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11-0207 (MECH)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: 2/28/11 Application Number: 11^0.0.0.00207 Owner: Property Address: C52685—AVENIDA OBREGON CONTRERAS ANGIE APN: 773-284-021-8 -000000- 52685 AVENIDA OBREGON Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL (760) 485-7177 Application valuation: 6200 r Contractor: Applicant•�% Architect o Engineer: J ANTHONY PLUMBINGM/AIR}�/j72216 NORTH SHORE SCC/THOUSAND PALMS, CA^O�q/4� (760)343-2121[ 1Lic. No.: 777794 010ffY OF A --------------------------------------------------------------- --------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (comme elhg with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professio Code, and my.Lir, nsa is in fu rce and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Cla C29-1236 License 94 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 9TX�:)ate. � (Contr- a o :- — _ _ 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 STATE FUND Policy Number 1932451 following reason (Sec. 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 o 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 become subjec to the workers' comp sation provis' of Section _ License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or _ 37 0 of the Labor Code, all fo comply ho ovision 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).: Dat T'/Applic� ant: 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 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 _ 1 1, 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 _ 1 I am exempt under Sec. , BAP.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.I. Lender's Name: _ Lender's Address: LQPERMIT WARNING: FAILURE TO SECURE WORKERS' 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. I certify that I have read this application and state that the above information is correct. I agree to comply !1 all city and county ordinances and state laws relating to building construction, he authorize repres9tives of this unty o en er upon the above-mentioned propert/y fo/c.+�pe ur es. �� / Signature (APPI� icanto Ag`ehtl:-! Application Number . . . . . 11-00000207 Permit MECHANICAL INV FEE Additional desc . . Permit Fee . . . . 66.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/27/11 Qty Unit Charge Per Extension BASE FEE 30.00 1.00 18.0000 EA MECH APPL REP/ALT/ADD 18.00 1.00 18.0000 EA MECH B/C <=3HP/100K BTU 18.00 ---------------------------------------------------------------------------- Special Notes and Comments INVESTIGATION FEE ASSESSED PER 2010 FOR WORK BEGUN WITHOUT BUILDING PERMIT.HVAC CHANGE OUT 3 TON 15 SEER HEAT PUMP PACKED UNIT. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473). 1.00 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 66.00 .00 .00 66.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 75.25 .00 .00 75.25 LQPERMIT Simplified Prescriptive Certificate of.Com liance: 2008 Residential HVACAIteradons CF -IR -ALT -HVAC Climate Zones 10 to 15 Site res : Q V6 Q1 Db OBl'� G-0�1 En orcement Agen Date: ZSs Permit #: ,6 Z Equipment T ' List Minimum Efficienc 2 Duct insulation requirement Conditioned Floor Area Thermostat Q Packaged Unit O Furnace O AFUE_ O COP Over 40 ft of ducts added or Setback O Indoor Coil 42SEEROrHSppZ-7 replaced in unconditioned space Served by system (Ifnot already O Condensing Unit O EER O Resistance ❑ R 6 (CZ /0./3) ( 2_0D sf present, must be O Other OR 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment beinginstalled: if more than one system• use another. CF -1 R -AL T -HVA Cfor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 789,6AFUE, 7.7HSPFjortypical 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and si ed. 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 replaced CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH- 25 -HERS CF -411 forms: MECH- 21 and fors lit 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-411forms: 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 Fxempted from duct leakage testing if: �❑ 11 Duct system was documented to have been previously sealed and confirmed through HERS verification, or lift. Duct systems with less than 40 linear feet in unconditioned space, -or O 3. Existing ducts stems are constructed, insulated or sealed with asbestos 0 2. New HVAC System Required Forms: with new CF -6R forms: MECH-04, MECH-20-HERS,and for lit • Cut s- al Chang outducting ducts; (all new ducting and'all ( split systems) MECH-22-HERS, and MECH-25-HERS CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) 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 Fotrms: •, 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 CF4R 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 0 4. New Ducting over 40 feet Requited Forms: • Include, adding or replacing more than 40 linear feet of duct in unconditioned space. CF -611 forms: MECH-04, MECH-21-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 Com liance. • 1 cenifi that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requiremen Title 24, Parts I and 6 of the Califomia Code of Regulations. • 'i he design features identified on this Certificate of Compliance are consistent with the infomtation documented o eraI le mph form worksheets. calculations, plans andspecifications sub(pitted to the enforcement agency forapproval with the permit a n. ' Name: ISignature: lam► -AZ-► ll\`�� I ' // ��,,((��'/ Com �h/ v �l.�V'1"t ��1� V'' �'f� Date •�l� �� 10 \ License: City/Statc/Zip PIZLU,--VZ Phone: V l ' ZUUo nes•taenttat c.ornpltance Forms March 2010 Bin # City of La QuInta Bi iiding.8t Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Qulnta, CA 92253 - (760) 777-7012 Building Permit. Application. and Tracking Sheet Project Address: Owner's Name: } A P. Number. Addtess: Z675S AUA o C ..7 Legal Description: City, ST, Zip: G ZZS�-s Contractor: J ANTHONY SERVICES ?Co)Telepho e Co Address: THOUSAND PALMS, CA 92276 Project Description: City, ST, Zip: ••.� / �� by Telephone7?607 13 `Z (� State Lic. # : -% City Lie.4, ink /J Arch., Engr., Designer. Address:r An City., ST, Zip: M APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Plan Sets • Structural Calcs Trans Calcs. 11tie 24 Calcs. Flood plain plan Grading plan Subcoutactor List Grant Deed Req'd Reed TRACIMG Plan Check submitted Reviewed, ready for corrections Called Contact Person Plans picked up Plans resubmitted 2id Review, ready for correctionstissue Called Contact Person Plans picked up PERMIT FEES Itwn ' Amount Plan Check Deposit Plan Check Balance Construction ' MechaNcal Electrical Plumbing SALL H.O.A. Approval Plass resubmitted . Grading IN HOUSE:- Planning Approval '^' Review, ready for corrections/issue Called Contact Person Developer Impact Fee A.LP.P. Pub. Wks. Appr Date of permit issue Schodl Fees Fees il