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12-0908 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: -12:_ 000'OA908� Property Address: 81.835 PRISM DR APN: 764-270-999-67 -300232- Application description: MECHANICAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 12725 Tdv14-4Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: RICHARD MEAD 81835 PRISM DRIVE LA QUINTA,, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/13/12 Contractor:�D� 'Applicant:. Architect or Engineer: GENERAL AIR CONDITIONI 31170 RESERVE DRIVE ; 1� �0 j �J) `� . THOUSAND PALMS, CA 922AUS , 6 (760)343-7488 ! _ Lic. No.. 686310MCC C17Yn(zP,�1�i!d7l� -------—-----------------------------—- LICENSED NTRACT0R'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am lice under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business. and f ronals Code, and my 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 LicenseNo.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is cs issued. Date: a / 3 r� tractor: Prof- - plc.; I have and willmaintainworkers' compensation insurance, as required by Section 3700 of the Labor T Code, for the performance of the work for which this permit is issued. My workers' compensation OW 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 ZENITH INS CO Policy Number Z071741501 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't ork 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 appllcant.fur the person in any manner 30 es to b subjcct to the workers' compensation laws of California, permit to Hale signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should beco s jest 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 . 3760 of the Labor Code, I shall rt with' omply 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):: ate: _§( IQ pplicant: (_) 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 (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WO OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL 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 1, 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 conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request 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, (_ 1 1 am exempt under Sec. , B.&P.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 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: i Lender's Address LQPERMIT 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 per it, or cessation of work for 180 days will subject permit to cancellation. . I certify that I have read this application and state that the ab a information is correct. I agree to comply with all city and county ordinances and state laws relating to building struction, and hereby authorize representatives of this county to enter upon the above-mentioned property f ' spec ' n purposes. Pate: 11/( 3 12 s, ature (Applicant or Agent): Application Number . . . . . 12-00000908 Permit . . . MECHANICAL Additional desc . Permit Fee . . 40.50 Plan Check Fee 10.13 Issue Date Valuation . . . . 0 Expiration Date 2/09/13 Qty Unit Charge Per -Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT: 5 TON SPLIT SYSTEM, FURNACE,CONDENSER, INDOOR COIL. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due •Permit Fee Total 40.50 .00 .00 40.50' Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .00 51.63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 81835 PRISM DRIVE La Quinta, CA 92253 City of La Quinta Aug 12, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system ® Setback If not already present must be ® Condensing Unit [I EER ❑ Resistance ❑ R 8 (CZ 14-15)� sf 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 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 -IR 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 For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage 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. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The�system�w.ill not be Ducted (ie Ductless vMinq-Split,Sym stem}o(Also,Exept;fromjRefrigerant,Cha,rge) ❑ 2. New HVAC System Required Fottns: . Cut iWorChangeout with" - �` ` ' " 34" CF -6R forms: MECH-04, MECH 20-HERS,and'(fo�'split systems) MECH 22 -HERS, and new ducts: (all new, ducting all new MECH-25 HERS, ' CF -4R forms: ,MECH-20, and (for split systems) MECH-22, and MECH-25 , e ui ment- For Split System's: Duct leakage <,6 percent; RC, -CCA -,.2:.350 CFM/ton, FWD;'TMAH, SIMS, and either HSPP or'PSPP. For Packaged Units: Duct leakage{ < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement. . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R 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 than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ 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: Danielle Garcia Signature: panielle Garcia Company: HARRISON ENTERPRISES INC Date: Aug 12, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0043666A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2012/08/12 12:27:36 HERS Provider: CalCERTS, Inc. July 2010 BIR # Qty Of U. QuII1ta Building & Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253.:(760) 777-7012 Building Permit Application and Tracking Sheet Perinit # Project Address:�� r wn Dr • Owner's Name://. 1 fib o ltd A. P. Number. •�. W y 3 / o 0. W Address: S vIY1(j `e Legal Description: Contractor. ���- City, ST, Zip: Telephone: Project Description: v c C Vv l 73 WIC, Address: 31— 170 City, ST, Zip:"r , 2 2 -7,9'. I 5 Telephone• 760 �3 3 A� S State Lic. # : 6.B6 3. I O City Lia #: Arch., Engr., Designer Address: City, ST, Zip: Telephone: g Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: Sq. Ft.: 2 2 # Stories: # Unit;: Telephone # of Contact Person: Estimated Value of Project: I 2 5 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERMfI' FEES Plan Sets Pian Cheek submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Tross C21cs. Called Contact Person Plan Check Balance_ Title 24 Calci Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2" Review, ready for correctionsliissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '" Revtew; 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 Fees