11-0781 (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
Date: 7/19/11
Application Number: r11;;00000781 " `7 Owner:
Property Address: . 78720 VIA SONATA DAVID LABIBIERTE
APN: 646-050-010- - - 78720 VIA SONATA
Application description: MECHANICAL - LA QUINTA, SCA 92253
Property Zoning:. LOW DENSITY RESIDENTIAL D d
Application valuation: 8634
Contractor:
-Applicant: Architect or Engineer: PREFERRED PLUMBING HTG A/C
P.O. BOX 5120 pi,
PALM SPRINGS, CA 92263
(760) 322-3173
PIP Lic. No.:.457554. -
----------------------------------------------------
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 a rofessionals Cod .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
Licens lass: C10 C16 C2ns 57554 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is'
�7 issued.
ate: '/• %�J tractor. -I have and will maintain workers' compensation insurance, as required by Section 3700 of. the Labor
Qet
Code, for the performance of the work for which this permit is issued. My workers' compensation
-BUILDER DECLARATION insurance carrier.and policy number -are:
I hereby affirm under penalty of perjury that I afrom the Contractor's State License Law,for the Carrier EVEREST NATL Policy Number 7600006445111
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 shout become subject to theme° rkers' 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 C , I shall for co bly ith hose pro iionU
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by p
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: f / 1�R,
icant:1 I; as owner of the property, or my employees with wages as their sole compensation, will do the work, andthe structure is not intended or offered for sale (Sec. -7044, Business and Professions.Code: The WARNING: FAILTO SECURE WO KERS' C MPENSATION 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 ES 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
(_ 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 apermit 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,
(_ F 1 am exempt under Sec. , BAP.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 date of issuance of such permit, or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY permit 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 (formation is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws. relating to building struction, a here thorize representatives
- - of this ounty to enter upon the above-mentioned property f mspec urpo as
Lender's Name: - -
ate: A Si ature (Applicant or Agent):
Lender's Address:
LQPERMIT
" Application Number.'-..: 11-00000781
Permit .. MECHANICAL
.Additional desc .
Permit ,Fee 40.50 Plan Check Fee
10.13
Issue Date Valuation . . . .
0
Expiration Date 1/15/12
Qty Unit' Charge Per
Extension
BASE FEE
15.00
7.00 9.00.00 EA MECH FURNACE <=100K
9.00
1.00 16.5000 EA -MECH B/C >3-15HP/>100K-500KBTU
16.50
Special Notes and Comments -
REPLACE EXISTING HVAC/FAU, COIL,AD WITH
NEW 3 -TON 16 SEER UNIT. 2010 CODES.
- ----------------------------------- - -------
Other Fees . . . . . BLDG STDS ADMIN (SB147.3)
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 Com fiance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address:
Enforcement Agency:
Date:
Permit #:
1.4
L A QoitAA
7110 00(1
Conditioned Floor
Equipment T e
List Minimum Efficiency2
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
%WU_rC�^ aace
__�
W-AFUE
❑ COP
Over 40 ft of ducts added or
etback
f]'In�r Coil
BSE�FR
❑ HSPF
replaced in unconditioned space
❑ R 6 (CZ 10-13)
Served by system
sf
(If not already
present, must be
ondensing Unit
EKER
❑ Resistance
❑ Other
❑ R 8 (CZ 14-15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF jar 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
signSA. Beginning October 1 2010 a registered copy of the CF -1R and CF -61K shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
e Condenser Coil and /or
• Indoor Coil and /or
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 ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all.
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:
a 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 2:300 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 -6R forms: MECH-04, MECH-2I-14ERS CF -4R forts: MECH-21
linear feet of duct in unconditioned s ace.
___l
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 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 o r pli le compliance forms, worksheets,
calculations plans andspecifications submitted to the enforcement a enc for a royal with the icati .
Name: Te.rF UA�SOS
Signature:
CompanDate:
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Address-License:T O -130x
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City/State/Zip: fAW s9aix)(5 CA 92,U
Phone: s zz -
2008 Residential Compliance Fortes March 2010
B'° #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Buildin Permit A lication and Tracking Sheet
Permitfl
'�� ....
Project Address:::-:.. _
Owner's Namd: J A v� � . A `a ( 13C 2TE
A. P: Number
Address:
Legal Descnptlon r` p ,
City, S f, Zip: T A �
referredriAr Conditioriing dba
Con oto r:Pr'e'fea,,!Jf :.RTumbin Heatin &Ai
Tele hone:
p
Project Description: �Z PL �E S"
Address PO...BOx.`.., 51, 2.Q .
City; ST, Zp:Palmr.SPrngs, •CA 92:26
Tel ,(. 7 6 0 )' 32 2 317 3.:.
a-
457554 ,`
State Lle # City
Arch,;:1✓ngr: Designer;.: :
`9
Address:
Z.
Tele hone:-
p ;:.l EM). N�.
State Lip: #:.?` • '` ��.
3
Name of :Contact,Per.'son:.:;
Construction' Occupancy:
Piaoject.type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone #`of Corifact Person:
Estimated Value ofPro act: 3Y. GO.
APPLICANT: 00 NOT WRITE BELOW THIS LINE
'Re
Recd
TRACKING
PERMIT FEES
Plan 8cts; : ` ..
Plan Check Mmitted °
Ite
Amount
Strnetdrel Calcs..`
Reviewed, ready for corrections
Flit Check Deposit
Trdss Calcs...:.: - :..
•:`
Called Contact Person
Pla Check Balance
Energy. Calcs, _ ''
Plans Icked u P
Con truction
Flood plain plan
Plans.resubmitted
Me anical
Gradingplan:'` .
2"d Review, ready foi'correctlons/issue
Ele real
Subcoiitactoi.Llst
Called Contact Perjon
Pm ping
Grant Deed
Plans picked up
H.O.A. Approval .
Plans resubmitted
Gra ing
INHOUSE -
'a Review, ready for corrections/issue
Dev toper Impact Fee
Called Contact Person
A.I. .P.
Ylauriigg Apprbval
Pub Wks Appr
Date or permit issue
"
School Fees '.
Toft I Permit Fees