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10-1204 (MECH)`f _ P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00001204 l Property Address: 79389 CETRINO APN: 772 -120 -031 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 Tu�/ " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect r Engineer: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Su sin n Professionals Code, and my License is in full force and effect. License Class: C20 -C36 L4nse N 7420 (i Date: Contracto . 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 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 _) 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 _ 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: MILCHMAN RESIDENCE 79389 CETRINO LA QUINTA, CA 92253 Contractor: D ALL SEASONS A/C, PLMBG P.O. BOX 1112 PALM DESERT, CA 92261 (760)568-2663 Lic. No.: 827420 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/05/10 ° D NOV 0-8 2010 A2 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 NORGUARD INS Policy Number ALWC124752 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 la s of California, and agree that, if I should b ome subject tothew s c pensation ons of Section 3700 of the Labor Cod sh I forthwith c with th a provi Date: % O Applicant: ZIA // 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 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 a o comply with all city and county ordinances and state laws relating to buil ' ��Iion,hereb a representatives of this county to enter upon the above-mentioned pro ban i se _Date: Signature (Applicant or Agent). 11 4 . .. Application Number . . . . . •10-00001204 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . Valuation . . . . 0 Expiration Date 5/04/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH ----------------------------------- B/C <=3HP/100K BTU 9.00 ----------------------------------------- Special Notes and Comments AIR CONDITIONING & FURNACE CHANGE OUT 17 SEER 5 TON 2007 CODES. ----------------------------------- =---------------------------------------- _ Other Fees •... . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ----------------- ---------- Paid Credited Due ----------- Permit Fee Total 33.00. I -------------------= .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -1R -ALT -HVAC Alterations Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 79-389 Cetrino La Quinta, CA 92253 City of La Quinta Nov 5, 2010 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit 0 Furnace 0 AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system a Setback 0 Indoor Coil 0 SEER 13.0 [3HSPF ❑ R 8 (CZ 14-15) 2000 sf If not already present 0 Condensing Unit ❑ EER F] Resistance must be 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, Z7HSPF 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 -611 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 -1R 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 -411 forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF -6R 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 For Packaged Units: Duct leakage < 15 percent Exempted from duct leagage 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 1:12. New HVAC I Required Forms: V System / r- rl / f 1 ! _ ! J, • J . Cut in or Changeout new ducts: CF -6R fo'rms: MECH-04 MECH-20-HERS and (for split systems) MECH-22=HERS, and�ti,.^� with (all new ductingaad' 11 MECH=25-HERS �J f - f � w g l; , lf CF -4R forms:,MECHr20,•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 El 3. New Ducts with/or without Required Forms: Replacement s . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor coil CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS 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 CF -6R forms: MECH-04, MECH-2I-HERS than 40 linear feet of duct in CF -4R forms: MECH-21 unconditioned space. 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: David Beale Signature: David Beale Company: ALL SEASONS AIR CONDITIONING PLUMBING & HEATING INC Date: Nov 5, 2010 Address: P 0 BOX 1112 License: 827420 City/State/Zip: PALM DESERT / CA / 92261 Phone: (760) 568-2663 t 0 Reg: 210-A0023704A-00000000-0000 Registration Date/Time: 2010/11/05 12:45:40 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 rro ===Jm���Projca �tm Type: Oa�ncy: State LIP#: (circle one): New Add'n � Repair Demo Name ofContnet person: Sq- F-: Stories: I# units. Telephony # of Contact Person: Estimated Value of ptoJeet 0 00 Ci• ` 2 APPLICANT: DO NOT WRITE BB.OW THIS UNE U Bin # Crty of U Quetta Req'd Building & Safety Division Perrrilt # P.O. Box 1504, 78-495 Calle Tampko La Quints, CA 92253 - (760) 777-7012 + , Building Permit APPilcation and Tracidng Sheet Item Anosnt Project Address:' Owner's Name: 1✓ Plan Se6 A. P. Number: Address: . Legal Description: City. ST, Zip: Contractor. W, S Plan deck Balance Address: city. sr, zip: Com- � CL:Z Telepitoner76v —66 �6-2c-,63 Prqca Description: r)�_L ��� 5 • � �� Rerievred, res State Lia #: `—' City Lia #; T m tea' dy for eorrectionstassue (}W.. Deoper Person Title 21 cafes. Plumbing Adm: Plans picked a Flood plain plan City. ST. Zip: Grading Plans raubmi Teleptione: Person ===Jm���Projca �tm Type: Oa�ncy: State LIP#: (circle one): New Add'n � Repair Demo Name ofContnet person: Sq- F-: Stories: I# units. Telephony # of Contact Person: Estimated Value of ptoJeet 0 00 Ci• ` 2 APPLICANT: DO NOT WRITE BB.OW THIS UNE U Submittal Req'd Reed Item Anosnt for corrections Plan Se6 Plan Check Deposit Person Plan Chock Plan deck Balance Straetural Cafes Coastrsction Rerievred, res T m tea' dy for eorrectionstassue C&IW contact Person Title 21 cafes. Plumbing p Plans picked a Flood plain plan Grading Plans raubmi Grading plan Person 2'! Rewlew, rea issue Subeontactor List filled Cbnaa Grunt Deed Plans picked a H.O.A. Approval Plans resubml IN HOUSE:- Review, res Planning Approval Caked Contact Pub. Wks. Appr Date of permit School Fees IUCIMG aba�Itted d7 p the fled a PERMIT FEES Item Anosnt for corrections Plan Check Deposit Person Plan deck Balance Coastrsction Mechanical dy for eorrectionstassue Electrical Person Plumbing p Grading dy for eorreetionsAssue Developer Impact Fee Person A.LP.P. issue Total Permit Fees