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12-1342 (MECH)
4.4 P.O. BOX 1504 "�..•r� VOICE 760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/13/12 Application Number: =1`2=000013-42 Owner: Property, Address: 81316' VICTORIA LN HELEN KUTASH _APN: •764-270-999-115 -300234- 81316 VICTORIA LANE Application description: MECHANICAL 'LA QUINTA, CA 92253 a Property Zoning: MEDIUM HIGH DENSITY RES D Application valuation: 13237 0 NOV 13. 2012 Contractor: Applicant: Architect or Engineer: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE CITY OFLAQUINTA THOUSAND PALMS, CA 92276 FINANCE DEPT. (760)343-7488 Lic. No.: 686310 i • - - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed nder provisions Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professio 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 Licen 'Class: C20 License No.: 686310 ate:'I ontractor: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. t'Ttave 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 O ILDER 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 Carrier ZENITH INS CO Policy Number Z0 717415 0 2 • 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 rk for which this permit is issued, 1 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 beco 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 1 should becomes ct 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 3700 of the Labor -Code, .l shall fort it j ply with those provisions. - that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by \I any applicant for a permit subjects the applicant to a civil penalty of not more than.five hundred dollars 1$500).:te: 1 3 licant: - ( 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: FAIL RE TO SECURE WO S' C PENSATION 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 provingthat he or she did not build or - - improve for'the purpose of sale.). ' APPLICANT 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 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 performedunder or pursuant to any permit issued as a result of this application, _ . (_ '_l 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 Ouinta, 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. 1 herebyaffirm 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 at' on 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 conand hereby authorize representatives J of this county to enter upon the above-mentioned property for insur ses. - Lender's Name: 1 t/ ,� - ' - - Date: I ature (Applicant or Agent): Lender's Address: LQPERMIT - Application Number •12-00001342 _ -- ,-Permit MECHANICAL ' Additional desc . Permit Fee_ . . . . 40.50 Plan Check Fee 10.13 Issue Date Valuation 0 Expiration Date 5/12/13 Qty Unit Charge Per Extension BASE FEE 15.00 •1.00 9.0000 EA MECH FURNACE <=1OOK 9,00 1.00 16.5000 EA MECH.B/C >3-15HP/>100K-500KBTU 16.50 ------------------------------------------------,---------------------------- Special Notes and Comments HVAC CHANGE -OUT? INSTALL 5 TON COMPLETE SYSTEM AT GROUND 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 .00 00 51..63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 81316 VICTORIA LANE La Quinta,, CA 92253 City of La Quinta I Nov 9, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP [3 R 6 (CZ 10-13) Served by system IM Setback ® Indoor Coil ® SEER 13.0 [3HSPF ❑ R 8 (CZ 14-15) 2091 sf If not already present, must be ® Condensing Unit ❑ EER ❑ Resistance installed) ❑ Other 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 -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1111 and CF -6R 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<i15_ percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted,from duct leakage testirigif: - ' s,❑ is o,uct system was documented to have been previously sealed and confirmed through HERS verification; or - ❑ 2,:Duct systemswith less than 40 linear feet in unconditioned space, or -'[3 3. Existing duct systems are'constructed, insulated or sealed with asbestos 0'4,. Thegsystemgwill not be Ducted (ie Ductless Mini -Split System)=(°Also ExemptIfromtRefrigerant Charge) ❑ 2. New HVAC_System Required Forms rrt^'t";�",_ . Cut infor Changeout with', CF 6R forms:,MECH-04, MECH=20 HERS, and,(for split systems) MECH ,22 HERS and new ducts -.:`(all new ducting and all newA MECH-25 HERS 1 , z " y� {` ' .. CF 4R forms 20, and (for split systems) MECH=22 and MECH-25 equipment) ,MECH fit) 'K tr^"+b .,',>�• n:.r:� sxrx x. For Split'Systems:,;Duct leakage -�s' "percent;'RC;'CCA >,350 CFM/t6h` FWD, TMAH STMS and`either,HSPP`or"PSPP. � *_ For Packaged.Units 'Duct leakage < 6 percent 111. New4Du6ts with/or,'w1thout Required Forms: „ Replacement �a ) "` . Includes, replacing or installing all'new ducting and/or outdoor. condensing',unit CF -6R forms: MECH=04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/orfurnace.;No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. 40;? ' 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 -6R 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: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: Nov 9, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0063367A-000000000-0000 Registration Date/Time: 2012/11/09 18:58:41 HE 'Provider: Ca10ERTS, Inc.• 2008 Residential Compliance Forms 2,, July 2010, 5 Ca10ERTS CF -1R Re ' gi stration ` Y . f 'z ' Nage l of I r A Danielle Garcia logged in [Logout] Public Home' [Home] CONGRATULATIONS S ` ♦. }Secure Home . • T e . ". , ' ' r Your CF -IR -ALT -HVAC Registration is complete! r About us You may want to print this page for your records. 81316 VICTORIA LANE Training Site Address: La Quinta, CA 92253 'CEC Registration: 212-A0063367A-000000000-0000 ' ' Rater Directory CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD ' �• _ Norms Assigned Company: HARRISON ENTERPRISES INC- - S•., t „ "• Do you know your HERS Rater? r '4, Membership BenefitsIf you do, you may want to.send this CF -1R to them. ' .. ; ' A • � r • '�• ,; _ r F. s CaICERTS Rater ID: t Events OR My Rater Quick Select:From [71 FroL_ist IndustryPartners' A Every CaICERTS rater has a license number. r, , if you need to find the rater by name [Click HERE] to search our directory. " r• T , ` •Job Placement. ^- � SEND -CF 1RJO-HERS RATER1d -� 6 t • 4 Y Resources(, . ♦ { News [CLICK HERE] to do another OR you can [OPEN and EDIT] this project you just created. A f't - 1.. � [: ,_ .,`t.' ' ,._. may.• r T•., To register for • our monthly �' t '. • * .i i <,. i. newsletter, w r - please click here. , •'• P ,E - �, Copyright © 2010 CaICERTS, Inc.'AII rights reserved. Revised: January 11, 2010 ' .. 'rte - . ,• . ' [Terms and Conditions] [Privacy Statement] (Class Cancellation Policy] 1 •; `' CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 ti - t 4• '• �" Office: 916-985-3400,Toll Free: 877 -HERS -11811, (877-437-7787) '`j • - ° ., ?: v Fax: 916-985-3402 Contact Us r., `_ t r • • �/ r rr f "Cr/rrV7/rr� r/..�, tv , , • t •+ ' I,'a ,�„ r'.,w r y _�• ra -yr t a • , ♦ �. It Y�/Y• 1 ., r'( 1 i 4 '1• ♦ r 4. t `t • = a • '•til r • J`<�'. j + • •.. '� r l '-., https://www:calceits.com/public_cflR.cfin?project_id=225938 -H `Y f 11/9/2012 . ' City of La Quinta Building 8i 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:��`'J��O Is`. �1P4 Owner's Name: A. P. Number: Address: Legal Description: -1u4 -14009°1 City, ST, Zip: � � Q Contractor:' w Telephone: ((� (A tQ . <: Address: Project Description: 'J7 1� City, ST, Zip: "- y s . T Telephone: State Lic. # - 3 City Lic. Arch., Engr., Designer: Address: City., ST, Zip: Telephone:. Construction Type- Occupancy: State Lic. �� : mac!% ✓..3c %a :.> . t` .proJs type circle Add' New. n Alter Repair Demo: Name of Contact Person: 60,Z.-65 j1Y1_.) Sq. Ft.:CQQ 9 171 #. Stories: # Units: Telephone # of Contact Person: 7!o O :3 1- 13 -7 It & S_ Vaia_ a �f_pr�i� _ L 22 APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACIMG PERMIT FEES Plan Sets. Plan Check submitted Item Amount Structural cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cale s. Called Contact Person Plan Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Gradibg plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing . Grant Deed Plans picked up. S.M.I. H.U.A. Approval Plans resubmitted Grading IN '•d Review,.ready for corrections/tssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees