13-0552 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA.QUINTA, CALIFORNIA 92253
Application Numbers
13=00000552
Property Address;7---'V~56'025`VIliLA6E DR
APN:
764-030-008- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
17854
Applicant:
1
•r
y .,.,. . BUILDING& SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
VOICE (760) 777-7012
G�
FAX(760)777-7011
�fC� /INSPECTIONS (760).777-7153
Owner:
FRY CARL
"{ 56025 VILLAGE DRIVE
LA QUINTA, CA 92253
(
Contractor:
GENERAL AIR CONDITI
31170 RESERVE DRIVE
THOUSAND PALMS, CA
(760)343-7488
Lic. No.: 686310
Date: 4/3.0/13
' LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
_ •••I hereby affirm under penalty of perjury that Iam licensed under provisions of 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 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' compensation, as provided
" .License Class: C20 License No.: 686310
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
�tf e � - ,+,C� ont�rac'to : ���2� ���
_ 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 that I am exempt from the Contractor's State License Law for the
Carrier ZENITH INS CO Policy Number . Z071741502
- . 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 the applicant'for 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 (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith comply with those provisions. .
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by�..._�
any.applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:C
Date:�.4' �b 3 A
1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
•'`lam ..
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 -
(_) 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 contractors) 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 applicatiori,
(_ 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 -
-being
"
of La Quinta, its officers, agents and employees for any act or omission related to the ,work -
Date: - Owner:
_ CONSTRUCTION LENDING AGENCY
I 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
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 the above information is correct. 1 agree to comply with all
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 purposes. -
_Date: Signature (Applicant:or Agent): S�iMJa
Application Number . . 13-00000552 .
Permit, ,;:`: MECHANICAL
Additional desc .
Permit Fee 37.50 Plan Check Fee
9.38
Issue Date Valuation.
0
Expiration Date 10/27/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH FURNACE <=100K
9.00
1.00 4.5000 EA, MECH VENT INST/ DUCT ALT
4.50
1.00 9.0000 RA MECH $/C <=3HPI100K BTU
9.UU
Special Notes and Comments
REPLACE 5 TON A/C 110K BTU FURNACE &'50'
OF DUCTING. 2010 CODES.
-------------------_--------------------------------------------
Other Fees BLDG STDS ADMIN (SB14.73)
-------------
1.00 -
Fee summary Charged Paid Credited
Due
Permit Fee Total 37.50 .00 .00
37.50
Plan Check Total 9.38 .00 .00
9.38
Other Fee Total 1.00 .00 .00
1:00
Grand Total 47.88 ..00 .00
J
47.88
LQPERMIT
Bin #
City of La Quinta
BuQding 8L Safety Division
P.O. Box 1504,78-495 Calle Tampico
4-Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: S (o C � V l- 0. t✓ r ► v t
Owner's Name:.
A P. Number.
Address: 5(oozS V it lr;\t
Legal Description:
City, ST, Zip: lc,, CA q Z 25
Telephone: )
Contractor. Ger ;� A; /+ i.
�f n
Address: 31170 `<e v
Project Description:
City, ST, Zip: 1hoV So-Yk A POA rn s.C,4 9 Z2. 7fo
Pe )O1GG E+ory Alc 1101.,-
Telephone: ?fop - 34 3.7 y 8�
�-•
State Lic. #: (ONO 31 O City Lic. #,
Arch, Engr., Designer.
_ • .
Address:
City., ST, Zap:
Telephone:
State Lia #:
Construction T ype:. Occupancy:
Project type (circle one): New Add'n Alta Repair Demo
Name of Contact Person:
Sq. -FL: #Stories:.
#Unit;;
Telephone # of Contact Person:
Estimated Value of Project "7 $S'i - DO
APPLICANT: DO NOT WRITE BELOW THUS UNE
A
Submittal
Place Sets
Req+d
Recd
TRACKING PERhIIT 1FF:ES
Plan Check submitted Item Amount
Strgdoral Cales
RevleR ready for correcdom Plan Check Deposit.
Ttuss Glu.
Called Contact Person Plan Cheek Balance
'Title 24 Gla
Plana picked up Construction
Flood plate plan
Plans resubmitted Mechanical
Grading plan
V Review, ready for correctionaftasue Electrical
Subeontactor List
Called Contact Person Plumbing
Gnat Deed
Plana picked cep S.M.L.
ILO.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''a Review; ready for carrectioaslissue Devdoper Impact Fee
Planning Approval
Called. Contact Person A.I.P.P.
Pub. Wks. APpr "
Date of permit Issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address: i
Enforcement Agency: a
Date:
Permit #:
56025 VILLAGE DRIVE La Quinta, CA,92253 -
City of.La,Quinta
Apr 29:, 2013
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7L: R � �' �
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❑ Package Unit.
- ., -M 1. a �Y .Sr^ ..
:i�• . 1 �� � .
�
�.� 3. r_ •.
® Furnace -
®Indoor Coil ' - ,
.
w
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Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address: i
Enforcement Agency: a
Date:
Permit #:
56025 VILLAGE DRIVE La Quinta, CA,92253 -
City of.La,Quinta
Apr 29:, 2013
•
•' Equipment Typel
List Minimum Efficiency? ..
Duct insulation
requirement
Conditioned Floor
Area
:' Thermostat ' a
❑ Package Unit.
® Furnace -
®Indoor Coil ' - ,
® AFUE 78%
®SEER x,3.0
❑,COP,'
O HSP•F
0 R.6 (CZ 10 13),
Served by system
® Setback �
If aot already present, must
® Condensing Unit _
El EER
Resistance
R g (CZ'1415) , ^
,
4168' sf
be installed) y "
® Other <= 40' Duds,
,
1. Equipment Type; Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC fur 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 fad 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 registe-ed copy of the CF. -1R
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 /orr.;
. Indoor Coil and /or
CF -611 forms: MECH-04; MECH-2I-HERS and'(for split systems) MECH-25-HERS r ''
Furnace r,
CF -4R farms: MECH-21 and (for split systems) MECH-25
.
For Split Systems: Dud leakage:<:;15 percent; RC, CCA <_ 300 CFM ton Minimum Air Flow Requirement),TMAH
/ ( .
Fee. PawVaged Unix..,
Exempted from dud leakage testing if::
[] 1: Duct system vias documented to have been previously sealed and confirmed through HERS veification,,or• '.� i •,+ `
p'2."Duct systems with.less than: .40 linear feet in�unconditioned space, -or " t;
'03.
Existing duct systems are"'constructed, insulated or sealed with asbestos
Q'4. The systems -will not be Ducted fiery Duchess. MIni�Splil System)emp
Als Ext irorti Refrigerant har e '
9 )
Re q :.: .
13 2. New:F\fAG.`S sfetti uir<ed
Cut in-.-,,, K-Cliangeout w th ° r fEutr .::
CF -6R formsgMECH-04 MEClM2(iERSatr tot lits steFxrs :MECHfERS and
new j fi sA Y )
dutt,V all new r y+
ductirk tea-- (all new Cf forms MECH '
-4R 20 anor split sytemsj MECii 22 ants MECH 25�
equiprrtefrt)
�..,
�x
Duct lge;r 6 perc
ystems.. eaka
For Split Sent RC, CCAS 350 CF1M/ton, FIND #TMAH, 5t1ti15 amd ettfier
« ;
For Packaged`Units: Duct leakage:;:percedt%%i'
0 3. !!iew,Ducts with/or without
Required_ .Forms:
Replacement �.
. Includes replacing or iristalfing.all.riew
ducting and/or'outdoor ciindensfiig::unit
CF -6R forms: MECH-04, MECH-20-HERS; and (for'split MECH-25=HERS
,: ,
and/or indoor coil and/or furnaces::No.or some
systems_)
CF -4R forms: MECH-20 and (for split systems) MECH-25.: ' �:: ' '•
equipment changed.
1
For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH ,ort
For Packaged Units: Duct leakage < 6 percent ':•\ r
❑ 4. New Ducting over 40 feet
Required Forms: E .
. 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)
r
. I oertify 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 Com Alance conform to the
, -
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. i • ;
• The design features Identified on this Certificate of Compliance are consistent with the information documented on ether. applicable compliance ` r
' fofrns,.worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Danielle Garcia .• Signature: bartielle Gvcie ~
Company: HARRISON ENTERPRISES INC T , '„ 4 ,- Date: Apr 29, 2013
Address: 31-170 RESERVE DRIVE STE A Liceese: 686310
City/State/Zip:•THOUSAND PALMS / CA / 92276•;- Phore`..(760) 343-7488
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Reg: 213-A0025273A 000000000-0000'
Registration•Date/Time • 2013/04/29 11:21:17'
HERS Provider:~CalCERTS *Inc
«
2008 Residential.'Compliance Forms
2010
jii �` T.