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MECH (12-0783)`C� 414 P.O. BOX 1504 QuAm VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/16/12 Application Number: r-'12-OaO0:07-833Owner: Property Address: 81215 NATIONAL DR KUMP FAMILY / PETER E K D APN: 767-500-010- - - 81215 NATIONAL DR G /� Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW. DENSITY RESIDENTIAL 11 Application valuation: 12400 J�'- 16 Contractor: C�il'pF Applicant: Architect or Engineer:0 CONDTIONING 3117RESERVE IVE F�NgIyGE �p q THOUSAND PALMS,.CA 92276 (760)343-7488 Lia. No.; 686310 ------7------------7--------7----7---------=------ LICENSED CONTRACTOR'S DECLARATION _ I hereby affirm under penalty of perjury that I am lic sed under provisions of Chapter 9 (commencing with Section 7000) of Division 3' of the Business and Pr sionals Code, and my License is in full force and effect. - Lice a Class: C20 License No.: 686310 Date: '7/6 1 ontractor: ER -BUILDER DECLARATION - I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the ' following reason ISec. 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, thebuilding 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 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 -———————————————————--—————————————---————————— 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 CO Policy Number Z071741501 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 sutth the workers' compensation laws of California, and agree that; if I should become subjecworkers' compensation provisions of Section 3700 of the abor Code, I shall forthwith with those provisions. plicant: ' /WARNING:: FAILURE TO SECURE WORKERS' COWPgATION 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 ssation of work for 1.60 days will subject permit to cancellation. 1 certify that I have read this application and state that the above inf tion is correct. I agree to comply with all city and county ordinances and state laws relating to building const c ton, and hereby authorize representatives githis county to enter up he above-mentioned property for insp on urposes. /Date: %f/� gnature (Applicant or Agent): LQPERMIT Application Number . . . . . 12-00000783 Permit . . . MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date ." . . Valuation . . . 0 Expiration Date 1/12/13 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 HVAC CHANGE -OUT: INSTALL NEW 5.TON SPLIT SYSTEM. 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 81215 NATIONAL DRIVE La Quinta, CA 92253 City of La Quinta Jul 15, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER 13. ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system ® Setback If not already y present, must be ® Condensing Unit 9 —� ❑ EER ❑Resistance ❑ R 8 (CZ 14-15), 2088 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -ZR -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 -IR and CF -6R shall also be on site for final inspection. ® 1. HVAC Changeout 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 ' 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. The system.w:ill not be Ducted (ie,,,Duetlesslmin-Split:5.ystem)r(Also Exempt frompRefrigerant=Charge) ❑ 2. NeW HVAC System Required Forms: � r:'• � * _ � .� c t�, .( } f . Cut intor Changeout with -° new ducts:i all new ( r x CF 6R forms: MECH-04, MECH-20 HERS, and (for split systems) MECH-22-HERS, and - ducting,and all ne.w � r/' ► �` � � � � � -�-- MECH;'25 HERS �k t ' -- - .,I CF 4R forms: (MECH 20, and (for split systems) MECH=22, and�MECH-25 a For Split Systems:' -Duct leakage <;6'percent RC, CCA 7?.-, CFM/ton, FIND, TMAH STMS, and either, HSPP"ot PSPP 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 CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace..No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 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 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: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: Jul 15, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg:•212-A0037415A-00000000-0000 Registration Date/Time: 2012/07/15 10:36:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms y July 2010 f }4 City. 'Fu Quirtta Building 8t Safety Division P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 - (760) 777-7012 Building Permit' Application and Tracking Sheet Permit # 2783 Project Address: 8 Z 7 N Q On W. Owner's Name:. A. P. Number. 5 Q O Address: 2 �j N , h Legal Description: City, ST, Zip:� Contractor: i Y Telephoner Address: _ 11 Project Description: Cj Tele hon ' State Lie. #: D 6. D City Lic. #; . Arch, Engr., Designer Address: City., ST, Zip: Telephone: State Lie. #: Construction Type: , Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft: �� #stories: #Units: Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE H Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cases. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Title 24 Calci. Plane picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2`' Review, ready for corrections/issue Electrical Subcontattor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" 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