14-0936 (MECH)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA.QUINTA, CALIFORNIA 92253 : BUILDING & SAFETY DEPARTMENT o INSPECTIONS (760).777-7153
BUILDING PERMIT +,
Date: 6/25/14
Application Number: 14-00000936 Owner: '
Property Address: 47965 VIA FIRENZE LEONELL MCCANN
APN: 643-130-007-7 -26152 - 47965 VIA FIRENZE
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 671-3110
Application valuation: 9374 D d
Contractor:
Applicant: Architect or Engineer: GENERAL AIR CONDITIONING ��� ?�q;
31170 RESERVE DRIVE'
THOUSAND PALMS, CA 92276
(760) 34377488 CITYOFLAQUWTA
Lic. No.: 686310 FINANCEQEP'r
---------------------------------------------------
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 '
License Class: C20 License No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Dyate�:�bl �'^511`T Contractor/ ��_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor L
V Code, for the performance of the work for which this permit is issued. My workers' compensation
2J 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 ZENITH INS CO Policy Number Z071741503
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 subject 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 forthwith comply 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):: DaJJteApplicant
(_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and t✓ + /'
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' 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 CRIMINAL 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, 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 request and 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. , BAP.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 to the 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 information 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 construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes. - -
Lender's Name:r -
Datink e: Signature (Applicant or Agent): 17m—
Lender's Address:
LQPERMIT
Application Number
14-00000936
Permit . . . ': MECHANICAL'_2013
Additional desc .
PermitFee
83.42 Plan Check Fee .
.00
Issue Date
Valuation
0
Expiration Date
12/22/14
Qty Unit Charge
Per
Extension
1.00 35.7500
EA MECH FURNACE
35.75
1.00 11.9200
EA MECH APPL REP/ALT
11.92
1.00 35:7500
Ell 11ECI1 CONDENSER/ COMP
35.75
----------------------------------------------------------------------------
Other Fees . . . .
. . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
52.43,
Fee summary Charged Paid Credited
----------
Due
-----------------
Permit Fee Total
83.42 00 .00
83.42
.Plan Check Total
.00 .00 .00
.00
Other Fee Total
143.00 00 .00
143.00
Grand Total
226.42 .00 .00
.226.42
LQPERMIT
"
Iain # City of La `Quinta .
Building &r Safety Division
Permit # P.O. Box 1504, 78-495 Cage Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking-Shee.
Project Address: Ll Owner's Name: L eov c-l) M eCa,.r\
A. P. Number:
Address: LA ci G S• \f i F- ,r ey.. z e
Legal Description:
City, ST, Zip: G viv, CA C1.ZZ53
Contractor:C
ex�er�l %��r
ter` d�� i o i
Telephone: -Ifo I) -
p
Address: 3 i d t_
Project Description:
City, ST, zip: 4.o S YY\ s Q Z Z-1 (,
e: 1 c.ce 31-S fio--� A G Co'
Telephone: .6 C> - 3L43 - "� ti 89
State Lie. # : (0 3 j O
City Lie. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
`' ?`>` r%>:>:'• >:
::.,.
Construction Type: Occupan.y
State Lie. #:::>::`%>
i w Add'n Alt✓r
Project type (circle one): New Repair Demo
Name of Contact Person: G
GYM e•.
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person: 60 - 3y 3 - 7 Li 2
Estimated Value of Project:. 9, 3 7 °�• '=o
p Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PEPMIT FEES.
Plan Sets
Plan Check submitted
Item
7Amnnt
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan-Check Balance
Title 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 Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionslssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
C
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency: Date: Permit #:
47965 VIA FIRENZE La Quinta, CA 92253 City of La Quinta ]un 20, 2)14
Dud insulation
Conditioned Floor
Equipment Typel
List,Minimum Efficiency?
requirement
Area .
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
11 AFUE 80%
®SEER 14.5
❑ COP
❑ HSPF
i] R 6 (CZ 10-13)
Served by system
® Setback
If not a.ready present, must be
® Condensing Unit
[3 EER
❑ Resistance
❑ R 8 (CZ 14-15)
2957 sf
installed)
❑ Other
I
,
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 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. Beginning October 1, 2010, a registered copy of the CF -111
and CF -6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -611 forms: MECH-04, MECH-21-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-21-HERS and (for split systems) MECH-25-HERS
. Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Dud leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
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 t6: .40 linear feet in unconditioned space, or
❑ 3� Existing duct systems areicanstructed, insulated or sealed with asbestos
❑ 4. The system -will not be Du,::" 41 (ie. Ductless Mini -Split System) (Also'Exempt from Refrigerant Charge)
❑ 2: New HVAC System
Required: Forms:
. Cut in orsChangeout;with
neve ducts:. (all new.'
Cl 6R forms MECH 04„ MECki 20 HERS artd {farfspGt systems) MECH 22 HERS and
9 and.all neva .. .:
MECH-2- . H .. >:.. :.
_ -.....
GF -4R forms MECH-20and {forspiit systems) NtECtf-22 and MECH
equipment).
For Split Systems Duct leakage < 6:percent; RC, CCA > 350 CFM/ton, FlND ;TMAH,, STb95 :andreither H�PP or PSRP :=:-:`
s.... 4
.,, _ _
For Pa ka -
c ed U n ,� . -
3 Neve ..-.:.. _ ::::.:<.;:;
❑ Ducts woth/ov wtthopt'
::... ......, :...:, . .... ...
R urr
esied,For!�s::�:::::.:.,..,::'
Replacement` . : ;
.
. Includes- replae n:g:or installing alUnew
d6i ting andjor outdoor condensing unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and�br furnace.. Nb 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: Dud 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
linear feet of duct in unconditioned space.
CF -411 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 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: Dayana Valdez Signature: Dayan Valdez
Company: HARRISON ENTERPRISES INC Date: Jun 20, 2014
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 214-A0046472A=000000000-0000 Registration Date/Time: 2014/06/20 20:15:19 HERS ProPider: Ca10ERTS, Inc.
2008 Residential Compliance Forms. July 2010
F�