum Air Flow Requirement), TMAH
mpted:from duct IeaKage tes
,❑ 1. buct system wa5,docul
[3 ...Duct systems.with less
Q.3..Existing duct systems.;
❑'r}, -Ther. ii''II not be
2. Ne.. ". tSV n Rei
new � f(all new
dual . �tall new,
to have been previously sealed and confirmed through HERS verification, or
) linear feet in unconditioned space, or
:trusted, Insulated or sealed with asbestos` ---.n - — .e�„N Ghcrnnl
Fr -➢
For Spht,Sy.ST.,�.tnTSR ?c+t4Uv?ca����. r �"iaA. "r.'A.:p•:... =tr" ?.,�,..z: r
For Packaged Uni .:.Oust leakag .� ,� wrce �.:.
214r`� r
❑.3:NcuyCFL itliorwithoilC; Required Forms:
. Intludes.replacing!or.ln5talling SII j'iiew
ducting and/or outdoor cdnderi4M unit CF -6R forms: MP -CH -04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or Indoor toll and/or.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:
e 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
El EXCEPTION: Existing duct systems constructed, Insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Deciaratlon 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 identined 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 Tide 24, Parts 1 and 6 of the California Code of Regulations. compliance
. The design features Identified on this Certificate of Compliance are consistent with the information documented on other applicable
com p
forms, worksheets, calculations, plans and specincatlons submitted to the enforcement agent for approval with the permit application,
Name: Danielle Garcia Signature: ponied. Go, -la
I I]atec lid 29. 2013
U
FM
STE C
/ CA
License:
Reg: 213-11005679oA-000000000-0000 Registration )Date/Time:.2013/07/24 12:65:44 HERS Providef! ealCERT.S, Inc..
July 2010
2009 Residential Camplianco Forns
Simplified Prescriptive Certificate of Compliance: 2008 Residential 1 VACAlterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address: Enforcement Agency:
Dqte.
Permit #:
7 g�sl�3 i/ i a Cc.r mal G L3 OP, LG Q uirya
-712-'k 1 13
Conditioned Floor
E ui ment Typel
List Minimum Eflicienc s Duct insulation requirement
Arja
Thermostat
❑ Packaged Unit
X Furnace
OAFUE 7 g �.
Over 40 ft of ducts added or
❑ COP
JW Setback
9Indoor Coil
ASEER i 3
replaced in unconditioned space
❑ HSPF
Served by _system
(If not already
WCondensing Unit
❑ EER
❑ R 6 (CZ 10-13)
❑ Resistance ❑ R 8 (CZ 14-15)
<f
present, must be
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed, • if more than one system, use another CF -IR ALT -HVAC -tor 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 CF4R forms (no hand filled CF4RE allowed) are filled out and
signed. Befonning October 1, 2010 a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH-21 and (fors lit stems) MECH-25
• Condenser Coil and/or
CF -6R fortes: MECH-2I-HERS and (for split systems) MECH-25-HERS
• Indoor Coil and/or
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
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 ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF4R forms: MECH-20, and (foi split systems)MECH-22, and MECH-25•
new 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 Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all 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 CF -4R fo-ms: MECH-21
linear feet of duct in unconditioned space.
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 foraproval with the permit application.
Name:
Signature:— C>
Company:
G�erc�1
Date:
��Z•��13
�r• ��i i
Address: 3 W70 � eSelCV� ��
License. GE6310
City/State/Zip: �hOust�hG� _b 1\ C_A gZZ-7(o
Phone: 7Go _3q3_7488
2008 Residential Compliance Forms July 2010