11-0836 (MECH)P.O. BO;6504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-0000083.6
Property Address:
80753 VIA SAVONA.
APN:
772-470-005- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
8950
Applicant:
f.
Architect:
ec%or Engineer
/ `''
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MILLER CHUCK'
80753 VIA SAVONA_
LA QUINTA, CA 92253
(310)505-5463
Contractor: -
GENERAL AIR CONDITIONING
31170 RESERVE DRIVE
THOUSAND PALMS', CA 92276
(760)343-7488
Lic. No.: 686310
VOICE (760) 7774012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: .8/03/11
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'is1n full force and effect.
I have and willmaintain a certificate of consent to self -insure for workers' compensation, as provided ,
License Cla C20 License No.: 686310
-
for by Section 3700 of the Labor Code, for the performance of the'work for which this permit is
-
issued.
Date: IL
J Contractor:" -'
' .
-_ 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
-BUILD R DECLARATION
insurance carrievand policy number are:
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the _
Carrier EVEREST NATL Policy Number 7600006147101
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 prowsi s.of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of theLabor Code, 1 shall forthwith comply with those pr
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
-7 -
I
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars.($5001•:.
O'Date: t/71 ✓/ 1 Applicant:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will. do the work, and
9�
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 -
(_ 11, 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. - , B.&P.C. for this reason
" the owner, and the applicant, each agrees to,'and shall defend, indemnify and hold harmless the City
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
of La Quetta, 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 hereb orize representatives
of this cyoun• to enter upon the above-mentioned property for inspection pur
_Date: - ✓ "�� ` (Signature (Applicant or Agent
' Application Number 11-00000836
Permit • . . . MECHANICAL
Additional desc .
Permit Fee 33.00 Plan'Check Fee
8.25
Issue Date' Valuation
0
Expiration Date .. 1/30/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00, 9.0000 EA MECH FURNACE <=100K
9"_00
1.00 9.0000 EA MECH B/C <=3HP/100K•BTU
9.00 -
•Special Notes and Comments
HVAC CHANGE OUT CONDENSER, COIL, AND
FURNACE 13 SEER 5 TON. 2010 CODES.
-----------------_-_--------------------------------
Other Fees.. BLDG STDS- ADMIN (SB1473)
1.00
Fee summary ChargedPaid Credited
Due
Permit Fee Total 33.-00 00 .00
3.3.00
Plan Check Total 8.25 .00 .00.
8.25
Other Fee Total 1.00 00 .00
1.00
Grand Total. 42.25 .00 .00
42.25
. LQPERMIT _
-.
Simplified Prescriptive Certificate of Compliance:2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:E forcetn Agetrcy Da Permit q:
Conditioned Floor
Equipment T" et List Minimum Efficiency' Duct insulation requirement Area Thennostat
❑ Packaged Unit
4L.,dooace❑ AFUE 80% Over 40 ft of ducts added or ❑ COP re laced in unconditioned s ace Served b s stem Setback
r Coil ❑SEER ! 3 " ❑ HSPF P p Y Y pJ�nor already
ndensing Unit ❑ EER / / ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be
❑Other ❑ R 8 (CZ 14-15) installed)
1. Equipment Type: Choose the equipment being installed; if mare than one system, use another CF -1 R -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPFJor typical residential systems.
HERS VERIFICATION SUMMARY Listed below are fonr'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 mast 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
si ned. Beginning October I, 20 1.0, a registered copy of the CF -IR and CF -611 shall also be on site for final inspection.
1. HVAC Changeout I Required Forms:
• All HVAC E ui ment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
q P P ('F AD C . AA17f1U �, _J - _
• Condenser Coil and /or
• Indoor Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace
m
CF -4R fors: 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:
❑ I. 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
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF -4R 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
❑ 3. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF -4R 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:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
For split system or packaged units: Duct leakage <.15 percent
❑ EXCEPTION: Existing ducts stems 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 o 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 I and 6 of the California Code of Regulations.
•'rhe design features identified on this Certificate of Compliance are consistent with the ' orm tion documented on other ftpplir ompliance forms, worksheets,
calculations, plans ands ecifications submitted to the enforcement auency for appro al with t e permit application.
Name: Clpen uluiS-Dyl
Sig tore:
Company:
Date: p
Address:
311-70 12,eSertle &-n.k ✓e.�
License:
City/State/Zip:-��0 � Pk,L&1,S�
Phone: 760-31'13_-748T
2008 Residential Compliance Forms M -ob 71W)
Ca10ERTS - CF -1 R Registration
Pagel of 1
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CONGRATULATIONS
Your CF -IR -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Site Address:
80753 VIA SAVONA
Quinta, CA 92253
CEC Registration: 1211-A0039277A-00000000-0000
CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD
Assigned Company:1HARRISON ENTERPRISES INC
Do you know your HERS Rater?
If you do, you may want to send this CF -1R to them.
Ca10ERTS Rater ID:
OR
My Rater Quick Select: j The Energuy CA LLC T.
Every CaICERTS rater has a license number.
Ifyou need to fend the rater by name [Click HERE] to search our directory.
f.j m,SEND-CF,,1R-,T%HERS RATER, h; ;j
[CLICK HERE] to do another
Copyright 0 2010 CalCERTS, Inc. All rights reserved. Revised:.lanuan, 11. 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy]
CalCERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
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https://www.calcerts.com/public_cflR.cfin?project_id=129242 8/2/2011
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Building 8L Safety Dtvislon
Permit'#
P.O. Box 15.04, 78-495 Calle Tampico
La Quinta, CA 92253 - (760). 777-7012
Building Permit-Applicatlon acid Tracking Sheet
Project Address: �b7' Ul��c
A. P. Number:
Owner's Name: c.fi4eW�r .
ti
Address:3 L)
Legal Description.
City, ST, Zip:
Contractor:
a��;� �?.asz�:;<,kv:>%•�h;•<:w:
Telephone: /
+.?
Address:
Project Description:'G
City, ST, Zip: 7
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Telephone:
City Lic.
State Lic. # : 3 L
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephoner
>5.
::.::., f..,,�. r>z?':'••.�:::.; :�:�;;;s,;.+,.,<�.
Construction Type: Occupancy:
State Lic. #:
{i �•SS:}: {{iS:.Lir : �r f i{..:'+:i{: ifi C.
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"'`•`s%'%w>:?<
'
Project type (circle one):. New Add'n Alter .Repair'Demo
Name of Contact•Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: 6. —
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Req Id'
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 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 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