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MECH (07-0006)57218 Medinah 07-0006 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Application Number: 07-00000006 Property Address: 57218 MEDINAH- APN: 7i62 -110 -025 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5200 BUILDING &SAFETY DEPARTMENT BUILDING PERMIT Owner: ' GREG CONWAY 57218 MEDINAH LA'QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1 I Contractor: ss ` 'lull 3 r,li o Applicant: Architect or Engineer: PALM DESERT AIR CONDITIONING', Date: 1/03/07 LQPERAf1T 42081 BEACON HILL _..-d9 AN ADEPT PALM DESERT, 'CA 922,11. (760)346-0677_- Lic. No.: 374937 --------—--------------- . LICENSED CONTRACTOR'S DECLARATION -------------------------- 7----------- WORKER'S COMPENSATION DECLARATION I hereby affirm under.penalty of perjury that I am licensed under 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 Business and Professionals Code, 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 Class: C20 - License No.: 374937 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is /``;, .`6 - ate: ntractor:% 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND - Policy Number 1795546-2007 following reason (Sec. 7031.5, Business and Professions 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, demolish; or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as 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 should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the L r Code, I shall forthwith comply with those provisions. - 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).:te: plicant: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and Ile XOMPENSATION the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an ownerofproperty who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 ADDITION TO THE COST OF COMPENSATION, 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, AND ATTORNEY'S FEES.. one year of completion, the owner -builder will have the burden of proving that he or shedid'not build or improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT (_) 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 contractor(s) 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 permit, or cessation 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 above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating to building construction, and hereby authorise representatives of this unty to enter upon t above-mentioned property for inspection purposes. Lender's Name: _ ate: 3b 5 azure (Applicant or Agent): • Lender's Address: _ LQPERAf1T Application Number 07-00000006 Permit . . . . MECHANICAL Additional- desc . Permit Fee . . . . 66.00_ Plan Check Fee 16.50 ". Issue Date . . . . Valuation 0 Expiration Date '7/02/07 Qty Unit.Charge Per Extension BASE FEE 15.'00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 .16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ------------------------------------------=--------------------------------- Special Notes and Comments REPLACE 2 CONDENSERS & 2 FURNACES Fee summary Charged Paid Credited Due ---------- ---------- Permit Fee Total 66.00 ---------- ------- .00 .00 -- 66.00 , ' - Plan Check Total 16.50 .00 .00 16.50 Grand Total' 82.50 .00 .00 82.50 LQPERMI1' certificate nf Compliance Prescriotive Method - HVAC -only Alteration CF -1 R -ALT Projec i Date: © CaICERTS 2005 Enforcement Agency Use Only Pro' Addroso. CII ate Zone: Building Permit # Doc m tation A o : Telephone: Plan Check Date p Ne: am Field Check Date IMPORTANT: This CF -1 R-ALT(foyn is only for use when an HVAC -only al eration is made to an existing home Use one form for each system'15'eing altered. This is system # / of systems altered in this house. Check all lines that aoply 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(0 A 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. 4 coolingor heatingcoil is to be installed or replaced. Duct Sealingand/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. ❑ Check here if the entire duct system is also to be new or replaced. Continue to next line. 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 ❑ This duct system 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 AN12EER 12 condenser will be installed with TXV(RCA) AND 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 Ahn 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 Atll2 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. Se tion 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The system 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. 20 ❑ iThis system is in Climate Zone 16 and line 14 is checked and not line 16. TXV RCA Is required. Go to Section 3. 21 A IThis 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 ❑ lif 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. Se ion 4 - E ui ment Efficiencies 25 ❑ lif lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values 26 ❑ lif more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 If less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R4.2 S tion 6 - see next page Version 03-10-06 rage 01 e 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 ' CF -1 R -ALT . t Project Tit Date: Q CaICERTS 2005 IM TANT: This CF -1 R-ALTforjn is only for use when an HVAC -only It tion is made to an existing home one form for each syste ing altered. This is system # Z of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed efficencies/R-values. 28 Configuratlo pIA system O Package Unit 29 ❑ Air Handler IlMas furnace, AFUE: OHeatpump FAU OHydronic FAU OOther 30 Q� Heat Exchanger 31 � Outdoor Condens' Unit C OHealpump fricien SEER/HSPF: EER if re d : 32j� Coolingor heating coil C OHeat um ❑H dronic 3 [3 Duds Location: I 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 o uthorized Agent Documentation Author NaVre Name: Ad omrPZN e: City/State/Zip: - Address: e Phone: City/ Phone: . Signature: Signature: Enforcement Agency (Building Department) Notes/C mments: 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 forms for a sam le group shall not be released until all testing and verification is completed and passed for the entire group. version U3 -1U -U6 rage z of z This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com' e Bin # City of La Quinta Building 8r Safety Division . P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permlt # Project Address: Owner's Name: A. P. Number: Address: O Legal Descriptio_N City, ST, Zip• Contractor Address: -40X11— r>?'s::>:{:<::> Telephone: :;:x';:38 Project Description: City, ST, Zi . Telephone:/oPA—11-e4 State Lia.# :,3 3 City Lic. #. Arch., Engi., Designer: Address: City., ST, Zip: Telephone: <>::'•.<:<:::<;<.:•.: t:;;:<;{{;.:. :>z:.:. P r<:::;.:>:{>'.,'.;'.>•<:r..':::::;:':•:::-.;;:,:;, State Lic. #: »<?< „%>;'t < s <> Name of Contact Person: Construction Type: Occupant Project type (circle one) New Add'nAlter Repair Demo Sq. Ft.: # Stories: # Units: :%-- Telephone # of Contact Person: O^ , Estimated Value of Project. Jam, -D 0-1Q16— J , '6 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted 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"d Review, ready for corrections/issueElectrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review, ready for correctionstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees