14-0524 (MECH)P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000524'
Property Address:
48585 VISTA CALICO
APN:
649-530-018- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
8400
Applicant: Architect or Engineer:
y
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed underprovisions of Chapter 9 (commencing with
Section 7000)•bf Division 3 of the Business and Professionals Code, and my License is in full force and effect. -
License ass: C20 License No.: 522775
Date; � oC ntractor: ZZ
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State .
License Law (Chapter 9 (commencing with, Section 7000) of Division 3 of the Business and Professions Code) or
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 1$500).:
(_ 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 '
Contractors''State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. B.&P.C. for this reason
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:
UOrLrIUrfPY
Owner:
RYAN EILEEN
2129 4TH ST ,
SANTA ROSA, CA 95404 '
Contractor:
SAN'S AIR CONDITIONING &
51530 JACKSON STREET
COACHELLA, CA 92236
(760)398-4287
Lc. No.: 522775
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/29/14
JIDon
HT
1
CIT,'rc'A QUIN lei
r!e''„'iWIE- VEPT
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury one of the following declarations: -
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided „
foi by Section 3700 of the Labor Code, for the performance of the work for which this permitis
issued.
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
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 9074503
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person inany manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should.become.subject to the workers' compensation provisions of Section
3700 of the La .or_Code, ;aorthwith comply with th se provisions. '.
Date: _5e�Applicant:
WARNING: FAILURE TO SEC RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE,.INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
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.
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.
1 certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin n truction, and hereby authorize representatives
of this county to enter upon the above-mentioned property or inspecti ur ses.
Date Signature (A� or Agent):
Application Number . . . 14-00000524
Permit . . MECHANICAL 2013
Additional desc .
Permit Fee . . 71.50 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date 10/26/14
Qty Unit Charge Per Extension
1.00 35.7500 EA MECH FURNACE 35.75
1.00 35.7500 EA MECH CONDENSER/COMP .35.75
-----------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 16SEER, SPLIT SYSTEM
[2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR•TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
----------------
Other Fees . . BLDG STDS ADMIN (SB1473) 1.00
PERMIT ISSUANCE M/P/E 90.57
PLAN CHECK, MECHANICAL 47.66
Fee summary Charged- Paid Credited Due
Permit Fee Total 71.50 .00 00 71.50
LQPERMIT
Bin #
City Of La Quinta . .
Building 8T 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:I/K �' t� Ile
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: a,� (:�:14
Contract or. 6i✓r f .f � �ONi4 �
Telephone:
Address: Q N j
Project Deescription:.
City, ST, Zip:
e UIQ K
Telephone:�+
b -
"t0 D'
State Lic. # :
City Lie. #'..'
t� �• Q low
Arch., Engr., Designer:
Address:
ip:
City, ST, Zip-
Tele h ne:
Telephone:
P0
'«:<:<:>>:<;:> <:>.::;:•»<?::»;;:<;:::::.
Construction Type: Occupancy:
•
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: Q(�
APPLICANT: DO NOT WRITE BELOW THIS LINE
t/
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
'Flood plain'plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for corrections/issue.
Developer 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 Com liance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC
Climate Zones 10 io 15
Site Address:
Ence ent Ag cy• Dat :
j f a�
Perini #:
-
/
Conditioned Floor
Equipment T '
List Minimum Efficienc z
Duct insulation requirement Area
Thermostat
❑ Packaged Unit
�umar
❑AFUE
❑ COP
Over 40 ft of ducts added or
❑ Setback
dooCoil
�3EER
❑ HSPF
replaced
laced in uriconditioned space Served b system
p p Y Y
(ljnot already
l�ndensing Unit
❑ EER
_
❑ Resistance
❑ R 6 (CZ /:Q -l3) sf
present, must be
❑ Other
❑ R 8 (CZ 14-15)
installed)
1. Equipment Type: Choose theequipment being installed. ijmore than onesystem, use another CF-1R-ALT-HVACforeach system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfortypical 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 CF4R forms.(no hand filled CF-4Rs allowed) are filled out and
si ned. Beginning October 1, 2010, a registeredcopy of the CF -IR and CF -6R shall also be on site for final inspection.
HVAC Changeout
Required Forms:
•All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21. and (fors lits stems) MECH-25
• Condenser Coil and /or
• Indoor Coil and/or
CF -6R forms: 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
For Packaged Units: Duct leakage < 15 percent
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
❑ 2. New HVAC System. Required Forms:
with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
• Cut s: al Chang ducting
ducts: (all new ducting and all
.new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA 2:350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage <6 percent
❑ 3. New Ducts with Replacement
'Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04; MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor
CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA 2:300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
• Includes addine, or replacing more than 40
linear feet of duct in unconditioned space.
CF -6R fors: MECH-04, MECH-2I-HERS CF4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent '
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• 1 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 cenifv that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
1'atu-i-and- i_of-the-Califomia-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 thrpermit application.
Name: ✓% ` /�
Signature:12
Company:
54
ate:
Address: �j Seo6�
.
t
License:
15 d�
•City/Statc2ip:CA
4a,- �
Phone:lf-
2008 Residential Compliance Forms March 2010