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13-0593 (MECH)P.O. BOX 1504,. 78-495 CALLE TAMPIC0 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 13-00000593 Property Address: 49190 RANCHO POINTE APN: 649-660-017- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8170 Applicant: Architect or Engineer: ----------------- 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. Licen�seClass: C20 LicenseNo.: 686310 Dater 1� Con tor. 5: OWNER -BUILDER DECLARATION 1 hereby affirm under peria� f 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 1, 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 ISec. 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 on 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 contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ 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: in Lender's Address: LQPERAIIT '�— VOICE (760) 777-7012 / FAX (760) 777-7011 v INSPECTIONS (760) 777-7153 Date: 5/08/13 Owner: STEVE ROBBINS/MITCHELL CAMERON 49190 RANCHO POINTE LA QUINTA, CA 92253 ( Contractor: GENERAL AIR CONDITIk26 31170 RESERVE DRIVE THOUSAND PALMS, CAMAY 0- 2093 (760)343-7488 Lic. No.: 686310 CITY OF LA 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. -A�z,Yhave 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 ZENITH INS CO Policy Number Z071741502 1 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. Dat" Applicant: ��/vW7?✓�' ' 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. 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. Date: $ 13 Signature (Applicant or Age -.Application Number . . . . . 13-00000593 Permit . . . MECHANICAL _ Additional desc . Permit Fee 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/04/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 .9.0000 EA MECH B/C <=3HP/100K BTU 9.0.0 Special Notes and Comments HVAC REPLACE (1) 2 TON 13SEER MINI SPLIT CONDENSOR AND COIL DUCTLESS. 2010 CALIFORNIA BUILDING 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 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 00 .00 31.00 sig.# CIS}/ Of La Qulhta Building $t Safety Division P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: Ll 9 1 g O c�-Y.c 1, 0 -1-)o i h c. Owner's Name:. S7t���olob irtis t }c�, J i C�umero A. P. Number. Address: 491010 1�0.rcho �oir.}� Legal Description: Ci ST, Zip : GA 9 Z 3 �'� L•G-Qvin�}o� Contractor. �';c -�;on� s, n Telephone: .W Address: 3 11 -� p e e r v -. Project Description: City, ST, Zip: th S d 7 �m5 G4 422�id. e - re— Z*0V-\ i Telephone: --)(,0- 343- 714 M - State Lie. # : City Lie #, Arch., Engr., Designer Address: City, ST, Zip: Telephone: State Lie. #: 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: Estimated Value of Project: $ g 170 , C)o APPLICANT: DO NOT WRITE BELOW THIS UNE i! Submittal Req'd Recd TRACIMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance • Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted ' Mechanical Goading plan Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Great Deed Plans #irked up S.M.I. H.O.A- Approval Phos resubmitted Grading IN HOUSE:- 3" Review, ready for eorreetionslicsue Developer Impact Fee Planning Approval Called Contact Person s. AJ.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees �r Simplified Prescri `tive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC Climate Zones 10 to 15 . Site Address: Enforcement Agency:' Date. Permit #: ygtgo �0.Y�c�o piv,}e a Ci IN Ol: La vi•.�ci 5 8 !3 Conditioned Floor Equipment T u List Minimum Efficiency 2 Duct insulation requirement Area Thermostat Packaged Unit _ ; Fu Q AFUE Q COP 40 ft of ducts added or Over• ' [N Setback SEER 13 HSPF ced Z unconditioned space 6 (CZ IO -13) ffi, Served by system sf rese already present, must be lcqlndoorCoil Condensing Unit EER Resistance 8 (CZ 14-15) installed) _ Other 1. Equipment Type: Choose the equipment being installed, • if more than one system, use another CF -1R ALT -HVAC jor each system. 2. Mmimu n 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 appropnate 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 CF4Rs allowed) are filled out and signed. 'Beginning October 1 2010, are 'stered copy of the CF -1R and CF -6R shall also be on site for final inspection. IN 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS CF4R forms: MECH-21 and (for split stems) MECH-25 • Condenser Coil and/or - CF -6R forms: MECH-2I-HERS and (for split systems) MECH725-HERS • Indoor Coil and/or CF-411forms: 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 sysiems with less than 40 linear feet in unconditioned space, or 3. Existin 'duct systems are constructed, insulated or sealed with asbestos [32. New HVAC System Required Forms: • Cutin or Changeoui with new ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS CF4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, SIMS, 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 CF -4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent M. New Ducting over 40 feet Required Forms: - • Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21 linear feet of duct in unconditioned space. For splits stem or packaged units: Duct leakage < 15 percent EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Docume`ntation 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 Califomie 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 a enc forapproval with the permit application. Name:Sfiw Signature: r% 4 Company: • Date: I $ I S t r I 3 Address: 31 �e5erty� l�r nuc° - • License: (o 8-G3 i 0 fDD City/State/Zip: 'T&UsC V-`c.� `m 5 CA C12-2--7(,Phone: ?foU-3jl3 2008 Residential Compliance Forms - July 2010 INSTALLATION CERTIFICATE (Page 10 of 12) CF -6R Site AddressPermit �G Sao ���� E Number � -��s� Insulation Installation Quality Certificate ✓ ❑ Description of Insulation, (CF -611, formerly IC -1) signed by the installer stating: insulation manufacturer's name, material. identification,.installed- R -values, and for loose -fill insulation;'minimum.weight per square foot and minimum inches ✓ ❑ Installation meets all applicable requirements as specified in the'High Quality insulation,Installation Procedures. (ACM, Appendix RH) FLOOR ❑ Yes ❑All No A floor joist cavity insulation installed to uniformly fit the cavity side-to=side and end-to-end ❑ Yes ❑Insulation No NA in contact with the subfloor or rim joists insulated ❑ No ❑ NA Insulation properly supported to avoid gaps, voids, and compression WALLS Nn ❑ ❑ .Wall stud cavities caulked or foamed to provide an air light envelope Yds No NA Yes ❑ No ❑ NA Wall stud cavity insulation uniformly fills the cavity side-to-side, top -to -bottom, and front -to -back es ❑ No ❑ NA No gaps Yes ❑ No V, No voids over 3/4" deep or more than 10% of the batt surface area.. .O ❑ Hard to access wallstud cavities such as; comer channels, wall intersections, and behind Yes No tub/shower enclosures insulated to proper R -Value Xes 0 No ❑ NA . Small spaces filled ❑ Yes ❑Rim No NK joists insulated Tes❑ ❑ Loose fill wall insulation meets or exceeds. manufacturer's minimum weight -per -square -foot No NA requirement ✓ ROOF/CEILING PREPARATION ❑ 'Yes ❑ . No SA N All draft *stops in, place to form a continuous ceiling and wall air barrier ❑ Yes ❑ No ❑ NA All drops covered with hard covers Yes ❑ No NA All draft stops and hard covers caulked or foamed, to provide anair tight envelope El. ❑ ❑ All recessed light fixtures IC and air tight (AT) rated and sealed with agasket or caulk between the Yes, No NA, housing and the ceiling ❑ Yes ❑ No ❑ NA Floor cavities on.multiple-story buildings have air tight draft stops to all adjoining attics ❑ Yes. ❑ No . A Eave vents prepared for blown insulation - maintain net free -ventilation area ❑ Yes ❑ No Knee walls insulated or prepared for blown insulation ❑ Yes. ❑ No Area under equipment platforms and cat-walks.insulated or accessible for blown insulation ❑ Yes 0 No ❑ Attic rulers installed Residential' Compliance Forms April 2005 INSTALLATION:CERTIFICATE (Page 11 of 12) CF -6R Site Address l ' 01 1 1C) 1 �f ' orm itNu�er,� �1 ROOF/CEILING BATTS ❑ ❑ Signature:Date: Yes No NA No gaps ❑ O, .Yes No 1 No voids over 3/. in: deep or more than 10% of the batt surface area:. ❑ ❑ ❑ Yes No NA Insulation in contact with the air -barrier ❑ ❑ ❑ Yes No NA Recessed light fixtures covered ❑ ❑ ❑ Aret free -ventilation area maintained at eave vents Yes No NA ✓ ROOF/CEILING LOOSE -FILL ❑ ❑ No 1 NA Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls. ❑ ❑. ❑ ;Yes No NA Baffles installed at eaves vents or soffit vents - maintain net free -ventilation area of eave vent . ❑ ❑. Yes No 1 Attic access insulated Yes No . NAA Recessed light fixtures covered ❑ ❑ Ye No NA. Insulation at proper depth — insulation rulers visible and indicating proper depth and R -value ❑ ❑ ❑ Loose -fill insulation meets or exceeds manuj cturer's minimum weight and thickness requirements Yes No NA for the target R -value. Target R -value Manufacturer's minimum required weight for the target R -value (pounds -per -square -foot). Manufacturer's minimum required thickness. at time of installation . Manufacturer's minimum required settled thickness . Note: To receive compliance credit the HERS rater shall verb that the manufacturer's minimum weight and thickness has been achieved for the target R -value. CF -6R only DECLARATION ✓ ❑ I hereby certify that the installation meets. all: applicable requirements as specified in the Insulation Installation Procedures: Installing Subcontractor (Co. Name) OR General Contractor.(Co. Name) OR Owner Signature:Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residential •Compliance Forms April 2005