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13-1551 (MECH)P.O. BOX 1504 - 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: r__ jill.— d3oa 0 Property Address: 56634 RIVIERA APN: 762 -023 -004 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: -7SOO Applicant: Architect or Engineer: �v ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 lcommencing with Section 7000) of Division 3 of the Businnd Professionals Code, and my License is in full force and effect. License Clas . 0 89774 Jr —U-0 , X —3 Dat!�3 Contractor: e OWNER -BUILDER DECLARATION I 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 fcommencing 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 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, 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 contractors) 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: LQPERA1IT Owner STEPHAN LEONOUDAKIS 56634 RIVIERA LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/02/13 ----------------------------------------------- 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 VC issued. -ave 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 WEST REPLC SRV Policy Number IAWC311850 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 I 00 of tl��ehatabif I � "u1come subject to the workers' compensation provisions of Section L or _,_ 'I I forthw ly with those provisions. DOC, Applicant�/_ ZZ 17 (09.� 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, a9d the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that - bove mf mation is correct. I agree to comply with all ,�cons ,g il!i$ trour city and county ordinances and state laws relatir c to Pd ction, and hereby authorize representatives of th4sco4uly enter upon the above-mentioned pr fZ inspection pu _4 P17 Date Signature (Applicant r__ jill.— d3oa 0 Contractor: :10 PERFECT WEATHER P.O. BOX 13308 PALM DESERT, CA 922SS (760)770-0404 Lic. No.: 897743 ----------------------------------------------- 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 VC issued. -ave 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 WEST REPLC SRV Policy Number IAWC311850 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 I 00 of tl��ehatabif I � "u1come subject to the workers' compensation provisions of Section L or _,_ 'I I forthw ly with those provisions. DOC, Applicant�/_ ZZ 17 (09.� 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, a9d the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that - bove mf mation is correct. I agree to comply with all ,�cons ,g il!i$ trour city and county ordinances and state laws relatir c to Pd ction, and hereby authorize representatives of th4sco4uly enter upon the above-mentioned pr fZ inspection pu _4 P17 Date Signature (Applicant Application Number . . . . . 13-00001551 Permit . . . . . . MECHANICAL 2013 Additional desc Permit Fee 71.50 Plan Check Fee .-00 Issue Date *. . . . Valuation . . . . 0 Expiration Date . . 5/31/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH-FURNACE 35.75- 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - 14SEER/78AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 20.10 CALIFORNIA BUILDING CODES. ----------------------------------------------------- ---------------------- Other Fees . . . . . . . . PERMIT ISSUANCE M/P/E 90.57 .. PLAN CHECK, MECHANICAL 47.66 Fee summary Charged Paid Credited ---------- ---------- Due ----------------- ---------- ---------- Permit Fee Total 71.50 .00 ..00 71.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 138.23 .00 .00 138.23 Grand Total 209.73 .00 .00 209.73 LQPERMIT Bin # City 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 # Project Address: /?I vt'e- ro,_ Owner's Name: k/ A. P. Number: Address: 5?663el Legal Description: S*;,116 /a- -fal "Olt A, City, ST, Zip: ZA_ —rPI Contractor: ParA%�� &blp�_c_lr -Telephone: Address: 90 Project Descr*iption: &J I77i_ City, ST, Zip: P6 Jm D ec erT- , CA- ;��,(2_ Telephone: . . . . . . . . . . . . State Lic. # City Lic. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person: . . . . . . . . . . . . . . . . . . . . . . .......................... Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # S!Ves: #Units: Telephone. #,of Contact Person: Estimated Value of Proielt16-7 C7 C, APPLICANT: DO NOT WRITE BELOW THIS LINE 11 Submittal Reqld RWd TRACK*lNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 CaIcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionslissue Electrical Sub.contactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.l. 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 1 Site Address: Enforcement Agency: Date: Permit #: 56634 Riviera Dr. La Quinta, CA 92253 City of La Quinta Nov 28, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat H Package Unit [I Furnace 0 AFUE 78% 11 COP [I R 6 (CZ 10-13) Served by system 0 Setback [] Indoor Coil N SEER 13.0 [1 HSPF [3 R 8 (CZ 14-15) 1200 Sf If not already present, must be [3 Condensing Unit 0 EEW [3 Resistance installed) [3 Other_ 1 11 1 1 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 6'p�ropriate 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 -4R 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 -6R shall diso be on site for final inspection. 0 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -6R forms: MECH-04, MECH-21-HERS and (�qr split systems) P49GH 2% WERS replaced CF -4R forms: MECH-21 and (f9F Split G�'St@FAS) MEECH 2-5 • Condenser Coil and /or CF -6R forms: MECH-04, MECH-21-HERS aRGI (fGF Split systems) NEGH 25 WERS • Indoor Coil and /or CF -4R forms: MECH-21 and (fGF Split systems) MEGH 2-5 • Furnace. Far- SpIR Systemsm Duct leakage < 1=5 perGeRtj PC=, C -9-A 300 GZFM�WR (MiRiFRIAM ?FneF#), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: El 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 03. Existing duct systems are constructed, insulated or sealed with asbestos 0 4. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge) 0 2. New HVAC System Required Forms:' Cut in or Changeout with CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and new clucts:�(all new MECH-25-HERS clucting and all new CF -4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25 equipment) 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 113. New Ducts with/or without Required Forms: Replacement Includes replacing or installing all new clucting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R 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 El 4. New Ducting over 40 feet Required Forms: Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-21-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent 0 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 I 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 Cullen ISignature: David Cullen Company: I A S MECHANICAL INC Date: Nov 28, 2013 Address: P 0 BOX 13308 License: 897743 City/State/Zip: PALM DESERT/ CA / 92255 Phone: (760) 770-0404 Reg: 213-AO089564A-000000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2013/11/28 22:49:06 HERS Provider:.CalCERTS,.Inc. July 2010