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11-0746 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 1.1-.00000.746; Property Address: 46100 ROADRUNNER LN APN: 649-061-011-12 -2180 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 13787 Applicant:. - Tdy 4 XP Q" Architect or Engineer: `o, BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: OWEN COTHRON 46100 -ROADRUNNER LANE LA QUINTA, CA 92253 Contractor: /// GENERAL AIR CONDITIONIN® 31170 RESERVE.DRIVE THOUSAND PALMS, CA 92,276 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/08/11 ------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licens underprovisions 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 Proles nals 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 686310 _ for by Section 3700 of the Labor Code, for the performance of the work'for which this permit is 8 ontractor: PseNo.: issued. have and will maintain workers' compensation insurance, as required by Section'3700 of the Labor_ _,�e:? Code, for the performance of the work for which this permit is issued. My workers' compensation WN -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 EVEREST NATL Policy Number 76 00 0 0614 7101 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 becom ublect 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 becomes ct to the workers' compensation provisions of Section de) License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Coor 3700 of the Labor Code, I shall fo rth 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, 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 5' C PENSATION 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 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, Businessand 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, I—) I 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 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: Lender's Address: c LQPERMIT 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 ces tion of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above infor io is correct. I agree to comply with all city and county ordinances and state laws relating to building constru and hereby authorize representatives of this county to enter upon a above-mentioned property for inspec urpo s. D e: V_AZ1 -1 S' ature (Applicant or Agent): Application Number . . 11-00000746 Permit . . . MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee.-. 10.13 Issue Date Valuation 0 Expiration Date . .1/04/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00'. 9.'0000 EA MECH FURNACE.<=100.K 9.00 1.00 16,5000 Ell MECI•I B/ C •x 3 15I•IP/2 100I{ 500Ir,BTU 16:50 Special Notes and Comments INSTALL 5 TON HVAC SYSTEM, FURNACE, INDOOR COIL, CONDENSER. 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 Sim lifted Prescriptive Certificafe of Compliance:- 2008.Residential H VA C Alterations CF -IR -ALT -HVAC, Climate Zones 10 to 15 ' 208 Residential Compliance Forms nt. �,•t 701n Site Address: En orcein Agency: Date Permit #: Z Ctindit:vned Floor Equipment T el List Minimum Efficient Duct insulation requirement area Thermostat INEf11 Packaged Unit Furnace ❑ AFUEBo% ❑COP ft - Over 40 of ducts added or Setback Indoor Coil ❑SEER ! 3 0 HSPF replaced in unconditioned space Served b- system (lfnot already Condensing Unit RO ❑ EER / / ❑ Resistance ❑ R 6 (CZ 10-13) ' sf present, nnnst be Other ❑ R 3 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF- l R-ALT-HVACfor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 73%AFUE, 7.7KSPFfor 0q.7ical 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-4R,s allowed) are filled out and si ed. Beginning October I, 201.0, a registered copy of the CF -IR and CF -6R shall also be on site for final in: ection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I -HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors lits 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 Requirem!nt), 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 systems with less than 40 linear feet in ttncondifioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout 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 new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 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 < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MC -CH -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 Packs ed Units: Duct leakage < 6 percent ❑ 4. New Ductin over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R fours: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems 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 an 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. • -rhe design feantres identified on this Certificate of Compliance are consistent with the • orm, lion documented on other 1pplic ompliance forms, worksheets, calculations, plans andspecifications submitted to the enforcement a ency for appro al with t e perniit application Name: Clee� Sig lure: Company. p� y. 6 en -e-ra 41\r Date: 77 Address: -3/1-70 PeserU2 �/`t` ✓� License: 68ro31v City/State/Zip:--rAQt4--5cj-.tL-,,;k PSL f,L-�S, 614 gPhone: a -a-7 6,7/ 0 -3 `V3 - 7'� 208 Residential Compliance Forms nt. �,•t 701n CaICERTS - CF -1R Registration Page 1 of 1 Pub31e Home Socusa Honu Ahput US Y Tmtntng Rater'Dirmory iwrttxs McmbcrsRtp Ocncf+tc Fvrnes To register for our monthly newsletter, please click here. Danielle Garcia logged in [Logout] [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: I46100 ROADRUNNER LANE La Quinta, CA 92253 CEC Registration: 1211-A0032374A-00000000-0000 CF-IR-ALT-HVAC:ICLICK HERE TO DOWNLOAD ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -IR to them. CaICERTS Rater ID: OR_ My Rater Quick Select: The Energuy CA LLC Every CaICERTS rater has a license number. If you need to find the rater by name [Click HERE] to search our directory. j SEND_CF 1 R. TO HERS .R TE.R I [CLICK HERE] to do another Copyright (0 2010 CaICERTS. Inc. All rights reserved. Revised: January 11. 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us .-t f BBB find us onFaC4book https://www.calcerts.com/public—cflR.cfin?project—id=122366 7/1/2011 Dill It City, of U QUinta Building &r Safety Division Permit # � P.O. Box 1504, 7&495 Calle Tampico /�► La Qulnta, CA'92253 - (760) 777-7012 Building Permit Application and. Tracking Sheet. Project Address: *'94.6 kA 1'2 Owner's Name, A. P. Number: Address: Legal Description: City, ST, Zip: ilk, 6t, &UP Contractor:(a Telephone: % ��:`��'4�"M�"'•<<��'�w: Address: 3 Project Description: City, ST, Zip: Telephone: ` :y'`s::%;''••''.' rc ::: ;:f' State Lic. # : 3 F City Lie. #; L Arch., Engr., Designer: Address: City., ST, Zip: Telephoner ' _ w•:N z { '. Construction Type: Occupancy: 4%t�iiN i��Xnii}:l%�'f,•;:y}'i'�:•i :;:y;iiti�?\\i+y ' ;?l State Lic. #: ,:.;:W .;•:.:::..::: :.:>'s :<;.r. :; . Project type (circle one): New Add'n Alter Repair Demo Name of Contact-Person:%.A Sq: Ft.: #• Stories: # Units: Telephone # of Contact Person: L760) 34 Q Estimated Value of Project: APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd Rec'•d TRACKING PERMIT FEES Plan Sets Plan Check submittedItem Y Amount Structural Cales. Reviewed, ready for corrections Plan Che -.k Deposit Truss Calcs. Called Contact Person Plan Che—,k Balance Title 24 Calcs. Plans picked up Ciinstruction Flood plain plan Plans resubmitted Mechanical Grading plan 2"a 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 Fees