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12-1109 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00001109 Property Address: 78725 BOTTLE BRUSH DR APN: 646-312-022-72 -000000- Application description: MECHANICAL Property Zoning: MEDIUM DENSITY RES Application valuation: 4500 Tity/ 4 4 Q" Architect or Engineer: PIP BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DEC TION I hereby affirm under pen tieMrjury that I am licensed under pr . ons of Chapter 9 (commencing with Section 7000) of Div's'iior 3 of the Business and Professions ode, and my License is in full force and effect. License Class: / 0 License No.: 619091 /Date: � r tractor: // 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 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 (5500)•: (_ 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.). (_ 1 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 contractors) 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: 9/24/12 Owner: LEBLANC JOEL 78725 BOTTLEBRUS A—Qui! CA 92253 1 D�IJ LLn I actoLC� 4 2012 ALOMA AIR CONDIT-IQN. G .OL—$'OXv3 0` Q (NTA (L7 -6-0-)-3V7 i =1212 Lic. No.: 619091 ------------------ 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 issued. 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 COMPANION PROPT--- Policy Number CPCA15666 _ I certify that, inlhf 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 th W compensation laws of California, and ag. ee that, if I should become subject t� workers' compensation provisions of Section 'e"{9d`df the Labor Code, I shall fort tfT"comply with those provisions. ate: Ap ant: r WARNING: FAILUR T♦ -URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 oromissi�to the work being performed under or folipwipg.issuance of this permit. 2. Any permit issued ale result of this application beco ull and void if work is not commenced within 180 y��m date of issuance of such mit, or cessation of work for 180 days will subject permit to etlation. I certify that I hav ad pplication and that the above information is correct. I agree to comply with all city and county ord' nc s and state law elating to he construction, and hereby authorize representatives of/th%'� coun [C€nt r upon he above-mentioned property for inspection purposes. ;of 'nature (Applicant or Agent): Application Number ... . . 12-00001109 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . Valuation . . . . 0 Expiration Date 3/23/13 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 ---------------=-----------------------------------7------------------------- Special Notes and Comments REPLACE HEAT PUMP SPLIT SYSTEM. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG SIDS 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 3 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 - IS Site Address: EnfotCemen>k Agency: Date' Permit #: ` 78-725 Bottlebrush Dr. La Quinta, CA 92253 City of'Irl Sep 17, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat 13 Package Unit ! ® Furnace 13 Indoor Coil ❑ AFUE ®SEER 13.0 p COP 111 HSPF 7.7 [3 R 6 (CZ 10-t3) C3 R 8 (CZ 14-15) Served by system 1600 sf ® Setback if not already present, must be 11 Condensing Unit p EER p Resistance Installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; If more than one system, use another CF-IR-ALT-HVAC for each system. 2. Minimum Equipment Efflclencles: 13 SEER, 76°/. AFUE, Z 7HSPF for typical n.siden pal systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteratibn 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 forams shall be left on site for final Inspection and a copy given to the homeowner.iAt 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-611 and registered CF-411 forms (no hand filled CF-4Rs allowed) are filled, out and signed.Begirinir,g October 1, 2010, a registered copy of the CF-IR and CF-611 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 (forsplit systems) MECH-25-HERS replaced CF-411 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 CF=4R.:forms: MECH-21 and (for split systems) MECH-25 . Furnace For Split Systems: Duct le~ �15;percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH Fell aoiltaqw, Unitas Exeippted from dud leakage':testing if, Q I OuctSystwas documented,to have been previously sealed and confirmed through HERS verification, or p:2 "Duct.:systems::with less: han 40,1inear feet in unconditioned pace, or ;p 3 Existing duct systems areonstrucked, insulated or sealed with asbestos p 4 Theterill :not be... Dud (lei ctl to - e%pW 2.;N ACS'>ttem Requil��sF. Y:.. _. .Cut ia­F(afll ECH 04 new new ductall n ECH r$ t s equipfr►ggF t. . For Split'Syt ers�leacae F Pi?Io .PSP PANa For Packaged Units. Duct leakagerpercen .�, : 3 illiWiQucts /or witho Required Forms:' Replace"rrient .Ini udes; epladng':or in$ IUng ail;new ducting and/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS ... i. and/or indoor coil and/dt.4Urnace Noor some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Dud leakage'::'6 percent; RC, CCA Z 300 CFM/ton, TMAH For Packaged Units: Dud leakage < 6 percent 0 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-411 forms: MECH-21 For split system or packaged units: Dud leakage < 15 percent ' p EXCEPTION: Existing dud 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 Cgrtlficate 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 Tide 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: Herman Paredes Signature: Herman Paredes Company: PALOMA AIR CONDITIONING Date: Sep 17, 2012 Address: P 0 BOX 3501 License: 619091 City/State/Zip: PALM DESERT/ CA/ 92261 Phone: (760) 347-1212 Reg: 212-AOOSiS83A-00000000-0000 Registration Date/Time: 2012/09/17 15:41:07 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forma July 2010 V 16 41 is1nff City of La Quinta Building 8lr Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking/ Sheet , Permit r�� �ti Project Address: kJAddress: wner's Name: $6 A. P. Number: — � Z T 8 (j?�,0I (/ S Legal Description: it}', ST, Zip: (� P �`-- C � Contractor: I!I �rU kl C elephone: bM. Address: PA!Project Description: Cin', ST, Zip: Telephone: P one. -7 6 rz� State Lic. # g 0a City Lic. #: Arch., Engr., Designer: Address: Citi-, ST, Zip: Telephone: ................................................. ............................................... .................................................... Construction Type: . ancv: Occupancy: State Lic. Project type circleone : New A d'o Alter Repair De mo Name of Contact Person:( Sq. Ft.: # Stories: # Units: 9 Telephone # of Contact Person: 200 %Y Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE t! 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 S.M.I. II.O.A. Approval Plans resubmitted Grading IN HOUSE:- " 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