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MECH (12-0665)P.Q. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000665 Property Address: 56250 MUIRFIELD VILLAGE APN: 762-390-006- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7666 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professi Is Code, and my License is in full force and effect. License Class: C20 Z License No.: 968141 Zllate: 6 Contractor: - UILDER 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 ($500).: 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.). (_) 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.). Lender's Name: Lender's Address: LQPERMIT Owner: ROBERTS ROY C 56250 MUIRFIELD VILLAGE e -- LA QUINTA, CA 92253 t VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/14/12 M ' JUN 14 2012 Contractor: I DCS AIR CONDITIONING GP°Y OF ;, A Lj;,yaN �/ 72078 CORPORATE WAY, #101; T);1(:.xl!, THOUSAND PALMS, CA 92276 (760)343-5562 Lic. No.: 968141 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 ZENITH INS Policy Number Z071741501 I certify that, in the performance of the w k for which this permit is issued, I shall not employ any person in any manner so as to becom ubject to the workers' compensation laws of California, and agree that, if I should become su - ct to the workers' compensation provisions of Section 3700 of he Labor Code, I shall fort it/co ply with those provisions. Date: 6 4 Applicant: WARNING: FAILURE TO SECURE WORK PENSATION 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 I have read this application and state that the abo a nformation is correct. I agree to comply with all city and county ordinances a state laws -relating to building o struction, and hereby authorize representatives of this;�Fe he above-mentioned property fo i spa tion purposes. Date: (Applicant or Agent): Application Number . . . . . 12-00000665 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 31.50 Plan Check Fee 7.88 Issue Date . . . Valuation . . . . 0 Expiration Date 12/11/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT: CONDENSER & COIL. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 31.50 .00 .00 31.50 Plan Check Total 7.88 .00 .00 7.88 Other Fee Total 1.00 .00 .00 1.00 Grand Total 40.38 .00 .00 40.38 LQPERMIT G Simplified Prescriptive Certificate of Compliance: 2008 Residential N ACAIterations . CF -IR -ALT -HVAC Comate Zones 10 to 15 Sire Address: L/7 ,.�1 ornament ai Dote: Perndt #: Floor. Equipment TYPe ' List Minimum Efficiency2 Duct insulation requirement Area Tbemostat Unit Over 40 ft of ducts added or . Setback AFUE [57 COP � m unconditioned space Served by system ,wt aka* HSPF beUnit kPaWdmg,ed oil EER R6 (CZ10-13) sfp�^t asst EER � lig R 8 (CZ 14-15)ftdaW t Tj+pe Choose the equipment being 6rstalled if more than one system. use another CF -IR ALT-XYACfor each system. 2. Minimum Egtdpmem E iC owtes: 13 SEER 78r/ AFU$ 7.7BSPFfor typical mxdentral systems $EitS VERIFICATION StThEWARY Listed below are four HVAC alteration Options. The installer decides what work is being done and HERS that be conducted. A copy of the forms shall be left on site for final picks one of the appropriate Options. Each Option lists the measures mast 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and October 1, 2010 a rcgbftred copy of the CF -1R and CF -6R shall also be on site for final inspection. HVAC Changeout 1-11 Required Foy: CF -6R forms: MECH-04, NEBM-2I-HERS and (for split systems) MECH- 25 -HERS • All HVAC Equipment replaced CF4R forms: MECH- 21 and for split stems MECR-25 • Condenser Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • indoor Coiland /or CF4R forms: MKS- 21 and (for split systems) MEM -25 • Ftmnace For Split Systems: Dud leakage < 15 percent; RC, CCA >_ 300 CFM/tgn(Ivfrnimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent 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 dud sysmwwnsareconstruct4 insulated or 9eaW with asbestos 0 2. New HVAC SYSUM Required Forms: • Cut in or Chapgeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-11ERS, and MECH-25-HERS ducts: (all new ducting Rd all CF -4R forms: WM 2O-, and (for split systems)MECH-22, and MECH 25 new equipmaAA For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFMhon, FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 per=1 3. New Ducts whWor without Replacement Required Forms: • Includes replacing or instellin8 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 CF4R forms: MECH-20 and (for split systems) WCH-25 and/or fiunace. No or some equipment c1=ged For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH For Pagend Unids: Dud leakwe < 6 Percent 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 CF -0R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21 linear feet of dud in unconditioned For split system or packaged units: Dud leakage < 15 percent EXCEPTION: Ddsting duct systems coxistructod, insulated or sealed with asbestos. . Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I ca* that this Caacxie of Complicate doccan ftwn a acmate and complete. • I am eligble under Division 3 of the California Business and Professions Code to accept responsibility for tie design identified on this Catif ft of Compliancx. Catid ate of C=plianoe con&M W the requirements of 7rde 24, I ca* that the energy features and performance specifications for the design identified on this Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information domaaented on other applicable compliance fomes, aaicst>e, cal and soecificatons stibinitted to the criftcanimt aamm for gooroval with li Name: Signature: Company: r c7-7 GS � License:..1 Address: �- #Z O I City/statetip: —rhA-,�.6a.,�t y}-'1 Phone: `ileo Vis- SSfo a" CaICERTS - CF -1 R Registration Page 1 of 1 Public Home Secure Home About Us Training Rater Directory Forms Membership Benefits Events Industry Partners News To register for our monthly newsletter, please click here. LESLIE ROGAN logged in [Logout] [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 56250 MUIRFIELD VILLAGE La Quinta, CA 92253 CEC Registration: 212-AO029782A-00000000-0000 CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD ned Driven Solutions, Inc. [CLICK HERE] to do another Copyright © 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 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 BBB Y.rt WIN1W https://www.calcerts.c'om/public_cflR.cfm?project_id=193012 6/9/2012 Birt# City of La Quinta Building 8C Safety Division I•Q P.O. Box 1504, 78-495 Calle Tamplw La QWnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # � " Project Address: :e 's Name: A- P. Number. rXd&;e—,ss: / aLegal Description: T, Zip: Contractor: S Telephone. Address' dl Project Description: City, ST, Zip: —4LC& P Telephone: -Zz State Lic. #: City Lia #; Arch.. Eng., Designer. Address: City, ST, Zip: T one: Construction Type: Occupancy: tate Lic. Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft: �. # Stories: # Units: SEi Telephone # of Contact Person: Estimated Value of Project: �— APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cala Pians picked up Construction Flood plain plan Plans resubmitted . Mechanical Grading plan 2" Review, ready for correctionwIssue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correctionsrwue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees