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11-0917 (MECH)
P.O. BOX 150,4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000917 Property Address: \..78910 MORNING STAR CT APN: 609-560-050-50 -23773 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: - 6000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ----------------- -------------------------------- LICENSED C 1VTRACTOR'S DECLARATION I hereby affirm under penalty of perjury hat I am lice ed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busi ess and Prof rsionals Code, a ' ee sh�e is in full force and effect. LicenAlassC20-C36 Licen o.: 777794—ate:nuactor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjur that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Busine s 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 70 00) 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 1$500).: (_ 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. BAP.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.I. Lender's Name: Lender's Address: LQPERMIT Owner: MARIA RUIZ 78910 MORNING STAR- LA QUINTA, CA 92253 Contractor: J ANTHONY PLUMBING 72216 NORTH SHORE THOUSAND PALMS, CA (760)343-2121 Lic. No.: 777794 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/25/11 AUG z5zo» 191 E 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 STATE FUND /bece Number 1932451-2011 I certify that, in the perfor ance oork f r which this permit is issued, I shall not employ any person in any manner as to su ect to the workers' compensation laws of California, and agree that, if I ho Id becoe to the workers' compensation provisions of Section3700 of th Lab o, shali comply with those rovisions. �tsdff man.. �.� 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 Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this pe it. 2. Any permit issued as a result of this application ecomes null and void if work is not commenced within 180 days from date of issuance of su permit, or cessation of work for 180 days will subject permit to cancellation. certify that I have read this application and state th t th above information ' correct. I agree to comply with all city and county ordinances and state laws relating t onstruction, d hereby authorize representatives of/t/his/ =enter the above -menti pope y inspection roses. aD te:ure (Applicant or Agent Application Number . . . . 11-00000917 Permit . . . MECHANICAL Additional desc Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . 2%21/12 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 INSTAL HVAC SYSTEM, FURNACE., CONDENSER, INDOOR COIL, 14 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 -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 78910 morning star way La Quinta, CA 92253 City of La Quinta Aug 23, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit CEJ Furnace p Indoor Coil 0 AFUE 78% 0 SEER 14.0 ❑ COP ❑ HSPF El R 6 (� 10-13) Served by system 0 Setback If not already present, must be • Condensing Unit ❑ EER []Resistance ❑ R 8 (CZ 14 -IS) 2000 installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -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 fad the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -IR and CF -6111 shall also be on site for final inspection. © 1. HVAC Chang eout Required Forms: • All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -4R 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 -4R forms: MECH-21 and (for split systems) MECH-25 -f 1-- ,,For ForSplit Systems: Dud leakage z 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH . Exempted from dud leakage testirg',if: ',❑ L Duct system "was documented to have been previously sealed and confirmed through HERS verification, or [12. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos 0'4. The system will not be Ducted (ie#Ductless+Mini-SplitSystem)r(Also Exempt from; Refrigerant Charge) 'if ❑ 2. New HVAC System Required Forms:.° If jz:. `: -- ..... J ;+a �� 4 4 k, Ir y'� • Cut in4or,Changeout with 5' ;/ o" new ducts: (all new CF-6Ryforms :MECH-04, MECH-20-HERS, and (for split systems) MECH-'22-HERS, and; MECH=25=HERS ducting ar � all new CF-4Rrforms MECH 20, and;(for split systems) MECH722; and MECH 25 equipment) !'1. For Split Systems: Duct leakage <,6 percent; RC CCA > 350'CFM/ton,, FWD, TMAH, SIMS, and either HSPP'orTSPP. 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 -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some equipment CF -411 forms: MECH-20 and (for split systems) MECH-25 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 linear feet of duct in unconditioned space. CF -4R 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: Kevin Robinson Signature: Kevin Robinson Company: J ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Aug 23, 2011 Address: 72216 NORTH SHORE ST #101 License: 777794 - City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 328-8096 _ f Reg: 211-A0043442A-00000000-0000 Registration Date/Time: 2011/08/23.13:33:02 •HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms. ,-July 2010 Bin # Qty of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �\ Project Address: MGru N V Owner's Name: "Z_ A. P. Number: Address: Legal Description: Contractor: City, ST, Zip: Telephone K(::7-;;7 r •' s "` Address: J ANTHONY SERVICES City, ST, Zip: THOUSAND PALMS, CA 92276 project Description: j Telephone.766 3l'+3 7,17-1 State Lie. # :- T7 -7 IiLi City Lie. C Arch., Engr., Designer. Address: City., ST, Zip: Telephone* P �`h:.. '. Construction Type:. Occupancy: << . State Lic. #:a • 'T>'` ., ..>�- : y Name of Contact Person: Project type (circle one): New Add'n Alter Repair Demo • Sq. Ft.:#Stories: # Units: Telephone # of Contact Person: Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates. 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:- ''' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Apps Date of permit issue School Fees Total Permit Fees