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08-0418 (MECH)P.O. BOX 1504 78-495 CALLETAMPICO LA QUINTA,'CALIFORNI"A 92253 -BUILDING & SAFETY, DEPARTMENT. BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/07/08 Application Number: 08-00000418 o Owner: Property Address: 50645 CALLE- QUITO SESSUMS JOHN D APN: 770-095-006-52 -000000- 50645 CALLE QUITO Application description; MECHANICAL LA QUINTA, CA 92253 '.Property Zoning: LOW DENSITY RESIDENTIAL :. } (760) 564-3877 Application valuation: 4200 Contractor: Applicant: Architect or Engineer: PALM DESERT AIR COND .CO INC 42081 BEACON HILL � PALM DESERT, CA 92211 ID (760)346-0677 Lic. No.: 374937 p MAR Qr% 2009 ————--—---—------------------—-—————————--'--——— ' LICENSED CONTRACTOR'S DECLARATION CITY OF LA QUINTA ——————----———---F414ANCEDERT ———— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjuryone of the following declarations: . Section 7000) of Division 3 of the Business and Professionals Code, andmy License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C20 License No.: 374937 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permitis 3`'x-46 issued. . Date: Contractor: - _ 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 ER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 238-0004656-07 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any ' construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, - permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or .3700 of the Labor Code, I shall forthwith comply with those provisions. 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).: Date: Applicant: (_ I 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 WARNING: FAILURE TO SECURE WO ERS' COMPENSATIONCOVERAGE IS UNLAWFUL, AND SHALL r - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the. work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN • improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. • 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.). - APPLICANT ACKNOWLEDGEMENT 1—) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditionsand restrictions set forth on this application. ' oronenv who huilds or imoroves thereon, and who contracts for the nroiects with a contractor(s) licensed 1, Each oerwn uevn whew aehalf this agglication i5 maft Qacn gQr§Qn at wno�e reguest and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I— 1 I am exempt under Sec- BAP.C. for this reason 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 fallowing issuance of this permit. ' Date: Owner: 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 ' CONSTRUCTION LENDING AGENCY permit to cancellation. 1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). - - - 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. - - Lender's Name: ' �1 Date: Signature (Applicant or Agent): Lender's Address: LQPERMIT Application Number. . . . . . 08-00000418 Permit . . . . MECHANICAL Additional desc . Permit,Fee 24.00 Plan Check Fee 6.00 Issue Date Valuation 0 '. Expiration Date 9/03/08 Qty Unit Charge Per. Extension BASE FEE 15.00 1:00`.- :':9.0000 EA MECH B/C <=3HP/100K BTU 9.00 --------------------------------------------- Special Notes and Comments I --------------- REPLACE (1)3.5 TON.CONDEN SER & COIL Fee summary Charged Paid Credited Due Permit Fee Total 24.00 .00 .00 24.00 Plan Check Total 6.00 .00 .00 6.00 Grand Total 30.00 .00 •.00 30.00 Bin # City of La Quinta Building 8L 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: Owner's Name: 9 Address: A. P. Number: Legal Description: City, ST, Zi 9 Contractor: Address: PALM t%GERT ASR CONCl ITIONINU COMPANY 81 BEACON HILL .>.Y:»:s<ys:s Telepho%Mlz> y:N s ::;.,y.y Project Description: /�, 3. City, ST, Zip: PALM DESERT, 760 346-0677 Telephone: ii r'f;4: 'LA 'Y:+iv' J. ��iM•'ry!,v,./: YL: 4:;J:i State Lic. # : City Lic. #, Arch., Engr., Designer: Address: City., ST, Zip: Telephone: W:>:Y.;<;t.;:r•:;:.:Y; .. f,. ;:..,:.; 'in:, '' "" Construction Type: _ Occupancy: State Lic. #:;•...:,..;r Project type (circle one) New Add'n ter Repair Demo Name of Contact Person:Sq. Ft: # Stories:I #Units: Telephone # of Contact Person: % Estimated Value of ProQV, �� as�,n -� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Title 24 Caics. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan 2a° Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue - - Developer Impact Fee _ Planning Approval Called Contact Person — "' A.I.P.P. " Pub. Wks. Appr Date of permit issue School Fees - Total Permit Faes rcr ifin-m4c of (--mmnlinnrP PrPSCrimU%F Method - HVAC-oniv Alteration CF -1R -ALT P j Title: roject/Addr Doc ntation uthor: Wte fA e: Telepho ©CaICERTS 2005 Enf6rcementrA" en Use Only" t3wldmg Permit;# ' En V 1 ;w' o Name: FieldlCheck Date sl IMPORTANT: This CF -1 R -ALT form is only for se when an HVA - only Iteration is made to an existing home Use one form for each system being altered. This is s stem # r o systems altered in this house. Check all lines that apply. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2 ❑ A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 n outdoor condensing unitis to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entire duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing Onl if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or B. No duct sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AM EER 12 condenser will be installed with TXV(RCA) D added duct insulation R-4 wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER.14 AdQ EER 12 condenser will be installed with TXV(RCA) D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 ANa EER 12 condenser will be installed with TXV(RCA) LAND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 & INone of lines 7-14 above are checked. Duct Sealing is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ Thes stem being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ This system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 07 iThis system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) is required. Go to Section 3. Sedlion 3 - HERS Rater verification 22 If line 15 is checked, HERS verification is required for Duct Sealing. 23 If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RCA). 2 ❑ If line 12, 13 or 14 are checked, HERS verification is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ if lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List in Section 6. Section 5- Duct R -Values 26 ❑ Ilf more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ 111 less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com s Praccrintivp Method - HVAC -only Alteration CF -1R -ALT Proje itle:. A�-IMPO Date: D �� •� CaICERTS 2005 - LT form is only for use when an HVAC -only altpration is made to 3n existing home Use form stem being altered. This is system #_Z of K systems altered in this house. "each Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed efficiencies/R-values. 28 Configuratio plit system ❑ Package Unit 29 ❑ Air Handler r Mas furnace, AFUE: ❑Heatpump FAU ❑Hydronic FAU ]Other 30 ❑ Heat Exchan er 31 1? Outdoor Condensing Unit 69WC ❑HeatpumpEfficien 'SEER/HSPF: JEER ff re d : 32 AP 33 ❑ Cooling or heating coil AMC ❑Heat ump ❑Hydronic Duds Location: Length (H):IR-value: All mandatory measures apply to any altered component. See MF -1 R = ALT forn. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative- regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation Author Name: Name: Address: Company Name: City/State/Zip: Address: PALM DESERT AIR CONDIT!r' °'^'• ' � ^ �•�'• 42081 BEACON t,r.. Phone: City/State/Zip: 11"�'"• . (760) 346-0677 Phone: Signature: Signatur Enforcement Agency (BuildingDepartment)s/06m en s: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Required forms: CFAR-ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement age --Icy, HERS rater. CF4R-ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. Version 03-10-06 royc a ui c This form can only be used on projects being verified by CaICERTS certified raters. www.ca[6erts.com Ca10ERTS 0 COPY Page 3 of 14 CERTIFICATE OF FIELD VERIFICATION R DIAGNOSTIC TESTING (Page 1 of 81 CF -4R 50-645 Calle Quito - La Quinta CA 92253 Palm Desert A/C - Heating/ ,374937 Project Address Contractor Name / License No. Contractor Contact 08-00000418 Telephone Permit Number Paul Van Vlvmen 760-777-1724 112403 HE ater Telephone Sample Group Number — n , , I' �,, October 31, 2008 CC14-1798452991 Certifying Signature Date Certificate Number Firm: Air Experts Air Conditioning Street Address: PO Box 94 HERS Provider:Ca10ERTS: Inc. City/State/Zip: La Quintan / CA / 92247 This CF -411 has been registered with the CalCERTSO registry in accordance with the Title 24 & Tittle 20 of the CCR. CaICERTS® is an approved HERS provider by the California Ene Commission. HERS RATER COMPLIANCE STATEMENT The house was 0 Tested DApproved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape Is used before a CF -411 may be released on every tested building. The HERS rater must not release the CF -4R until a properly completed and signed CF -6R has been received for the sample and tested bui dings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns m lieu of ducts). New systems where doth backed, rubber adhesive duct tape Is Installed, mastic and drawbands are used Ir combination with doth backed, rubber adhesive duct tape to seal leaks at dtirr r nn­+1­ NEW CONSTRUCTION - -- -- v�....�.,.�: Duct Pressurization Test Results (CFM @ 25 Pa) Measured ValueE 1 N/A 2 Fan Flow: Calculated (Nominal`.- Coolin Enter Total Fan Flow in CFM: g `' Heating) or _ Measured 1400 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 5 Enter Tested Leakage Flow In CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. 188 6 Enter Reduction in Leakage for Altered Duct System [Line 4 - Line 5] - (Only If Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass If Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )]' El Pass ❑ Fall TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass If Leakage Percentage < 15% [ 100 x ( Line S / Line 2 )]: 13.43% Q paw ❑Fall 10 Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: ❑ Pass ❑Fail 11 Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] and Verification by Smoke Test and Visual Inspection D Pass D Fall 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection © Pass El Fail Pass if One of Lines S9 through *12 pass 9 Pass D Fail c�cERTs -Page 4 of 14 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8 CF-4R 50-645 Calle Quito - Protect Address La uinta CA 92253 Palm Desert A/C - Heating,,t 374937 Contractor Name / License No. — Contractor Contact 08-00000418 Telephone Permit Number Paul Van VI men 760-777-1724 112403 HES ater Telephone Sample Group Number �f ober 31, 2008 CC14-1798452991 Certifying signature Date Certificate Number Firm: Air Experts Air Conditioning - Street Address: PO Box 94 HERS Provider:CaICERTB, Inc. City/State/Zip:La Qulnta / CA / 92247 Copies to: Homeowner HERS Provider and BuildingDepartment This CF-4R has been registered with the CaICERTSO registry in accordance with the Title 24 & Title 20 of the'CCR. CaICERTSM is an a roved HERSprovider b the California EnergyCommission. HERS RATER COMPLIANCE STATEMENT The house was O Tested ElApproved as part of sample testing,.but was not tested. As the HERS rater proylding diagnostic testing and field verification, I certify that the house' Identified on this form compiles with the dia nostic tested compliance requirements as checked on this form. The Installer has provided a co y of the CF-6R Installation Certificate . HERMOSTATIC EXPANSION VALVE TXV : Access is provided for inspection- The procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. HVAC System TXV 0 Pass ❑ Fail