13-0184 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Ceti
.4 VOICE (760) 777-7012 .�
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENTJ.: INSPECTIONS (760) 777-7153
X BUILDING PERMIT
Application Number:
13-00000184
Property Address:
77147 VIA HUERTA
APN:
773-350-016-16 -14496 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL.
' 'Application valuation:
6000
Applicant- Architect or Engineer:
NKK
V
D C RACTOR'S DECLARATION
'I hereby affirm under penalty of perjur hat I am lice under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the B siness and essionals Code, and my License is in full force and effect. '
License Cla s: 20 Licenco '�5z�6"
Date< Z6r:S Contract/
OWNER -BUILDER DECLARATION -
1�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 permitsubjects 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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and ProfessionsCode: The Contractors' State License Law does not apply to an owner of
property who builds or improve's thereon, and who contracts for the projects with a contractor(s) licensed '
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY -
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for whichthis permit is issued (Sec. 3097, Civ. C.).
Lender's Name: n \
Lender's Address: „ 1
L:QPERMIT
Date: 2/20/13
Owner:
RON RAMIES
77147 VIA HUERTA
LA QUINTA, CA. 92253
(
Contractor:
AIR EXPERTS AIR CTGPO
BOX 94
2 p 2LA
QUINTA, CA 922
r'T
.(760)777-1724QIJl1`s7LiC.
No.: 725283FrrcaEPT:
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
✓V 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 NORGUARD INS Policy Number PAWC334856
_ 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 b ome subject to the workers' compensation laws of California,
and agree that, if I shou ecom subject to the workers' compensation provisions of Section
3700 of the Labor Code, I sh6rforthwith comply with tho
ate: Appricant:
WAR ING: FAILURE TO SECURE WOR ERS' COMPENSATION COVERAGE IS.UNLAWFUL, AND SHALL '
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 ab 'on is correct. I agree to comply with all
city and co my ordinances and state laws relating to buil ' g construct' , and hereby authorize representatives. _
of this lco ty enter upon [he above-mentioned grope for in ion purposes.
Da�w ,�" Signature (Applicant or Aga _
Application Number 13-0000018,4
Permit MECHANICAL
Additional desc
„
Permit Fee . . . . 35.00
,Plan Check Fee
8.75
Issue Date ..
Valuation
0
;Expiration Date 8/19/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 11.0000 EA MECH
FURNACE >100K
11:00
1.00 9.0000•EA MECH
B/C <=3HP/100K BTU
9.00
'Special Notes and Comments
REPLACE A/C & HEATING EQUIPMENT"
CONDENSER AND COIL. 2010 CODES.
---------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due s
Permit Fee Total 35.00
.00• .00
35.00
_
Plan Check Total 8.75
.00 00
8.75
Other Fee Total 1.00
00 .00
1.00
Grand Total 44.75
.00 .00
44.75
'..
• ..
Iv
LQPERMIT
Bfi.li
Ck Of La Quinta
BuilcMg sc 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:. QA) JeArrJi`E S .
A P. Number.
Address: .-77/1-/7 ✓/,4
Legal Description:
City, ST. zip: L� C�u,nr . i Cj2Z S 3
Contractor A I - ��
n
Telephone:
Address: zoxcj
Project Description:
City, ST, Zip: LA 0,,,,,j rte}
eA 7 ZZ -7 7.
L 3
Te I eph o ne: --,60 % 7 7/ Z°
` ` I -aL,
City Lic fE;
State Lie. #: .�7 ZS Z ��
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: ZOaV # Stories: # Units:
Telephone # of Contact Person:
Estimated Valae of Project: —
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
' Rcc'd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss C21cs•
Ca11ed Contact Person
Pisa Check Balance
Tide 24 Calci.
Plana picked up
Construction
Flood plain plan
Pians resubmitted
Mecharilcsl
Grading plan
2" Review, ready for corrections(rssut
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
ILOAL Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review; ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
J
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
77147 Via Huerta La Quinta, CA 92253
City of La Quinta
Feb 20, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE. o _
® SEER 13.0
❑ COP
[3HSPF
13f R 6 (CZ 10-13)
Served by system
Iof already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
2000 sf
installed)
❑ Other
I
I
I
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 -611 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 -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -611 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 -611 forms: MECH-04, MECH-2I-HERS and (for split 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
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,sy_stem�will not be Ducted°(ie Ductless Mini -Split System)•(AIsoTExempt from;Refrigerant Charge)
❑ 2. New HVAC System
Required Forms: k ) s ++r,
. Cut in or Changeout with,
new, ducts: (all new
and
t {
CF 611 forms: MECH-04, MECH-20, HERS, and,(for split systems) MECH-22 HERS, and
MECH=25 HERS
ducting all new
CF 4R forms:•MECH-20, and (for split systems) MECH-22 and MECH-25 �.,
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/or without
Required Forms:
Replacement
• Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
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 -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 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: Paul Van Vlymen Signature: paul Van Vlymen
Company: AIR EXPERTS AIR CONDITIONING -HEATING Date: Feb 20, 2013
Address: PO BOX 94 License: 725283
City/State/Zip: LA QUINTA / CA / 92247-0094 Phone: (760) 777-1724
n
Reg: 213-A0010826A-000000000-0000 Registration Date/Time: 2013/02/20 13:01:14 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms, July 20.10'