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MECH (10-0872)f W • . �n� P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: __10-000_.0.087-2- Property Address: 80155 MERION APN: 762-191-005- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3475 Appli nt: Architect or Enginee : Y111 ----------------------------- -------------------- 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 Business and Professionals Code, and my License is in full force and effect. . LicensCs Y D License Class: C20 ` Lice No.: 374937 le Da: /•� 7T7- 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 countythat 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 ($5001.: 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.). (_ 1 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.). ' . ( 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 Owner: LEDERMINE FRANCINE 80-155 MERION LA QUINTA, CA 92253 (310) 600-.1250 Contractor: PALM DESERT AIR COND CO 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 LiC. No.: 374937 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/08/10 SEP 0`18 2010 CITY OF LA QUINTA T FINANCE DEPT. ----------=-----------------------------------— 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 WSIO03802-01 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 workers' compensation provisions of Section p,3700 of the Labor Code, I shall forthwith comply pffh those provisions. -Date: / Applicants 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 J$ 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 correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and here authorize representatives of this county to enter upon the above-mentioned property for inspection purpose Date: 'r (2 .Signature (Applicant or Agerltt�=-� LQPERMIT Application Number. . . . . . 10-00000872 Permit MECHANICAL Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6:00 Issue Date Valuation 0 Expiration Date 3/07/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.60 9.0000 EA MECH APPL REP/ALT/ADD 9.00 Special Notes and Comments ' -REPLACE REPLACE INDOOR COIL LIKE FOR LIKE.2007 CODES. --------------- - --------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited `Due'. Permit Fee Total 24.00 .00 .00 24.00 Plan Check Total 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 -.00 .00 31.00 LQPERMIT Sim pli.fiodtPtescriptivi&-.Cettirteiite-6fCorm D]iaiice::2008'Residentidl.'HVAC.Alterado.ns CF -1:R -ALT -HVAC Climate Zones 10 to 15, LEDERMAN, FRANCINE System: #1. Site Address: En orcementAggn Date: Permit'#: 80-155 MERION, LA QUINTA, CA 92253 City of 'La Quin6 9/8/2010 Conditioned, -Floor Equipm6nt-Typej List Minimum E I fficiency2 Duct insulation requirement Area. El Packaged Unit 0 Fumace 11 AFUE_ 0.00P- Over 40 A of ducts added or *Served —Thermostat ®Setback ED Indoor OSEtR 0 HSPF replaced in unconditioned space by system (Ifndt already . 0 Condensin . 9:lJnit 0 '.EER*— El Resistance 0 �R 6 :(CZ 1043) R 8 (U.1.445) sf p resent, Must be installed) 0 :Other.0 J.: EquipmePuType..-- Choose the: equipment-beinginstal/qd; More than one.systi�m, use another CF -1R -ALT -HVAC for each system: .if .2.. Minimum Equipment E 13, SEER, 78%AFUE, 7.7HSPPfortypical revid,,intialystems. HERS I VERIFICATION SUM.MWY. . Listed b.plowarei'four RVAC.alteration The i I nst4 . ller-cl,et , ides what. work is b6ing,done and , I . .:picks oof the app r* ria iw tithis EAc h op Option. lists the -HERS-measures-that must be conducied. Acopy bfthe -forms shall -beleft owsitef6rfinal te:'Op inspection diidacboygiydii:tt)tLhehomdo)Wner. At,final, the inspector verifies that the work listed on this f6im.Was in fact the, w6fkdomoleted by-tbe installer. TheInspiec.tor also verifies that cath appropriate CF -6R and registered CF4R. forms (no band filled CF-4Rsallowed) are filled -out and signed. Bieginninj;�Ottob& 1, 2010, a reUi.stered copy of the CF -Mand CF -6R. shall also be on site for Anal inspection. 0 1. HVAC..C44ngeout Required Forms:: El All HVAC Equipment replaced: CF76Rfdrms:.MECH_Q4 MECR=21-HERS arid. (156T split systems) MECH!- 25 -HERS . , I . . CFAR f6rms: MECH­ 21 and fors lit systems) MECH-25 0 Condenser Coil and /or 0 Indoor Coil and /or CF -6R% forms: MECH-21 -HERS and (for split systems) MECH- 25 -HERS ITFuinace CF -4 t forms: MEM 21. and (forsplitsystems) MECH-25 I For ,Split Systems: Duct4eakage < 15 Oerc6ht;. RC, CCA >_ 300 CFWton,(Minimum Air Flow Requirement), TMAH Foi?ackaged. Unitsi Duct leakage 4`15- percent Exempted from. dpctieakage testing if. 0 1. Duct system was documented to have been previously sealed and confirmed. through, HERS verification, or 0 2. DOctsystems with lessIhan 40 lin6ai feetin unconditioned spice,i or. 0: 3. Ekigting duct systehis are construct6dj6sulated. or sealed with asbestos 0 2. New HVAC -System Required Forms:' El Cut in or Chan eout with new CF -6k f6rms: MECH-04 MECH-22 0-BERS,and (for split systems). MEM22-HERS, andAECH-15-HERS ducts: (all new, ducting and all CF -4R forms:MECK20, and(for'split systems)MECH-22, and MECH 25 new quipment) percent; For I Split Systems.:, . Duct leakage <.6 percent;..RC,CCA.�:. .35 . 0 1 CF.M/ton, F . WD, TMAH, S--TmS,: andeither.H,8PP_',or PSPP. `For Packaged Units: Duct leakage <,6.percent 113. New Ducts4ith/Pir without Replacement Required Forms:. 0 InclWO,replacing or installing all new'ducting: CF.46Rforms: ME.CH-04,;ME�CH-20-HERS,and(for -split systems) MECH-25=HERSI and/or outdoor condensing unit. and/or indoor Coil CF4Rf0rms:.MEQ1H720-and (for split.systems) MECHw25 and/or furnace. No or some equipment changed. For: Split' Systems: Ductleakage < 6 percent.,. RC, CCA 2! 300 CFM/ton, TMAH For PukagW Units: -Duct leaks ge i< 6 oercerit 114. Newbuctingep.ver 40. kit. Required 1. Forms: El includesadding-or 'replacing more than 40 CF -6R. forms: MECH-04,:MECH=21 44ER5 'CF4R.forms- MECR-21 lin6ar:.fCetofduct:in,unconditioned gjli ., For split s system,or packaged. units: Dudtleaka -<15-percent y leakage 0 EXCEPTION: Existing.ducts ystems, constructed; .insulated -or sealed with asbestos. .Conttactot..(D.6cuineritzition.Authdt's../RespoiAible:D6ig,ner'gDeelgrgtion:Stateinent) 0 tcerfifylihatibis'Cer6ficatebftompliancedocumentaiion:isacclitiit6and compl6te. 0 1 am eligibli.under Division 3 of the California Business and.Professioms Code to,accept responsibility for the design identified -on tMi Certificate of Compliance. I certify that the energyTcatures and performance specifications for:the design identified on this Ceffificato of Compliance conform to the requirements of Title 24, Parts'l and'6 of the California Code of Regulations. The design f6turcs identified on thiste.r6ticate of compflince.are with the information document.ed'on other applicable compliance forms, worksheets;: 2consistent calculati6ns,,Olang�hd'smiticdfiohs-§ubiniti6d t6.tife:6jiforcem6j6t�ikency...f.. lirovil with the #emalicafion. Name: KARL BROWN rsignature: Z .company'* Palm Desert Air Conditioning & Heating Company Date:, 9/8/2010 -Address-.. ­ 42-081 Beacon Hill License: 374937 City/state/zip- Palm Desert, CA 92211 Phone: (760) 346-0677 2008,Resideniial:!C,bhipliiinC6 Forms: March 2010 PA.:Box 1:504 •:78 495:;Calle Tampicd, ; La Quinta;.Cal1f0rr ia:9221 f- Tel (760) 777-7012 • Fax:. (760):777-7.* 12 VNetslte www La=Quetta Org,• Email: Building@La=Quetta Org A•*FG&N �do+DFSERT'.''.xa : _ ... , : ., .:. ... ... .. BIn #:� Permtt #= BU il,di'ng Permit,.Appl cat on &,Tracking S°hetet: Project Address:< 80-155 MERION Owner's.'Names' LEDERMAN, FRANCINE A P Number: Address: 80-155 MERION Legal ID tion: City, State, Zip: LA QUINTA, CA 92253 Contra"Ctor. Palm Desert Air Conditioning & Heating Company Telephone:(310)600-1250 Address: 42-081 Beacon HillJ Pro ect Deseriptton.: y, State, Zip Palm Desert, CA 92211Q L 4.Q Telephone No:; (760) 346-0677 � : ;, • �` :State: Li&. # < 374937 'City Lic:-#:: 100886 ArchIEng:/Designer 'Address: City.State, Zip:' Telephone No:: ConshvcGon;;Type: Occupancy:, State:.:Lic .#;k„ .. ... .r -$✓w ... , . », ,Ay..sA....x, Project Type: .D: New;'®-Add:n'• O.Alfer�:0 Repair`�)O>Demo Name:of Contact Person; KARL BROWN SqLta #'stones' #Units: :Contact:Telephone:No :.. (760) 346-0677 Estimated Value.of`Project ' $3,475.00 APPLICANT :DO'NOT:WRITE.BELOW'THIS;LINE Submittal Re "d. _ Recd Tracking Permit Fee's. Plan Sets Plan` Check.Submitfed. Item Amount Sfructural Calcs Reviewed;- Ready: foe Correction's . Plan Check Deposit TrwwCalig:. Calied;Contact P?erson: plan'Check:Balance. Title 24 Calcs. Pians Plcked U'p Construction Plood ..ainsPlane Plans ResubnAed Mechanical Grading Plan,: 2nd Review, Ready forGorrec4ons Electrical Subcontractor.Llst GaII®d .Contacf Person , Ptumtiing Grant DeedPlans°Picked Up S:M'.t: W:QA. Approval' PlaftResubmitted Grading IN HOUSE, Tn , Review, Ready Corrections Developer Impact Fee Planrnng.Approval Called:Contact Person. AJ P.P.:.. Pati. W&ki Appr'I Date'& Permit Issue School: Fees: Total Permit,Fes's.