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09-0377 (MECH)P.O: BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09=0.0:000377-_�- Property Address: 55221 -RIVIERA APN: 775-153-012- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7800 Applicant: Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I 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. License Class: /C20 License No.: 374937 OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I 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 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 7000) of Division 3 of the Business and Professions Code) or 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).: (_ 1 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 _ 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 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: KIMITO YAMAMICHI 55221 RIVIERA LA QUINTA," CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 4/28/09 Contractor: PALM DESERT AIR CONDI 42081 BEACON HILL PALM DESERT, CA 92211 (.760)346-0677 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 t�a ?have _Qfhave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor 1 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 238-0004656-08 I 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 Q37000 of the Labor Code, I shall forthwith co with those provisions. at te: ZO L pplicant: �- 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 1$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 with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of t is county to enter upon the above-mentioned property for inspection purpos Date: i ignature (Applicant or Agentl:`-��o Application Number . . . . . 09-00000377 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 42.50 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/25/09 Qty Unit Charge Per Extension BASE FEE 15.00 .00 9.0000 EA MECH FURNACE <=100K .00 1.00- 11.0000 EA MECH FURNACE >100K 11.00 .00 9.0000 EA MECH B/C <=3HP/100K BTU .00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE 1 EXISTING 3 TON SYSTEM WITH 1 3 TON 16.00 SEER SYSTEM ---------------------------------------------------------------------------- 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 8.25 .00• .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.75 .00 .00 51.75 LQPERMIT Certificate of Compliance Prescriptive Method -'HVAC-only Alteration CF -1R -ALT Project Title: KIMITOYAMAMICHI Date: 04/28/09 © CaICERTS 2005 ,,.Enforcement Agency Use Only Project Address: 55-221 RIVIERA/LA QUINTA Climate Zone: 15 Building Pemvt # ° , Documentation Author: KimberlyGarcia' Telephone: 310-948=3698 Alan check Date Company Name: Palm Desert Air Conditioning & Heating Company 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 t. systems altered in this -house. . Check all lines that aRpjy. Check only lines that apply Scope of Alterations: 1 ❑ An Air Handler is to be installed or re laced. Duct sealing to be determined. Continue to next line. 2 ❑� Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 ❑p n outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4 El A cooling or heating coil is to be installed or replaced. Duct Sealing and/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 ❑ Ilf 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. uired. 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 revious CF -4R forn. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing isrequired. Go to Section 2. Note: 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 sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AND EER 12 condenser will be installed with TXV(RCA) D added duct insulation R-4 wrap on eAsting 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 AHQ EER 12 condenser will be installed with TXV(RCA) AND 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 Ah Q EER 12 condenser will be installed with TXV(RCA) ,AND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 D INone 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 system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 ❑D IThis 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 O If line 15 is checked, HERS verification is required for Duct Sealing. 23 0 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 ❑ If 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 us--iu-uts 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 -1 R -ALT Project Title: KIMITO YAMAMICHI Date: 04/28/09 ©CaICERTS 2005 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 ,# I of t 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 efficiencies/R-values. 28 Configuration: ® Split system O Package Unit 29 ❑ Air Handler mGas furnace, AFUE: a0% ❑Heatpump FAU ❑Hydronic FAU ❑Other 30 © Heat Exchanger 31 D Outdoor Condensing Unit ®AIC OHeatpump ,Efricien SEER/HSPF: 16.00 / wn EER f re d : 32 IZI Cooling or heating coil ®AIC ❑Heatpump ❑Hydronic 33 ❑ Ducts Location: Length (ft): R -value: All mandatory measures apply to any, altered component. 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 Author Name: Name: Kimberly Garcia Address: Company Name: Palm Desert Air Conditioning & Heating Company City/State/Zip: Address: 42-081 Beacon Hill Phone: City/State/Zip: Palm Desert, CA 92211 Phone: (760) 346-0677 Signature: Signature: Enforcement Agency Building Department) Notes/Co a s: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CF -1 R -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. CF4R-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. "" " "'-"" Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Bin # Qty of LQ Quints Building 8i Safety Division Q P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 55-221 RIVIERA Owner's Name: KIMITOYAMAMICHI A. P. Number: Address: 55-221 RIVIERA Legal Description: Contractor: Palm Desert Air Conditioning & Heating Company City, ST, Zip: LA QUINTA, CA 92253 telehone: p �'�•'�'!�4`i'ii$jifv" �Y:i::r :<:�{.{;f: :ii:�';: Address: 42081 Beacon Hill Project Description: City, ST, Zip: Palm -Desert, CA 92211 LACE 1 EXISTING 3 TON Telephone: (760) 346-0677 :<;:<f:>'z^�s>•><.; .::::;:>::::>::::i:>::s>::. ii;?:y:v;<:F SYSTEM WITH 1 3 TON 16.00 State Lie. # : 374937 CityLic. #: 100886 Arch., Engr., Designer: S EE R SYSTE M Address: City., ST, Zip: Telephone: :'•.`•<>l:v:>:::;:• ,:._ :..,:::::::. •.:>::>::: r: p :. :;;> •M:::«s=-:x>:»>: ' State Lie. #: <'s :.;•%ss«;::.;::>.>:»>::>:;:.<. <; '�'�'<'::•;'•vim'::•f.��.z;«�-;>:,":•: Construct ion Type: Occup Project a I type (circleone): New Add'n ter epair Demo Name of Contact Person: Kimberly Garcia Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: (760) 346-0677 Estimated Value of Project: $6,473.00 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 Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: '"' Review, ready for corrections/issueDeveloper Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Ca10ERTS 2� r] co PY �• CERTIFICATE OF FIELD VERIFICATION R DIAGNOSTIC TESTING (Page 1 of 8) CF -4R 55 221 Riviera - La Ouinta, CA 92253 Palm Desert Air Conditioning & Heating / 374937 Project Address Contractor Name / License No. Palm Desert Alr Conditioning & Heating 09-00000377 Contractor Contact Telephone Permit Number P 1 Van Viymen 760-777-1724 126673 H8R5 Rater Telephone Sample Group Number i r 1 May 12, 2009 CC14-1798467249 —���� Date Certificate Number Certifying Signature Firm: Air Experts Air Conditioning HERS Provider:Ca10ERTS, Inc. City/State/Zip: La Quints / CA / 92247 Street Address: PO Box 94 Copies to: Homeowner HERS Provider and Building Department This CF -411 has been registered with the CaICERTSO registry In accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was aested 9 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape Is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth —6-A a ihpeivP duct tape to seal leaks at duct connections. NEW CONSTRUCTION Measured Dud Pressurization Test Results (CFM @ 25 Pa) Values N/A 1 Fan Flow: Calculated (Nominal '._.'Cooling Heating) or'•-.•' Measured Not Tested 2 Enter Total Fan Flow in CFM: _ N/A 3 P. ! if Leakage ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow In CFM from CF -6R: Pre -Test of Existing Dud System Prior to Duct Not Tested 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM: Final Test of New Dud System or Altered Dud System for Not Tested 5 Duct System Alteration and/or Equipment Change -Out. Enter Reduction In Leakage for Altered Dud System Not Tested 6 [Une 4 - Line 5] - (Only If Applicable) Not Tested 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage < 6% [ 100 x (Une 5 / Line 2 )]: Not Tested TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: Pass If Leakage Percentage < 15% [ 100 x ( Une 5 / Une 2 )]: 10 Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Une 2 )]: Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 it )] and Verification by Smoke Test and Visual Inspection 12 Pass If Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection Pass if One of Lines #9 through #12 pass ot Tested N Not Tested N/A Pass U Fail Pass ❑ Fall Pass ❑ Fall Not Tested I ❑ Pass ❑ Fall Pass Ll Fall Pass ❑ Fait Ca10ERTS .z` 'CF -4R CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8 55 221 Riviera - La Quinta, CA 92253 Palm Desert Air Conditioning & Heating / 374937 Project Address Contractor Name / License No. Palm Desert Air Conditioning & Heating 09-00000377 Contractor Contact Telephone Permit Number 9E7 n 760-777-1724 126673 Telephone Sample Group Number r J` ` 1- 1 May 12, 2009 CC14-1798467249 Certifying Signature �/ Date Certificate Number HERS Provider:CaICE US, Inc. Firm: Air Experts Air Conditioning City/State/Zip:la Quinta / CA / 92247 Street Address: PO Box 94 CODies to: Hom ownerf HERS Provider and Building Department This CF -411 has been registered with the CaICERTSO registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTSO is an*approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was OTested `0 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the di a nostic tested compliance requirements as checked on this form. The Installer has provided a copy of the CF -611 Installation Certificate). 'THERMOSTATIC EXPANSION VALVE TXv : Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. HVAC System TXV ElPass ❑Fall