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13-1142 (MECH)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001142 Property Address: 52385 AVENIDA RUBIO APN: 773-252-017-6 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 22.00 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION fir BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professiohals Code; and my .License is'in full force and effect. License, lass: B -.C36 -C20 FI 'nA F' License No.: 704414 D t 1 O..l�.. Con�ctor: 1 LI p 91 t. INM6 1 . 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 structule; 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 -7600) of Division 3 of the.Business and. Professions.Code) or that he or she.is:6empt therefrom and the$asis for the alleged exemption. Any violation of Section 7031.5 by. any applicant fora permit subjects the applicant to a civil'penajty..of not more than five hundred dollars ($500).: 1 _ 1 I, as owner of the property, -or my, employees with wages as their sole compensation,'will do the work, and the'structureJs not intended or. -offered for sale (Sec. 7044„86siness 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 nofbuild or improve for the purpose of sale.). (_ 1 I, as owner ofthe 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`wtio'builds or improves thereon; and'who contraets'ior the projects with a contractorlsl licensed pursuant to the Contractors' State License Law.). (_ I 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: ANGELA QUINTANA 52385 AVENIDA RUBIO LA QUINTA, CA 92253 ( Contractor: RELIABLE ENERGY.MANAGEMENT; 7201 ROSECRANS.AVENUE'• PARAMOUNT, CA 90723 (562)984-5511 LiC: No.: 704414 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/10/13 D � I �P.1 o:2:03 CITY OF LA QUINYA FINANCE.DEPT. 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 forby Section 3700 of the Labor Code, for the performance of the work.,for which this'permit is / ssued:' I'have and will maintain workers' compensation insurance, as required by Section 3700of 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 STATE FUND"' Policy'Number 9039439 I certify that, in the performance of the work'torwhich thispermit 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 ode, 1 shall for'f ith comply with those provisions. late pp 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. r 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 actor omission related to the work being performed under or following issuance of this permit. 2. Any permitissued 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 ounty to.1le tqE\r upon the. a/�borve mentioned property for inspection purposes. Date: ! fl�o 1 �..6ignature` "(Applicant or Agen Application Number . . . . . 13-00001142 Permit . . . MECHANICAL 2013 Additional desc . . Permit Fee . . . . 71.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/09/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH FURNACE 35.75 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 -----------=---------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - 13 SEER, ROOF PACKAGE UNIT [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 47.66 Fee summary Charged Paid Credited ------------------------------------- Due -------------------- Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total A0 .00 .00 .00 Other Fee Total 139.23 .00 .00 139.23 Grand Total 210.73 .00 .00 210.73 LQPERMIT Bin # , Cay of.La `Qunta -Building & Safety'DiWsion �P.0..•Box 1504;..78-495 Calle Tampico La Quinta,�CA 92253- (76.0)1777-7012 Buildim Permit Application and �Trackigk5heet Permit # ( Project Address: V : v :I . O. erA Owns Name: . a V' L'l V N A IY° A. P. Number: Address:'J V;a'V 14A A A;' O Legal Description: .City, ST, Zip: 1; N NQ G -� L. 'v Contractor: IU L E Nil y , ' Telephone: > _. ' .`: t::?::%S'i,:'} s:::; Adress: c� . N.GPro ect Description . :f: ouT oo F Ach AGS City, ST, Zip: .M t"U NSI T �, k ,: ' 0 -' .1' :Q N 1 � . N E Al � L,C Telephone: State Lic. # : City Lia #•: Arch., Engr., Designer: A 1 Address: City, ST, Zip: Telephone: >< Construction•Type: Occupancy: State Lic. #: Project type (circle one): New Add n Alter Repair Demo Name of Contact Person: o U IRT, Sq. Ft.: # Stories: #Units: Telrphone #,of Contact Person:' 0F. . I EsGrriated Value of APPLI CANT:, DO -NOT.: WRITE. BELOW,,THIS LINE # Submittal Req'd -' Rec'd 4 TRACKING , 'PERMIT FEES. Plan Sets PlaruCheck;submitted. Item Amount Structural Calcs. Reyiewed,•ready for corrections Plan Check.Deposit Truss Calcs. Called Contact Person -A',,- Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted • Mechanical Grading plan 2od,Review, ready for corrections/issue . Electrical Subcontacior List' Called Contact Person Plumbing" Grant Deed p Plans picked up' .; S.M.I. , H.O.A. Approval Plans resubmitted, Grading IN HOUSE: '"' Review, ready for correctionsrissue Dcveloper,Impact Fee Planning Approval . Called +Contact Person, A.I.P.P. Pub. Wks. Appr Date of perinit issue School Fees ' Total Permit Fees r Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: t� [ (`I G n n t' I (, Enforcement Agency:�I '" I NTA Date: 9 110 111 Permit #: Conditioned Floor Equipment Ty el List Minimum Efficiency Duct insulation requirement Area Thermostat Q Packaged Unit Furnace i AFUE © COP Over 40 ft of ducts added or 14 Setback Indoor Coil SEER_W Q HSPF replaced in unconditioned space R 6 (CZ 10-13) Sery d by system sf (If not already must be Condensing Unit I EER © Resistance e R 8 (CZ 14-15) present, 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. 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 -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and s' ned. Beginning October 1, 2010, a registered copy of the CF -111 and CF -611 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 El 2. Duct systems with less than 40 linear feet in unconditioned space, or El 3. Existing duct systems are constructed, insulated or sealed with asbestos E32. 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 E] 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 s stem or packaged units: Duct leakage < 15 percent split • Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 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, calc%Llations, plans andspecifications submitted to the enforcement agency for approval with the permit application. Name: MR O Signature r 1 $j�IO Company: Q � � (6 l l ` L� jj�� I f� l rr, �A nI 'j `' � R U . Ir' 1 `� � I I � V C , Date: I r\ Address: j, U l C. A NS `I �` ' License: V City/State/Zip: N q 077.3 Phone: M -5 Si 2008 Residential Compliance Forms July 2010