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11-1351 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 11-00001351 ,786'70 HIGHWAY 111 643-220-001-2 -000000- MECHANICAL REGIONAL COMMERCIAL 9000 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- 1� 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 B si and Professionals Code, and my License is in full force and effect. License lass:. JC20 License No.: 438781 tractor: NER-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: 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/21/11 Owner: i D WASHINGTON ADAM PARTNERSHIP 4 43692 PIASANO PL TEMECULA, CA 92592 c��. 1 ZOJJ s Contractor: a.• "�. COOL FLO INC ',. 44 79469 COUNTRY CLUB DR, #H BERMUDA DUNES, CA 92203 (760)345-6606 Lic. No.: 438781 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 1 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. 1-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 COWC239005 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any mer so as to become subject to the workers' compensation laws of California, a d agree the if I should became s ject to the workers' compensation provisions of Section Jy � 700 oft L or Co �al ort ith comply with those provisions. Date: / I// Applicant: , /ARNING: 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 at the above information is correct. I agree to comply with all city and co my or inances and state laws relati to buil • construction, and hereby authorize representatives of this co, o ty/to nter upon he above -mention rop spection purposes. at �! gnatura (Applicant or Agent): L Application Number . . . . . ,11-00001351 Permit . . . MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date Valuation 0 Expiration Date 6/18/12 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 OF EXISTING EQUIPMENT AT GNC RETAIL: PACKAGE UNIT 15.8 SEER, 12.8 EER. 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 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Reside tial HV,9CAlteratiotts CF -I R -ALT -HVAC Climate Zones 8 Site .-1 rlclress:Enfnrcenient. A enc r: ate Permit =: / GquipmcItT}PC, List Minintunt Lfficiencv' Conditioned Floor Area Thermostat Packaged knit Furnace Q AFUE ❑ COP 0 Indoor Coil EER�B Condensing Unit EF.R [5?HSP S d by system jzkmsf 'aback l/'nor alrcarlr prescm. nu s1 he in.radledl �,g Q Rcsistattce Other I. Equipment Tvpe: Choose the equipment being installed ifntore than one system use another CF -I R AL f-H\rAC litr each System. 2. Nlinimum Equipment Efficiencies: 133 SEER. 79%AFUE. 7.711SPh' for typical residential systems. HERS VERIFICATION SUMMARY Listed below are three HVACalteration 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 foams 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 foam was in fact the work completed by the installer. The inspector also verities that each appropriate CF -6R and registered CF -4R fonts (no hand filled CF-4Rs allowed) are tilled out and signed. Beginning October 1, 2010, a registered copy of the CF -1 Rand CF -6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -6R foams: iMLCH-04. Ml -CH- 25 -HERS replaced CF -4R fonts: MECH-2; • Condenser Coil and /or • Indoor Coil and /or CF -6R fonts: MUCH- 2; -HERS • Furnace C'F-4R ('onto: MECH-25 Systems: RC, CCA >-300 CFiM/ton. TMAH ko"90lit ckaged Units: No testing required ew HVAC System Required Forms: • Cut in or C'hangeout with new ducts: (all new ducting CF -6R forms: MECH-04. MEC H- 3> -HERS and all ne,,v equipment) CF -4R forms: MECI I -2s For Split Systems: RC, CCA > 300 CFM -ton. TMAH. For Packaged Units: No testing required El 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R Fonns: iMECII-?i-HERS and/or indoor coil and/or furnace. -Not all CF -4R lornts: MGCH-2� equipment changed. For Split Systems: RC, CCA 300 CFM%ton, TMAH For Packaged Units: No testing required Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certif} that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division ; ol'the California Business and Professions Code to accept responsibilit% for the design identified on this Certificate of Compliance. • I ccrtifj that the energy features and oerfitn»ance specifications fur the design identified on this Certificate of Compliance conform 'l to the requirements of Title 24. Partsand 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 m compliance fors- worksheets. calculations. plans and specifications submitted to the enforcement agency for approval with the erntitg. a .tic tion. ` Nannc: LA Signature I' CotCb,� �� Date: {� .�o License: f IfZ Addr twh Y� T`a City/State/lip: Phone: h •43 s a/ 2008 Residential Compliance Forms llarc•h 2010 P Bin # � , . .... .. .City' Q �f La il(11 tQ Building 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet • ... + Permit # �� Project Address: Owner's Name: � DNc t5 ALG A. P. Number: Address: Legal Description: City; ST, Zip: " Contractor Co C�t� D L��LO Tefe hone: :;>;x;;" Address: -7tD �1 �- Project Description: City, ST, Zip pa,+ Telephone: — �>s�;h„?�`':rs,�;�3:>,><:3t>>':•'x:�.%� State Lic. # : Arch., Engr., Designer. O City Lic. #: Address: City, ST, Zip: Telephone: p State Lic. #: Name of Contact Person: s" h `;:ga"`; . .%rY s,„N4�:: :^� ;>;;;>�:�s�; Construction T as Type: Occupancy: Project type (circle one): New Add'n Alt Repair Demo Sq. Ft:YL-%.n #Stories: # Units: Telephone # of Contact Person: P> 2,t9�_5 Estimated Value of Project: / f,2 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. 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 H.O.A. Approval Plans resubmitted Grading WHOM:-' ''d 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