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12-0580 (MECH)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/24/12 Application Number:- 12-00000580 Owner: Property Address: 52200 AVENIDA RAMIREZ CAROL MARQUETTE. - APN: 773-222-011-12 -000000 52200 AVENIDA RAMIREZ Application description: MECHANICAL (9 = V LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL Application valuation: 3200 Contractor: Applicant: Architect or Engineer: ��� J ANTHONY PLUMBING HEAT./AIR- �.4$.d 72216 NORTH SHORE STREET, #101 THOUSAND PALMS, CA 92276. (760)_328-8096 Lia. No. 777794 CENSED CONTRACTOR'S DECLARATION ' WORKER'S COMPENSATION DECLARATION I hereby, affirm under penalty ofdperjury th I am.licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of 6e following declarations:* - - Sectioa_7000) of Division,3 of.th_e Bu 'ne and Professionals Code, and my License is in full( force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided' License,Class: C20 -C36. - License No.: 777 for by Section 3700 ofthe Labor Code; for the.performance of.the work for which this permif'is r issued.. .. ate j1� ontractor. - - '- - •I have and will maintain workers compensation'in` rance,,as required by Section 3700 of the -Labor. ,' Code for theperformance of the. work for which this permit'is issued. My workers'.compe'ns ation . OWNER-BUILDERDECLARATION insurance carrier and policy. number are:. - I hereby affirm under; penalty of perjury that I am�exeinpt from the contractor's State License Law'for the Carrier GRANITE STATE Policy Number .WC06525559.9 following' reason:(Sec:'-7031.5; Business•and Professions Code: Any city or county that requires a permit to- � � _ _ I certify that, ingthe performa ce-of the work for which -this permit is issued, I shall not employ any construct, alter, irnpiove;.demolish, or repair any structure, prior to its issuance; also requires the applicant for the person in any manner so s to become subject to the workers' compensation laws of California, permit to file a signed statement that.he or she is licensed; pursuant_to the provisions of -the Contractor's State and agree that, if I shout. become subject the workers' compensation provisions ofSection` License Law (l:hapter,9 (commencing with Section 7000) of Division,"3 ofthe'business and Professions'Code) or 3700 of the'Labor ll`forthwit - co ply with thos&provisions. that he or she -is'exempt therefrom and the basis for the alleged exemption.: Anyviolation 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).:ate: �l lv pplicant: t- _ (_ I I, as owner of the property,. or my "employees with wages as their sole'compensation, will do the work;'and - the structure isnot intended.or offered for sale (Sec. 7044, Business and•Professions Coder The - WARNING.'FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL; AND SHALL Contractors' State License Law'does not apply to an ownerof property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND'CIVIL FINES UP TO ONE HUNDRED THOUSAND. and who does the work himself or herself through his ocher own employees, provided that the DOLLARS ($100,000). IN ADDITION TO TH. 'COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for'sale. If, however; the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one;yearof completion, the owner -builder will have,the burden of iproving that he'or she did not build or " ' - improve for the purpose of sale.). - - APPLICANT ACKNOWLEDGEMENT 1 _) I, as.owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. - IMPORTANT ' Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions CoIde:�The Contractors' State License Law does not apply Wan owner of conditions and restrictions set forth on this:applicatiori. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose -behalf this application is made, each person at whose request and for pursuant to the Contractors' State,License Law.). whose benefit work is performed under or pursuant to any permit issued as a. -result of this application, (_) I am exempt under Sec. B.&P.C. for this reason 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. Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date ofissuance of ch permit, or cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY - permit to cancellation. ' I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that a above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws rel to ilding c nstruc ' n, and hereby authorize representatives of this co my t enter upon the above -mention ns io urposes. - Lender's Name: 7/ 1 te: � ' ature (Applicant or Ir m): Lender's Address: �J LQPERMIT Application Number . . . . . 12-00000580 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 24.00 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/20/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 .00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU .00 -------7--------------------------=----------------------------------------- Special Notes and Comments HVAC CHANGE -OUT: INSTALL NEW 3.5 TON FURNACE, INDOOR COIL. 2010 CODES. ---------------------------------------------------------------------------- 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 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 35.13 .00 .00 35.13 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #.. 52200 AVENIDA RAMIREZ La Quinta, CA 92253 City of La Quinta May 24, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit m Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ®Setback ® Indoor Coil ❑ SEER ❑ HSPF [I R 8 (CZ 14-15) 1450 sf If not already present must be [3Condensing Unit [IEER ❑ Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -SR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF 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 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 CF -6R forms: MECH-04, MECH-2I-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-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH 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 duct systems are constructed, insulated or sealed with asbestos ❑ 4. The system=will not be Ducted (ie. Ductless Mini -Split. System) (AISOL Exempt from "Refrigerant Charge) [12. New HVAC System Required Forms: a • Cut in'or Changeout with, CF -611 forms: MECH-04, MECH-20-HERS /and (for split systems) MECH-22-HERS, and new ducts: (all new l,f' MECH-25=HERS ducting and all new CF -411 forms: MECH -20, and (for split systems) MECH-22, and MECH-25 equipment) �/ , ;'�� , For Split Systems: Duct leakage < 6 percent; RC, CCA 2t 350 CFM/ton, FWD, TMAH, SIMS, 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 -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. 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 >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 114. 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 duct in unconditioned space. 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, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Kevin Robinson Signature: Kevin Robinson Company: I ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: May 24, 2012 Address: 72216 NORTH SHORE ST #101 License: 777794 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121 Reg: 212-A0026562A-00000000-0000 Registration Date/Time: 2012/05/24 12:05:07 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # .. City,of Ld, Quin Building 8T Safety. Division 78-495 Caile Tampico U. Qwnb, C-4#22.513- (760)..777-170-12 Buj�ilding' Permit Application and Tracking Sheet Permit #P.O.Boxr1504, 60 1 Project Address: SZ?00 • �( llllw A0ik1't6Z Owner's Name: /FIGO A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: ' v.y :~ >. ° .<•" -:ti: \a Telephone: ��� %%1, 3: -OA? Address: J ANTHONY SERVICES Project Description: 72216 NORTH SHORE ST."STE 101 City, ST, Zip: • THOUSAND PALMS, CA_ 92276 ��/}�� j Fvot /✓- Telephone:'MN State Lic. # : 7-717441City Lic. #;/oro'S'/ . Arch., Engr., Designer: Address: City, ST, Zip: , Telephone: P State Lic. #: }C:?r }.: < r!.::i }.•}:N:�ih iy:i.vhk}J?+.' t<a A ;sr x,441{ �: Xdnstrudion T Occupancy. protect type (circle one): New Add'n Alter Repair . Demo - Name of Contact Person: W` Sq. Vt.: # Stories: # Units: Telephone # of Contact Person: Al 247J Estimated Value of Project: .3 � ° APPLICANT: DO_N0T4WRITE BELOW.THIS LINE N Submittal Req'd : ?Reed ` TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed; ready: for corrections Plan.Check Deposit Truss Cales. Called ContacC,Person Plan Check Balance Title 24 Celts Pians 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 resubquitted` Grading IN HOUSE:- ''' Review, ready for corrections issue Developer Impact Fee Planning Approval Called Coutact Person A.I.P.P. Pub. Wks. Appr Date;of permitissue School Fees Total Permit Fees