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10-0746 (MECH)- ,t P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: it O - 0�` 0 746 Property Address: 788'8.5 — SANITA DR APN: ," 604-162-007=79 -23269 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL AFiPlication'valuation: 10000 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LADD JOE 78885 SANITA DR LA QUINTA, CA 92253 ( VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/11/10 J !' Contractor: Applicant: Architect`or Engineer: GENERAL AIR CONDITIONING /Y 31170 RESERVE DRIVE - n &AJY//\/�J THOUSAND PALMS, CA 92276 (760) 343-7488 ` Lic. No.: 686310 r;(,, ;;✓:�_ z,� LICENSED CONTRACTOR'S DECLARATION I 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. License la : C20 LicenseDo.: 686310 Dater , Conte to A A H�A . � 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, priorto its issuance, also requires the applicant for the permit to file aligned 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 penaltybf notmore than five hundred dollars (5500).: (_ 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 whobuilds 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 _ 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. , BAP.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 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjuryone 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. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, forthe performance of the work for which this permit is issued. My workers' compensation insurance farrier -and policy number are: Carrier PREFERRED EMPL.- Policy Number WKN1295355 _ 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 700 of the La Code, I.sh II forthwith corn I th:those provisions. at Applicant; t e e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001. 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 Quints, 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 my o enter upon the above-mentioned ", operty for inspection purposes. n� ,' p is A .I I [ . Signature (Ippplicant•or Agentl✓V Application Number . . . . . 10-00000746 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 42.00 Plan Check Fee 10.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/07/11 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 APPL REP/ALT/ADD 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT 3 TON SPLIT SYSTEM 13 SEER ,INDOOR COIL. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ---------- ---------- Paid Credited ---------- ------ Due --- ----------------- Permit Fee Total 42.00 .00 .00 7 42.00 Plan Check Total 10.50 .00 .00 10.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 53.50 .00 .00 53.50 LQPERMIT D!U fl Clay. of La Quinta Building &r Safety Mslon P:b. Box 1504, 78495 Calle Tampico B La Qdinta, C.A 92253. (7610)1777-7012 urlding.Permrt-Application and: Tracking Sheet Permit # Project Address:MIS Owners Name: A. P. Number: Address: Legal Description: City, ST, Zip l ^' Contractor: Telephone: #.•.��^'' F3{?h>; Address: J e f J e � Project Description: City, ST, Zip: Tele hone:Z H ld`"%Y%:'+C ^t::'.'f+• !i'^l: is •' 2% 'n `W'iv.4:: :•iil+.•iQ,;�f,.i tiFi::fr i • r� State Lic. # : City Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: H�J�:;•••,;;;;til<.A;.<.:�::�<;:;':�;`;1+i{, .... . , «,r ,;w } ".. ConsttiType: e: Occu an YP P cY: . Project type (circle one): New Add'n Alter Repair Demo ' - State Lic. Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Plan Sets: Req'd Recd TRACIGNG Plan Check submitted PERMIT FEES Item Amount Structural Calcs. 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 2°" Review, ready for corrections/issue Electrical $ubcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading INI HOUSE:- '^' Review, ready for coirectionsrissue Developer Impact Fee Planning ApprovalCalled Contact Person Pub. Wks. ApprDate of permit issue School.Fees " Perm it Fees Sim lified Prescriiptive Certificate of Com fiance: 2008. Residential HVA C Alterations CF -IR -ALT -HVAC Climate Zones. 10 to 15 dr .-� nforcem Agency: te: G� Permit 1:. PEquipment T er List Minimum Efficienc Z Duct insulation reuirement Conditioned Floor Area Thermostat aged Unitkokndensioniglr ace ❑ AFU ❑ COP Over 40 ft of ducts added or. �---__ r r C ❑SEER ❑ HSPF replaced in unconditioned space Served by system (fjnot already Unit ❑ EER ❑ Resistance ❑ R 6 • (CZ 10-13) sf present, must be ❑ Other ❑ R 8 (CZ 14-1 S) installed) I. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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. T Spector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and si eginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final Inspection. 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 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 ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut s: Chang with new ducts: CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS (all new ducting and all new equipment) CF -411 forms: MECH 20-, and (for split systems)N(ECH-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: MECH-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 Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Re uired 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 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) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 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 andspecifications submitted to the enforcement agency for approval with the t licatio . Name:I's af Signature: Company:rote: /0 j 1/0 Address: 1 jn r \ CG� License: City/State/Zip: 1�a S G h �c Phone: -7 t rn , 2, Q q.