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11-0225 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Applicant: Tity14,-4Q*&, 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 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 /1 License No.: 374937 /ate; �� trac�Or. 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 _ 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 _ 1 1, 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: 3 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: RON VILLA 51295 CALLE QUITO LA QUINTA, CA 92253. VOICE (760) 777=7012 FAX (760) 777-7011 INSPECTIONS (760) -777-7153 Date: 3/07/11 Contractor:6 PALM DESERT AIR COND C1( C 42081 BEACON HILL U PALM DESERT, CA 92211�� C 7'2011 (760)346-0677 Lic. No.: 374937 1 1 i7Y OF LA 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 FIRST COMP INS Policy Number 010111WC 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 forthwit mply with those provisions. plicant WARNING: FAIL RE T0, 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 160 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 an tate laws relating to building construction, an ereby authorize representatives of thi •county to enter up he above-mentioned property for inspection pu ate: ignature (Applicant or Agent/" Application Number: 11=00"000225 -. Property Address: 51295 CALLE QUITO APN: 770-173-009-175 -000000- Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 16056 Applicant: Tity14,-4Q*&, 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 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 /1 License No.: 374937 /ate; �� trac�Or. 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 _ 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 _ 1 1, 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: 3 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: RON VILLA 51295 CALLE QUITO LA QUINTA, CA 92253. VOICE (760) 777=7012 FAX (760) 777-7011 INSPECTIONS (760) -777-7153 Date: 3/07/11 Contractor:6 PALM DESERT AIR COND C1( C 42081 BEACON HILL U PALM DESERT, CA 92211�� C 7'2011 (760)346-0677 Lic. No.: 374937 1 1 i7Y OF LA 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 FIRST COMP INS Policy Number 010111WC 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 forthwit mply with those provisions. plicant WARNING: FAIL RE T0, 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 160 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 an tate laws relating to building construction, an ereby authorize representatives of thi •county to enter up he above-mentioned property for inspection pu ate: ignature (Applicant or Agent/" LQPERMIT - Application Number . . . . . 11-00000225 Permit MECHANICAL Additional desc . Permit Fee . . . .' 66.00_ Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/03/11 Qty Unit Charge. Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 11.50.00 EA B/C 53-15HP/5i00K-500KBTU 33.00 Special Notes and Comments REPLACE (2) SPLIT A/C•SYSTEMS. 2010 CODES.. -- ------ - -------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total '66.00 .00 .00 66.00 PlanCheck Total 16.50 .00 .00 16:50 Other Fee Total 1:00 .00 .00 1.00 Grand. Total.. 83.50 .00 .00 83.50 LQPERMIT - Simplified Prescriptive Certificate of-Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 51-295 CALLE QUITO (SYSTEM 1) La Quinta, CA 92253 1 City of La Quinta Mar 4, 2011. Equipment Typel List Minimum Efficiency2 Duct insulation requirement _ Conditioned Floor Area Thermostat ❑ Package Unit p Furnace • Indoor Coil o AFUE 8% p SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system ack f Setbrea already present, Q Condensing Unit ❑ EER Resistance ❑ R 8 (CZ 14-15) 1200 sf must must be 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 Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for 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 onducted. 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 CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-1111 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 (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 • 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-4R forms: MECH-21 and (for split systems) MECH-25 117A - For Split Systems: Duct leakage`:<A5 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow RequiremenU, TMAH For.Packaged Units: Duct leakage z 15 percent Exempted from duct leagage 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. Ex ijt:IpVJuctyoystems are constructed' insulatedtiorsealed with asbestos 1:12. New HVAC SystemX"t;�- Require lFor"ms K f yam' =fr . Cut in•or Chan eouAll 9 t with new ducts (all new ductin fall" p^ h n �x J �, , CF 6Rjforms ,-MECH 04 MECH 20 HERS• andr(for split systems) MECH 22HERa; and"` I MECH 2S=HERS '. �i} �I� •`r k 9�� �• - r new CF 4it forms MECH f20and (fors lits MECH 22 and MECHa25 P Y )�, equipinerit)' •stems c-y For Split Systems: Duct leakage<;6 percent;-RC; CCA'>_'350 CFM/ton, FWD; TMAH, STMS, and either HSPP or PSPP. For: Packaged:,Units: Duct leakage: <'S percent ❑ 3. New Ducts with/ora, without Required Forms: Re lacement "` - • Includes replacing or installing Wlf:, ' new ducting and/or outdoors+„l' condensing unit and indoor'coil` CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or furnace. No orr some an- CF-4R forms: MECH-20 d (for split systems) MECH-25 equipment changed.- For Split 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 linear feet of duct in CF-6R forms: MECH-04, MECH-2I-HERS unconditioned space. CF-4R forms: MECH-21. For split system or packaged units: Duct leakage < 15 percent ' t, ❑ EXCEPTION: Existing duct 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: Karl Brown r Signature: Karl Brown Company:,PALM DESERT AIR CONDITIONING CO INC Date: Mar 4, 2011 Address: 42-081 BEACON HILL License: 374937 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 346-0677 Reg: 2�1L 1=A�! 902`A-000000-0000 Registration Date/Time:'2011/03/04 18:50:27 HERS Provider: �CaiCERTS Inc' 2008 Residential Compliance Forms July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -_R -ALT -HVAC Alterations Climate Zones 10 - 15 Site Address: • . Enforcement Agency: Date:Permit #: .51-295 CALLE QUITO (SYSTEM 2) La.Quinta; CA 92253 City of La Quinta Mar 4, 2011 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit p Furnace R AFUE 780% ❑ COP ❑ R 6 (CZ 10-13) Served by system 0 Setback • Indoor Coil . 0 SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 1600 sf If not already present, 0 Condensing Unit El EER ❑ Resistance must be 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 Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for 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 inspectoraleo verifies that each appropriate CF -6R 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 -111 and CF -61111 shall also be on site for final inspection. 0 1. HVAC Changeout Required Forms: - • All HVAC Equipment CF -6R forms: MECH-04,*MECH-2I-HERS and (for split 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 -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS Furnace. CF4R forms: MECH-21 and (for split systems) MECH-25 • c.t.,- 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 leagage testingif:' .❑ 1. Duct system was documented to, have be6n previously sealed and confirmed through HERS verification, or • 17, 2. -,Duct systems with less than 40 linear feet in unconditioned space, or r ❑ 3 •Ek!iting�d acct -,systems aretonstr msulatedror, sealedkwithTasbestos iccted �.. O 2 New�1HVAC i� Require'dIFofms f� - :r'�� tr f+ System . Cut iiil& Chan eoutyam# - 9 with newducts (aIJa CF 6R forms MECH 04 MECH 20 HERS; and (for split systems) MECH 22 HEF1S and w, f; . new ducting )all MECH 25HERS,. , 'and ', ` -CF new equi en-' 4R formsMECH20 (fospht systems) MECH 22, and MECH�25 = = For Split Systems: Duct leakage 6 percent;'RC ;CCA'> 350 CFM/ton; FWD,-TMAH; STMS, and either KSPP or PSPP. For Packaged Units: Duct leakage;<5 6 percent 3 New,Ducts with%or without j` ' Required Forms: Replacement "' S;'r �Vt . Includes replacing or installing aIle;' - new ducting and/or outdoor",Tm "".` condensing unit and/or indoor coil °w CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems; MECH=25-HERS and/or furnace. No or some CF -411 forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split 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 CF -611 forms: MECH-04, MECH-2I-HERS than 40 linear feet of duct in _ CF -411 forms: MECH-21 unconditioned space.. For split system or packaged units: Duct leakage < 15 percent - E] EXCEPTION: Existing duct 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: Karl Brown Signature: Karl Brown - i Company: PALM DESERT AIR CONDITIONING CO INC Date: Mar 4, 2011 Address: 42-081 BEACON HILL License: 374937 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 346-0677 Mtty:+LII-AUU117U.3H-UUUUUUUU-UUUj t(egiscraClOn uace/Tlme: &U11/Us/U4 1t3:S1:5b HEKS FrOVlcier: (CalCERTS;—`IriC� 2008 Residential Compliance Forms July 2010 s P.Q. Box 150.4.78-495:.Galle Tampico, La:Quinta; California 92211 L [ t m TO::(760)'777-7QT2 • Fax: (760)'771-77112 r r«.-�!GEM,�rA.DF_SER'1'—•- ,e 1Nebsite: ww, w:Ca�G2uinta.Org�• Email: B.Uilding@La-Qdinta.4� + - in # . Permit #:�� _ ZZS, .Buildi:ng Permit.Applicat on &Tracking $hetet. Project•Addre"Ss:- 51-295 CALLE QUITO OWner-s NaMe: •VILLA, RON .A.R.- Number. :Address: . 51-295 CALLE Q'JITO Legal Des.990ion: city, State, Zip: LA QUINTA, CA 92253 •COntraCtor: Palm Desert AirConditioning & Heating Company Telephone; ( Address: 42-081 Beacon Hill Project DeWiption ! City, .State, Zip > Palm Desert, CA 92211 REPLACE�Z) ETLiio.IR CONDITIONING SPLITSYSTEM. Alf- r T®lephone 346-0677 State: Lica •# '374937 Citylic. #: 100886 Arch %Engr /Designer Add tess: Tele honeNo:;., .- p ��. � ' .. �,� .. ConstnJctio� Type: Occupancy:. State.:Lic::#i; �+� �� % r •4 �`y� Y ` Prpject•Type O New • ® Addn e;-.oAlt&.4. O Rala-V-t:O Demo 'Name of C6ntact:Perd6n: _KARL BROWN .'Sq. Ft.: # Stories: #Units: Contact Teleptione;No.:. (760) 346-0677 Estimated Uaiue:of Project .. .$16,056.00, • APPLICANT::'DO NOT:WRITE;BELOW THIS.LINE' # Submittal Re. 'd Recd ' Track'ing , Permit.F_ee's Plan Sets Plan`Che6k Submitted; Item Amount Sfructu°ral Calcs:. Reviewed;; Ready fol Corrections' . Plan ChecN. Deposit Truss Cali:CalteticContact i.,ersbn. Ilan Chect 'Balance Title 24 Calcs. Plans'Picked'Up Constructirn Flood platn;Plan PIgps,Resgbmitted: , _ Mechanicol Grading Plan .2ndReview, Ready for�Gorrections Electrical - 5ubcontractot`List Called.Contact Person Plumbing, Grant Deed 'Plans, plcked;Up S:M...1. H Q;A. Approval Plans'RdsubMitted Grading: ' IN' HOUSE ,. -w Ready:for Corrections Developer'impaetF,ee "Planrnng:Approval. Called Contact Person. A.I:P.P, Put :- Works Appy l : Date of Rerrnii Issue School: Fees: Total Permit Fe®'s.,