10-0739 (MECH)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT,
Application Number.10"000.00739';
Property Address:'
78748 VIA SONATA
APN:
646-050-006- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
31.00
Owner: -
YOUNG JIM
78748 VIA SONATA.
LA QUINTA, CA.92253
(760)574-6302.
a
Contractor
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/10
- - --- 1 _ E ,- --"---.--•---
Applicant: Architect or Engineer: J ANTHONY PLUMBING HEAr R �, n t�
�fj/�� 72216 NORTH SHORE STRE #101 v 2>s( I U(7
(/
j000vTHOUSAND PALMS, CA 92276
(760)343-2121 CtrYr —�
iA
LiC. No.: 777794 f..
- l
-'= •• -= - 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 o 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 -
Cicense Cie is No. 7 4 for by Section 3700 of the Labor Code, for the performance of the work for which this permit isissued.
ie`� _ 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 workerscompensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are: -
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier, STATE FUND - Policy Number 1932451 .
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' con
wensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of. Division 3 of the Business and Professions Code) or 00 of the Labor Code hall f it tply with provisi -
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by - _
any applicant for apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Da et (/ ...A_pplicant: -
--- -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 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 orimproves 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.). _.... .. - A ANT ACKNOWLEDGEMENT
( 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to r ct0 f 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 i ion. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose ben �p 'cation is e, each person at whose request and for
• pursuant to the Contractors' State License Law.). - - whncP.hPnefit work is perfor d der or I r; adt o any permit issued as a result of this application,
(_) I am exempt under Sec. , BAP.C. for this reason the owner, and the applicI ea agrees to, a all defend, indemnify and hold harmless the City
of La Quinta, its officers6 agent and employees fo y act omission related to the work being
performed under or fol wing i suancevof.f(fsipermit. .
Date: - Owner: 2. Any permit issued as result o is application b]pcomes n kind void i ork is not commenced -
within 180 days fro ale of i u %,e u( SULA-Gerfrui� ur cess It
u fur. 180 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation. R�'i � c7 -
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 a ate�theRbA bove i 0t ion is r osr I agree to comply with all -
work for which this permit is issued (Sec. 3097, Civ. C.). - city and county o dina es and state laws rela td b.¢ilgin� ns c ion, a eby authorize represent es
of this unt an upon the above-mentioned thy, u S.. .
Lender's Name: '"� �\
_Date:-ignature (ApplicanvovAgent):
Lender's Address:
LQPERMIT
Application Number10-00000739
Permit MECHANICAL
Additional desc
Permit. Fee': 31.50, Plan Check Fee
7.88 -
Issue•Date Valuation
0
Expiration Date 2/05/11
Qty Unit Charge Per
Extension
- BASE FEE
15.00
1.00- 16.5000.'EA MECH B/C >3-15HP/>100K-500KBTU
16.50
-
--------------------------------------------
Special Notes and Comments
CONDENSER CHANGE OUT 5 TON 14 SEER HVAC
CHANGE -OUT. -- - -
—...... _... ...-- ...... --• =
--
------------- - - - - -- 7 -----------------------------------------
Other'Fees BLDG STDS ADMIN (SB1473)
-------------
1.00
- - ---
:_
Fee summary: Charged. Paid Credited
---- :_
Due i
-__-
Permit Fee Total 31:50 .00 .00 .
31'-50
z al J
.0101.
Plan -Check Total - 7:88 ..00 .00
7.88
Other (-Fee Total_.. 1.00 00 - 00'
1':00
Grand rTotal 40.38 .00 .00`
40:38 '
i
i'.
t
LQPERIIIIT
Simplified Prescriptive Certificate of Compliance: 1008 Residential-HVACAItecatiotts CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address
[L-�f U1 �6�#t'
Enforcement Agency:
DaterPermit
/10''
#:
Equipment ni
O Packaged Unit
List Minimum Efficien 2
Duct insulation requirement
Conditioned Floor
Area
Thermostat
"Sack
❑ Furnace
❑ AFUE_ ❑ COP
Over 40 ft of ducts added or
*Indoor Coil12SEER_`i
❑ HSPF
replaced in unconditioned space
Served by system
afnot already
UCondensing Unit
❑ EER ❑ Resistance
P 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 more than one system, use another CF -1 R-ALT-HVACjor each system.
2. Minimum Equipment E denies_ 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 be left for
shall on site final
inspection and a copy given to the homeowner. At final, the: inspedoe verifies that the work listed on this fort 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 -411s allowed) are filled out and
sigpd. Beginning October 1 2010 a registered copy of the CF -1R and CF -6R shall also be on final
site'for Inspection.
1. HVAC Changeout Required Forms:
• All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -FIM'
CF -4R forms: MECH- 21 and for split stems MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF 6R forms: MECH-2I-HERS and (for split. systems) MECH- 25 -HERS'
• Furnace
CF -4R forms: MECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA 2!'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 dud systems are construct, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Chang with new
duds: (all new ducting
ng 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 lit 22; and MECH 25
----_—... .-..- �'stems )MECH-
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 (forsplit 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 ganged.
For Split Systems: Duct leakage < 6 percent, RC,CCA>_ 300 CFMRon, TMAH
For Packs ed Units: Duct leakage <6 percent
0 4. New Ductin . over 40 feet
Required Forms:
• Includes adding or replacing more than 40
linear feet of duct in unconditioned s ce.
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forts: MECH-21
For split system or packaged units: Duct leakage < 15 percent . .
❑ EXCEPTION: Existing dud 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 Tide 24,
Pans I and 6 of the California Code of Regulations.
• Me design feawres identified on this Certificate of Compliance are consistent with the information documented on other applicable 1' ones, worksheets,
cal ul ions, and
plam sRkificatiqns submitted to the enforcement agency for approval with the p=fit
Name:
Signature:
Company: Dat
J ANTHONY SERVICES
Address: 72216 NORTH SHORE License:�� C/ qJ
THOUSAND PALMAS, CA 92276 l `
City/Statt:/lip: Phone: -760 —3q3 Z Z
1UU6 Kesraenttal Compliance Forms March 2010
Bin #
Qty Of La Quinta
Building BPSafety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building'Pertriit Application and Tracking Sheet
Permit #
D '
Project Address:
Owner's Name: KA
A. P. Number: ck
Address:
Legal Description:
City, ST, Zip:
Contractor: �V��
Telephone -
Address6. ' 10
Project Description:
City, ST, Zip: �l�`-'��
Tel -Z, I Z ;t
:.; % r' ` :> F" s :•.':•:><°^' s
'� I C4
State Lic. # : ��%%�
City Lic. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:.
Telephone: s ;N4 srnr :4<;t<.
:4 vi{: yti"M .L:E4v>'4. 4`;`.fr"'; ?.
State Lic. #: :4:<;;: # ; s»F <<::>:.»>:::::: c ;.
; s>s.•;; ..........
Name of Contact Person ►J
Construction Type: Occupancy
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person -760Z1 Z
Estimated Value of Project: W 6 6
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
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
211 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
tll