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13-0674 (MECH)P.O. BOX 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000674 Property Address: 43179 CORTE DEL ORO APN: 609-380-997-10 -293233- Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 14789 Applicant: Architect or Engineer: �V 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. License Class: C20 License No.: 686310 "ata" �_��Contracto l�4 ,,�,,�/L 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 ($500).: (_ 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.). 1 1 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: LQPERIt1IT Owner: BOLGER KARYN 43179 CORTE DEL ORC LA QUINTA, CA LA QUINTA, CA 92253 Contractor: GENERAL AIR CONDITI 31170 RESERVE DRIVE THOUSAND PALMS, CA (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/29/13 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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. Q5;I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor lj 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 Z071741502 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. Da%a , AApplicant; 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 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 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. 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 county to enter upon the above-mentioned property for inspection purposes. .- Dater Signature (Applicant -or Agent l: Application Number . . . . 13-00000674 Permit MECHANICAL 2013 Additional desc . . Permit Fee 71.50 Plan Check Fee .00 . Issue Date... Valuation 0 Expiration Date 11/25/13 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 (1) 5 TON A/C 90 K BTU FURNACE & COIL 2010 CBC CODES. CARNON MONOXIDE ALARMS TO BE INSTALLED PRIOR TO FINAL INSPECTIONS. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 Fee summary Charged Paid Credited Due Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 91.57 .00 .00 91.57 Grand Total 163.07 .00 .00 163.07 LQPER111T Bin.# Cityof La Qurnta Building & Safety Division P.O. Box 1504,78-495 Calle Tampico La.Qidnta, CA 92253 -:(760) 777-7012 Building Pennit Application• and Tracking Sheet Permit # �1 I Project Address: L �� Cir Tv._ Ot Owner's Name:. p A. P. Number. Address: y 3 1-7 9 Corte �l OV -0 Legal Description: City, ST, Zip: ;r CA ctZZ53 Contractor. �? A C-' i t' 41- I YN V /-! Telephone: - Address: I I�7�� 0e,t Ye �jyr; Project Description: City, ST, Zip: LhOUSrr�o.�rY� �2Zi(o , 5V Telephone: %60' 343.%7Lf R(t Fv State Lic. # : (p $10 3 i oCity Lic. #; Arch, Engr., Designer Address: City., ST, Zip: Telephone: State Lie. #: A' t Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.:#Stories: To Units: Telephone # of Contact Person: Estimated Value of Project: 411A7&-9.00 APPLICANT: DO NOT WRITE BELOW THUS UNE N Submittal Req'd Reed TRACKING PERMrPFEES Plan Sets Plan Check submitted Item Amount Structural Calci. Reviewed, ready for corrections Plan Check Deposit, . Truss Cates. Called Contact Person Plan Check Balance. Title 24 Calci. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'! Rtvlew, ready for correctioWiissue Electrical Subcontactor List Caned Contact Person Plumbing Great Deed Plans picked up SMI. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- ''d Review,' ready for correctionsrWae Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residents! HVACAltefatlons CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enfbrcement Agency: Date: Permit 78206 CALLE LAS RAMBLAS La Quinta, CA 92253 City of La Qulnta May 29, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficlency2 requirement Area Thermostat Q Package Unit ® Furnace ®Indoor Coil ® AFUE 78% ®SEER 13.0 ❑ COP O HSPF�- E3R 6 (CZ 10-13) Served by system ® Setback If not already present, must be Condensing Unit 0 EER p Resistance (3 R g (CZ 14 -IS) 1830 sf Installed) Q Other 1. Equipment Type: Choose the equipment being installed; 9 more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFtK, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below aro 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 fad the work completed by the installer. The inspector also verifies that each appropriate CF -611 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 -611 forms: MECH-04, MECH-2I-HERS and (or split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-2S . Condenser Coil and /or . Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Dud leakage < 15 percent; RC, CCA s 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from dud 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) Alsojxempt.from.Refrigerant Charge) 112. Ne .,HVAC Syitenn Required Foams:* " . Cut in orChangeout with V ez. rs ° t� 61t°forms =ME. H-04 MECH-20-HERS and,(for split systems) MECH 27-#1ER5 and new ducts: all new_ MECH-25 HERS �l duding;and(all new CF -4R forms .MECH-20 and•(for split sy$tems) idECH 22, rtd MECH-25 v equipment For Split Systems: Dud leakage < 6 percent; RC, CCA Z 350 CFM/ton, FWD;`TMAH, S MS, and-eitherHSPP or PSPP. For Packaged Units: Dud leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Incudes 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 -411 forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Dud leakage < 6 percent; RC, CCA 2 300 CFM/ton, TMAH For Packaged Units: Dud leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -61k forms: MECH-04, MECH-2I-HERS linear feet of dud in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Dud leakage < 15 percent ❑ 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 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: Danielle Garcia Signature: Danielle &wcio Company: HARRISON ENTERPRISES INC Date: May 29, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 213-A0032483A-000000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2013/05/29 01:52:26 HERS Provider: Ca10ERTS, Inc_ July 2010