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11-0834 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11200000834 Property Address: 44670 SAFFRON CT APN: 604-252-019-39 -24208 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application Valuation: 5000 4 �wa�rw BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: PINTO RICHARD/DOSANTOS 44-670 SAFFRON COURT LA QUINTA,•CA 92253 Contractor: Applicant: _ Architect or Engineer: TELFORDJONES, INC. 25920 IRIS AVE, STE MORENO VALLEY, CA 92 (951)486-0337 Lic. No.: 856936 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/03/11 ANGELIC D l, AUG C 3 2611 . i 1i 00. CITY OF F—A:$UINTA ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION 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 perjury one of the following declarations: Section 7000) of Divisi a Business and Profasijionals 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: B , • 0-C20- License No.: 856936 for by Section 3700 of the Labor Code, for.the performance of the work for which this permit is ' Q 7 ./ issued. Datef� v Contractor: _ •1 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: r I hereby affirm oder penalty of jury that I am exempt from the Contractor's State License Law.for the Carrier' STATE FUND Policy Number 0059112009 following reaso Sec. 703 , Business and Professions Code: Any city or county that requires a permit to _ I certify that, J6 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 a t, if I should become su ' the workers' compensation. provisions of Section - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the La. Code, I sh 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).: ate: - Applicant: (_ 1 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: AILURE TO SECU ORKERS' COMP ATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN RIMINAL 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 (_) 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 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 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 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: 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 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 i rect. I agree to comply with all city and county ordinances. and state laws to building constr nd ereby authorize representatives of ount to en//ter upon the above-. entioned p perty for i cti n u ses. Day�� /;Signature (App cant or Agent): Application Number . . . . . 11-00000834 Permit MECHANICAL Additional desc . Permit Fee 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . 0 Expiration Date 1/30/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH APPT. RFP/AT.T/Anr) 9.00 -------------------------------------.--------------------------------------- Special Notes and Comments HVAC CHANGEOUT - 5T/16SEER/80W AFUE [2010 CALIFORNIA ENERGY CODE] August 3, 2011 12:21:23 PM AORTEGA ---------------------- -----------------_-_---------------------------------- 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 St Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # 04��} Project Address:��Q Owner's Name:./�_� AA P. Number. 1,01,12.572 Address: �� ey— Legal Description: �OT3!` T� .Z `�Zo g City, ST, Zip:14_01 Contractor. 70`:70 /�G Telephone: ? Address c—ljao,�l/� -zyZ ,�zyi2p Project ' ) L-0 City, ST, Zip: ,,o Ufa ��Gf �Z. � �Deesscription: /�fi G/�L� �✓ht9�i�—li�Y�T7 Telephone: Zf—/ �sra u ? s»m ,,�. _ AC 10 .1,Q1C. 1317) G.(�✓ State Lie. # : �$e�QJ`'6 City Lie. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: L State Lic. #: , , . Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New • Add'n Alier a a' Demo Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: 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 Cala.Reviewed, ready for corrections Plan Check D.:posit. 'Russ Calcs. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked upConstruction 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.L r- H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for eorrectionsl�ssue Developer Impact Fee n Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr ' Date of permit issue (. School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 44670 Saffron Ct La Quinta, CA 92253 City of La Quinta Aug 3, 2C11 Equipment Typel List Minimum Efficiency2 . Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit 211 Furnace Ej Indoor Coil Q AFUE 78% CEJ SEER 13.0 (:]COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system f Settack lrea If not already present, must be 0 Condensing Unit C] EER ❑ Resistance ❑ R 8 (CZ 14-15) 1600 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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. F. 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 :he work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF 6' R 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 -111 and CF -6R shall also be on site for final inspection: D 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -611 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 d flMECH-25 an(ors pits systems) For Split Systems: Duct leakage < 1S 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 will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge) ❑ 2. New HVAC System Required Forms: . Cut in or Changeout with new ducts: (all new CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and MECH-25-HERS ducting and all new CF -4R forms: MECH 20, and (for split systems) MECH-22, and MECH 25 equipment) 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/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some equipment CF -4R forms: MECH-20 and (for split systems) MECH-25 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 icentified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design identified on this Certificate of Compli'3nce 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 ogler applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Ken Telford Signature: Ken Telford Company: TELFORDIONES INC Date: Aug 3, 2011 Address: 25920 IRIS AVE STE 13A 400 License: 856936 City/State/Zip: MORENO VALLEY / CA / 92551 Phone: (951) 486-0337 Reg: 211-A0039349A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2011/08/03 10:24:11 HERS Provider: CalCERTS, Inc. July 2010