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14-0618 (MECH)r.4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: 14-00000618 80355 VIA VALEROSA 777-250-007- - MECHANICAL LOW DENSITY RESIDENTIAL 22468 T4'�l 4 4 Q" Architect or Engineer: NW ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT. BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 LicenseNo.: 686310 O jr� r3 1,4 Contractor l/ OWNER -BUILDER 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 70001 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).: (_) 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.). (_) 1, 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.). I _ 1 I am exempt under Sec. , B.&P.C. for this reason 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 Owner: WILLIAM AND ANN IWATA 80355 VIA VALEROSA LA QUINTA, CA 92253 (760)619-3304 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5./13/14 Contractor: GENERAL AIR CONDITIONI 31170 RESERVE DRIVE THOUSAND PALMS, CA 922 (760)343-7488 Lic. No.: 686310 ----------------------------------------------- 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. � thave 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 u insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741503 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 the 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. Date_ cl 144Applicant: 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 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 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 ofthis county to enter upon the above-mentioned property,for inspection purposes. � f e Date:'e� i3 )4 Signature (Applicant or Agent) Application Number . . . . . 14-00000618 Permit . . . MECHANICAL 2013 desc . 4Additional Permit Fee . . . . 143.00 Plan Check Fee .00 Issue.Date . . . Valuation . . 0 Expiration Date 11/09/14 Qty Unit Charge Per Extension 2.00 35.7.500 EA MECH FURNACE 71.50 2.00 35.7500 EA MECH CONDENSER/COMP 71.50 Special Notes and Comments HVAC CHANGE OUT - (2)14.5SEER/78AFUE SYSTEMS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. -------------------------------------------------- -------------------- Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL' 95.32 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 185.89 .00 .00 185.89 Grand Total .328.89 .00 .00 328.89 LQPERMIT - .. . Bin.# City Of % Quinta Building 8i' Safety Division P.O. Box 1504, 78-495 Calle Tampico La La Quinta, CA 92253 - (760) 777-7012 Permit Application and Tracking Sheet Permit # 116 Project Address: ill 3�S vi cL V0.\er�s� Owner's Name: r Arr J,, w .A. P. Number: Address: R0 355 V � Val CC o.54 Legal Description: City, ST; Zip: �a Qvi�n}G CA G 22.53 Contractor: �ere w\ Asi Telephone: � D - (oI q - 33 p} :. Address:3��1� j2eSe,tvz �r Project Description: City, ST, Zip: hov s c-t. m Cil e I a C-e-Z -S+6 c k Telephone: -''<>'s.<'>€> P - '�O 343 788 3>.„%::::::...::::::: '>::;:>:;>: _::<:»:<:<;:<:!»:;<::>:::=; �-) VA C S sic s State Lic. # : (o$(p3 (Q City Lie. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: <:<.:::>;.:.>.:;>:<;.:;•;:n!<::•;::;Y:F;#:;>:::>::>:;:;> f,: Construction Type: Occupancy: State Lic.#• vY: • F.. n.....nv:....;:::;i:Y.:...::. <z:» v.....;::;>::::>:#:z> Project type (circle one): New Add, n Alter Repair Demo Name of Contact Person: ske-N ehSc Sq. Ft.: # Stories: # Units: Telephone #,of Contact Person: 9S I - 2- L4 1- (og 7(, Estimated Value of Project: ZZ., 46 $ _ no APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd 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 Balance Title 24 Cales. 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 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -AL -&-HVA Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 80355 VIA VALEROSA (SYSTEM 1) La Quints, CA 92253 City of La Quints May 8, 2014 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat []Package Unit ® Furnace ®AFUE 78% ❑COP ❑ R 6 (CZ 10-13) Seryed by system ® Setback ® Indoor Coil ® SEER 14.5 L)HSPF ®R 8 (CZ 14-I5) 326 sf If not already present, must be 11 Condensing Unit 13 EER ❑ Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -1R and CF -61Z shall also be on site for final inspection. ` ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R 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 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 Split Systems: Duct leakage < 15 percent; RC,"CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),-TMAH FGF Pa ka"dAd UnIM. Duet leakage e. 15 peFeeFit4 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 tRan 40 linear feet in unconditioned space, or `02 - '[3-3; Existing duct systems are..- nstructed, insulated or'sealed with asbestos - ❑ 4_. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge) ❑ 2:.New HVAC System Required Forms: . Cut in or Cltatigeout with CF SR forms MI_Cti-04, MECf' -0 HERS; and tfor split systems) MECH 22-tf€it5 and new :: ... ductin=::anrT:>'Anew::---' __.,Y.:;�;;;c:.>::;<:-_;:':iNECH-20, and {far:,spiit systefns}:m cm22, ,, a ...... -......._....>.................. u... •. Dint teaks e < 6= argent RC CCA 350:CFM loft FY' :TMAH .5?MS :_and;:either1SPPr'PSPP.:: i i'":: ... For SpIt�,Systems.,.. _. ..: g__,..:. �:...., - For Pa4k ed U tts..._ •.. ,P _.._....:. %'>' _ ❑ 3. New Ducts withq%­ r vvithot� :::.;::::;i::,;:._ �:.::::,:...R. v}red:FbfKtns::':?`:,:.:...: •: ;::.:-::::::': `;;,;.::....:. <::;:;>:::::::::::.:::::<;=..:.. .. . Includes:;re.placirid .or installing ai flew ddc6ng ana'/oi'outdoar condensing:=unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS anis%or indoor coil "06r. furnaciCho or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed_ For Split Systems: Duct leakage 1�s6 percent; RC_, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leaka, 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-411forms: MECH-21 = For split system or packaged units: Duct leakage < 15 percent I ❑ 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: Doyon Valdez - Company: HARRISON ENTERPRISES INC Date: May 8, 2014 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 214-A0032518A-000000000-0000 Registration Date/Time: 2014/05/08 12:54:22 HERS Provider: 'Ca10ERTS„ Inc. •, 2008 Residential Compliance• Forms July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT.-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 80355 VIA VALEROSA (SYSTEM 2) La Quinta, CA 92253 City of La Quinta May 8, 2014 Duct insulation Conditioned Floor Equipment Typei List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER = 13COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system If ® Setback not already present, must be ® Condensing Unit ❑ EER ❑ Resistance 0R 8 (CZ 14-15) 3267 sf 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 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-411 forms (no hand filled CF-411s allowed) are filled out and signed. Beginning October 1, 2010: a registered copy of the CF-IR and CF-611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-6R 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 CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Indoor Coil and /or CF-411 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 Exempted from duct leakage.testing.if: ❑ 1. Duct system was docurnenfed to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less thi"'40 linear feet in unconditioned space, or 0-3..Existing duct systems are'."hstructed, insulated or sealed with asbestos ❑ 4.. The system will not be 136fted '(ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge) ❑ 2:.New HVAC System Requir­.­.Forms: . Cut in or.Cttdngeoul h w[t :; :: .:.. .;>..;;:.. CF-6R forms MECtl=04 MECti-30=FiE�RS anal (fat spl[t systems). MECH 22=f+fER5, and new ducts (aQ , MECH-2. HE#35...: � duct[n ::a.n ..ail new":­ 4—� ; ,_>y,::::;>::::::.:,:...;:��-�::;:::.:..:... C-4Et€orti s: MECH-20, and'{dor split systems MECH-22„and AM1ECIi 25 equ[pmerit ): ,. For Spltt Systems:.. Duct leaks e < 6.6 ent; RC, CGA � 350 CFM/Lbn FWI3 :.TMAH'S4MS, .....,.:.:: _ ., leaks . , ...e .. r ent<:�= - For Uuert` a 6'= t - ❑ 3. Necg Ducts:with/ar RepEacemetit`.: . Indudes;;repladfng'or installing ail: flew ducEing;andl--- `outdoor condensii.g: unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS ani!/or indeor coil and%or. fumac"o or some CF-4R fors: 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 leikage:< 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF-6R fors: 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: Dayann Valdez Company: HARRISON ENTERPRISES INC Date: May 8, 2014 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 214-A0032524A-000000000-0000 Registration Date/Time: 2014/05/08 12:58:41 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010