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10-0805 (MECH)P.O. BOX 1504 78-495-CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ,.� 10-00000805 Property Address: 44640 SAFFRON CT � APN: 604-252-020-40 -24208 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL. Application valuation:. 6000 Applicant: Architect or TdY. " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 4\ - ----- - - - - - - - - - - - - - - - - -- LICENSED CONTRACTOR'S DECLARATIONCF Q I hereby affirm under penalty of perjury'that I am licensed under provisions of Chapter 9 (com ,e Section 7000) of Division 3 of the Business and Professionals Code, and my Licenseis' II forc etrt. License Class: C20 -C36 / _ License No.: 7777S4J 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 70001 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 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 I, 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 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: Lender's Address: r LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/26/10 Owner: SMITH KELLIE W 44640 SAFFRON COURT LA QUINTA, CA 92253 Contractor: J ANTHONY PLUMBING HEAT/AIR 72216 NORTH SHORE STREET, #101_ THOUSAND PALMS, CA 92276 (760)343-2121 Lia. No.: 777794 ------------------ WORKER'S COMPENSATION DECLARATION 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 STATE FUND Policy Number 1932451 '4� _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any x., 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' comper sa 'on provisions of Section 3700 of the Labor Code, all forthwith co ly with those p 'ions. - 'Date: " ���a pplicant: - WARNING: FAILURE 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 and state that the above information is correct. I agree to comply with all . city and county ordinances and state laws relating to building construction, and hereby authorize representatives- of epresentatives- o/ft�b�s /county t � enter upo a above-mentioned property f action rposes . ,I- 2K— `' nature (Applicant or Agent): �� Application Number . . . _ . 10-00000805 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . 0 Expiration Date 2/22/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9;0000 M. P• ECII D/C <-3IIP/100K BTU 0: 00 -------------------------------------------------------- Special Notes and Comments -------------------- INSTALL NEW 5 TON 14 SEER SPLIT SYSTEM. 2007 CODES. ------------ ---------------------------------------------------------------- Other Fees . . . . BLDG STDS ADMIN (SB1473) •1.00 Fee summary -------------=--- Charged -------------------- Paid Credited -------------------- Due Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT Bin # City of LA Quinta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I Project Address: �� 6"�`� Owner's Name: e�� y '� , A. P. Number: Address: Legal Description: City, ST, Zip: Contractor. � ANTHONY SERVICES Address: THOUSAND PALMS, CA 922M .� � �r• 4' Telephoner � � � �, Project Description: City, ST, Zip: �L. �J fell 0(h Telephone. 6O . (43 z l zI. :. ..< r. Lic. & State Lic. # Arch., Engr., Designer: Address: City., ST, Zip:, Telephone: State Lic. #: ¢ Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 6 e APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cala. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2i° Review, ready for corrections/issue Electrical Subcont actor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A .P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees e Sim lifted Prescri g tive Certificate of Compliance: 2008 Resfdendal'HVAC Alterations CF -IR ALT -HVAC Climate Zones 10 to 15 Sit Add e n orcement A err f 8 ��� C /\ i V :Permit#e- Equipment T 'Conditioned ❑ Packaged Unit List Minimum Efficiency a Duct insulation requirement Floor Area Thermostat O Furnace dAFUE $014 p COP Over 40 ft of ducts added or Setback door Coil UWEER_a� ❑.HSPF replaced tin unconditioned space Served by system afnot already Condensing Unit ❑ Other _ O EER ❑ Resistance ❑ R 6 (CZ 10-13) ❑ R 8 (CZ 14-15) sf present, inns( be insral�ed) 1. Equipment Type: Choose the equipment being installed: ijmore than one system, use another CF -1 R-ALT-HVACjor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfortypical 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 formas be left shaU 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 -6R each appropriate CF and registered CF -4R for (no Band filled CF -411s allowed) are filled out and sign .B Inning October 1 2010 a registered copy of the CF -IR and CF -6R shall also be on site for final Inspection. 1. HVAC Cbangeout . 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 for lit stems MECH-25 • Condenser Coil and /or • Indoor Coil and/or CF -6R forms: MECH-21-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -411 forms- MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA 2 300 CFM/ton(Minimum Air Flow Requirement), 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 unconditioned space, or 133. E dstin ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in -or Chang with new (all new and all ducts:ducting. CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and -MECH-25-HERS new CF -4R forms: 20-, and for - " a ui inert ..ms: MECH __--_-__-- _. (" split systems)MECH-22, and MECH 25 ." For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, T'MAH, STMS, and either-HSPP or PSPP. For Packaged Units: Duct leakage <.6 percent ❑ 3: New Ducis 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 -411 fors: MECH-20 and (for split systems) MECH-25 . coil and/orfunace. -Not all equipiiient changed.. For Split Systems: Duct leakage < 6 percent, RC, CCA 2:300 CFM/ton, TMAH For Packaged Units: Duct l e < 6 percent ❑ -.-.New Ductin—k over 40 feet Required Forms:. • Includes addingct in or replacing more than 40 linear feel of duCF-6R•forms: MECH-04, MECH72I-HERS ' CF=4R forms:. NECH-21.. unconditioned s ace.' For split system or. packaged. units: Duct leakage < 15 percent ❑ - EXCEPTION:. Exist n duct stems eonstru insulated or sealed with asbestos: Contractor (Documentation Author's /Responsiblh Designer's .:Declaration Statement)' . • I certify that this Certif este of Compliance documentation is accurate and complete. . " 1 am eligible underDivision 3 of the California Business and Professions Code to accept responsibility for the design identified on'this Certificate of Compliance. • [ cenify that the energy• features and performance specifications for design the identified on this Certificate of Compliance conform to the teguirements of Title 24, Para I' and 6 ofthe Califomia:code of Regulations: " • The deign features identified on this Certificate of Compliance are consistent with the information.documented another applicable mpliance forms; worksheets, calculation's,. lams ands ifcations submitted toth enforoentent a fora with roval the' t licatios Name: . 1 N l Signature: Company: Date:' ANTHONY -SERVICES" Address: 72216 NORTH SHORE ST STE 109. License - THOUSAN' CA 92276 �.�.7.-� PALMS ' A City6tatc/Zip: Phoria:. 2008 Residehtia�mpliance Forms March .2010 :