10-0712 (MECH)P.O. BOX 1504 VOICE (.760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT. INSPECTIONS (760) 777-7153
BUILDING PERMIT
e. 02/10
Application Number: 10-00000712-•, , _ Owner: 1
Property Address: 78470 VIA SEVILLA BAKER HARRY RAY
APN: 604-211-008-29 -23971 - 78-470 VIA SEVILLA )
Application description: MECHANICAL LA QUINTA, CA 92253 Ai �� o 2010
Property Zoning:. LOW DENSITY RESIDENTIAL
Application valuation: 18244 f�uiWi�
CITY
t Contractor:
Applicant: Architect or Engineer: DESERT AIR CONDITIONING,
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264'
(760)323-3383
p1 A •
liic. No.: 276586
---------------- - - ---- - --- _
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-C43- Lic se No.: 276586 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
_. v issued. ."
Co ctor: 0.I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
"111""""' Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER-BUILDER DECLARATION - insurance carrier and policy number are: - -
"Ihereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier INS CO OF WEST Policy Number WSD216397402
_ 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 s II forthwith comply with se visions.
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).: ate; pplicant: • j $% -
(_) I, as owner of the property, or my employees with wages as their sole-compensation, will do the work, and 00the 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 SECT16M3706 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,.
1 _ 1 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
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 data of issuance of such permit, or cessation of work for 180 days will subject
- CONSTRUCTION LENDING AGENCYpermit 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�nty ordinances and state laws relating to building construction, and hereby authorize representatives
of thi ounty to enter upon t above-mentioned property inspection purposes: -
Lender's Name: ON-
Date: nature lApplicant. or Agent): ,
Lender's Address:" -
Application Number . . . 1.0-00000712
PermitMECHANICAL
Additional desc .
Permit Fee 51:00 Plan Check .Fee
12.75
Issue Date . . Valuation
0
Expiration Date 1/29/11'
.,Qty .Unit Charge Per
Extension
BASE FEE
15:00
2.00 9.0000 EA. MECH FURNACE.<=100K
18.00
2.00 9•.0000 EA MECH B/C <=3HP/100K BTU
18.00
Special Notes and Comments
REPLACE 2 SPLIT SYSTEMS AT_GROUND LEVEL,
18 SEER, 80 AFUE. 2007 CODES.
------------------------------------------------------..
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited,
----------
'Due
-----------------
Permit Fee Total 51.00 :00 .00
51.00
-Plan Check Total 12..75- .00 .00
12.75
Other Fee Total 1.00 00 .00
1.00
Grand Total 64.75 .00 ..00
64.75
LQPERMIT •
-
Sim lifted Prescriptive Certificate of Com 'liance: 2008 Residen#d YAC A erallons CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site AQQin - �7a v;,
'Unfomenteat Agency.
Date:
Punta M
Equipment T
O Packaged Unit
List Minimum Efficien Z
putt insulation uirerrtent
Conditioned Floor
Area
elm
O Setback
pf not already
0lurn1oe
door Coil
ErAFU, EKO O COP
9)SEER4- O HSPF
Over 40 ft of ducts added or
replaced in unconditioned space
Served by system
&roondinsing Unit
O EER O Resistance
OR 6 (CZ 10-13)
sf
present, must be
O Other
OR 8 (CZ 14-15)
Installed)
I. Equipment Type: Choose theequtpnr a beih j installed: if more than one system, use another CF -1 R -ALT -HVAC jor each "em.
1. Mln/nrrttrkL.qufpntetuE#tcietrcles: /3•SBBK 78%AFUE, 7.7HSPFj
art picalresidetrlialsystems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
P icks one of the appropriate. Options. Option lists the HERS measures that must conducted.
.. .be A copy. of the foams shall be left oat site, o final:
inspection and.a copy given W tht> horaebwnEi: At final, the inspector verities thffi fhe wotlk listed on fhis fortXi in > the work completedby the
installer. The inspector also verifies 1heYioh ffie CF -6R and
'-4R forms (no hand filled CFjts gilowod) are 611ed out and
si ed Beginning October 1 2010 a c i91*d M of the CF -Ht ttn4'CF-6R'tiW ahw be on•dfe toi fiIiid
1. HVAC Changeout
Re0trtillForms:
• All HVAC Equipment replaced
CF -6R forms: ME3CH-04, MECH= `- and (for split sysieiti$j'IYAW
CF-411fortes: MECH- 2,1 and for sPlit MECH-25
• Condenser Coil and/or
• Indoor Coil and /or CF -611 forms: MECH-2I-HERS and (for spljt,systems) MECH- 25 -HERS
• Furnace CF -411 forms: MECH= 21 and (for split systetis) MECH-25
For Split Systems:, Duct. leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow
RequinmeAll), TMAH
For Packaged Iluits: Duct leakage < 15 percent
Exempted from duct leakage testing if:
O E D6 t system was documented••to'have been previously sealed and confirmed through HERS verification, or
0.2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are r insulated or . ..ed witb asbestos
O 2..New HVAC
ai IForms:
wianne l
• Cut in or Chagg qutducting
ducts: (all new ducting gnd-all
CF -6R foams ' MF.CH•04, MECH•20�HERS d for rt
,� ( �tl' systems) MECH-22-HERS, and MECH-25-4IS
new equiorncntf
CF -4P forms: MECH 2O-, and (foo split systems)MW14-22, and M ECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, $TMS, and either HSPP or PSPP.
For Packaged Units: Duct I<6 percent
0 1Ncvt, Ducts with Re 1acetnent
-Required Norms:
Include-
• Includes, replacing or installing all new ducting
CF -6R forts: MECH-04,,MECH=20-;20(forsplit systems) MECH-25-HMS
and/or' condensing unit and/or indoor
,
CF -0R forms: MECH-20 and (for split systems). MECI-1-25
coil and/or furnace. `Not all equipment changed.
For Split Systems: Metleakage < 6 liercent, KC, CCA 2:300 CFMtton, TMAf
For Pa ' ° Ut11ts:'Duct t e < 6 'ftent
❑ 4. New Dt ctin over 46 feei R ttiii`T -Forms:
• Includes adding or replacing more than 40
Linear feet of duct in uheonditioned s ce.
CF -6R forms: MECH-04, MECH621•HERS CF -0R forms: MECH-21
For split system or packaged un ' Duct leakage < 15 percent
❑ EXCEPTION: Existing ductstems constructed,insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration S`tatiment)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• 1 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 Comphance.eonform to the requirements ofTiite 24,
Parts I 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 fortes, worksheets,
calculations, Plans and sPecifications submitted to the enforcementage
ncyforapproval with it icatign..
Mime: L COC Signature:
Com .
k IQ A l2 Ct) wap iT(Ax// t w
Date:
Address:
License,
7a - s gl
City/Start (Zip:
Phone:
ZUUn aestaential Compliance Forms March 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlteradons CF -IR -ALT -HVAC
Climate Zones 10 to 1.5
Sit ess:
1.70 .11
Enforce ent Age cy:
Date:
Permit #:
s
�:
a 9%ice
Conditioned Floor
Equipment T er
List Minimum Efficiency'
Duct insulation requirement
Area
Thermostat
❑ P aged Unit
OT
❑ AFUE
❑COP
40 ft of ducts added or
❑ Setback
-Over
or Coil
❑SEERyrrface
/
rp
❑ HSPP
replaced in unconditioned space
Served by system
(If nor already
ondensing Unit
❑ EER
_
❑ Resistance
❑ R 6 (C7. 10-13)
❑ R 8 (CZ 14-15)
sf
present, must be
installed)
❑ Other
L Equipment Type: Choose the equipment being installed; if more than one syslem, use another CF -1 R -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 wort: 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
si ne eginning October 1, 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final inspection.
. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF-611forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lit systems) MECH-25
an
• Condenser Coil and /or
• Indoor Coil and
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
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
For Packaged Units: Duct leakage < 15 percent
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
❑ 2. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECI-1-20-FIF.,RS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF -4R forms: MECI-1 20-, and (for split systems)MECH-22; and MECH 25
new 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 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-21-HERS CF -4,R 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.
• 1 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 I 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 enc forapproval with the permit a I ation.
Name:
Vii✓ � -e -
Signature:
Company Dat %
; ;Oe -)n �� 7 a rn
; ,f--
C-
Address: License: /1 � r -
v 2�:1 d 6
City/State/Zip: g Phone: Q.
2008 Residential Compliance Forms
A
March 2010
bw . i V
City of La Quinta
-Building &r 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: Y40rl e_(--
A. P. Number:
Address:
Legal Description:
City, ST, Zip: 44
Contractor: Desert Air Conditioning Inc.
Address: �590 Williams Rd
Telephond.
Project Description: ce C,P- orL,
City, ST, Zip: Palm SpringS_ ('A''c)2264
1510 X 4- n 0/to—ey7_6 07
Telephone: 760). 323-3383
ffi,:� . <:;4:<:
Z k-e- lFo r C4 !e
State Lie. #: 276586
City Lie. #.-.. 3 6 3
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type.
MeLA- Occupancy:
State Lie.
type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: C5M_C!q0e_/.'Ae Z41 )C
Sq. Ft.:
'
# Stori es:
# Units:
Telephone # of Contact Person:( 7 6 0 ) 3 2 3 — 3 3 8 3
Estimated Value ofProject:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Reqld
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Caics.
Called Contact Person
Plan Check.Ralance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' 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.F.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
M