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10-1279 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00001279 Property Address: 79615 CETRINO APN:. 772 -330 -036 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8624 Applicant: Tay/ 4 4 Q" - BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: /W�_ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Nness and Professionals Code, and my License is in full force and effect. Llcensa,CIAss- C20 I _ LicensaXM: 686310 V 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.). (_) 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: CONSYRUCTION 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: STOSS GEORGE 79615 CETRINO LA QUINTA, CA 92253 ( Contractor: GENERAL AIR CONDITIONI G 31170 RESERVE DRIVE _ THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/22/10 r Ota zoo ► ;`; G1Ty rJF LA QUiN7-A WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 EVEREST NATL Policy Number 7600006147101 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 laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 0 of the Labor epe, I shall forth ith c mply with those provisions.. Dat Applicant: WA ING' 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 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned p/rop^e��'rtyJJJ for iinnf�pection purpo s. ` Date/1? %-0��/ ignature (Applicant or Agent;✓�Y`f� /E1 LQPERMIT Application Number . . . . . .10-00001279 Permit . . . . . MECHANICAL Additional desc . . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date Valuation 0 Expiration Date 5/21/11 Qty Unit Charge Per Extension I BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT'13 SEER 2007 CODES. ----------7----------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 24.00 .00 .00 24..00 . Plan Check Total 6.00 .00 .00 6..00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 LQPERMIT Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF-IR-ALT- s F-IR-ALTs 10 to 15 FnPackaged eAddr..ess. F.'nforcement,Agencv: Dater Permit#. Conditioned Floor Equipment T e' List Minimum Efficienc 2 Duct insulation requirement Area Thermostat Unit o lnondensing urnace ❑ AFUE' ❑ COP Over 40 ft of ducts added or ,kSetback door Coil ❑SEER ❑ HSPF replaced in unconditioned space Served by system (If not already Unit ❑ EER ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be ❑ Other ❑ R 8 (CZ 14-15) installed) I. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUAIMARY 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 T.ed. B innin October 1 2010, a re istered co of the CF -1R and CF -6R shall also be on site for final ins ection. 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 forsplit sstems MECH-25 • Condenser Coil and /or • Indoor Coil and an CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS 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: ❑ 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 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 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 CF -4R forms: MECH-20 and (for -split systems)1viECH-25._— _ coil and/or furnace. Not all 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 Re uired Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -611 forms: MECH-04, MECH-2I-HERS 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, 11 calculatio tans ands ecifi 'ons submitted to the enforcement agency forapproval with the i a li i . Name:110 Signature: Company: Date:. Address: 2� License: (/9,24 0 City/State/Zip: Phone:', O, raplified Prescriptive Certificate of Compliance: 2008 Residential RVA C Alterations CF -IR -ALT -HVA [mate Zones 10 to 15 F drBs : Fn Forcement4gengv: Date: Permiti157 C4—ly-ri Conditioned Floor i ment T er List Minimum Efficienc z Duct insulation requirement Area Thermostat rl Packaged Unit o Furnace ❑ AFUE� ❑COP Over 40 ft of ducts added or Setback ndoor Coil ❑SEER ❑ HSPF replaced in unconditioned space Served by system (If not already ❑ R 6 (CZ 10-13) sf present, must be ondensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor typical residential systems. KERS 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 -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 lits 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: ❑ 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 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 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 CF -4R forms: MECH-20 and(for split systems) MECH-25 coil and/or furnace. Not all 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 split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems 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 thi's 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, calculatioy,ol,plans ands ecifi "ons submitted to the enforcement agency for approval with thej)6r4lit appliwQ1. Name: Signature: Company:r�2 (0� Date: ! / —92 --ID Address: 1 e r� License: �0 City/State/Zip: ( Phone: --7(_V0, 3U-2;,- 7L4%J CaICERTS - CF -1R Registration Pagel of 1 Home AboutIs Tninin�, Rater Directory \ltmbenhip 6enefita Events Indmtry 1'mmet. New Danielle Garcia logged in [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 79615 CETRINO La Quinta, CA 92253 CEC Registration: 210-A0026807A-00000000-0000 CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD ENTERPRISES 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: Energy Driven Solutions, Inc. Every CaICERTS rater has a license number. Ifyou need to find the rater by name [Click HERE] to search our directory. SEND -CF -1 R TO HERS.RATER [CLICK HERE] to do another Copyright © 2010 CalCERTS, Inc. All rights reserved. Revised: January 11, 2010 [Terms and Conditions] [Privacy Statement] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Tou Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402, E -Mail: info@calcerts.com BBB - httns_//www.ca.lcert.s_cnm/nnhlic cfl R .cfm9nrniPrt ir1=R4960 1 1 /??/?()In rs,n ffCity Of La Quin Building 8I' Safety Division 'Permit # P.O. Box 1504, 78-495 Calle Tampico r La Quinta, CA 92253 - (760). 777-7012 �. Building Permit -Application and Trackin Sheet g Project Address: Owner's Name: A. P. Number: Address: 7q S Legal Description: City, ST, Zip: et_ Contractor:>:. Address: ✓ r "'✓f'' Telephone: ? Project Description: City, ST, Zip: PY ,n /- Telephone: V State Lic. # : 3 City Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone:':r`:., State Lic. �;:.:.• 4 sr.r r Construction Type: Occupancy: project type (circle one): NewAdd n Alter Repair Demo Sq. Ft.: #Stories: #Units-. Name of Contact -Person: Telephone # of Contact Person: Estimated Value of Project: & il, C7� APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets . Pian Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Caics. 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:- 7nd Review,.ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr. Date of permit issue School Fees Total Permit Fees