12-0596 (MECH)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO1d�Q , FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92 53 1'y� 10 b�j� fib" BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
�6d� -Date: `5/29/12
Application Number: CT2=0'00 ����` • Owner,
Property Address: 47910 '3 ZURIC BARBARA TRAVIS.
APN: 643-140-059 -2611D/. � i 47910"' IA ZURICH
Application description:: MECHANICAL �/ LA QUINTA, CA ''9.2253
Property Zoning: LOW DENSITY RESIDENT O p * j
Application valuation: 7450 r s
Contractor: t
Applicant: Architect or Engineer: ; _ • GENERAL AIR CONDITIONING'..f ,
'r ,r 31170 'RESERVE DRIVE -
.y. t, THOUSAND PALMS, CA 92276
(760)343-7488
Lic No.: 686310
1`
n .L t• �
--•.' 1- LICENSEDCO CTOR'S DECLARATION .WORKER'S COMPENSATION DECLARATION
-- - -
• Ihereby affirm under penalty of perjury that I am license der provisions of Chapter 9 (commencing' with V _ I hereby affirm under penalty. of perjury one of the following declarations:. • _
Section7000)of Division 3 of the Business and Profassi Is -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 ,h ••
'License Class:. C20 - - Lice a No.: 686310 s,r '� ti - r— for by Section 3700 of the Labor Code, for the performance. of the work for which this permit is •;
- •. ,.. issued.
ate: S 2� ontractor: - t �;• ` I have and will maintain workers' compensation insurance,;as required by Section 3700 of the Labor
t y.- _•r.'x Code, for the performance of the work for which this permit is issued. My workers' compensation
WNER-
'BUILDER DECLARATION . '` !.t .J`• insurance carrier and policy number are: r :r
.I hereby affirm under penal[yof perjury that Lam exempt from the Contractor's State License Law for the'- -Carrier ZENITH INS CO Polic Number 2071741501
' 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 ork for which this permit isissued, l'shall not employ any
.:construct, alter, improve; demolish, or repair any structure; prior to its issuance, also requires the applicant for the YD'ate
._, -person in anymanner so as to beco subject to the workers' compensation laws of California,
permit to file a signed statement that he or sheds licensed pursuant to the provisions of the Contractor's State --- - and agree that, if I should become s ject to the workers' compensation provisionsof Section11t w tLicense Law (Chapter 9,(commencing with Section 7000) ofDivision 3 of the Business and Professions Code) orr700 of a Labor Code, I shall fort itc ply with those provisions:that heor she is exempttherefromand the basis fonthe alleged exemption. Any violation of Section 7031.5 by�any applicant for a permit subjects the applicant toa civil penahyof not more than fivehundred dollars IS5001:: - ,r,/Z Applicant:'1, as owner of the property, or my. employees with wages as their sole compensation, will do the work, and 4.,the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The NING: FAILURE TO SECURE WOR CO PENSATION COVERAGE is UNLAWFUL, AND SHALL.
Contractors- State License Law does not apply to an owner of property who builds or improves thereon ° "^ SUBJECT SAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND r. -
.r >4 . - 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 CO INTEREST, AND ATTORNEY'S FEES. Y'
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.).
PPUCANT ACKNOWLEDGEMENT
_ 3 - ._.
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 •,4<`
7044, Business and Professions Code: The Contractors' State LicenseLawdoes 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 ;+c
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
(_y I am exempt under Sec. , B-&P.C. for this reason - F .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 per i , or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY ' - r 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 Lhave read this application andstate that the abo i formation is correct. I agree to comply with all
work for which this permit is issued (Sec: 3097, Civ. C.). a - - - �- "� city and county ordinan sand state laws relating to building truction, and hereby authorize representatives
of
s county to enter pon the above-mentioned property for pection rposes. r ' •� - '
Lender's Name: _
d .a ate: s z 1 'gnature (Applicant or Agent): }
Lender's Address: • r + _
LQPERMIT r '
.Application Number 12-00000596
Permit . . . MECHANICAL
Additional desc .
Permit Fee 40.50
Plan Check Fee
10.13
Issue Date . . .
Valuation
0
Expiration' Date . " 11/25/12
-: Qty Unit Charge Per
'Extension
BASE
FEE
15.00
1. 00 9.0000 EA MECH
FURNACE -<=100K
9.00
1.00 16.5000 EA•,. MECH
B/C'>3-15HP/>100K7500KBTU
16.50
Special Notes and Comments
_ HVAC CHANGE -OUT: INSTALL NEW 1.5
TON
SPLIT SYSTEM•OUTDOOR UNIT AT GOUND
LEVEL. 2010 CODES..
-.------.-------------- ---------------------------------------
Other Fees :, BLDG STDS.ADMIN (SB1473)
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
'0.0 00
51.63 .
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10'- 15
Site Address:
Enforcement Agency:
Date:
Permit #:
47910 VIA ZURICH La Quinta, CA 92253
City of La Quinta
May 26, 2012
Equipment Type1
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE%j
® SEER 1
COP
❑ HSPF
13R 6 (CZ 10-13)
Served by system
If of already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R 8 (CZ 14-15)
1605 sf
installed)
❑ Other
I,
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-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-41k
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
• Indoor Coil and /or
CF-6R 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 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from dud leakage testing'if:
❑ 1.'Ductsystem was documented to have been previously sealed and confirmed through HERS verification, or-
❑ 2. Dud systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing dud systems are constructed, insulated or sealed with asbestos
❑ 4. Theme ystem v ill not be Ducfed (ie Ductte s Mini-Split $ystem:)�(AIso Exempt Ref�riger,,ant Charge)
❑ 2. New HVAC System
Required Forirns. s ,_ : Iiv ...,.
�
. Cut infor''Changeout with.
new ducts (all
' '� ei" f
CF 6Rforuns MECH-04, MECH, 20 HERS, and',�for split sy terns) MECH 22 HERS, and ~
new
ducting' all new '
MECtir25 H�ER,S
CF 4R forms MECH-
a�
equipment)
w >.-r .. r:.
-0 and,(fior spilt systems) MEE+i.i22 an'd MECH=25
�y
E.s�.a°i'.,.�-rx
For Split Systems_, Duct leakage
< 6 percent, RC ,-,W- `350 CFM/toil;'4FWD)jTMAI I; SIMS, and either HSPP"or"PSPP.
For Packaged Units: Dud
leakage <.6:percent ''
11 3New-rDu. With/or without
Required Forms:
. Includes replacing or installing 611, 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-20and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Dud leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF-611 forms: MECH704, 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: Danielle Garcia Signature: Danielle Garcia
Company: HARRISON ENTERPRISES INC Date: May 26, 2012
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 212-A0027054A-00000000-0000 Registration Date/Time: 2012/05/26 18:31:24 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
BIn. #
, ,
City Of %? Qiiinta
Building 8r Safety Division
P.Q. Box 1504,78-493 Calle Tampico
L4.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking. Sheet
Permit #
(P
I
Project Address: L+ 1 0 1
Owner's Name:. Y --V V. S
A P. Number.
Address:'•..
Legal Description:
r
City, ST, Zip: � . � 2 2� .3
Project Description:
ddress:
Address:
City, ST, Zip:
5 � our ot)V Jt)n v
Telephone: " tt
State Lic. #: City Lic. #;
Arch, Engr., Designer
Address:
City., ST, Zip:
Construction Type: Occupancy:
Telephone:AIM,
State Lic. #: " project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq, Ft.-. 3 Cj # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project 1+150, 00
APPLICANT: DO NOT WRITE BELOW THIS UNE
9
Submittal
Req'd
Recd ..
TRACKING
PERMU FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Pian Check Balance
Tide 24 Calci.
Plana picked up
Contraction
Flood plainpias
Pian resubmitted.'.
Mechanical
Grading plan
2'a Review, ready for correctionsfissue .
Electrical
Subeontector List
Called Contact Person
Plumbing
Grant Deed
Plans picked up ,
S.M.L
H.O.A. ApprovalPleas
resubmitted
Grading
IN HOUSE:.
2" Review; ready for correcdonsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees