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11-0888 (MECH)P.O. BOX 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00`000888 Property Address: 78895 MORNING STAR APN: 609-560-052-52 -23773 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: ' 7912 Tit�`- 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and r fessionals Code, and my License is in full force and effect. License Class: C20 License No.: .595145 ,,,Xate: g ontractor: WNER-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 ($5001.: (_ 1 1, 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, 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: A LQPERMIT Owner: HAUF DENNIS D 78895 MORNING STAR COURT LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: DCS HEATING/AIR CONDITONNG INC 72078 CORPORATE WAY, #101 THOUSAND PALMS, CA 92276 1 (760)343-5566 t Lic. No.: 595145 Date: 8/18/11 2011 ----- - - - - -- 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 HARTFORD INS Policy Number 72WECLS7131 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 bject to the workers' compensation laws of California, and agree that, if 1 should become sub' to the he compensation provisions of Section 3700 of the Labor Code, I shall forth corgi y with those provisions. n ate: 8 plicant: WARNING: FAILURE TO SECURE WORKE COM ENSATION 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 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 ab information is correct. I agree to comply with all city and county ordinances and state laws relating to building nstruction, and hereby authorize representatives of this county to enter upon the above-mentioned property fo spect'on purposes. �fe: 8 ( nature (Applicant or Agent): Application Number . . . . . 11-00000888 Permit MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . 0. Expiration Date 2/14/12 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-5bOKBTU 16.50 ---------------------------------------------------------------- Special Notes and Comments ------------ INSTALL NEW 4 TON HVAC SYSTEM, FURNACE CONDENSER & COIL. 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 HVACAlterations . CF -IR -ALT -HVAC -1 Zones Site Address: Enforcemen gency: Dat : Permit #: $$4S 0rn < <S�' tj -1-7- G Conditioned Floor Equipment T e' List Minimum Efficiency 2 Duct insulation requirement Area Thermostat Packaged Unit Q Furnace �AFUE gr7�v ®COP Over 40 ft of ducts added or Setback door Coil EER 1� HSPF 91R] laced in unconditioned space Served by system (I not already densing Unit [3EER l I ® Resistance 6 (CZ 10-13) sf present, must be Other 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HYACfor 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 s' ed. Beginning October 1, 2010, a registered cop of the CF -1R and CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: •. All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors lit stems MECH-25 • Condenser Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Indoor Coil and /or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if. 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 ducts stems are constructed, insulated or sealed with asbestos ® 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent 3. New Ducts with/or without Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor. coil CF -4R forms: MECH-20 and (for split systems) MECH-25 and/or furnace. No or some equipment changed. 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 -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. For splits stem 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 t 's Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The desi features identified on this Certificate of Compliance are consistent with the i form on documented on of r applicable compliance forms, worksheets, calcul4onj plans ands ecificati ns s bmitted to the enforcement agency for approval ithth rmit application. Name: D Signa e: Company: GS _0 N j Date: p�✓�� Address: � O ` License: City/State/Zip: �'�� —t Phone: CaICERTS - CF -1R Registration Page 1 of 1 Public Home Chris Brown logged in [Logout) [Home] Secure Home About Us Training Rater Directory Forms Membership Benefits Events Industry Partners News To register for our monthly newsletter, please click here. CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 8895 MORNINGSTAR WAY La Quinta, CA 92253 CEC Registration: 211-AO04238OA-00000000-0000 CF -IR -ALT -HVAC: CLICK, HERE TO DOWNLOAD Assigned Company: ID C S HEATING & AIR CONDITIONING INC Do you know your HERS Rater? If you do, you may want to send this CF -1R to them. CaICERTS Rater ID: OR My Rater Quick Select: The Ene_rg_uy CA LLC Every CaICERTS rater has a license number. Ifyou need to find the rater by name [Click HERE/ to search our directory. I v : SEND_CF71:R.TQ HERS -RATER, [CLICK HERE] to do another Copyriglu «92010 CaICI:R:fS. Inc. All rights reserved Revised: January I1, 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us it. w, T BBB Find us an https://www.calcerts.com/public—cflR.cfin?project—id=132419 8/17/2011 Bin # City .of La QuInta Building a Safety Dh4slon P.O. Box 1504, 78-495 Calle Tamplco La Quinla, CA 92253 - (760). 777-7012 Building Permit APPlication and Tracking Sheet Permit # 1\ � 1 Project Address: Mer ; /l cSd42r (,e-9 •. Owner's Name: S A. P. Number: Address: Legal Description: City, ST, Zip: C% S Tele hone: P 7 &4 7Z � 94`7 . Contractor: D -S Hea,61 't lei Ir � "f Address: '��_ G 4 -to Project Description: 7 C4. HVA/..G �1 n' City, ST, Zip: Pian Check Deposit Telephone :'?'SS(a a . . -- r State Lic. # : SCJS tC jS City Lie. #; Arch., Engr., Designer. Truss Cales._ Address: City., ST, Zip: Telephone: f State Lic. Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair 'Demo: Name of Contact Person: tff�� . Plans picked no • Sq. Ft : # Stories: # Units:. , relepnone # of Contact Person: 3 kJ5 ��(p�j Estimated Value of Project: APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Plan Sets Req'd Recd TRACMG Plan Check submitted PERMIT FEES Item Amount Structural Cale.s. Reviewed, ready for corrections Pian Check Deposit Truss Cales._ Called Contact Person )Plan Check Balance Title 24 C$les. Plans picked no Construedori Flood plain plan Plans resubmitted Mechanical Grading plan tad Review, ready for corrections/Issue Electrical Subcontactor ListCalled Contact Person Plumbing ..Grant Deed Plans picked up, S.M I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'rd Review, ready for correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr. Date of permit issue School Fees Total Permit Fees