12-1299 (MECH)4 P.O. BMX 154" VOICE (760) 7-701��5
78-495 CALLE TAMPICO FAX (760) 77 -
LA QUINTA, CALIFORNIA 92253, BUILDING & SAFETY DEPARTMENT Q; INSPECTIONS,(760) 777-7153
BUILDING PERMIT
Date: 10/31/12
Application Number: X12-00001299 Owner:
Property Address: t48425 VIA SOLANA, MILNE RESIDENCE '
APN: 646-380-070- - - 48425 VIA SOLANA
Application description:' MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 698-8783
Application valuation: 800 D �rti!
Contractor:j
Applicant: Archi ct gineer. PREC H & A INC OCT 31-2012.
2U112
P.O. BOX "11090 '
PALM DESERT, CA 92255 CITMOFVQQUINTA
(760) 776-1550 FIFA+ EDEPT.
Lic. No.: 818759
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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 1 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. P_ _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided
License Class: C20 C36 License No.:' 818759 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
%a > ( /^2 issued.
-��eC._Contractor:� - v ✓'_� _ 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
OWNER-BUILDER DECLARATION insurance carrier and policy number are:
�I hereby affirm under penalty of perjury thatam exempt from the Contractor's State License Law for the Carrier TRUCK INS EXCHN Policy Number N 2008 71 19 .. -
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 theapplicantfor 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 (Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith co ply with those provisions.
tharhe or she, is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by i -�/ A
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date• pplicant:
1 _ 1 1, 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 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
(_ 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; -
• (_) 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 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 Icertify 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 county ordinances and state. laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection pur sea
Lender's Name:" // �
Date4L_? ' l /C _Signature (Applicant or Agent):
Lender's Address:
-' LQPERMIT - -
Application Number 12-00001299
c
Permit. . MECHANICAL
Additional desc .
Permit Fee . . . . 24.00 Plan Check Fee
6.00
Issue Date Valuation .
. 0
Expiration Date.. 4/29/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH APPL REP/ALT/ADD
_
9.00
------------------------------------------------.7- --
Special Notes and Comments
REPLACE EVAP COIL CHANGE OUT SAME FOR
SAME. 2010 CODES.
-----------------_--------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
------------
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 1.0.0 .00 .00
1.00
Grand.Total 31.00 .00 .00
31.00
• LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
48425 Via Solana La Quinta, CA 92253
City of La Quinta
Oct 26, 2012
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
❑ Furnace-
® Indoor Coil
[3
0 SEER
❑ COP
p HSPF
[3 R 6 (CZ 10-13)
Served by system
® Setback
If not already present must be
❑ Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
1200 sf
installed)
❑ Other
i. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC for each system.
2. Minimum Equipment EHIc/enc/es: 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 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 signed.Beginning October 1, 2010, a registered copy of the CF -IR
and CF -6111 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF -611 forms: MECH-04, 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 <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
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
❑ 4. The system will not be Ducted (ie. Ductless Mini -Split System) .(Alsq,Exempt.from .Refrigerant Charge)
❑ 2. New HVAC System
Requirdd Forms: y
. Cut in or Changeout with
new duets: (all new
r.
CF -6R forms: MECH-04 MECH-20-HERS, and..,(for split systems) MECH 22 -HERS, and
ductingMECH
all new -
equipment)
25 HERS T
CF. -411 forms; MECH-20 and (for split systems) ;MECH-22, and MECO-25
F
or Split Systems: Duct leakage < 6 percent;. RC, CCA z 350 CFM/ton, FWD; TMAH, STMS, and either HSPP or'PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or.without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF -4R forms: MECH=20 and (for split systems) MECH-25
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
CF -611 forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R 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.
• 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 other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the.enforcement agency for approval with the permit application.
Name: Gerald Dobbins Signature: Gerald Dobbins
Company: PREC H- &A INC Date: Oct 26, 2012
Address: P O BOX 10991 License: 818759
City/State/Zip: PALM DESERT / CA / 92255 Phone: (760) 776-1550
Reg: 212-A0060167A-000000000-0000 Registration Date/Time: 2012/10/26 16:33:37 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
4)
Bin.#
of*La Quints
Bullaft 8r Safety Division
P.O. Box 1504,78-495 Calle Tamploo
Ia.Quinta, CA 92253.:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
nn
Project Address:
Owner's Name:.
A. P. Number.
Address:
Legal Description:
City, ST, Zip: G, `� gl. 2-zs-
Contractor. rt-. d)
Telephone:
Address: at- v
Project Description: a IClio
City, ST, Zip:
Telephone:
State Lic. # :
City Lic. #;
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
r ,
State Lic. #: , �,:• ,
Name of Contact Person: (Dog
Construction Type:. Occupancy:
Project type (circle of e): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: d % �d
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
p
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES .
Plan Sets
Pian Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Coles.
Called Contact Person
Plan Check Balance
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
tad Review, ready for correctiionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.OA. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correctioasliissue
Developer Impact Fee
Planning Approval
Called Contact Person
A-LP P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Lrmit Fees