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11-0252 (MECH)P.O. BOX 1504 78-4.95 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-iht 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of .perjury that I am licensed underprovisions 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. LicenseClass, C10 C16_C2nse o. 4 7554 't Date: ` Contractor:( OW EI -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am empt 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).: ( ) 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 _ 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 contractor(s) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/15/11 Owner: � WEIR ROBERT 79535 RANCH SANTA MARGARITA LA QUINTA, CA 92253 ( Contractor: PREFERRED PLUMBING HTGC n a P.O. BOX 5120 D (r"-�j PALM SPRINGS, CA 92263 (760)322-3173 MA 1v 2011 Lic. No.: 457554 GITy OF; -A QUINTA 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 EVEREST NATL Policy Number 7600006445111 _ 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 b me subject to the w�rl s' compensation provisions of Section �j 33770-0 of the Labor Code, I all fort itch cc p f wit tho provisions. Date:_ Applicant. f WARNING: FAILURE TO SECURE WOR S' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL lALT1E AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE T 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 ' formation is correct. I a to comply with all city and county ordinances and state laws relating to building n ruction, and hereby a o ze epresentatives of this counter upon the above-mentioned property f r ' sPection pur r Date: %/ Signature (Applicant or Agent): Application Number . . . . . 11-00000252 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date Valuation . . . . 0 Expiration Date 9/11/11 Qty Unit Charge Per Extension BASE FEE' 15.00 1:00 9.0000 EA MECH.APPL REP/ALT/ADD 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments REPLACE EXISTING AC & COIL WITH LIKE FOR LIKE GROUND UNIT 5 TON 13 SEER. ------------------------ --------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ------------------------------------- Paid. Credited -------------------- Due Permit Fee Total 33.00. .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT Sim lified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address:Enf1 "3 y 3rd OCIWAV 5l;.4 os4 ,i/I A�?GA�t i� rc�ment Agency C,I� /tJ / A Date: Permit #: C6nditioifed Floor Equipment T e' List Minimum Efficiency Duct insulation requirement Area The ostat ❑ Packaged Unit ❑ Furn e Coil ❑ AFUE J� ❑ COP ❑ HSPF Over 40 ft of ducts added or replaced in unconditioned space Served � by system pe VSetback (Ijnot already -/� ❑ R 6 (CZ 10-13) sf present,mustbe ondensing Unit L�E-R ❑ Resistance ❑ R 8 (CZ 14-15) 7__ ❑ Other 1. Equipment. Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT --HVAC jor 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 -411 forms (no hand filled CF-4Rs allowed) are filled out and si ed. inning Ociober 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection. 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 -6R 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 t'7 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. 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 Splij 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 ❑ 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/orpoutdoor 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 Sphi Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Pact'. aged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includgs adding or replacing more than 40 CF-611forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear.t'eet of duct in unconditioned space. For splitsystem or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) Y • I certi fly 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 andspecifications submitted to the enforcement agency for approval with the permit application. Name: '��+/ C� Signature: Compan Date: 3 -/6-- ZG� Address:` � j)A)Ajq � v 4� License: rc_ity/_ State/Zip: S o—f 06_1- CA 24 Phone: _ 322 3 2008 Residential Compliance Forms March 2010 Bin # City of La QuAnta Building U Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 -Building Permit Application and Tracking Sheet Permit.#P.O. Project Address:' S,35 ` !/t Owner's Name: A. P. Number: %GAl %/T-4 Address: ?953 (1 MAOMrt[ Legal Description: City, ST, Zip: Preferred Air Conditioning dba Contractor: preferred Plumbing.Heatin &Ai -� — Address: -PO Box 5120 Project Description: City, ST,Zip:Pa-lm Springs, CA •92263 ��t!�� �' �G /�C t4O Telephone: ( 7 6 0 ) 3 2 2 .317 3 a 1. �� D� (� ( G2oLN State Lic. # : 4 5 7 5 5'4 City Luc. #: Arch., Eagr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Projecftype (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING , PERMIT FEES Plan Sets Plan Check submitted Iten Amount Structural Calcs. Reviewed, ready for corrections Play Check Deposit Truss Cafes. Called Contact Person Play Check Balance Energy Calcs. Plans picked up Con truction Flood plain plan Plans. resubmitted Mec anico Grading. plan' 2"d Review, ready foi'correctionsrissue Ele rlcal Subcontactor List Called Contact Perlon Pln bang Grant Deed Plans picked up S.M I. H.O.A. Approval Plans resubmitted Gra ing IN HOUSE:- Review, ready for correctionsrssue Dev Loper Impact Fee Planning Approval Called Contact Person A.I. .P. Pub. Wks. Appr Date of permit issue School Fees ' Totfl I Permit Fees