11-0506 (MECH)P.O., BOX 1504 VOICE (760)777-7012
4-
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &•SAFETY DEPARTMENT, INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/16/11
Application Number: '11-00000506 Owner:
Property Address:78860—VIA7.VENTANA . �. CHRISTIANSON CHARLES W }
APN: 646-320-031- 78860 VIA VENTANA • '1r
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning:. LOW DENSITY RESIDENTIAL 4
Application valuation: 12170 D
4 Contractor.y
Applicant: Architect or Engineer: DCS HEATING/AIR CONDI G I1�yYw 1 C
tl
U 72078 CORPORATE WAY, 10 4-
a THOUSAND PALMS, CA :92 76 ��t -
.�
s _ W F LA QUINT
(760) 343 `5566 C17Yn /� ,
Fttrl�at�Sf T '
LiC No 595145 t. E
r " LICENSED CONTRACTOR'S DECLARATION. ':+. •;` ' , ,' •�� ,� WORKER'S COMPENSATION DECLARATION,� _ r
-,. I hereby affirm under penalty of perjury that ram licensed under provisions of Chapter 9 (commencing with -. ` I hereby affirm.under penalty. of: perjury. one_ofthe following declarations:
s - Section7000) of Division -3otthe 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'com compensation, as provided tt
. • Licen aass/s: '/C 220 icense No.: -.595145 - '<' "- "'; - t -for by Section 3700 of the Labor Code, for the performance of the work for which this permit is, F '-
' Sf'l �G'VI f P. a+ issued. ". •
y Date: C _ actor, M
_ - - 'T t1�7�1. have and will"maintain:workers'.compensationy insurance, as required by Section 3700_of,ttie labor ,, " y
x --, ' '. ' - - • • ' ; "' R ' ' • ` •, ' '
ode, for the performance of the work for which this permit is issued. My workers'. compensation y
'
OWNER-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty-of perjury that I am exempt from the Contractor's State License Law for the f Carrier .HARTFORD INS Policy Number _ 72WECLS7131 +;!
following reason (Sec. 7031.5, Business and Professions Code: .Any city or county that requires a permit to: <, '• _,:I certifyahat, in the performance of the work'fprwhich this permit is issued, I'shall not employ any r
construct, alter, improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the ,+' - ' _ Y 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 -;znj - ' +r f x and agree that, if.l 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 .e~, : - ., ,; 3700 of the'Labor Cod , I shall -forthwith.comply 'With those provisions) z ''•
3 r that he orshe is exempt therefrom and the basis for alleged exemption..-Any violation ofSection 7031.5
by s 1 ..rte'
'any applicant for a permit subjects the applicant to a. civil penalty of:not more'than'five hundred dollars.IS5001.:; ,' Date - v �� cant �" y�
1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and .`.- - +', •.
--- - _ - the structure is riot intended or, offeied 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 ' r
and who does the work himself or herself through his or her own employees,. provided that the - - DOLLARS ($100,000):' IN ADDITION T0. THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN. ..y
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 .•ti : - - - - - • -
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 fora permit subject to the �c
17044, Business and Professions Code: The Contractors' State License Law'does not apply town owner of conditions and restrictions set forth on this. application. • _ . '.0.
property
0
property who builds or improves thereon, and who contracts for the projects with acontractorlsl 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 '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 -
.. s - of La Quinta, its officers, agents and•employees for any act or omission related to the work being a -
" 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. - -
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 county ordinances and state laws relating to building construction, and hereby. authorize representatives
county to enter upon the ove-mentioned propettor 'nspection po S. - -
- « •Lender's Name:. r .. - _
- - Date: �� �� ature (Applicant or Agent): -
Lender's Address:- -
- - Application Number"` . . . . . 11-.00000506
- Permit MECHANICAL
..'
Additional-desc'
z Permit"Fee . . . . 40.50 _ P1an.Check Fee
10.13.
''Issue Date Valuation,
0
Expiration,Date `11/12/11 V
•
Qty Unit Charge Per J
Extension
BASE FEE
15.00
1:00. 9.0000 EA MECH FURNACE <=100K
9.00
1.00 ..16.5000 EA- _ MECH B/C >3-1'5H'P/>100K7.500KBTU
16.50',
-- ----------------- - - - ---------
Special Notes and Comments "_
- --- - - - - --
y ,
HVAC CHANGE-OUT", FURNACE CONDENSER '( •13
SEER)INDOOR COIL, . 2010 CODES:
2' - - - - ----------- --- '' --'--- - - -- - -- - -- - --
- - - - - -- --
] Other` Fees BLDG 'STDS ;ADMIN *(SB1473)
-
1.00-,
Fee summary Charged PaiCredited
Due
Permit Fee Total40.50 - --- . 00 --.
00
40- 50 t' ' ` •V`' •:. w
[
PlanCheck Total _ 10.13 00 ,.00 r 10.13
�.
- ' Other Fee Total`_ � 1� 00 ' : '� 00
1:00 " «`
•00 _ F
Grand Total 51:63 y :00 ' 00 +
."51 63 f
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LQPERWr
Simplified Prescriptive `Certificate of Compliance: 2008 Residential/ HVAC CF-1'R-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
78860 Via Ventana La Quinta, CA 92253
City of La Quinta
May 16, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
-
p Furnace
2 AFUE 78%
❑ COP
❑ R 6 (CZ 10-13)
Served by system
2 Setback
R Indoor Coil
0 SEER 13.0
[3HSPF
0 R 8 (CZ 14-15)
2288 sf
If not already present,
p Condensing Unit
❑ EER
❑ Resistance
must be installed)
❑ Other
1. Equipment Type: Choose the equipment being installed,, if more than one system, use another CF-1R-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 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-111 and CF-611 shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R 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
CF-6R forms: MECH=04, MECH-2I-HERS and (for split systems) MECH-25-HERS
.Indoor Coil and /or
CF-411 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 leagage testing,if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
1712. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing-duct systems are constructed, insulated>�or sealed with asbestos
-:.> �.,t._..
❑ 2. New HVAC '`
Required-forms:
System
`r
Cut in or Changeout
with new ducts alk
(
'� i x '
CF:6R forms MECH 04, MECH 20 HERS, and (forrsplrt systems) MECH;22 HERS, and �
MECH 25 HERSL r4 N c F 1 rs,
new duc'CF.4R
forms `MECH 20 -anpym�MECH;22and MECH�25 r
new equipment)
For Split Systems: Duct leakage -e6 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/or without
Required Forms;
Replacement
. Includes replacing or installing all
new ducting and/or outdoor
condensing unit and/or indoor coil
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
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
CF-611 forms: MECH-04, MECH-21-HERS
than 40 linear feet of duct in
CF-411 forms: MECH-21
unconditioned space.
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: Sara Hart Signature: Sara Hart
Company: D C S HEATING & AIR CONDITIONING INC Date: May 16, 2011
Address: 72-078 CORPORATE WAY STE 101 License: 595145
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-5566
Reg: 211-A0023519A-00000000-0000 Registration Date/Time: 2011/05/16 14:33:15 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
9
1)
Bin # O�f Q ,.
La` Uinta
t ,
Building 8r Safety Division
Permit # P.O. Box -1504, 78-495 Calle Tampico -
la Quinta, CA 92253 - (760) 777-7012
``
Building Permit Application and Tracking Sheet
Project Address: ia Owner's Name: .
A. P. Number: .. � - Address:.
Legal Description: City, ST, Zip: L722 S
Contractor:�:y?
Y Telephone•
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Address. � ProjectDescriptionn:, D Ie'
City, ST, Zip: R S r' Z S
Telephone:
on
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State Lic. # :
City Lic. S ta(0 n�^ti -1-•
Arch., Engr., Designer. S Qin AZW w 1�►'�-IN �. �( CC�� {L
Address:' t' C ee U 1 Nto CR
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City, ST, Zip: A, ,c - Pu •e. /'C)r s sko
N.
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Telephone: Occup ancy; -
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State Lic. Project type (circle one) New Add'n Alter Repair Demo �
Name of Contact Person: Sq. Ft:: # Stories: _ #Units:
Telephone # of Contact Person:
Estimated Value of Project:
o I � OO
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
A' PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance.
•
Title 24 Cales.
Plans picked up" - s _
Construction "
Flood plain plan
-
Plans resubmitted
Mechanical
Grading plan
2°d 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
i
Planning Approval
Called Contact Person
A.LP.Y.
Pub. Wks. Appr
Date of permit issue
"
School Fees
"
_.
Total Permit Fees