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13-1594 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001594 Property Address: 79603 POMO APN: 772 -180 -061 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2500 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Zk U :nrr- 1 0 2013 TY OF _LA QUIMT FINANCE DEPT. 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 Business and Professionals Code, and my License is in full force and effect. Licrs!.Class: C20 LicenseNo.: 686310 k_�' Date: 12-11D113conif/acZr: 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 therefro m 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, 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, 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. _, B.&P.C. for this reason Date: Owner: I 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: W/"��.RMIT Owner: BRONSON CJ 79603 POMO LA QUINTA, CA 92253 (760)771-9612 Contractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE THOUSAND PALMS., CA 92276 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (7i&0) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/10/13 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 _j6 ed - 1:-S-1-haysuand will maintain workers' compensation ins6rance, 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 Z071741503 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 3700 of the Labor Code, I shall forthwith comply with those provisions. ____1 D J�t_ol 11 ' Ape ri-ant: 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 wo rk 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 construciion, and hereby authorize representatives of th!,s,�nty to enter upon th b ntioned property for inspection purposes. Signature�(=pplicant Date: or Agent): LAAAJZ— LQPERMIT Application Number . . . . . 13-00001594 Permit . . . . . . MECHANICAL 2013 Additional desc . . Permit Fee . . . . 35.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/08/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH FURNACE 35.75 ------- -------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - 5 TON HVAQ CHANGE OUT (COIL ONLY) (2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 23.83, - Fee summary, Charged Paid Credited ---------- ---------- ----------- Due --------------- ---------- Permit Fee Total 35.75 .00 .00 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 115.40 .00 .00 115.40 Grand Total 151.15 .00 .00 151.15 LQPERMIT Din# .City of La Quinta -Building &r 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: -7 q C> Owner's Name: A. P. Number: Address: -7960--% Legal Description: City, ST, Zip: CA (�I LZJG�3, Contractor: Gc-y\ c_� A-;, Telephone: Address: -10 Project Description: City,ST,Zip: CA q 7- ZS --:s ov, \��j Telephone: -7�0_ -7 -7 1— q ....................... State Lic. # : (0 (0 10 City Lic. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: Units: Telephone. #,of Contact Person: Estimated Value of.Project: scc:> APPLICANT: DO NOT WRITE BELOW THIS LINE M Submittal Rcq'd Rec1d TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit Truss CaIcs. Called Contact Person Plan Check Balance. Title 24 CaIcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2,d Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Planspicked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3d Review, ready for corrections/issuc Developer Impact Fee Planning Approval Called Contact Person, A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: 7ermit 79603 FOMO La Quinta, CA 92253 City of La Quinta Dec 3. 2013 'Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat L] Package Unit [3 Furnace [3 AFUE E3 COP [3 R 6 (CZ 10-13) Served by system Setback to Indoor Coil [3 SEER [I HSPF [3 R 8 (CZ 14-15) 397.1 sf If not already present, must be 13 Condensing Unit [3 EER_ Q Resistance installed) [30ther_ 1 , - I 1. Equipment Type: Ch;o- the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies. 13 SEER, 78% AFUE, 7.711SPF 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 tothe homeowner. At final, theinspector 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 -111 and CF -611 shall also be on site for final inspection. 9 1.- HVAC Changeout Required Forms - .All HVAC Equipment CF -611 forms: MECH-04, MECH-21-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-21-HERS and (for split systems) MECH-25-HERS • Furnace CF , -411 -forms: MECH-21 and (for split systems.) MECH-25 For Split Systems: Duct leakagel<:15 percent; RC, CCA :5 300 CFM/ton (Minimum Air Flow Requirement), TMAH For. Par.16aged Uni­ M.-19 pereeRt Exempted from duct leakage testing"..1f bl."Duct% system ­iWi s documeikied to have been previously sealed and confirmed through HERS verification, or 0 2. Duct systems with less th A'A',40.1inear feet in unconditioned space, or 0 3. Existing duct systems are, 4structed, insulated or sealed with asbestos O.A. Th��T, not be Duet6d1ie,;',,., ni7 T. r:ge) �p El 2. Nejn�S .. ..... ... . Requil�,, 0.6 IM, Cut inr' KtAlibrigeout new :CH -04, ducunq.�,and all new. R.- equip _1V For Sp fit's V01ems'C,:.,. .0 MS an ei e Forfackagied nift: Duct leiaka, 113. New--Ducts`-"�With/or Required Forms: Includes replacing or iriltt:alling a - It r i ew ducting and/or outdoor condens-itig.,unit CF -6R forms: MECH-04, MECH.-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or hirnac`:e:`:�':':'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 a- 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 13 4. New Ducting over 40 feet Required Forms: Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-21-HERS I linear feet of duct in unconditioned space. CF -411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent . [3 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 informatio , n documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Dayana Valdez ISignature: boyana Valdez Company: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING Date: Dec 3, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 ,City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 213-AO090289A-000000000-0000 Registration Date/Time: '2013/12/03 15:-08:22 .2008 Residential Compliance Forms HERS Provider: CalCERTS, Inc. July 2010 I I