12-0727 (MECH)79816 Arnold Palmer
11111111 VIII III VIII(III 13
P.O. BOX 1504 _ _IE _ _ _ ' 4Q"
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: 6/29/12
Application Number: 12-00000727 Owner:
Property Address: 79816 ARNOLD PALMER JOHN W CAUNT
APN: 775-241-074- - - 79816 ARNOLD PALMER "HTG Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7300 Contractor:Applicant: Architect or Engineer: ALL SEASONS A/C, PLMBGP.O. BOX 1112
PALM DESERT, CA 92261
Olt
(760)568-2663
Lic. No. : 827420
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LICENSED
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LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed er provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 3 of the Bu- ss nd Pr fess'.nal Codes and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Cla s: C20 C36 i ense No.: 827420 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued.
Date: Contractor- _ 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
WN -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of p rjury t t I am axe t from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number ALWC124 752
following reason(Sec.:7031.5.B siness d Profess' s 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,demolis , epair any stru ure,prior to its issuance,also requires the applicant for the person in any manner so a to become subject to the workers'compensation laws of 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 b come to a fs'compensation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 ofthe Labo C hall rth i h (i with hose proYisions.
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).: Date: Applicant: 41-111)
( 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 WARNING: FAILURE TO SECUR W KERS'COMP S ION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO C IMINA PENALTIES ND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDI ON THE COS OF OMPENSATION,DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,A ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_1 I,as owner.of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractorls)licensed - 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. ,B.&P.C.for this reason 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.
Date: Owner: 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 per '-,or ssation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this.application and state that the a ve in or on is orrect. a ree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating to build' const cY n,and h re uth rize representatives
of this countiW enter upon the above-mentioned propert f r in ti n purpd?;e
Lender's Name:
Date: P15 Signature(Applicant or Agent): 1244
Lender's Address:
LQPERMIT
Application Number . . . . . 12-00000727
Permit . . . MECHANICAL
Additional desc .
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 tl::
79-816 Arnold Palmer La Quinta, CA 92253 City of La Quinta Jun 26, 2012
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑Package Unit
p Furnace @ AFUE 78% [3 COP O Setback
p Indoor Coil @ SEER 3 0 [3HSPF E)R 6(CZ 10-13) Served by system If not already present, must be
p Condensing Unit ❑EER �- ❑Resistance C)R 8(CZ 14-15) 1200 sf installed)
❑Other
1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-SR-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-6R 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-1111
and CF-611 shall also be on site for final inspection.
1. HVAC Changeout Required Forms:
•All HVAC Equipment CF-6R 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-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
.Indoor Coil and/or Cr -ms: MECH-21 and (for split systems) MECH-25
.Furnace
For Split Systems: Duct'.' -)ercent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement),TMAH
Pop.._ - �.._f, if ��
Exp
have been previously sealed and confirmed through HERS verification, or
, `near feet in unconditioned space, or
` I-,i insulated or sealed with asbestos
❑2. \
.Cut.
new AM_
ducti r
equ'
For r. _. . .
For i` _
C Required Forms:
R
•,
duct.,siy and/or outdL,. w t CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/, )r some CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leak.- 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-4R 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 26, 2012
Address: 73605 Dinah Shore Drive, Suite 1310M License: 827420
City/State/Zip: Palm Desert/CA/92211 Phone: (760) 568-2663
Reg: 212-A0033642A-00000000-0000 Registration Date/Time: 2012/06/26 19:50:51 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin# City of La Quinta 'M
Building&Safety Division
Permit# n P.O. Box 1504, 78-495 Calle Tampico
��,(�l ` La Quinta,CA 92253- (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: CI109Owner's Name:
h4 C-aun4-
A.P.Number: Address: 5-
Legal Description: City,ST,Zip:
Contractor: VIS Telephone:
Address:, �Di r�j(�S�(7�e�� I?�ID/r Project Description: -�
City,ST,Zip:f bl I I I { L.LtSW t o 6122-1
Telephone:]0-51.9— .: Em
State Lic.#: City Lic.#.- U611 J
Arch.,Engr.,Designer:
Address:
City,ST,Zip:
J:�tiu�jj'wry
'%`:/+::•R:v'•�i>::n<:;+iuf}:{yii`•;:%::•Sig%::
Telephone: :<.':�,.,.,.,:..�;.%;:%.:;:.,;;::.�:;::::.,,:,�::., Construction Type: Occupancy:
State Lic.#: >> Project type circle one New Add'n Alter Repair Demo
Name of Contact Person: A V� Sq.Ft.: #Stories: —#units:
Telephone#of Contact Person: Estimated Value of Project: a
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets Plan Check submitted tem Amount
Structural Cales. Reviewed,ready for corrections Plan Check Deposit
Truss Cales. 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 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:- '"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