13-0410 (MECH)P.O. BOX 1504 �—�^` VOICE (760) 777-7012
78-495 CALLE'TAMPICO \'- ---•- FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &-SAFETY DEPARTMENT , J INSPECTIONS (760) 777-7153• _
BUILDING PERMIT f
Date: 4/04/13 ,•
Application Number: 13-00000410 Owner:
Property Address: 78740 WAKEFIELD CIR DEVEAU CHARLES
• APN: 604-433-010-67, -23995 - *NOT ON FILE
Application description: MECHANICAL UNKNOWN, CA 99999 D d
Property Zoning: LOW DENSITY RESIDENTIAL
ApphCatlOn VdiUadUll: 4500
APR 04 2013
Contractor:
Applicant: Architect or Engineer: JBS MECHANICAL CITYOFIA
OUTSIDE CITY LIMITS
FINAAIQUINTA
CE
328 E. COMMERICAL ROAD #114' OEP7.
SAN BIC1 . CA 92408
No.: S
y Lic. No.: WC1009326
--------_----------------------------------
• LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury that I am licensed underprovisions of Chapter.9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of' on 3 of the Business and Professionals Code, and my License is in full force and effect. � l have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class—.83.7985 - License No.: SWC1009326 1 . for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ,
�•y �^ f l - issued.
Date: 4'1 Contractor: 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 3500 Policy Number SECURITY NATL
following reason ISec. 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.sighed 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 /•7 ' any applicant for a permit subjects the applicant to a civil penalty of -not more than five hundred dollars ($500).: Date: 4 bi -13 . Applicant: C�
(_) 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 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 ($100,0001. 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 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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 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 -1 whose benefit work is performed under or pursuant to any permit issued 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, agents and employees for any act or omission related to the work being
_ - performed under or following issuance of this permit. J
Date: Owner: 2. Any'permit issued as a result of this application becomes null and void if workis.not commenced
within 180 days from date of issuance of such permit, or cessation of work for ISO days will subject
•CONSTRUCTION LENDING AGENCY - • . permit to cancellation. '
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 above information is correct. I agree to comply with all
work for which this permit is issued (See. 3097, Civ. C.). . city and county ordinances and state laws relating to building construction, and hereby authorize representatives ,
+ • - - - ,. • of this county to enter upon the above -mention_ ed property for inspection purposes.
Lender's Name:
Name: • " ,._' Te+ -
', Date:914411:N_Signature (Applicant or Agent):
Lender's Address:
LQPERMIT - i ` e • - .
Application Number 13-00000410
Permit MECHANICAL
Additional desc .
Permit Fee 42.50 - Plan Check Fee
10:63
Issue Date . . . . Valuation
0
Expiration Date 10/01/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
.1:00 11.0000 EA MECH FURNACE >100K
11.00
1..00 16,5nnn Fa mprH R/r >1-15HP/>100K-500KBTU
16.50
Special Notes and Comments
HVAC CHANGE -OUT - 14.5 SEER/AFUE 78, (1)
5 TON AIR CONDITIONER. {2008 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2010
CALIFORNIA BUILDING CODES.
---------------------------------------------------------
Other, Fees . . BLDG STDS ADMIN•(SB1473)
1.00.
Fee summary Charged Paid Credited
------ ----
Due
----------------- ----------
Permit Fee Total -42.50 .00 .00
-
42.50
Plan Check Total 10.63 .00 .00
x0.63
Other.Fee Total 1.00 .00 .00
1.00
Grand Total 54.13 .00 .00
54.13
•
l
LQPERMIT
04/04/2013 01:42PM 8187353575
IPERMIT ERATERS
PAGE 02/11
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04/04/2013 01:42PM 8187353575 IPERMIT ERATERS PAGE 03/11
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations,
CF -111 -ALT -HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency:
Date:Permit #:
78-740 Wakefield Circle La Quanta, CA 92253 County of. Riverside
Apr 4, 2013
Duct Insulation Conditioned R
or
Equipment Typel List Mlnlmum Effidency2 requirement Area
Thermostat
E) Package Unit
® Furnace 119 AFUE 28% E3 COP D R 6 (CZ 10-13) Served by sy
® Indoor Coll 0 SEER 1%o [3 HSPF 1 sf
em ® Set3ack
If not already present, must be
• Condensing Unit 0 EER E3 Resistance R 8 (C1 14 -IS)
installed)
0 Other
Y. Equipment type: Choose the equipment being Installed; pmore than one system, use another CF -IR-
T -HVAC ferea syste-
2. Minimum Equlpment EFfFrdenales: 13 SEER, 7896AFUE, 7.7HSPFfor typkal residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration options. The instal
er decides what work is being done
and picks one of the appropriate Options. Each Option It= the HERS measures that must be
nducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector
rifles that the work listed on this
form was in fact the work Completed by the Installer. The Inspector also verifies that each app
oprlate CF -6R and registered CF -4R
forms (no hand filled CF -411s allowed) are filled out and signed.Beginning October 1, 2010,
registered copy of the CF -IR
and CF -6R shall also be on site for final Inspection.
IM 1. HVAC Changeout
Required Forms:
. Ali HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems)1ECH-25-H
=RS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coll and /or
CF-611forms: MECH-04, MECH-2I-HERS and (for split systems)
ECH-75-HRS
. Indoor Coil and /or
CF -411 -forms: MECH-2i and (for split systems) MECH-25
. Furnace
For Split Systems: Duct leakages<.:1'5 percent; RC, CCA S 300 CFM/tan (Minimum Air Flow I
kequirement), TMAH
Exerrlpte2l from:duct.leakage testis �:
...
'•'1':i:lura syistetifi:was. docurrie d,to have been previously sealed .and confirmed throug
HE verification, or
: _Duct Stems;:Vvith`lessAh . 4b'lmear feet in uncondl[foned s ace, or
: 3 EXistinfl:dU2t•systeiris.ace stnicted,, insulated or sealed with asbestos
.4,..t Il not be -::Du d.:Fie ... e e
.:�..,:..: ... ...: -.. ..... ._.. ......
a ..._ .: e
:. � : -.-
. Cut i th.geout.w
ME
new (all ne'° ��
ducti all n .ECH
equip
Por Split%. . .,,.. ,.:,::� e • � e : p . ,y r . "
Por'PadcilgedUt+lts::f3uct:le kag ,,,, a t .. .
6 P.
❑`ff / .Q
"IN
Required Forms.
esu
.... nro.��„ r -
:.:..,.....::.
. Ihctudes%replacing or lnst9IIIn9'a ;new
ducting and/or outdoor 6q4biiAd5unit
CF -611 forms: MECH-04, MECH-20-HERS, a
id (for spli- systems) MECH-25-HERS
and/or Indoor coil and/or fuFrlacl,N6 or some
CF -4K forms: MECH-20 and (for split syste
s) MECH-25
equlpment changed.
For Split SyStems: Dud leakage< 6 percent; RC, CCA z 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
O 4. NeW Ducting over 40 feet lRequIred Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
I CF -41K forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Stateme
)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I'ain eligible under Division 3 of the California Business and Professions Code to accept responsibility fo
I the design identified on this Certificate of
Compliance.
• 1,certify that the energy features and performance specifications for the design identtned on this Certltl
zte of Cornolance 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 docL
mented on either applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for appy
val with the permit application.
Name: Kristin Contreras ISignature. Kristin Contrera;
Company: 3 B S HEATING & AIR INC
Date Apr 4, 2013
Address: 328 E COMMERCIAL ROAD
Licerse: 973084
City/State/Zip: SAN BERNARDINO / CA / 92408
Phone: (909) 915-7509
Reg: 213-AO020024A-000000000-0000 Registration Date/Time: 2013/04/04 12:20.17 HRRS p.=ovider: Ca10ERTS, Inc.
2008 Residential Compliance Forms I July 2010