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MECH (09-0610)51585 Avenida Martinez 09-0610 P.O. BOX 1504 787495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00000610 Property Address: 51585 AVENIDA MARTINEZ APN: 773-141-005- - Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 6490 Tiht 4 4 Q" Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that 1 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 LicenseNo.: 686310 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).: 1 _ 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—) 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: LQPERAIIT Owner: BURTON ROBERT/INA 1196 SUPERIOR AVENUE VENTURA, CA 93004 Contractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/10/09 ----------------------------------------------- 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 PREFERRED EMPL Policy Number WKN1295354 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 3700 of the Labor Code, II shall forthwith comply with those provisions. C,Applicant: /t} /' i ✓/art/ 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 (5100,000). 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 1 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 this county to enter upon the above-mentioned grope//ryt\ for inspecyt /iron p/uurr pos es. , %ate: —/0— nature (Applicant or Agent): /ry l e- C Application Number . . . . . 09-00000610 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/07/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------7------------------------------------------------ Special Notes and Comments HVAC SYSTEM CHANGEOUT (CONDENSING UNIT AND FAU) USING EXIST DUCTWORK. HERS VERIFICATION FOR.DUCT SEALING AND TXV REQUIRED. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due. Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT R Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Project Title Date: © CaICERTS 2005 Enforcement Agency Use Only Project Address: N& 1 lVY it Climate Zone. 1t> Building Permit # Docurntati Aut or: T lephone: 14 Plan Check Date Company Name: Q m A Z (-, Field Check Date IMPORTANT: This CF -1 R -ALT form is only for use when an HVA only alteration is made to an existing home Use one form for each system beingaltered. This is system # of systems altered in this house. Check all lines that apply. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. 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 n outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 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. S duct system is also to be new or replaced. Continue to next line. ❑ Check here if the enft 6 ❑ If 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. 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 previous CF -4R form. Go to Section 2. 10 ❑ is ducts stem is sealed or insulated with asbestos. No duct sealing is required. 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 existing 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 Abtp,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 ANLL 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 None of lines 7-14 above are checked. Duct Sealing is Required. Continue. Sec ion 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The s stem 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. 204 2 This s stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. is 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 If line 15 is checked, HERS verification Is required for Duct Sealing. 23 ❑ 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 - E ui me 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 ❑ Iore than 40 feet of duct is bei installed or re laced, duct R -value must meet or exceed Package D requirements 27 ❑ 11f,missfthan 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R 4.2 Section 6 - see next page Page 1 of 2. Version 03-10-06 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 CFA R -ALT Project Title: Is Date: / ©CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVA -onlyy alteratioh is made to an existing home Use one form for each system being altered. This is system # of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipm t must match typellocation and meet or exceed efficiencieslR-vatues. 26 Configuration:AWSplit system O Package Unit 29 ❑ Air Handler Mas furnace, AFUE: ❑Heatpump FAU OHydronic FAU ❑Other 30 e Heat Exchanger 31 JCS/) Outdoor Condensing Unit ❑A/C ❑Heatpump JElfici;ncy SEER/HSPF: JEER K re d : 32 Coolhg or heating coil OA/C OHeatpump OHydronic 33 ❑ Ducts Location: Length (ft): R -value: All mandatory measures apply to any altered component. See MF -1 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 Nam Name: Address: 'CTIS-16s- A ,)Q( \, Comp ny Name: Z_ er cr)A Ac City/State/Zip: Address: Phone: 440 City/State/Zip: y" o -,, r, \r\, k Vr' A q Phone: _ Signal t re: Signature: Enforcement MeniinqDepartment) Notes/Comment 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. CF -4R -ALT: by HERS rater: Required to close permit. Copies to home owner, enforcement agency, installer..The CF -4R form's for a f C cpornleted and passed for the entire rou . simple rou shall not -be released until all testln and vers Ica Ion Page 2 of 2 Version 03-10-06 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com APPLICANT: Bin # City of La Quinta Building & Safety Division Submittal Plan Sets: ` Permit # P.O. Box 1504, 78-495 Calle Tampico PERMIT FEES Item Amount 0 f 0 La Quinta, CA 92253 - (760) 777-7012 _ Building Permit Application and: Tracking Sheet Project Address: 4 v e AAK Mi° z_ Owner's Name: u t a __ AA Address: L°N v t tcr— e 2 - A. P. Number: Truss Calcs. Legal Legal Description: City, ST, Zip: %,4 u t Al 04 .9 -2 S :wok«:*;' {Ysry h Telephone: 3 _ 7 4 PIP. ''t 7Sv'fiY i n :^K'; Project Description: Contractor: / ' m e2 `4 G e Address: 3 / v K pS e2 Jf_ (]Q (re 'C , "L E—/1 S \'T% IL L _e'\ y f L O /► , City, ST, Zip: 9-4 9 7% \33.::,..f.YY •.:.r,:vYiti y\til' Telephone: 7 U<3{'•?Y: A^:'::;£ %; ': Vii,' is i.'`^'Yk'+'Yf V%:::1{. ••: :. /f. ?j.G, f- ' State Lic. # City Lic. #; Title 24 Calcs. Arch., Engr., Designer: Plans picked up Construction Address: Flood plain plan City., ST, Zip: Plans resubmitted Telephone:- , ,• wc•-- ;:•:;;;.,: :- Lic. #:Project Construction Type: Occu ancState d type(circle one): New Add'n Alter Repair De Grading plan Name of Contact Person: Sq. Ft: #Stories: #Units: Electrical Telephone # of Contact Person: Estimated Value of Project: 42 z/'9 APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Plan Sets: Req'd Recd TRACICIIVG Plan Check submitted PERMIT FEES Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. 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 correctionstissue 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.LP.P. Pub. Wks. Appr Date of permit issue School Fees Permit 0