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10-0657 (MECH)_ w P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000657 Property Address: 44120 CAMINO AZUL APN: 604-180-009-24 -24517 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1200 Applicant:. - Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ------------------------------------------------- LICE fi TRACTOR'S DECLARATION I hereby affirm under penalty of perjury I agrl d der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the B inessy6 P e ono Code, and my License is in full force and effect. License Class: C20 -C38 censeNo.: 826714 .Date: 7__&:;/_0Contractor: .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 70001 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 _ 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.). (_) I am exempt under Sec. , BAP.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: GRAY RICHARD 44-120 CAMINO AZUL LA QUINTA, CA 92253 ( Contractor: BEST IN THE WEST 255 N. EL CIELO' 140-125 PALM SPRINGS, CA 92262 (760)343-1002 Lic. No.: 826714 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/16/10 ----------------------------------------------- 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 STATE FUND Policy Number 1932774-09 _ 1 certify that, in the perfor he work for which this permit is issued, I shall not employ any person in any manner o s to me subject to the workers' compensation laws of California, and agree that, if I o d subject to the workers' compensation provisions of Section 3700 of the Labor f hwith comply with those provisions. Date.applicant: 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 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. certify that I have read this application and state that t&infor n is correct. I agree to comply with all city and county ordinances and state laws relating to b and hereby authorize representatives of this county toentter upon the above-mentioned proprposes. Dat:)r ^i' v Signature (Applicant or Agent): Application Number . . . . . 10-00000657 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date Valuation . . . . 0 Expiration Date 1/12/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL 5 TON EVAP COIL IN HVAC -------------------------------.- 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 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to IS Site Addr ss: Enforcement Agency: Dare. Permit #. / % o 7-16 Floor Equipment T t List Minimum Efficiency' Duct insulation requirement Area Thermostat O Packaged Unit Over 40 ft of ducts added or O Setback ❑ Furnace Irindoor Coil O AFUE_ OSEER ❑COP O HSPF replaced in unconditioned space Served by system (1%+rut ulreuch ❑ Condensing Unit ❑ EER — O Resistance O R 6 (CZ 10-131 ❑ R 8 (CZ 14-15) sC purse+rr. Hurst he installed) ❑ Other 1" Equipment Type: Chuuce the equipment tieing installed: if more than one stent, use unother CF -1 R -:I LT -116;1 CPr each x.msten+. ?. rltinimum Equipment Efficiencies: 13 SEER 8%.4FUE, 7.711SPFfor tI picul residential sustents" 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 Cor 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 -611 and registered CF411 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. 1. HVAC Changeout Required Forms: CF 6R forms: MECH-04, MECH-2i-HERS and (for split systems) MECH- 25 -HERS • All HVAC Equipment replaced CF -4R forms: MECH- 21 and fors lits stems) MECH-25 • Condenser Coil and /or CF -611 forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Indoor Coil and /or CF -411 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 ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or O 3. Existing ductems are cotstructed, insulated or sealed with asbestos O 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -611 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 fors: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percerit; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 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 CFAR forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed- hangedFor ForSplit 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 fors: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. 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) • 1 cenify 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 desibm 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 Titre 24, Pails 1 and 6 of the California Code of Regulations. • The dcsi d tun." -s idcntittcd on this Certificate of Compliance are consistent with the info t�d.ted on other applicable crmplianec forms, worksheets. calcu to la ands cifications sub itteJ to the cnfonrment a fora royal .v" tcation. Name. j Q- m 17-/L J Z , /��v £i Signature Com n Comp �� � �i4• / Date? /� /Lf Address:� led.la / Lo ^�Z j License..-.� 6 �/ City/Statc/Zip' /Z �/ ij- 'Z -- Phone:? en --Z— .—T, 2008 Residential Compliance Fornms Murch 2010 Bin # City of La Quinta , Building at 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: VY12b �mjeyoAzttL ner's Nam : V �b A A. P. Number: [Address:LkL Legal Description: , ST, Zip:z„Contractor: ^� liy� SSS' ephone: - Address:'s�(j, �r G "ZI lorylu'Z Project Description:ff ^Mw.E 1/� City, ST, Zip:1 /ZI s �19' 927.E 2- i Telephone: WC) 3 /00 21 - State Lie. # : City Lic. #: State Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7 1-6)3 3 j o a Z- Estimated Value of Project: $ . APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIMG • PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2`' Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. A.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`' Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. App r Date of permit issue School Fees Total Permit Fees