11-1200 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C-77�7711-00001: 0bb-- -Z
Property Address: C
48246 -VISTA DE NOPAL
APN-
646-110-010- - -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
13042
Applicant:
c& -At 4-.4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STACY LOVE
48240 VISTA DE NOPAL
LA QUINTA, CA 92253
Contractor: .
GENERAL AIR CONDIT
31170 RESERVE DRIV
THOUSAND PALMS, CA
(760)343-7488
Lic. No.: 686310
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/03/11
— � L
G ..�
6 NOV 0 3 201 d
GI'n OF 1-A QUJNTA
F:'1?:"moi"'
-------=-----"-------------------------------- -- — — — — — — — — — — — — — - - — — — — — — — — — — — — — --- — — — — — — — — — — — — — — — — — — - - - - -- -
. - LICENSED CO TRACTOR'S DECLARATION -
- WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I.am licens 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 Profe i als Code, and niy License is in full force and effect.
_ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License CI s: C20 / Lic se No.: 686310
tt
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is '
, - issued.
_ILIZntractor. - '.
" .. 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
-BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
Carrier ZENITH INS CO Policy Number Z071741501 "
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance 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 t come 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 be a 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 L or Code, I s forth ' h 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
i - -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
te: 3 scant:
( 1 1, 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: FAILURE TO SECURE '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 C MINAL 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
(_ 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. I J
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 performed under or pursuant to any permitissued as a result of this application,
(_) 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 a ants and emP to ees for anY act or omission related to the work being
Date:
Owner:
CONSTRUCTION LENDING.AGENCY
1 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:
• 9 Y
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 Jn
essation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state thation is correct. I agree to comply with all
city and county ordinances and state laws relating toon, a hereby authorize representatives
of thi coun�enter�e above-mentioned proses. -
Date: (Applicant or Agent):
LQPERMIT
Application-Number 11-00001200
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13
Issue Date . . . . Valuation . . . .
0
" Expiration Date 5/01/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00. 9.0000 EA MECH FURNACE <=100K.
9.00
1.00 16.5000 EA MECH.B/C >3-15HP/>100K=500KBTU
16.50
Special Notes and Comments
4 TON.HVAC SYSTEM, CONDENSER, COIL &
FURNACE - 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
EQPERMIT ------ -- - ----===_-,--- - ---- - _'._._--'----_". - -_ _.
.
Simplified Prescriptive Certificate of Compliance:- 2008 Residential HVACAlterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Addres :Enfo ement ncy: Date: Permitll:
V2 Conditioned Floor.
Equipment T e� List Minimum Efficiency 2 Duct insolation re uirement Area Thermostat
13 Packaged Unit
urnace ❑AFUE 80 ❑COP
Over 40 ft of ducts added or Setback
�o
ndoor Coil ❑SEER ! 3 ❑ HSPF replaced in unconditioned space Served by system (/J'nor already
idensing Unit ❑ EER' / / ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be
❑ Other I ❑ R S (CZ 14-15) installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R-ALT-HVACfor 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 mast 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
si ed. Beginning October 1, 201.0, a registered copy of the CF -IR and CF -611 shall also be on site for final inspection.
I. HVAC Changeout Required Forms:
• All HVAC Equipment re laced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
P rc AD r---.
2008 Residential Compliance Forms AG -1, 1n to
• Condenser Coil and /or
• Indoor Coil and/or
CF-611forms: MECH-21-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
E.xemptekfrr duct leakage testing if.
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
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
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 > 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 > 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
linear feet of duct in unconditioned space.
m
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R fors: 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)
• 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 I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the ' orm tion documented on other Pplic ompliance forms, worksheets,
calculations, plans and specifications submitted to the enforcement a ency for appro at with t e permit application.
Name: ���eh �/tcSD�
Si lure:
Company: 41"r
"
t�r�►1,B('CDi /•fit^ CDi1GCe `Of'7 t`
Date: l/
Address: 3�1-7
n _tt ✓�
lo"t `
License:
�8�3iv
City/State/Zip: 99JI-7(11
Phone: -7.60 3-74ff�P
2008 Residential Compliance Forms AG -1, 1n to
CaICERTS -. CF- 1R Registration
Page 1 of 1
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CONGRATULATIONS
Your CF -IR -ALT -HVAC Registration is complete!
You may want to print this page for your records.
Site Address: 48240 VISTA DE NOPAL
La Quinta, CA 92253
CEC Registration: 211-A0057106A-00000000-0000
!"T /TT AT T TXT/A! _ f�T rfiV YM. nT? T/ T\/II TT ! A T
Assigned Company: I HARRISON ENTERPRISES INC
Do you know your HERS Rater?
- - - If you do; you may want to -send this CF -IR to them. - - -
CaICERTS Rater ID:
OR_
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If you need to find the rater by name [Click HERE] to search our directory.
I•.��.:�:$END�CF-1R„Tq,HERS RATER,,,;,r,j
[CLICK HERE] to do another
Copyright 02010 CalC[:RfS, Inc. All rights reserved. Revised: January I I, 2010
[Terms and Conditions] [Privacy Statement] [Class Cancellation Policy]
CaICERTS, Inc.,. 31 Natoma St Suite 120, Folsom, CA 95630
Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787)
Fax: 916-985-3402 Contact Us
BBB �irtctusoaFa�e$t3CkQ;!
https://www.ca1c.erts.com/public—cflR.cfin?project—id=147478 11/2/2011
WU
REBATES
GENERAL
Air Conditioning & Heating
31-170 Reserve Drive • Thousand Palms, CA 92276
(760) 343-7488 9 Fax (760) 343-7494
www.calithegeneral.com
Residential CornfortSurvey
INSTALL DATE l (/2 . JOB# s- 3 CUSTOMER#
NAM]
JOBS
CITY
PHONE �� � —,CELL
SEPARATE BILLING ADDRESS? ❑ YES ❑ NO
NEW EQUIPMENT
COND YLa 16 �Y/ 0�22 M
FAX <— OFO U46— !yC—
COIL O� 6
TSTAT
FILTRATION &VV AP
MISC
PERMIT YES ONO j J—'-.//
DUCT WO
NOTES
�`i
EXISTING EQUIPMENT
CONDM#
S#
FAUM#
S#
COIL M#
S#
UNIT LOCATION:
CRANE? ❑ YES
❑ NO SIZE
WARRANTY
PLATFORM SIZE
ATTIC HEIGHT
OPENING
❑ FINANCING • DAYS ❑ CREDIT CARD ❑ C.O.D. ❑ .COSTCO
1
Bin #.
--
Qty of La QuInta
Building 8L Safety Dh4slon
P.O. Box 15.04, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit' Application and Tracking Sheet
Permit'#
Project Address:
Owner's Name:
A. P. Number:
Address: o U t��Av, A ePZk
Legal Description:
City, ST, Zip:
Contractor:
Address:
City, ST, Zip:01�1),,'�
,ors •'::oat:a:.:;itj.t;
Telephone: fix)? ''•<•' S:
,:..._ ...,.:...::.. ,r
Telephone:
Project Description: �t vG
qF
3L
State Lic. # : City Lie. C.(—
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
P
f•:..,:.:: ,
State Lic. #: •;:i
frw
Construction Type: Occupancy:
' Project type (circle one): New 4 Add'n Alter Repair 'Demo
Sq. Ft.: #. Stories: #Units:
Name of Contact Person: p (,(c �u OYU
Telephone # of Contact Person: -7& O 3 .V3 -7-4 Ek Estimated Value of Project:
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets •
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates..,
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2a° 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
Grk,'ling
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