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BMCH2014-104078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4tit 4-14 Qumr(v COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O14-1040 Property Address: 54700 SECRETARIAT APN: 767780010 Application Description: REPLACE CONDENSOR COIL FURNACE Property Zoning: Application Valuation: $8,000.00 Applicant: D Lr a ALL KNIGHT HEATING & AIR CONDI P 0 BOX 5232 LA QUINTA, CA 92248 AUG 0 7 2014 CITY FO LAOUINTA COMMUNITY DEVELOPMENT DEPARTMENT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/7/2014 Owner: WILLIAM SCHWARTZ P0BOX 1260 LA QUINTA, CA 0 Contractor: ALL KNIGHT HEATING & AIR CONDI P 0 BOX 5232 LA QUINTA, CA 92248 (760)772-4947 Llc. No.: 771254 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 1 hereby affirm under penalty of perjury one of the following declarations: (commencing with Section 7000) of Division 3 of the Business and Professions Code, and have and will maintain a certificate of consent to self -insure for workers' my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance of License Class: C� License No.: 71254 the work for which this permit is issued. �,f/ �.�J _ I have and will maintain workers' compensation insurance, as required by J,Date: Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit is II" issued. My workers'.compen sation insurance carrier and policy number are: OWNER -BUILDER DECLARATION Carrier:_ Policy Number:_ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and agree that, if I should become subject to the structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions of Section 3700 of the �;La�borde, I shall forthwith statement that he or she is licensed pursuant to the provisions of the Contractor's State comply with those provisions. 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 Date: 7 Applicant: '^ 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).: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, (_) 1, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE compensation, will do the work, and the structure is not intended or offered for sale. HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT:Application is hereby made to the Building Official for a permit subject to or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application. (_) I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf this application is made, each person at whose construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued License Law does not apply to an owner of property who builds or improves thereon, and as a result of this application, the owner, and the applicant, each agrees to, and shall who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and State License Law.). employees for any act or omission related to the work being performed under or (_) I am exempt under Sec. B.&P.C. for this reason following issuance of this permit. 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 Lender's Address: 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 city to enter upon the above- mentioned property for inspection purposes. Date: Signature (Applicant or Agent): DESCRIPTION:. `''}� FINANCIAL •• ''� ACCOUNT;' • QTY �y AMOUNT �4'. '.PAID' :r *r .PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 •', " . _ . `�'" PAID BY ''' METHOD 'RECEIPT # , CHECK#- CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 . , • � DESCRIPTION ACCOUNT- QTY -AMOUNT-.'. - *'PAID' PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $71.50 $0.00 PAID BY_' METHOD,,. -RECEIPT# CHECK # _ CLTD BY DESCRIPTION ACCOUNT QTY: "AMOUNT'...' • PAID.. ` r PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $35.75 $0.00 ' PAID BY METHOD .�'.. -< RECEIPT # ,; CHECK # CLTD BY = Total Paid forCHANGEOUT: $107.25 $0.00 DESCRIPTION :'' ` " ..ACCOUNT - . 'QTY ,AMOUNT - � PAID � PAID DATE, PERMIT ISSUANCE 101-0000-42404 0 $90.57 $0.00 PAID BY. "° ;r METHOD RECEIPT # F - `CHECK A CLTD BY. Total Paid for PERMIT ISSUANCE: $90.57 $0.00 TOTALS:00 NameofCanta�t Ful N i T �ai(�ge�soo: F�aledVaSeof� - - APRI AW.- DD NOrrV M BBDN TNS tM e a need pbn8eb+oeets�tled cwlmat,n��xee�s TEMCMn j' �odpliBlm . Ph= Nkdmckd 9 w so 30lb araeeedrslfaee ]Billtod S�oerL LBst cod cba� p"l GrMl eed SQA.A�saral 12bmmr IIJ '�'BEiiesse�rir ��, � d��3eabet2ksms - A�.t2 _ PVb6Wb .AW b mo Tom remawm . _• +`„ - • } t- a ,'' mss)*r .` s r �,.,,�. f, Rte. .' - r Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Ciimate tones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 54700 Secretariat La Quinta, CA 92253 City of La Quinta Jul 31, 2014 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 y Present, must be ® Condensing Unit ❑ EER Resistance ❑ R 8 (CZ 14-15) 2400 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-1111 and CF-61K 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 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH FGF Paekaged Units- leakage 4 19 -Pi-let peFGeRt 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 CF-6R forms: MECH-04, MECH-20-HERS, and, (for split systems) MECH-22-HERS, and new ducts: (all new MECH-25-HERS ducting and all 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/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-611 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: April Knight Signature: April Knight Company: ALL KNIGHT HEATING & AIR CONDITIONING INC Date: Jul 31, 2014 Address: P O BOX 5232 License: 771254 City/State/Zip: LA QUI NTA / CA / 92248 Phone: (760) 772-4947 Reg: 214-A0066064A-000000000-0000 Registration Date/Time: 2014/07/31 12:45:32 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010