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12-0728 (MECH)- .Iz. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 CApplication Number: 12-100000728 Property Address: 54220 RIVIERA APN: 775-031-060- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2580 Applicant: Architect or Engineer: UCENS O CONTRACTOR'S DECLARATION 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT hereby affirm under penalty of perjury tham at lit sed under pr ions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus, ss n Pr fessional C a d my License is in full force and effect. LicenseCla s• C20 C36 e e : /82720 rDate � � Contractor: AIX W R-BUI R DECLARATION I hereby affirm under penalty of perju y that I a exempt fr m he Contractor's State License Law for the following reason (Sec. 7031.5, Busi ass and Pr fessions a Any city or county that requires a permit to construct, alter, improve, demolish, o.rgp • y structur , pri • r to its issuance, also requires the applicant for the permit to file a signed statement that he or she is license pur uant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 700 of ivision 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the Ile ad exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civi enalty of not more than five hundred dollars ($500).: (_ 11, as owner of the property, or my employees with wages as their solecompensation, 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.). Lender's Name: _ Lender's Address: LQPERMIT Owner: BEAMS RESIDENCE 54220 RIVIERA LA,QUINTA, CA 92253 Contractor: ALL SEASONS A/C, PLMBG & P.O. BOX 1112 PALM DESERT, CA 92261 (760)568-2663 Lic., No.: 827420 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153- Date: ' 6/29/12 ------------------------------------ ---- 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. 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 _ insurance carrier and policy number are: Carrier NORGUA M INS Policy Number ALWC124752 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner o a become subject tot orkers' compensation laws of California,- and agree that, if I o be co a subject to the or ers' compensation provisions of Section 2 700 of the Labor Co I s II fo p those prov • ns. Date: 'Applicant: WARNING: FAILURE TO SECURE 0 ERS' A N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C INA) ENALTIES AND I IL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN AD TION T THE COST OF 0 PENSATION, DAMAGES AS PROVIDED_ FOR IN SECTION 3706 OF THE LABOR 98 , NTEREST, AND T ORNEY'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 a e inf r ion is torr t. I gree to comply with all city and coun y ordinances and state laws relating to buil n on ction, d he by a thorize representatives of this co—l7fnt to enter upon the above-mentioned prope y or ection p r os ~Date: v -Signature (Applicant or Agent)' LQPERMIT - Application Number . . . . . 12-00000728 PermitMECHANICAL c . Additional des' Permit Fee 31.50 Plan Check Fee 7.88 Issue Date Valuation . . . . .0. Expiration Date 12/26/12 Qty Unit Charge .Per Extension. BASE FEE 15.00 • 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16'.50 ----- Special Notes and Comments AC CHANGE OUT 13.0 SEER ------------------ ---------------------------------------------------------- other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 31.50 .00 .00 31.50 . Plan Check Total 7,.88 .00 .00 7.88 Other Fee Total 1.00 .00 ..00 1.00 ' Grand Total 40.38 00 .00 40.38 LQPERMIT - Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 54220 Riviera La Quinta, CA 92253 City of La Quinta Jun 27, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit p Furnace p Indoor Coll p AFUE 78% 2 SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) R 8 Served by system 1200 sf 0 Setback If not already present, must be p Condensing Unit ElEER ❑ Resistance ❑ (CZ 14-15) installed) ❑ 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% 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-1R and CF-611 shall also be on site for final inspection. D 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-4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Indoor Coil and /or CF-4R forms: MECH-21 and (for split systems) MECH-25 . Furnace 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 ❑ 4. The system will not be Ducted (ie�Ductless+Mini-Split System)•(Als ,Exempi. from;Refrigerrant-''Charge) b �" - ❑ 2. Nevi HVAC System Required Fbrms: f Ji `' I • Cut in•lor Changeout with{ " ` r * ;i " CF 611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH,22-HERS, and new ducts: (all new ductin g all new � N � . MECH,-'25tHERS � � � ,� forms: MECH-20, MECH-22, ` CF-4R and (for split systems) and'MECH-25 equipment) (/ + _., J For Split Systems: Duct leakage < 6 percent; RC, CCA,2: 350 CFM/ton, FWD, TMAH, STMS, and either HSPP"or,PSPP. For Packaged Units: Duct leakage` < 6 percent ❑ 3.. New Ducts with/or without Required Forms: Replacement 1 • 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 toll 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 ❑ 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 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: David Beale Signature: David Beale Company: ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC Date: Jun 27, 2012 Address: 73605 Dinah Shore Drive, Suite 1310M License: 827420 City/State/Zip: Palm Desert / CA / 92211 Phone: (760) 568-2663 Reg: 212=A0033856A-00000000-0000 Registration Date/Time: 2012/06/27 13:23:44 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # Qy of La Quinta Building & Safety Division P.O. Box 1504, 78.495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit C i� Project Address: Owner's Name: PC na t, -;;i VZ✓�� S ' A. P. Number: Address: 6q 2 lzv Legal Description: City, ST, Zip: La Q a j ri f 7t r 1 64 12 -Z5 3 Contractor: � Telephone: D� r��{ �e Address:LAS Project Description: n1cS���,(7}IZ4 /�16122-1 City, ST, Zip: I ( A 61� 1 I Y Y + i ,/ a Ci &VtA e D 1AA Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: :<r#= State Lic. #: Name of Contact Person: Construction Construction Type: Occupancy: Project type circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: -?5S00 U APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted � tem Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan r. 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: ''d 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