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14-0840 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Y! I, Application Number: 14-00000840 Property Address: 57721 SANTA ROSA TR APN: 762-240-013-9 -30487 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 900 fico : G „/� Tuvl- 4aQ" BUILDING & SAFETY DEPARTMENT . BUILDING PERMIT Architect or Engineer: AAd- ------------------ LICENSED CONTRACTOR'S DECLARATION ..1 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. LicenseClass: C20 C38 � Li� 967982 Date: Contractor: 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: 1 _ 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.). (_ 1 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: LQPERMIT Owner: RIGGS STEVEN 57721 SANTA ROSA TRAIL LA QUINTA, CA 92253 ( Contractor. BEST IN THE WEST AIR 255 N. EL CIELO, 140 - PALM SPRINGS, CA 9226 (760)343-1002 Lic. No.: 967982 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/12/14 /HTG 51 q jry 2-1 CITY OF 9..A (QUINTA F-PJAirlc CEPT. -------------------------=--------------------- WORKER'S COMPENSATION DECLARATION 1 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 NORGUARD Policy Number 'BEWC337354 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 37�0[0 of the Labor Cod ��aaaNNN rthwith comply with those provisions. Date:C 12 �"iT Applicant: /�� &/Y—�"' 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 Ouinta, 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 this c unty to enter upon the above-mentioned property f r ' on/purposes. t): Date:~�� Signature (Applicant or Agenv`_vV / �•' Application Number . . . . . 14-00000840 r Permit . . . MECHANICAL 2013 ` Additional desc . . Permit Fee . . . . 11.92 Plan Check Fee .00 Y Issue Date . . . . Valuation . . . . 0 Expiration Date 12/09/14 Qty Unit Charge Per Extension 1.00 11.9200 EA MECH APPL REP/ALT 11.92 ---------------------------------------------------------------------------- Special Notes and Comments REMOVE & REPLACE 5 TON EVAP COIL ONLY.[2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINALINSPECTION. 2013 CALIFORNIA BUILDING CODES ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 4.77 Fee summary Charged Paid Credited Due ------- ---------- ---------- ---------- ---------- Permit Fee Total 11.92 .00 .00 11.92 Plan Check Total .00 .00 .00 .00 Other Fee Total 96.34 .00 .00 96.34 Grand Total 108.26 .00 .00 108.26 LQPERMIT # Pe7ft Project Address: S 7-7Z P Pty of La Quints Building U Safety Division P.O. Box 1504,78-495 Calle Tampico Ia.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet ti 20Se, _?/' l• Owner's Name:. 15j(!?N,6e? A P. Number.Address: 57-77-1. 5o,,mS Legal Description: City, ST, Zip: G OVIrIIA Contractor. e �- �� /C Telephon . ti,�G Address: 2_S'(; �- C'�'el� 1 "IZ,j ProjectDescription: �,CV OL / le, t City, ST, Zip: !"G( !Y q `G' e D t , / �► o r Cu Telephone: 7 0^,ay ,1002 City Lic #: State Lic. 4: %C 7 Cj Z Archy Engr., Designer 1 P11 O �I Address: Address: City., ST, Zap: Telephone: Name of Contact Person: iok Construction Type:. Occupancy: Project type (circle one): Ncw ter epair Demo Sq. R. # Stories: # Unity: Telephone # of Contact Person: E Value of Project # Submittal Req'd Plan Sets APPLICANT: DO NOT WRITE BELOW THIS LINE Recd T'RACICTPiC PERMIT FEFS Plan Check submitted Item Amount Structural Calces Reviewed, ready for corrections Plan Cbc& Deposit. . Truss Calet. Called Contact Person Plan Check Balance Title 24 CaIcL Plans piekcd up Constmetion Flood plain plan Pians resubmitted Mechari(cal Grading plan 2" Review, ready for correctiionsrissue Electrical Subeoutactor List Called Contact Person Plumbing Grant Deed Plane picked up S3U H.O A. Approval Plans resubmittedCradlag IN ROUSE:- Review; ready for wrrectionsRssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr - Date of permit Issue Scbodl Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: . Enforcement Agency: Date: Permit #: 57721.1 Santa Rosa TO La Quinta, CA 92253 City of La Quinta Jun 11, 2014 Duct insulation Conditioned Floor .Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ❑ Furnace ® Indoor Coil ❑AFUE ❑ SEE ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system ® Setback If not already present, must be ❑ Condensing Unit [3E ❑ Resistance ❑ R gCZ 14-15 ( ) . 2000 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, Z 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 -111 and CF -6111 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 -611 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 5 300 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 [14. 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�CFian eI666with g new ducts new CF 6R'forms MECH 04 MECH=20 HERS, and (for split systems) MECH 22 HERS, and .(all ductin and?all new MECH 25=HERS; ,- 'CF 4Riforms ors equipment) rMECH-20, andS(fplit sysmmtc atesyH-22,pan'&MECH-25, & .+�' For SphtSystems Ducteakagel<76pkacent RC, CCA;350 CFM/ton, FWD., TMAH;�STMS; and either HSPPor PSPP'"' For Packaged Unitts:b6co leakage < V. �r k �a r �A` �YiN_� percent I� rY..�tp�i . ❑ 3. New Ducts with/or Required-.Forms•"'"�,� 3�'-• � ��"':': 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, TMA -H,. 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 -411 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: Richard C Weaver Sr Signature: Richard C Weaver Sr Company: BEST IN THE WEST AIR CONDITIONING & HEATING INC Date: Jun 11, 2014 Address: 255 N ELCIELO ROAD #140-125 License: 967982 City/State/Zip: PALM SPRINGS / CA / 92262 Phone: (760) 343-1002 Reg: 214-ACfJ42529Pa-000000000-0000 Registration Date/Time: 2014/06/11_ 18:39:05 HERS Provider: CalCERTS,.Inc. 2008 Residential Compliance Forms July 2010 4