13-0767 (MECH), .�
P.O. BOX'1504" �:Y/ 4
f�✓
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT_
BUILDING PERMIT
Application Number: 13-00000767
Property Address: 80100 VISTA GRANDE
APN: 649-141-005-5 -3505 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7533
Applicant: Architect of Engineer:
- - ——LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 30
f the Business d Professionals C e, and my License is in full force and effect.
License Class: C10 C16 C2 Lit n N .: 457554
s
Date: b % Contractor:214�
OV1�NE BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am ex [ 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 ($500).:
1 _ 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.).
(_ 1 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.).
( 1 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.1.
Lender's Name:
Lender's Address: n
LQPERi\71T
Owner:
MALCOLM LEE
80100 VISTA GRANDE
LA QUINTA, CA 92253
(760)347-3855
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/20/13
Contractor:
PREFERRED PLUMBING HTG A
P.O. BOX 5120 JUN 20 2013
PALM SPRINGS, CA 92263
(760)322-3173 CITY OF
Lic. No.: 457554 FINANCEp INTA
EPT. I
-------------------
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
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
issued.
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 EVEREST NATL Policy Number 7600006445131
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I shout come subjeo o tfhrtKers' compensation provisions of Section
3700 of the Labor Cod , shall fort vith c hose pro 6nions.
Appjivant:
WARNING: FAILURE TO SECURE WORKERS O PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 Applicationis 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 ab information is correc I agree to comply with all
city and countyrordinances and state laws relating to buildi nstruction her y th rize representatives
of this cou y-tD enter upon the above-mentioned propert r insp ti purp ses
Da4�
6: ' Signature (Applicant orA�genr t)!
Application Number 13-00000767
Permit MECHANICAL 2013 ...
-. Additional.desc .
•Permit -Fee 35.75 :: Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 1 12/17/13
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT (1) 14SEER/12EER 5.TON
CONDENSOR-AND COIL [2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING CODES.
------------- -- ---
----------------------------------------------------------------------------
Other Fees BLDG:STDS ADMIN (SB1473)
Other
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
23.83
Fee summary Charged Paid Credited'
Due
Permit Fee Total 35.75 .00 00
35.75
Plan Check Total .00 .00 .00
.00
Other Fee Total 115-.40 .00 .00
115.40
Grand Total 151.15 .00 .00
151.15
- - LQPFRAIIT
Bin #
City of lea QU
Building 8L Safety Division
-P.O. Box 1504, 78-495 Calle Tampico
Permit.# La Quints, CA 92253 - (760) 777-7012
:Building Permit Application and Tracking Sheet
,
Project Address: '; :. (-` ` <; .: ✓rr? " '. ....
%rid ; '::: r5 ? G'R AIAr
Owner's Name: M!t o
A. P. Nurnbei .
Address: Sblao I! 7i9
g..•.Pt .Y;:.;a'Le al De C� oo , r
City, ST, Zi Q„�'
j
"ppre en eco : M.7 _Conditioning dbi3
Con �aetbr P> o f �r>^ e �'..P:1 umb i n H e a t i n &A 1
Telephone:
Addiess'
Project Description:
9 2 6City;ST...
sw!; w 'l•N2i
<<
Telephone y (7 6 Q) ,rv3 2 .317 3.6'V
_10A
StateLic. # : 45:7;5:54'.;x::: ,.. CityLic.
O
Address: '-'
City'.ST;
State,Ll#.c:"=.::,;,;:4 >
ME
Construction Type: Occupancy:
PiojecYtype (circle one): New Add'n Alter Repair Demo
Name of:Cotilact Peop `
Sq. Ft,:
# Stories:
#Units:
Telephone""#,of;CoiitaetPerson.:
Esdmaied Value of Project: ' 75.x.3
.;; ::';;;;; • ; .. APPLICANT: DO NOT WRITE BELOW THIS LINE
# .
`Submittal; ::''=:::.' '.:
' : <Reg'd' . . Recd
TRACKING
PERNLtT FEES
Plan Check "ft Itted
Ite
Amount
StrpetpraFCsilts. ...
Reviewed, ready for corrections
Flai Check Deposit
Trdss'Calcs. .'
Called Contact Person
PIN Check Balance
Ener gy'Cales. °
Plans �itcked up
Con traction
Flood plain plan.,,
Plans.resubmitted
Me apical ' '
Grading.plan' ' '..
2nd Review, ready f0i'correctionsAssue
Ele rival
506oiitaetor1lst - .
Called Contact Peron
Plui ibing
Grant Deed .
Plans picked up
S.M L
H.O A, Approval '.
Plans resubmitted
Gra ling
Il`iOUSE:=
''d Review, ready for correctionsrssue
Dev toper Impact Fee
PlanntngApprbval..
Called Contact Person
AM .P.
. Pub. Wks. Appr
Date of permit issue
801001 Fccs '
TotI Permit Fees
SuraUp 'feed Prescriptive Certificate of Compliance: 2005 Residential HVAC Alterations
Climate Zones 10 to 15
ii eYn1 EC� Dyte:.nforcemen!Aen Address:
10 V6
f� fD/Zo
List Minimum
❑ Packaged Unit
❑ Furnace �� AFUE ❑ COP
�ridoor Coil EER ❑ HSPF _
2Condensing Unit SER 11 Resistance
Duct insulation
Over 40 ft of ducts added or
replaced in unconditioned space
❑ R 6 (CZ 10-13)
Area
CF -IR -ALT -HVAC
Permit #:
Floor
Thermostat
erved by system ' (If not already
sf present, must be
❑Other ❑ R 8 (CZ 14-I5) installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R-ALT-HV.9Cfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFOE, 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 forts 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
si . Beginning October 1, 2010) a registered copy of the CF -112 and CF -6R shall also be on site for final inspection
f Yl HVAC Changeout Required Forms.
o All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems MECH-25
s Condenser Coil and /or
C Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MUCH- 25 -HERS
r
a Puace CF -4R forms: MECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/toti(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 ducts stems are constructed, insulated or sealed with asbestos
H
O 2. New VAC System Required Forms:
o Cutin or Changeout with ::LF�6]1
ducts: (all new ducting anforms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new a ui ment FR forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CF1VI/ton, FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 Dercent
❑ 3. New Ducts with Replacement Required Forms:
0 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 > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 Dercent
❑ 4. New Ducting over 40 feet
Includes adding or replacing more than 40
linear feet of duct in unconditioned snace_
uired Forms:
CF -6R forts: MECH-04, MECH-2I-HERS
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 Declaratio St t
CF -4R forms: MECH-21
n
C 1 certify that this Certificate of Compliance documentation is accurate and complete. a ement)
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 Cgrtificate of Compliance con rm 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 inform on documented on other plica le compliance forms, w s eels,
calculations lams ands ecificatious submitted to the enforcement a en fora approval with rmij ti
flame: �' ��L CA -
V�N 5 Signature:
Company: r
Address:®
City/State/Zip
G
Date:
License: / l —7 4+
Phone: ' �
3 ZZ — 3 1'7:3