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MECH (11-0962)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant - 11 -000009.62 52930 AVENIDA MENDOZA 773-333-010-17 -000000- MECHANICAL COVE RESIDENTIAL 7000 Architect or Engineer: 1A ------------------ LICENSED CONTRACTOR'S DECLARATION �f �4uu�rw BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensed under provisions ap r 9 (commencing with Section 7000) of Division 3 of the Business fessional ode, an n is in full force and. effect. License/CWssmssp C�2-0 C36 100 Alense 27 Contractor: OWNER -BUILDER DE N 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, 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 ani 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: L LQPERMIT Owner: SULLIVAN PAUL 52930 AVENIDA MENDOZA LA QUINTA, CA 92253 (760)200-7005 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/06/11 Contractor: ALL SEASONS A/C, PLMBG &rUPF,,1.,P P.O. BOX 1112 3L PALM DESERT, CA 92261 (760)568-2663 nc2011 Lic. No.: 827420 V U IA 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 theperformance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NORGUARD INS Policy Number ALWC124752 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' comp; on laws of California, and agree that, if I sh be me subject to the w rkers' compen revisions of Section 3700 of the Labor ode, I shat forthwith co w' those ions. Date:%& Applicant: �- 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, each agrees to, and shall defend, indemnify and hold harmless the City of La Ouinta, 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 enced within 180 days from date of issuance of such permit, or cessation of work eys will subject permit to cancellation. I certify that I have read this application and state that the ve information is c ct agree to comp ah all city and cou ty rdinances and state laws relating to b ' ing c nstruction, an reby ho 'ze mpresentao s of this cc y enter upon the above-mentioned pr er y for i spection purp ses. Date:— - ' _Signature (Applicant or Agent LQPERMIT Application Number . . . . . 11-00000962 Permit . . MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date . . . Valuation . . 0. Expiration Date 3/04/12 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 REPLACE ONE A/C UNIT.FURNACE, INDOOR COIL, 4 TON, & 16 SEER. 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 -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 52930 Avenida Mendoza La Quinta, CA.92253 City of La Quinta Sep 6, 2011 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit p Furnace ` p Indoor Coil 2 AFUE 78% p SEER 13:0 ❑ COP El HSP ❑ R 6 (CZ 10-13) Served by system © Setback If not already present, must be p Condensing Unit .❑ EER ❑ Resistance R 8 (CZ 14 -IS) 1600 sf . installed) ❑ Other - 1: Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -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 -1R . and CF -61111 shall also be on site for final inspection. D 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced - CF -411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF -411 forms: MECH-21 and (for split systems) MECH-25 ' For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow, Requirement), TMAH Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or , ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. TheFsystem,will not be Ducted (ie Ductless;Mini-Split System),(AIso,ExemptrfromJRefrigerant-Charge) ❑ 2. New HVAC System Required Forms: . Cut in[or Changeout with;f,,,,� 1.-f new ducts: (all new CF=6R.forms MECH-04, MECH;20-HERS, and (for split systems) MECH 22 -HERS, and MECH-25-HERS C�o rmsyMECH20,nd allvv� (for spli,t'ste,) MECH- �; and,MECH 25 equipmei ] f For Split Systems: Duct leakage!<16'percent;-RC; CCA -2: 350 CFM/ton; FWD,_,TMAH, STMS, and either- HSPP'oFPSPP. ' For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement • Includes replacing or installing all new ducting and/or outdoor condensing unit'and/or indoor CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some equipment CF -4R forms: MECH-20 and (for split systems) MECH-25 changed. E. For Split Systems: Duct leakage < 6 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 -611 forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -411 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: Sep 6, 2011 Address: 73605 DINAH SHORE DR STE 1310M License: 827420 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 568-2663 Reg: 211-A0045986A-00000000-0000 Registration Date/Time:.2011/09/06 11:07:53 ' HERS'Provider:.Ca10ERTS, Inc. 2008 Residential Compliance Forms _ July 2010 Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 7B-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: Pa UIL CSVIU v (il� A. P- Number: Legal Description: Address:jZ�'� City, ST, Zip: w CA -92-?-5-3 Contractor: Telephone: :;�>>;:;:>••.�;��<::=�>:<t:; Address: 11'2- Project Description: a , n n ; /1 i/. City, ST, Zip: '1 I r I' 1 D: -C= -F 4 CA I�bI n. G; Telephone: , 1 State Lie. # : City Lie. #..- t Arch., Engr., Designer: Address: City., ST, Zip: Telephone: :<•^«r >><>:x:: '>? :::<::::»#:<::: • :<•Kv.,....; ..,:,.....: :::»,����<<<::r:::<>::«::>;;•>�<::::;r, State Lie. #: ......... ..•.-«;c•::::•<•;...r.:.;.::.:.;•.;,; Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories:. #Units: Telephone # of Contact Person: Estimated Value of Project: 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 Cales. Called Contact Person Plan Check Balance Tide 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:- 7rd 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