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10-0311 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000311 Property Address: 48643 • PASEO TARAZO APN: 646-082-022- - Application description: MECHANICAL Property Zoninq: LOW DENSITY RESIDENTIAL Application valuation: 6000 4 BUILDING &SAFETY DEPARTMENT BUILDING PERMIT ' Applicant: '�_---� �-- Architect or Engineer: ads ------------------------7------------------------- 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.: 791437 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 foe 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 _ 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 contractor(s) licensed pursuant to the Contractors' State License Law.). ( ) 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: - _ a Lender's Address: 7 LQPERAIIT Owner: TUCKER JOSEPH W 48643 PASEO TARAZO LA QUINTA, CA 92253 ..---Contractor: MENDEZ AIR COND & HEATING 72096 DUNHAM WAY, SUITE C THOUSAND PALMS, CA 92276 (760)345-6001 Lic. No.: 791437 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/13/10 ® .261_J9 CITY CF C. A QUINTA ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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. IY I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor 1i•' Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier FARMERS INS Policy Number B09242175 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 ��/3/770'0 of the Labor Code, I shall forthwith comply with t se provisions. ��� A cant:!/�TL� iZ�Xs WARNING: FAIL E 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 andgproperty a5p, Pr./ agree to comply with all city and county ordinances and state laws reauthorize representatives of this_c/pu/ try to enter upon th above-ment ate: /l �d Si [ure (Applicant or Application Number 10-00000311 Permit . . . MECHANICAL Additional desc . Permit Fee• 42.50 Plan Check Fee 10.63 Issue Date Valuation . . . ". 0 Expiration Date 10/10/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH•FURNACE >100K 11.00 1:00 i6.9`000 EA MFCH B/C >3. 15HF/>'10UK-5UUK&w 1b.SU Special Notes and Comments-. ------ —---------- " ---- ---- - -...REPLACE EXISTING ­SPLIT'-SYSTEM"-WITH"HIGH EFFICIENCY (14 SEER, 80% AFUE)SYSTEM. 2007 CODES. ----------------------------------------------------- ---------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 42.50 .00 .00 42.50 Plan Check Total 10.63. .00 .00 10.63 Other Fee Total 1'.00 .00 .00 1.00. Grand Total 54.13 .00 .00 54.13 LQPERMIT Sim lifted Prescri five Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: ��� U^_ Y -,7oEn oreement Age cy: o G- D e: -/3. D Permit #: Equipment T t List Minimum Efficient 2 Duct insulation requirement Conditioned Floor Area Thermostat OPackaged Unit l ace ❑ AFUE80 O COP Over 40 ft of ducts added or p'§etback ndoor Coil ❑SEERJ=0 0HSPF replaced to unconditioned space Served by System (if not already 1111ro-ndensing Unit O EER J -Q 0 Resistance OR 6 (CZ 10.13) OU `f present, must be 0 Other 11 R 8 (CZ 14-15) installed) • - r ype. i—wir the equipment oetng installed: if more than one system, use another CF- I R -ALT -HVAC for each system. 2. Minimum Equipment Efficiendes: 13 SEER, 78% AFUE. 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below ane 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 foams 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 _n. fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF4R forms (no hand filled CF4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -111 and CF -6R shall also be on site for find inspection. 14 1. HVAC Changeout I Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and for Split stems MECH-25 • Condenser Coil and/or • Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH= 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirerrent), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: O 1. Duct system was documented to have been previously sealed and confirmed through HERS verificatnon, or 0 2. Duct systems with less than 40 linear feet in unconditioned space, or O 3. Existing ducts stems are constructed, insulated or sealed with asbestos 0 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -61K forms: MECH-04, MECH-20-HERS and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH -e5 For Split Systems: Duct leakage < 6 percent; RC, CCA 2:350 CFM/ton, FWD, TMAH, STMS, and either. HSPP or PSPP. For Packaged 11 nits: Duct leakage <6 oercent 0 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 2:300 CFM/ton, TMAH For Packaged Units: Duct leak e. < 6 percent 0 4. New Ducting over 40 feet!F11forms: uired Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space MECH-04, MECH-2I-HERS CF -4R _oris: MECH-21 For split system or packaged units: Duct leakage < 15 percent D EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 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 identi tted 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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information d gated ther aaplicable compliance forms, worksheets calculations, plans andspecifications-submitted to the enforcement agencyfor roval with rmit i Name: �� _-, , . . , J e:.. o« . _ %-uuip,ul m ii Date: Address:j License- L�2 City/Stattr7ip.� ca 9 -7 4, - Phone: ���� �G/� - �r(�y/ 2008 Residential Compliance Forms March 2010 Bin # City of La Quinta Building 8i' 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: ^-UL+�Stoa Owner's Name: d V ,�O- A. P. Number: Address: LI i& -to Legal Description: COntraCtoC: C UYI /h. City, ST, Zip: TeleU � phon Address: ,C) efx Project Description: City, ST, Zi . U. V I _ Telephone ICIQmC State Lic. # : City Lia #:. l`7. E E J2 Arch., Engr., Designer: Address: City., ST, Zip: 6�J\:xk, Cp�nh,..jM1i;�i;j •�Yrit i :; j {' Telephone: %.`}�i`:"C::i: �ij'{j\`Zy�. J:ti{{`;�A:}' <•{ti•Y�: State Lic. Name of Contact Person:. Z . Construction Type: Occupancy: Project type (circle one) New Add.'n Alter Repair Demo Sq. Ft.: Ob # Stories: #Units: I Telephone # of Contact Person .O` �� Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Pian Check Deposit' Truss Calcs. Called Contact Person Plan Check Mance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" 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 Perm& Fees