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11-1213 (MECH)P:O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00001213 Property Address: 80719 CHERRY HILLS'. APN: 775-132-013-. - Application description: MECHANICAL. Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5000 Applicant: Architect or Engineer: PJA LICENSED CTOR'S DECLARATION I hereby affirm underpenahy of -perjury_ hat I a need under provisions of Chapter 9 (commencing with Section? 00) of Division 3 of the, Bu nese Professionals Code, and my License,is in full force and effect: License 620 _... C ctor: IF OWNGR-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am^exempt from the.Contractor's.State .Lleense.Law forthe following reason (Sec. 7031.5, Business and.Professions Code: Any city or,coumy that requires a permit to wnstruat,,alter, improve, demolish, or repair any structure, prior Wits issuance, also`requlres the applicant,for the permt.to fiWs 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 Section7031.5 by any applicant fora 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 wiih wages,as their sole compensation, will do,the work, and thestructurels not, intended or offered forsale (Sec. 70",,Business and Professions. Code. The Contractors' State:License Law does not'epply 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, Improvement s are not intended or offered for sale. If,. however, the building or improvement Issold within one year of completion, the owner-bullderwill.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 - 7044i Business 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 wntractoos) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under. Sec, ; 8.&P.C. for this reason Date' Owner: - - CONSTRUCTION LENDING AGENCY I hereby affirm under penalty: of perjurythat there is a construction lending agencyfor the performance of the work for which this permit is Issued (Sec. 3097, Civ. C.). Lender's Name:. Lender's Address: Owner: MARTIN 80719 CHERRY HILLS LA QUINTA, CA 92253 Contractor: AIR EXPERTS AIR, CC PO BOX 94 LA QUINTA, CA 9224 (760)777-1724 Lic: No.: 725283 VOICE (760) 777-701-2 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/07/11 ONG FiTG0 r `ZD1 j JPj ----------------- 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;performanee of the work for which this perrnitis issued. I have and will maintain workers' compensation insurance; as required by Section 3700 of the Labor Code, for the performance of the work rfW,which this permit is issued. My workers' compensation Insurance, carrier, and policy num are: Carrier GUARD' INS GROUP- - Poll& Number PAWC226751 I certify that, Irf tKe perform ce of th ork for which this permit Issued, shall not employ any person in any manner as to b me subjecf,to the workers' compensation laws of California. end agree thaD. if I sh Ide-subject to the workers' compensation provisions of, Section. 3700 of the Labor C nen to ose prov�siong. /Date• 1l want WAR IN p 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 (8100,000)• 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 fora permit subjecfto the conditions and restrictions_:set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose requestand for whose benefit work is performed under orpursuant to any permit -issued as a result of.this application, the owner, and the applicant, each agrees to, and shall defend, •indemnity and hol8:harmless the City after Quinta, its,officers, agents and.employaes for any actor omission related to the work being performed under or following issuance'of this permit. 2. Any permit Issued as a resultof this application becomes:null and vold.ifwork is not commenced within 180 days from date of Issuance of such permit, or cessation ofwork for 180 days will -subject permit to cancellation. I certify that I have read this application and stets tfbulidingc a above i ormation incorrect. I agree to comply with all city and county ordinences and state laws relating t truction, and hereby authorize represenof thj u t ent;uponabove mentioned py nspection purpos ate: 7 l - Applicant or Age"; Application Number . . . . . 11-00001213 Permit.MECHANICAL Additional desc . . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date Valuation . . . . 0 Expiration Date 5/05/12 Qty Unit Charge Per Extension' BASE FEE 15.00 1.00 9.0000 EA NOTCH FURNACE <=10.0K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-50OKBTU 16.50 ---- --------- Special Notes and - Comments INSTALL NEWS TON PACKAGE UNIT. 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 LQPERM[T Simplified Prescriptive Certificate of Compliance:: 2008 Residential IfVACAIterations CF-IR-ALT-HVAC Climate Zones 10 - 15. Site Address: Enforcement Agency: Date:Permit #: 80-719 Cherry Hill. La Quinta, CA 92253 City of La Quinta Nov 7, 2011 Dud insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat 0 Package Unit ❑ Furnace ElIndoor Coil O AFUE 80% Ea SEER 15.0 (:]COP_ ❑'HSPF LlR 6 (CZ 10-13) Served by system ® Setback if not already present, must. be ❑ Condensing Unit ❑ EER ❑.Resistance ❑ R 8 (CZ 14-15) 2000 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being lnstalled; if more than one system, use another'CF-SR ALT-HVAC for each system. 2. Minimum, Equipment Ef►Ielendes: 13 SEER, 78% AFUE, 7.7HSPF lbr 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 tothe 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-611 and registered CF-411 forms (no hand filled CF-411s, 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. 0.1. HVAC Changeout Required Forms: • All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS replaced CF-411 forms: MECH-21 • Condenser Coil and /or CF-611 forms: MECH-04, MECH-2I-HERS • Indoor Coil and /or split CF-411 forms: MECH-21 -_a (ter split systems) MEG14 MEG14 • Furnace -.._ _. _,_�...-� Packaged Units: Dud leakage e 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 [13. Existing duct systems are constructed, insulated or sealed with asbestos 04. The,systeirm.mill.not be Ducted (ie.-Ductiess;Mirti=Split-System) (Also ExerriDt�from'Refrigerart-Charge) ❑'2. Nevin HVAC System Required Forms: t • Cut in'or Changeout wjthCF-6R.forms, MECH-04, MECH-20=HERS; and (for split systems)MECH=22-HERS, and new duds: (all new !; ducting &ad all new,% " MECH-25-HERS i /. T CF-4R forms: MECH.20 and (for splits~stems) MECH-22, and MECH-25 ._, 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/or without Required Forms: Replacement • Includes replacing or installing all new ducting and/or outdoor condensing unit CF-611 forms: MECH-04, MECH-20-HERS, •and (for split systems) MECH-25-HERS and/or indoor coil and/orfurnace. No or some CF-411 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-611 forms: MECH-04, MECH-2I-HERS linear feet of dud in unconditioned space. CF-4R forms: MECH-21 For split system, or packaged units: Dud 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 Callfomia 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: Paul Van Vlymen Signature: Foul Van Vlymm Company: AIR EXPERTS AIR CONDITIONING-HEATING Date: Nov 7, 2011 Address: PO BOX 94 License: 725283 City/State/Zip LA QUINTA / CA / 92247-.0094 Phone: (760) 777-1724 Reg: 211-A0057631A-00000000-0000 Registration Date/Time: 2011/11/07 11:24:13 KERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin #. CltY Of La Quinta . SAIng ar Safety. DMdon P.O. Box .1504, 78-495 Calle Tampico La Quinta; CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:6'7/ lbG L Owner's Name: �� ,�/ A P. Number: �A/ Address: Flo 7/ Legal: Description: City, ST, Zip: ZA 6A -IJ, -1A- a Contractor:A Telephone: Address: a)o X �/ Project Description: City, ST. Zip: 5Z7 L% Telephone: —2(o (3 -777!?2 e% State Lic # : City Lic. #, AS _2e -c Ak t/n1I Arch., Engr.; Designer: Address: City, ST. Zip: Telephone: Siete Lica#: Name.of Contact Person: Construction Type: Ory: Project.type (circle one): New Add'n Alter Repair Demo #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: _ APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Reqld Rec'd TRACING PERMrf FEES Plan Sets Plan. Cheek submitted Item Amount Structural CalcL Reviewed, ready for. con ons Plan Check Deposit Trans Cain. Called Contact Pawn Plan Cheek Balance • "Otic 24 Cates. Plans picked up Construction ' Flood pinta plan Plans submitted Mechanical Grading.plan rXeview, ready for eorreedoasJlssne Electrleal Sabcontactor list Called Contact Person Plumbing GraotDeed Plans picked no S.M.I. MO -A. Approval Pians resubmitted Grading IN HOUSE:- Review, ready for eorrectlonaftm Developer Impact Fee Planning Approval Called Contact Person. M.P.P. Pub. Wks. Appr Date of permit tssnt Sebool Fees Total Permiffees