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MECH (12-0541)54599 Avenida Madero 12-0541 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, -CALIFORNIA 92253 Application Number: 12 OOAA0.54=1 Property Address: 545-9-9 AVENIDA MADERO APN: 774-261-005-5 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 7104 Applicant: C&hf 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: PfA 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 Businesspqd Professionals Code, and my License is in full force and effect. License Class: C10 C16 C2 457554 ` OWNIj9-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am,eze{npt 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.). (_) 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: dt 1-1 LQPERMIT Owner: GLORIA LEE 54599 AVENIDA MADERO LA QUINTA, CA 92253 . Contractor: D PREFERRED PLUMBING HTG A/C P.O. BOX 5120 PALM SPRINGS, CA 92263 I (760)322-3173 [I Lic. No.: 457554 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/15/12 LJ MAY 15 2012 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 EVEREST NATL Policy Number 7600006445121 I certify that, in the performance of the work for which this permit is issued, 1 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 ome subject to the or rs' ompensation provisions of Section 3700 of the Labor Code _"_,If hwi co th a provisi s. 4/ r Z.te: tJ 5 plicant: WARNING: FAILURE TO SECURE WORKER' COM ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA 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. I certify that I have read this application and state that the above information is corr I agree to comply with all city and county ordinances and state laws relating to buildi nstruc . and reby uth rize representatives of this county to enter upon the above-mentioned prope f ins a ion p rp es — 50tf / ' nature (Applicant or Agent)' Application Number . . . . . 12-00000541 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10:13 Issue Date . . . . Valuation 0 Expiration Date 11/11/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 -----------------------------------------------= Special Notes and Comments ---------------------------- HVAC CHANGE -OUT: INSTALL NEW 4 TON PACKAGE UNIT. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ------------------------------------- Paid Credited ------------------ Due -= Permit Fee Total 40.50 .00 .00 •40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00• .00 .00 1.00 Grand Total 51.63 .00 00 51.63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - is Site Address: Enforcement Agency: Date: Permit #: 54599 Avenida Madero La Quinta, CA 92253. City of La Quinta May 11, 2012 Equipment Typel List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat 0 Package Unit ❑ Furnace ❑ Indoor Coil 0 AFUE 80% 0 SEER[IR ❑ COP � HSPF 6 (CZ 10-13) Served by system ® Setback If not already present must be ❑ Condensing Unit .14.4 _ ❑ EER ❑ Resistance [IR 8 (CZ 14-15) 1580 sf installed) ❑ Other 1. Equipment Type. Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efflclendes: 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 m forwas 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.Beg inning October 1, 2010, a registered copy of the CF -1111 and CF -6R shall also be on site for final inspection. 0 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS replaced CF -411 forms: MECH-21 . Condenser Coil and /or . Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS .'Furnace 9C4Rfocros: MECH-21 4,R F FQF splic Systems. N.— RG, GGA 490 i; G904�tap (P4iA*mwFA Air. Plow R-e-quigameRt), TMAW For Packaged Units Du`.ci ieakage 15 percent Exempted: from dud leakage testing�,if ❑ i Duct system was docume ted to have been previously sealed and confirmed through HERS verification, or ❑ 2 Duct syst$mswith>gs.s. th n 40 linear feet in unconditioned space, or p3 Exlating;duct systems are cxoftructed,:i�sulated or sealed with asbestos ❑ 4 The not be t7u d:(i st rtg r9e) r ❑ 2 Ne`AG"Sy em Requ f ep F , . Cut ir�or#(*�ian9eout w . s ti Y,� ,_ new (all new r�s�ECH 04, M Chi ERS a " (fo sy to �MECh22 ERS,�an` M2�IN ductlr)g an all n s equiprliecllA14. r MECH ,� .n r s it st y �2 , Y 5 !h..rwi�i�f �R " `• �..,. For s c[S> VW 0 kagesc d�FN17h �„ WDH�MAH, ' S anti <e)t r 5 P`or PS P. For Packaged Units Ducent q:3 New pucts�with or without '� Required forms: / Re placement' ...... . Includes replacing of 0.- l ing'all etN ducting and/or outdoor.:soddens+ng$utnit and/or indoor coil and/orfur; a �Nii': or some CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS CF -4R forms: MECH-20 and (for split systems) MECH-25 equipmentichanged.> For Split Systems:. Dud leakage: <> 6 percent; RC, CCA 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ff 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -611 forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing dud 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 eligibleiunder Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. ; . I certify thattthe 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. e 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: Jeff Leavens Signature: Jeff Leavens Company: PlIffERRED AIR CONDITIONING Date: May 11, 2012 Address: P 0 BOX 5120 d License: 457554 City/State/Zipi: PALM SPRINGS / CA / 92263 ,,, ,,... „_-_ . Reg: 212-A0024043A-00000000-0000 Registration Date/Time: 2012/05/11 18:53:08 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 °'" ff City of La Quanta Building 8U 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: Owner's Name: A. P. Number: Address: 541S,99 A VIP , MeAUM0. Legal Description City, ST, zip: .41? J i jN;r4 a oZ referred Ai;r Conditioning dba Con actor:preferred Plumbin - Heatin &A'i Tele hone: p 76 Project Description: Address:pO . Box• ' 5120.. City, ST,ZipP.alm' Springs,. CA .92263 /}(ces' -UNI Telephone: (7 6 0) - 3 2 2 = 317 3 State Lie: # :. 4,57,55-4 City Lic. #: Arch., EllDesigner.'. Address: City, ST, Zip:.: Telephone: State Lic. #: Name of Contact Persell: -,--A Vr-wS Construction Type: Occupancy: Praject;type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # o Ci ntactPerson: %lOd % 1 -V7 3 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal ' : Req'd Recd TRACKING : PERMIT FEES Plan Sets . `.' . Plan Check 9e mitted Ite Amount Structural Coles. Reviewed, ready for corrections Pla Check Deposit Truss Coles. .. Called Contact Person Pla Check Balance Energy Cales. Plans (licked up Con tructlon Flood plain plan Plans.resubmitted Me apical Grading plan' 21d Review, ready for'correctionsfissue Ele rival Subcontactor.List Called Contact Perjon Plu bang Grant Deed. Plans picked up S.M I. H.O.A.Approval Plans resubmitted Gra ling IN HOUSE:- Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.L .P. Pub. Wks. Appr Date of permit issue school F'ecs Totgl Permit Fees