12-1049 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12•_00001049 f
Property Address: 79085 VIA SAN CLARA
APN: 649-400-009- - -
Application description: MECHANICAL
Property Zoning: ' LOW DENSITY RESIDENTIAL
Application valuation: 6565
i
Applicant : Architect or
Engineer:
i
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
n �
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` LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjur that I am licensed under provisions of Chapter 9 (commencing with
L
7000) of Division 3 of the Bu ness and Professionals Code, and my Lic t.
C1 s: C20-1236 Licens 94
'/ .Contractor
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 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 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 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—) I am exempt under Sec. , BAP.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:
MESZAROS EDWARD J
79085 VIA SAN CLARA
LA QUINTA, CA 92253
(760)771-2890
Contractor:
J ANTHONY PLUMBING HEAT/
72216 NORTH SHORE STREET
VOICE {760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) .777-7153
Date`. 9/13/12
D Q �
uEP 13 2012
IR CITY OE LA QUiNTiA
, #1oi FINANCEDEPT.
THOUSAND PALMS, CA 92276.
(760)328-8096 -
Lic. No.: 777794
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.
• _ 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 mber are:
Carrier GRANITE STATE Policy Number WCO65255599
.. _ I certify that, in the performs a of the work for which this permit is issued, I shall not employ any
person in any manner sok to become subject to the workers' c of California,
and agree that,pshle subject to the work mpensation provisions o ec3_70/0 of the LaI fo with comph those provisions./ 1(3 �vApplicant
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 gd'g
mit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state thinformation is correct. I agree to comply with all
city and county ordinances and state laws relatin nstruction, ���vv�esof this c my !enter upon the above-mentioned rction pu
Date: 1 / Signature -(Applicant or Agent
Application Number . . . 12-0000.1049
Permit MECHANICAL
Additional desc .
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date . . . Valuation
0
Expiration Date 3/12/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
3.00 1 F 5nnn FA MECH R/C r3 15IIr'/s 100IC 500ICDTU
16.50
Special Notes and Comments
REPLACE 5 TON SPLIT FURNACE / COIL &
CONDENSER 2010 CODES.
- -
Other Fees . . . . . . ." ... BLDG STDS ADMIN (SB1473)
- - - - - -- ----
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 40.50 .00 .00
40.50
Plan Check Total 10.13 .00 00
10.13
Other -Fee Total 1.00 .00 .00
1.00
Grand Total `51.63 .00 .00
51.63
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations• CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
79085 VIA SAN CLARA La Quinta, CA 92253
Enforcement Agency:
City of La Quint:
Date:
Sep 13, 2012
Permit #:
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
H AFUE 78%
®SEER 13.0
❑ COP
❑ HSPF
[3 R 6 (CZ 10-13)
Served by system
® Setback
® Condensing Unit
❑ EER
❑ Resistance
13R 8 (CZ 14-15)
sf
n not dready present, must be
innot
i
[3 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 Effidencles: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides+hat 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 -511 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 -1R
and CF -6111 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 -411 forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or•
oil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and fors lits stems MECH-25-HERS
)
• Furnace
ce
CF -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirementi, TMAH
Exempted from duct leakage testing if:
0 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
p 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 system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut inor Chanwith
new ducts: (alll new
new
CF -6R lits
( p systems) forms: MECH-04, MECH-20-HERS, and fors stems MECH-22-HERS, and
ducting and all new
equipment)
MECH-25-HERS
CF -411 forms: MECH-20, and (for split systems) MECH-22, and MECH-25
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
0 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
and/or indoor coil and/or furnace. No or some
CF -611 forms: MECH-04, MECH-20-HERS, and (for split s+stems) MECH-25-HERS
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA 2: 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
0 4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned
CF -611 forms: MECH-04, MECH-2I-HERS
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 this
Compliance. on Certificate of
• 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 othe- applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Kevin Robinson I Signature: Kevin Robb sm
Company: ] ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Sep 13, 2012
Address: 72216 NORTH SHORE ST #101 Ucense:'777794
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121
Reg: 212-A0050915A-00000000-0000 Registration Date/Time: 2012/09/13 12:41:20 HERS Provieer: Ca10ERTS, Inc.
2008 Residential Compliance Forms
July 2010
a
city' Of. La E�clln�a .
Building a Safety Division : t
P.O. Box.1504,'78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit # .
Project Address: O $ ! A %%J e ( A -kA-
Own s Name: .
' �DIU.420f Ne5z''4405
A. P. Nuinber.
Address: .
Legal Description
Cotttractor.
City, ST, ?aP:
Telephone: 760 %%� D
Address: J ANTHONY SERVICES
Cit),, ST, lap: THOUSAND PALMS, CR 92276
Project Description:
/ S I 0 .N It "�
Telephone:
c9 L L .CO a' '� (�, �.,�illlt—
State Lia # city Lia
Arch, BW., Designer.
Address:
City, ST. Zap:
Telephone:
State Lia #: -
Construction Type:. Occupancy:
Project ,
J type (eirde one): New Acd n Aber Repair Demo
Name of Contact Person
Sq. Ft.:
#Stories # Univ:
Telephone # of Contact Person:
Estimated Value of Project to
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
plan Sets
Req'd
Rev'd
TRACIUNG PSItMfF FF.FS
Plan Check submitted hent Amount
Structuial Coles.
Reviewed, ready for corrections Pian Clack Deposit. .
Trus Cal".
Called Contact Person Plan Cbeck Balance _
Title 24 Cales.
Pians picked up Constrnedon
Flood plain plan
Pians resubmitted.. Mecbasiical
Giading plan
2'! Revlew, ready for correctionsfrssue Electrical
Subeontaetor List
Called Contact Person Plumblag
Grant Deed.
Pians pldced up S,Iy,I,
H.O.A. Approval
Plans resubmitted Grading
HOUSE-
''' Review, ready for correctloaslissoc � Deck per Impact Fee
Planning Approval
Called Contact Person A.LP.T.
Pub. Wks. APPr
Date of permit issue
Sebool Fees
Total Permit Fees