13-0619 (MECH)414
P.O. BOX 1504 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: 5/16/13
Application Number: • 13-00000619 Owner:
r
Property Address: 77440 VISTA ROSA HAMMER MICHEAL
APN: 658-220-021- - 77440 VISTA ROSA `
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL . (
Application valuation: 39349 D
Contractor: A.�,��/ C 9
Applicant:_ Architect or E gineer: DESERT AIR CONDI I G, 1■i�l. 6 2013
590 WILLIAMS ROAD
PALM SPRINGS , . CA 9 2 6 CITY OF LA QUINTA
(760) 3.23'-3383 FINANCE DEPT..
Lic. No.:,276586
LICENSED CONTRACTOR'S DECLARATION - - - WORKER'S COMPENSATION DECLARATION -
` I hereby affirm under penalty of perjury that I am 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 BusinUandfessionals 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
LicenseClass: C20-C43•,. licenseNo.: .276586 for bySection 3700 of the Labor Code, for the performance of the work for which this permit is
-/��S-Tissued.DatContractor. .. 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: `
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the F Carrier EVEREST NATL Policy Number 7600007908121 -
- following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ 1 certify that, in the performance of the work for which this permit is issued,,) 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, Wshobeca 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 ' _ 3706 of the Laborthwith 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•1any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date•• 'Applicant• -
(_ ) 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 (Seca 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 ADDITIONTOTHE 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
(_ 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 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 performed under or pursuant to any permit issuedas a result of this application,
I—) 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
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 daysfrom date of issuance_ of such permit, or cessation of work for 180 days Will subject
CONSTRUCTION LENDING AGENCY permit to cancellation.
I I hereby affirm 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 a4ve info mation 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 build' - cons ction, and hereby authorize representatives
of this county to enter upon the above-mentioned prope r in ction purposes.`
Lender's Name:
�Date:30;4'q Signature (Applicant or Agent):
Lender's Address:
LQPERMIT
LQPERMIT -
Application Number 13-00000619
Permit - MECHANICAL
Additional desc .
Permit Fee . . . 91.50 Plan Check Fee
22.88
Issue Date Valuation . . . .
0
Expiration Date .. 11/12/13
Qty. Unit Charge Per
Extension
BASE FEE
15.00
3.00 :9.0000 EA MECH FURNACE 5=100K
27.00-
3.00 16.5000 EA-. MECH B/C >3-15HP/>100K-500KBTU
49.50
----------------- ----------------------------------
Special Notes and Comments
REPLACE (3.) SPLIT SYSTEM ON GROUND LIKE
FOR'LIKE 13 SEER HVAC CHANGE OUT/78o
AFUE SPLIT SYSTEM ]2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CBC-
------------ ---------- -------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
1.00
..
Fee summary_ Charged Paid Credited
Due
---------- ---------- ----------
Permit•Fee Total 91.50 .0.0 .00 -----91.50
Plan Check Total 22.88. .00 .00
22.88 .
Other Fee Total 1.00, .00" 00
1.00
Grand Total • 115.38 .-00 .00
115.38
LQPERMIT -
Bin #
City of La Quinta
Building &I Safety Division
Permit #
P.O. Box 1504, 78-495 Calle TarnPico
\
(a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 7 ;g
0.'i Owner's Name: C—
A. P. Number:
Address: vtk A S A
Legal Description:
City, ST, Zip: -5A wqk e° 120 3
Contractor: Desert Air Conditioning Inc. Telephone;
Address: 5 9 0 William Rd Project Description: a,c j }
City, ST, zip: p 1
o c•% �c Coe -
Telephone: ('7 6 0) 3 2 3— 3 3 8 3
11010,110t� L�
State Lic. #: 276586
City Lia & 3 6 3
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone;"A
}
` "'""= Construction Type: Occupancy:
State Lic. #:
_„-;<' `.'_ Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: a C, Je,1; ,nQ ZAL ;,< Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person:( 7 6 0)
3 2 3 — 3 3 8 3 Estimated Value of Project: '�% f • O
APPLICANT: DO NOT WRITE BELOW THIS LINE
N Submittal Req'd Reed 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 Valance •
Title 24 CalcL
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21” Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE--
'"' Reylew, ready for correctionsfissue Developer Impact Fee
Planning Approval
- Called Contact Person ALP P.
Pub. Wks. Appr
Bate 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:
Enforcement Agency:
Date:
Permit #:
77-440 VISTA ROSA 3 OF 3 La Quinta, CA 92253
City of La Quin ta
May 15, 2013
Duct insulation
Conditioned Floor
Equipment Typei
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE _ 78%
® SEER 13.0
E3 COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
p EER
[3 Resistance
O R 8 (CZ 14-15)
1200 sf
installed)
O Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC for each system:
2. Minimum Equipment Efflclencies: 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 -611 and registered CF -411
forms (no hand filled CF -411s allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -111
and CF -6R shall also be on site for final inspection.
® 1. HVAC Changeout.
Required Forms:
. All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -611 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 <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
[11. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
[12. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4'. The system:lwill not be Ducted (ie Ductless;Mini-ySplit_S.ystem);(Also-Exempt fromrRefrigerant Charge)
112. New.HVAC System
Required Forms: f„ `rr
. Cut in .. Changeout with
new ducts: all new ,
(
='.
CP-6R•forms. MECH-04, MECH 20 -HERS, and (for split systems) MECH ;22 -HERS, and
ducting and all new, -.,=CF
equipment) . , t�• .. "�.
MECH 25=HERS +
4R forms{,MECH-20, +dT(for split sy ie s MECH 22 a d MECH-25 ,
_: y ._
For Split Systems: Duet leakage <c 6 percent; RC`CCA`>_"350 CFM/ton; FWD, 'TMAH, SIMS, and`eitlier HSPP or`PSPP. "
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
• Includes replacing or installing all 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 -411 forms: MECH-20 and (for. split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
O 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 dud in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
p EXCEPTION: Existing dud 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: Jacqueline Zabik Signature: Jacqueline Zabik
Company: DESERT AIR CONDITIONING INC Date: May 15, 2013
Address: 590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
Reg: 213-A0029457A-000000000-0000 Registration Date/Time: 2013/05/15 17:33:18 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
77-440 VISTA ROSA 2 OF 3 La Quinta, CA 92253
City of La Quinta
May 15, 2013
Dud insulation
Conditioned Floor
Equipment Typel
List'Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
H AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (cz to-13)
Served by system
® Setback
If not already present, must be
®Condensing Unit
[3 EER
[3 Resistance
13R 8 (CZ 14-1s)
2000 �
installed)
[3 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 Efflcienc/ese 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-611 and registered CF-411
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-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-411 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 <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
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
[14. The system will not be Ducted (ie �Ductless{Mini _Split System) (Also..Exempt fromzRefrigerant°Charge)
❑ 2. New=HVAC System
Required Forms. f y
• Cut in or Changeout with-.-'-'-'
CF 6R forms:'MECH-04, MECH=:20=HERS; and (for split systems) MECH-22 HERS, and
new duds: (all new ,
=all
ducting new._ i
MECH 25 HERS
"CF 4R forms 20, and (for spUt systems) MECH-22'a`nd MECH-25 ,fir
e ui merit
;M
hl I
For Split Systems: Dud leakage' <!6 percent, RC _CCA* 350-CFM/ton; FWD; TMAH; SIMS, and either HSPP or-PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3: New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all 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-411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < b 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 40CF-611
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: Jacqueline Zabik - Signature: Jacqueline Zabik
Company: DESERT AIR CONDITIONING INC Date: May 15, 2013
Address: 590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
Reg: 213-A0029455A-00000000070000 Registration Date/Time: 2013/05/15 17:30:57 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - IS
Site Address:
Enforcement Agency:
Date:
Permit #-
77-440 VISTA ROSA 1 OF 3 La Quinta, CA 92253
City of LaQuint I
May 15, 2013
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil '
® AFUE 78%
® SEER13.0
❑ COP
❑ HSPF
13R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
®Condensing Unit
❑ EER
❑Resistance
❑ R 8 CZ 14-15
(� )
��-�
installed)
Q 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°x6 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 -611 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 -IR
and CF -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
• Indoor Coil and /or
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF -411 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
Exempted from dud leakage testing if:
❑ 1. Dud 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
❑ 4. They .ystem-.will not be Ducted (ie "ctiess,Mini Split System),,( lso Exempt from RefrigeEantiCharge)
❑ 2. New VACS stem
y
Re wired Forms•
q c
.Cut in,oe.Changeout with
new ducts: (all news
' F a '440, t:cra
CF 6R -forms ,MECH-04, MECH'20-HERS, andx(for,split systems) MECH,22 HERS, and
k
`1
ducting and all new +r
i1
MECH 25aHERS a r r! yr' ,
CF4Rforms - . At -
'aM..ECH 2.,0_, a�nd+(for spl_it.
equipment) �..
�..sstems),MECH-22;and'MECH-25
.s,
For Split Systems: Duct leakage zy6.percent, RC CCAS>r350-�CFM/torr; FWD; TMAH -SIMS, and either HSPP or`PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all 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 -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
O 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 -411 forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing dud 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 agencyfor approval with the permit application.
Name: Jacqueline Zabik Signature: Jacqueline Zabik
Company: DESERT AIR CONDITIONING INC Date: May 15, 2013
Address: 590 WILLIAMS ROAD License: 276586
City/State/Zip: PALM SPRINGS / CA / 92264 Phone: (760) 323-3383
e
Reg: 213-A0029454A-000000000-0000 Registration Date/Time: 2013/05/15 17:28:46 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010