13-0834 (MECH)P.O. BOX 1504' +
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
J
Application Number: 13-00000834 Owner:
Property Address: 79090 VIA CORTA GAYNOR RICHARD E & I
APN: 649-460-009- - - 23802 HOBART BAY
Application description: MECHANICAL DANA POINT, CA 9262!
Property Zoning: LOW DENSITY RESIDENTIAL
Application Val'Uation UUU
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a license u r rovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business Profess als Code, and my License is in full force and effect.
License Class: C20 ' License o.: 954337
ri"3
f */Contractor:
f J
OWNR-(WtoR DECLARATION
I hereby affirm under penalty of perjury that I am axe pt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Profess ons 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)•:
(_ 1 1, 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 1 I am exempt under Sec. B.&P.C. for this reason
r
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
Contractor:
ALL DAY HEATING & C(
83947 MOONLIT DRIVE
COACHELLA, CA 92236
(760)834-1064
Lic. No.: 954337
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: .7/05/13
-----------------------------------------------
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.
!f'ri'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 NORGUARD INS Policy Number MIWC460495
_ I certify that, in the performance of the work r whic this permit is issued, 1 shall not employ any
person in manner so as to me su ect a w�fkers' compensation laws of California,
and agree that, if I should bec subjec o e wor rs' compensation provisions of Section
3700 of the Labor Code, I sh rthwit omply wi those provisions.
Date �3 Applicant: ..
WARNING: FAILURE TO SECURE WORKERS' COMPE SATION CO AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES D 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 far 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 d void if r is not commenced '
within 180 days from date of issuance of such permit, or ce ation work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov nforma is correct. I agree to comply with all
city and county ordinances and state laws relating to building structi , and hereby authorize representatives
of this county enter upon theeaab/ove-mentioned property fo ' Spec ill purpoes.
Signature (Applicant or Agent):
Application Number - 13-00000834-
l
Permit MECHANICAL 2013
Additional desc ...
Permit Fee 35.75 Plan Check Fee
.00
Issue Date Valuation . .
. . 0
Expiration Date .1/01/14
~
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
Special Notes and Comments
HVAC - 13 SEER, HVAC - REPLACE INDOOR
COIL LOCATED IN ATTIC. 2010 CALIFORNIA
--
BUILDING CODES.
---------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
--
1.00
PERMIT ISSUANCE M/P/E
90.57 ,
PLAN CHECK, MECHANICAL
23.83
Fee summary Charged Paid Credited
Due
Permit Fee Total 35.75 .00 .00
35.75
Plan Check Total .00 .00 .00
.00
Other Fee Total 115.40 .00 ,.00
115.40 -
Grand Total 151.15 .00 _ .00
151.15
- LQPERMIT - -
Bin #
City of La Quint
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
lLa
7j
Project Address:-meq(—p11D V, C.,
Owner's Name:
A. P. Number:
Address: --t-( —pGt O
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address: t7I-Z
Project Description: T1,—
City, ST, Zip: �e.�L� i z ta.G! ; CA Cq ��3
o r� 2 Ga
Tele ho
..::..:..:.
"''"
State Lic. # : G2®cj 533
City Lic. A. I b l Z93
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
;;::rr:#>1.<::;?;::;:>::;:;
Construction TOccupancy:e:
State Lic. #:
Project a (eircle'one): New Add'n Alter . Repair Demo
J type
Name of Contact Person: t 6 v �`L 5 �—
Sq. Ft.: t 0-C>
# Stories:
# Units:
Telephone # of Contact Pers � D6
Estimated Value of Project: god f�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balat.ce
Tiile 24 Calcs.
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:-
'd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Sint ted .Prescr.I Cive Certificafe"titCmolittincei 2008 Residential HVAC.41teratioits CF-1R=ALT-RvAC
Chratate'Zones iWto IS.
Site •Address:
-�3— 0-9i Q Enjoreemen! Agency: Date:
Permit #:
v IZTa'
Equipment T ' Conditioned Floor '
List Minimum Eflicienc •2 Duct insulation re uirement Area Thertnosfat
❑ Packaged Unit
'❑ Furnace ❑ AFUE ❑ cop Over 40 ft of ducts added 3 back
orSet
Indoor Coil ❑SEER ❑ HSPF replaced in unconditioned space Served by system t/ Ifna y
back
❑ Condensing Unit ❑EER ❑Resistance 11R 6 (CZ 10-/3) pl3o a sf presear. must be
❑ Other ❑ R 8 (CZ 14-15)instnryed)
/ Equipment Type: Choose the equipment being installed: ijmore than one system, use anotherCF-IR-ALT-HYACjor.each system.
2. Minimum Equlpmem Efficiencies: 13 SEER, 7801. AFUE, 7.7USPFj or
typical residential rystents.
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 fittal
inspection anda 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 appivpriate CF -6R and registered CF4R forms (no hand filled CF-4Rs allowed) are filled out and .
signed. Beginitiag October 1, 2010 a r tered COPY of the CF -1R aced CF -6R shall also be on site for &MI Inspection.
❑ 1. HVAC Changeout Required' Forms:
• All H VAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -411 forms: MECH-.21 and for lit sterns MECH-25
• Condenser Coil and/or
• Indoor Coil and/or CF-61tforms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
Furnace CF4R fornu: 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 ,
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1 Duct s%•stem 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: Exi ' ducts I ystems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC S tem Required Fonns:
• Cut in orChangeout with new CF -6R forms: MECH-04, MECH-20-HERS,and fa
ducts: (all new ducting gd all ( split systems) MECH-22-HERS, and MECH-25-HERS
new equipment) CF4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFMAon, FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage z 6 nt
❑ 3. New Ducts with Replacement Required-Formt:
• Includes replacing or installing all new ducting CF -6R forts: MECH-04; MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF4I1 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:
• Include; adding or replacing more than 40
linear feet of duct in unconditioned s ace. CF -6R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts sterns constru.cted, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 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.
1 certify that the energy features and performance specifications for the design identifiod on this Certificate of Compliance conform to the requirements of Title 24,
Parts 1 and 6 of the Califomia Code of Regulations.
•... ih� ife>+gn a tu�esiaenul eE on this Certificate of compliance are consistent with the information d6cymenqd on other applicable compliance forms,
calculations, plans ands cifications submitted to the enforcement for oval with the i ti worksheets.
Name:
Signature:
Company:
Date:
Address: Q� `
C� -:R`4 -4- License:
Citp/Statc2ip:
C2v�Sy33�-
r: -3 z z3Phon
� �oZ) -0 66
2008 Residential Compliance Forms
March 2010