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08-0824 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, "CALIFORNIA 92253 Application Number: . Property Address: APN: _Application description Property Zoning: Application valuation: X08-00000824 i 54447 RIVIERA 775-031-029- - MECHANICAL LOW DENSITY RESIDENTIAL 5300 BUILDING & SAFETY'DEPARTMENT ' BUILDING PERMIT Owner: JERROLD NOVOTNEY - 54447 RIVIERA LA QUINTA, CA.92253 Architect or Engineer: -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with _ Section 7000) of Division 3.of the Business and Professionals Code, and my License is in full force and effect. LicenClass: C20 License No.: 374937 Date:S�� tractor: . . WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the following. reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the 1• permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or ` that he or sheds 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).: / ( ) 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 (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.). I—) 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 LQPERAfIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/09/08 v AA,A� Contractor: ` I�/i� 0��� PALM DESERT AIR COND CO INC 42081 BEACON HILL ClnOF(q PALM 60)3D46E0677CA 92211 F�fvQ%fO FpINN Lic. No.: 374937 ------------------ 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 STATE FUND Policy Number 238-0004656-07 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, - and agree that, if I should become subject to the workers' compensation provisions of Section D/ .L� 3700 oft Labor Code, I shall forthwith comply with those provisions. •t V ApplicantsJ CNQ WARNING: FAILURE TO SECURE WORPENSATION 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. 1 certify t t I have read this application and state that the above information is correct.' I agree to comply with all city county ordinancesand state laws relating to building construction, and hereby authorize representatives o is county to enter up the above-mentioned property for inspection purposes. Date: �� `� nature (Applicant or Agent): LQPERA11T Application Number . . 08-00000824 Permit . . . MECHANICAL Additional desc . Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Expiration Date 11/05/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.'00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE (1) 5 TON COMPLETE A/C, HEATING SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 33.00 .00 .00 33'.00 Plan -Check Total 8.25 .00 .00 8.25 Grand Total 41.25 .00 .00 41.25 LQPERA11T Certificate of Compliance Pre Iptive Method - HVAC -only Alteration CF -1R -ALT Pr oje i le: Date: low ©CaICERTS 2005 Enfbrdement,A eri . " se' n :. fl�fject Address: clirfiate ne: I3uudmg Pelma # a Docu entation or: Telephone: 7/7/. �r Plan check Date =: Com y ame: �/� � Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing home Use one form for each system being altered. This is system # t of systems altered in this house. Check all lines that apply. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 20 A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 rQ An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4� coolingor heatingcoil is to be installed or replaced. Duct Sealingand/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entire duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Not If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealin and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 ANIIEER 12 condenser will be installed with TXV(RCA) D added duct insulation R-4 wrap on e)dsting ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 ANQ EER 12 condenser will be installed with TXV(RCA) D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AUn EER 12 condenser will be installed with TXV(RCA) ND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 None of lines 7-14 above are checked. Duct Sealing is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ This s stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 2 is system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) is required. Go to Section 3. Section 3 - HERS Rater verification 22\ If line 15 is checked, HERS verification is required for Duct Sealing. 2 � If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RCA). 24 ❑ If line 12, 13 or 14 are checked, HERS verification is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List in Section 6. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ 11f less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R-4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT Pro' t Title: Date: ©CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is yfifi for use when an HVAC -only alteration is made to an existing home Use one form for each system being alt9fed. This is system #___L_ of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed efriciencies/R-values. 28 Configuration: plit system ❑ Package Unit 29 ❑ Air Handler as furnace, AFUE: ❑Heatpump FAU ❑Hydronic FAU ❑Other 3tqo Heat Exchanger 31Outdoor Condensing Unit MC ❑Heatpump lEfficiency SEER/HSPF/ JEER if re d : 32A Cooling or heating coil C ❑Heat ump ❑H dronic 33 Duds Location: Length (ft): R -value: All mandatory measures apply to any altered corn onent. See MFA R -ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation thor Name: Name: Address: Company Name: City/State/Zip: Address: PALM DESERT AIR CONOITIONING COMPANY Phone: • City/State/Zip: PALM DESERT, CA 92211-5107 (760) 346-067/ Phone: Signature: Sig e: Enforcement Agency (Building Department) Notes/C ments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CFAR-ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. wvvw.calcerts.com Bin # Qtyu of LQ Quinta B%ilding & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �• Project Address: . V Owner's Name A. P. Number: Address:LV Legal Description: City, ST, Zip:. , Contractor: telephone: . Address: PAW DESERT 42081 BEACON HILL Project Description: &c� C/:,}:.. City, ST, Zip: (760) 346-0677 Telephone: 'i.:;:�\?}4ii �R}>.i0:}J;}.}:•iitix•fr0.fiwJ x City Lic. #: . State Lic. # : —1 3 Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. # `:fro:^.••iScriix£:ti:5�":<•?'?<#;, `'3;>.H >:':,:,,::;:<.>.;?>. . }', <: • ;>}:;:.:: , ., <;.<>:......> ` . Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Sq. Ft.: #Stories: #Units: Demo J• Name of Contact Person: Telephone # of Contact Person: 0 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 211 Review, ready for correctionsrssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.1. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' 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