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MECH (10-1026)78900 Lima St 10-1026 Application Number: 10-00001026 Property Address: 78900 LIMA APN: 772-102-010- - - Application description: MECHANICAL ' Property Zoning: . LOW DENSITY RESIDENTIAL " Application valuation: 10542 T44t 4 4 Q" Applicant: Architect or Engineer: 17 cla.-I-J�C47L_ - ------------------- 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 (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 _Liccee./��Cg�No.: 374937 Date:' 97ontractor 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 (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).: i (_ 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 projece (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 ContractorsState License Law.). I _ 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/04/10 Owner: JEPSON JIM 78900 LIMA Jq; LA QUINTA, CA 92253 � i�,--- !x-`- ��Fn) (760),777-4124 L) i4 _ ri jr 20 0 Latr'i ' Contractor: _-_----__ `!(6 Of- 5-A Ea PALM DESERT AIR COND C INC 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 . 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 SOUTHERN INS Policy Number WSI0036802-01 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 w kers' compensation provisions of Section 3770000 of the Labor Code, I shall forthwith comp) ith those provisions. Date: ZqqL/Applican'£--cT!!5�.JPP 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, and the applicant, eachagreesto, 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 eby authorize representatives of this county to nter upon the above-mentioned property for inspectuiJoonn� purp Date: Q' Signature (Applicant or Agent):- /� Application -Number 10-00001026 Permit MECHANICAL Additional desc Permit Fee . - . . 42.00 Plan Check Fee1-.50 'Issue Date Valuation... o Expiration Date 4/.02/11 r•' i �' Qty Unit Charge Per' Extension BASE,FEE 15.00 4: 1.00, 9.0000 EA MECH FURNACE,<=100K 9.00 1.00- •,-9.0000 EA MECH APPL REP/ALT/ADD- 9.00 ' �t '• 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ' ---------------- - ---'-- ------------ I ---------- -----------•---- ` Special'Notes and Comments t ' REPLACE ONE (1)AIR CONDITIONING SPLIT • SYSTEM. 2007 CODES. --------------------------------------------------- - --- ----------- Other Fees •. . . . . BLDG STDS ADMIN (SB1473)' 1.00 Fee summary, Charged, ''Paid: Credited --Due .. . Permit Fee Total 42.00 00 00 42.00 f Plan Check Total 10.50 .00' a .00 10.50 ` Other'Fee Total 1,:00 .00 .00 1.00 + Grand Total, 53.50 .00.. 00 53:50 LQPERMIT - - Sim pmw-prescripOve-Certificate of Compli'ance: 2008 -Residential JITVAC AlteratioAs. CF-M-ALT=RVAC Climate Zones 10 to IS, JEPSON, JIM System: #1 - 'Site Addtws: Enibrcqment Agen bate: Pennit*.- 78-90011MA, LA QUINTA, CA 92253 City of Ia Qun"6 10/11/201:0 C-briditioneffloor Equipment Type' List.MM*1m Efficiency' Duct insulation -re quirement Area Thermostat =Packaged Unit M Furnace M: AFUE 80% 0 cop. Ov401 f ductsddd- e'er oaeor ®:Setback 0.1ndoorCoil N SEER 17.00 E] HSPF replaced in unconditioned space Served by; system;' (If not dIrFdy. 0 Condensing Unit MEtk 13.00 El Resistance 0 X6 .(CZ 10-13) R.8 (CZ 0, 'pres0l.-piwi be -e—. -14-15) 1:':.E4u0me* 6p :ChoOse,-iheeqyt'pm'e'n't,oeilig.,Wtoo CP - IR -ALT HVAC foreach:system. ,2.,Minimum Equipment .E fffe40;;gs: 13 -ZM 78% AME; 7.7HSPfjor:"ka1 raa,0Athzl systems. .'HERS VIEWFICATIONISTA04"V Listed below -are1dur HVAC. alteration Options. The. ins4decides whgt!.,wofkJs,being�ftim ne,and' do 'measures ,�.'idks one:dthe appropriate -Dotioni; Each Option lists. the-MERS that must be,conducted.' A copy..-of.,the;.fbi.ms,,,shd'U"be.ilift,�i)ii;s'ite"for final -'inspection and a copy give646thb1omeowner. At.final, the insp'ectorvefifies that the workliswd on thigAmn Was -iii factthe,w oWz'Q*mp'I10�-*1b edb Y 0: .installer. The, inspector also verifies that each appropriate CF -%---and registered CFAR forms (no handdfilled C ,signed, M 1. -HVAC Ch4ligeout Riequired.:V6 -m s: M All HVAC Equipment replaced CF -6R forms: MECH-04, MEC H-24 4MRS,and. (for, split systdms)'MECH- 25t -HERS. CF -4R forms:. MECH- 2,1 -and (for split systems) MEC -H-25 M Condenser Coil and /or 0 Indoor Coil and /or 'CF -6R forms: MECH-21-HERS and (for split systems) MECH45-!KERS i3 Furnace -~21 split systems). 'MECH=25 CF -4R forms�MECH- -23 For Split.. Systems: Diictleakage : 5- Percent :RG., CCA:2:100. QFM Air,-Flow:Requirement), TMAH •AoR R :For Psickajed Uhits': Diicvkakage- < IS percent .,ExemptO.ftibduct le*go*ttgfihg.f., 0 1. Duct system was-.dqcumentq&to have been previously seated and confiiined:*ToughtHER5-.verification, or G2. Duct sysi6nis,,.*iih-less .,,'dia'n4'0-linear feet in.iincoiiditioriedspace; or 1313. ExikfingductsYstems 1sire constrdcted,jdsitlatbdof sealed with asbestos 0 2.. New HVAC System Req*e.d*otMsr 0 Cutin or'Changeoift with new :CF -6R forms: NECHrO4i.MEC,,H-20-'HERS�iiiid::(faf�sp.fit systems),:MEC�H-l2-14L4t-Si.'ind'h�mal-15�HERS ducts: (all new ducting all - . 1. CF -4R forms.: .14ECH (for's 207, and 'plit syAbms)NMCIT422j.ifid MECH25 & ,..,PO,rSolit'-Systeras:'jictIe a -i56:cFNvton,FWD, TmAR,5TMs": wd iih .Torfapkaged Units t:!Duct j4W -<6.percent .03*.NewDiidtswith/or vnth6itt:Replacemoiit Required, Forms: D tiicludes,re0lating.loiiiisWiing.afl'new-ducting CF-4MOrms: MECH-04, MECH-HHERSand (for split. sy.6tcmt),MEGH45MEkS andIdt.-putdoor conden'sing.unit.And/br indoor coil CF4R*fbrms: MECH-20 and (for split systems)MECH-25 and/or furnace. Noor:. equipment ,changed. S lit Syst6hi�-. D&H < - � : T 6 ere CA, p ent,RC,'� C >100- CFWton, TMAH T.o7TkkAgtd Units :,Duct ;1 ke,< 6-jj:eiuiit, 0 4.'Now!).tictiiiig,over -40reit .. -Wid- eq 01ncludes:addin ---la- more1han40 gor.-rep replacing linear: -feet of du'ct,,jnl.u'n'-- pprid-itio . ned , -A . pace. CF-'6R,fbrms: -MECB-04, A110CH-11 -REM CF -41k f6 MWH-2-1 'kag-ed-ulfl-ts: Duct leakage -15 percent: ;ForspjitsysteniorpWc 0 EXCqMPN!:'Eiisting.duct ,.systems constructer insulatdd.otsealed witi:asbatos. Contrattor (Dbctidiititatidn.Adt,h6r't.:/Resp6iftibre,-D6sig#et!s Declar.ati'0,11.stsitt.iiielit).: 0 Tcertify that this Certificate.6bbornpliance docurnentatib.n.16'accuraie and complete. i=eiigibl6.under-Division jof. the.Califomia.Businessand -..P.iof onsCode'to,acceptrcsponsibili responsibility for -tho.designidentifiod;on *is Certibeatevt-6 ''I' Mp lapoe.. I certify -that the enm4eaftires andp.ekfonhancespecificitions'f6t:the.desigh`idenfified on this 'Ceftifica(dbtfiiAo1hd.Jt-4i of - "i of Complianoe�conf q Title Parts Iand 6 oftho.Calitomiw.C.odc:;6fRegulatibns. The design-teawresiden"ed on this Certiticafe of Cornpliincc are consistent with the infotmation.dopumentcd on other applicable .con.T.�ia.ncelf0m�si.Ni(o eq4j'. cilc4lations, plant'�n4�spedtcitions:stuiubniLitted to. the c6breemencagency fora . I "th'the fe/taraakation. Name: KARL BROWN Signature: `� Company: Palm Desert Air Conditioning & Heating Company Date: 10%1/2010 11201 G "Address: 42-081 Beacon Hill License: 374937 ilcity/statdzip: Palm Desert, CA 92211 Phone: (760) 346-0677 2008 Residential Compliance Forms March 2010 51? P.Q. Box 150.4.78-495 Calle Tampico, La Quinta, California V 1: y Tel 760 777=7012'•; Fax 760 7.77 7112:` =6ENq/�DLSEfT-•.w Website: WwW.Li4uihta.Ord.• Email: BuildingI@40-00in#6 ;c 9l. # Permit :#,- A0 Buil'di'ng Perm"it;Appfication & Tracking Sheet. ProjectAddress> 78-900 LIMA Owner's Name:. JEPSON, JIM A.P.: Number Address: -78-900 LIMA LegplPescriptiom: City, State,•Zfp: LA QUINTA, CA 92253 Y Contractor Palm Desert Air Conditioning &Heating Company. Telephone:(760) 77774124 ;Address: 42-081 Beacon Hill Project Des"eriptions. City,_.State; Zip;:" Palm Desert, CA 92211 REPLACE ONE (1) AIR CONDITIONING SPLIT SYSTEM. . t ` i,• •'_ Telephone No; (760) 346-0677 State tic `.#: 374937 City Lic. #: 100886 ArchJEngr/fs esigne'r :Address: City,.State''Zip: .. Telephone No: - �' ... , ,# Construction Type: Occupancy: �State.:Lic:�.#'. . " �" Project Type: O New • ®-Add'n •'.0 Alter O'Repair :O DeMo `Name of Contact Person: KARL BROWN Sq: Ft.: # Stories: #'Units: Contact Teleph6h6M.`.. (760) 346-0677 Estimated Value:of Project:•$10,542.00 APP.LI,-ANT-,00-NOT. WRITE BELOW:THIS.LINE Submittal , Re "d Recd. Tracking Perm�E Fee's. Plan Sets Plan Check.Sut mifed. 3 Item Amount Structural Calcs ,Reviewed, Ready for. Correction"s' , Plan, Check:De"pos4, Truss,CaCcs.: Caged•.Conta.ct Person .., Plan Ghe6k:l3al9nce: Ttle:24'C61cs., "Plans Picked'Up " . Construction Flood Piam:Plan: Plans,Resubmitted i Mechanical Grading Klan: 2nd`RwAew, Ready:for Corrections Electrical Su6cont�acfor List Called Contact Person _ Plumbing Grant. Deed Plans' Picked:U' S.M.I. H -OA. Approval Plans' Resubmitted .. Gradirfg• IN HOUSE: 3`d"Review, Ready for.;Corrections Developerlmpact Fee Planrnng:Approval Called:Contact Person. ' A:I:P.P.. Pub: Works.Appi'1 :Date of Permit Issue School: Fees. f . Total Perrhit: Fee's ,