10-1032 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
C10-0.00050.3.2«__^;'�
Property Address: -
79800 VIA SIN CUIDADO
APN:
772-390-006- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2000
Applicant:cGArchitect or Engineer: .. A4_
------------------
LICENSED CONTRACTOR'S DECLARATION
4 VOICE (760)•777-7012
FAX (760) 777-7011
BUILDING & SAFETY'DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/04/10
Owner:
MIKE MORGAN
79-800 VIA SIN CUIDADO
LA QUINTA, CA 92253
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with _
Section 7000) of Division 3 o�the B iness and Prof sionals Code, and my License is in full force and effect.LicenseClass:C200License No.: 791121 -
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 apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
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 improvementis 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 I, 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 am exempt under Sec. , B.&P.C."for this reason
Date: owner:
CONSTRUCTION LENDING AGENCY
1 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
3 `�--: j
Contractor. � (•'J -.,-•�--.� � �
UNIVERSAL MECHANICAL
74698 CANDLEWOOD DRIVE' ` '` • t ___I�
PALM DESERT, CA 92260
(760)851-9679 C!' C!'T"{'0 Q:IP�4IA
�-w!`�r''-i"urea• ' n; }
i
LiC. No.: 791121 - _•_•=__-.:`_._...._ _—._
--7----------------------------—---------------
WORKER'S COMPENSATION DECLARATION
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 number are:
Carrier EXEMPT Policy Number EXEMPT.
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any marine as to become subject to the workers' compensation laws of California,
and agree that, if I sh I ecome subjecj. 61-e.rorkers' compensation provisions of Section
. 3��7ss00�0 of the Labor Cc , I all forthw'(h co ty with those provisions.
is Data] 0"-1`I D Applican - •"-- "
`WARNING: FAILURE TO SECURE WO ' C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 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 h above information is correct. I agree to comply with all
city and county ordinances and state laws relating to b ildi construction, a by authorize representatives
of this county to enter upon the above-mentioned prop y f inspectio -
Date:. Signature (Applicant or A-
Application Number 10-00001032
Permit :, . . MECHANICAL
Additional desc
Permit..Fee 24.00
Plan Check Fee
6.00
Issue Date
Valuation
0
Expiration Date 4/02/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00
-----------------------------------------------
Special Notes and Comments
---------
HVAC CHANGEOUT INSTALLING.NEW.13
SEER
CONDENSER. 2007 CODES.
--------------------------- -------------------------------------------------
-----------------------------------
OtherFees . . . . BLDG STDS ADMIN (SB1473).
---Other
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 24.00
.00 .00•
24.00
'. Plan Check Total 6:00
.00 .00
6.00
Other Fee Total 1.00
.00 .00
1.00
Grand Total 31.00
.00 .00
31.00
LQPERMIT _
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations
Climate Zones 10 to 15
1
CF -IR -ALT -HVAC
J'
Jute Address:
SOD s, A S Iln Cu l Q C7,
Enforcement Agency:
Date:
Permit #:
Equipment Type' Conditioned Floor
List Minimum Efcien Z Duct insulation uirement
❑ Packaged Unit Area Thermostat
mace ❑ AFUE4M ❑ COP Over 40 ft of ducts added or Cl Setback
❑ ❑SEER ' ❑ HSPF replaced to unconditioned space Served byy system. (ljnot already
Condens' Unit ❑ EER ❑ Resistance ❑ R 6 (CZ 10-13) �SOv sf
present, must be
er ❑ R 8 (CZ 14-I5) installed)
I. Equipment Type: Choose the equipment being installed: ijmore than ore system, use another CF- I R -ALT --HVAC or each
j system.
2. Minimum 994- ent E
�9clencles: I3 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
shall 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 -611 and registered CR4R forms (no hand filled CF4Rs allowed) are filled out and
signed. Beginning October 1 2010 a registered copy of the CF -1R and CF -6R 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-411forms: MECH- 21 and fors lit stems .MECH-25
• Condenser Coil and/or
• Indoor Coil and/or CF -61t forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Furnace CF4R forms: 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
Fxempied 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 thin 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 Chang with new
ducts: (all new ducting
ng rg�td all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF4R forms: MECH 20-, and (for split systetns)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
- s:
• 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
CF4R 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 CFMtton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
adding or replacing more than
• linear feet
linear feet Of duct in unconditioned space.
CF-6It fortes: MECH-04, MECH-2I-HERS CF4R 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.
• 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.
• 1 certify that the energy features and performance specifications for the design identified Certificate
on this of Compliance conform to the requirements of Title 24,
Parts I and 6 of the California Code of Regulations.
• fhe design features identified on this Certificate of Compliance are consistent with the informa documented on other applicable compliance forms, worksheets,
calculations, ands
plans specifications submitted to the enforcement for approval with it lication.
Name: `
t r 'f f
Signa Q,-----
r
Company :/s
vt�l� �sA4l
Date:
Address:
Dont
�/ Ll :OS� vy� t r -
License: 7q ! 1 2-1
` L l
City/State/Zip: f� c�
Phone: Z60 0^' 1167 9
Mbld Residential Compliance Forms March 2010
Bin #
City of La Quints
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: 7 _I 3U) Y iA 4nj �p
Owner's Name:0
. tr AN
A. P. Number:
Address:79.3
SOD fa/, A I h u .
Legal Description: ,
City, ST, Zip: L
Contractor:U.,G A '6 1 •
Telephone: :t
Address: =1-1 11.1 r ee6
Project Description: JA .- e-6 A#n 044
City, ST, Zip: PAIM 0e jet" -Z24�
Telephone: -76c�j3S I q 6-7 q
ON..;��.
State Lie. # : 7� 1 .Z 1 City Lie. #:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: <; ,;•:�.
State Lic. #: �'%` '
',•''°';`�?••
Name of Contact Person:
Construction Type: Occupancy:
Project a circle one New Add'n Alter Repair Demo
J type � )�
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIGNG
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
Tide 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
20° 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:-
''d 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