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12-1060 (MECH). P.O. BOX 1504 78-495 CAL LE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: P.roperty Zoning: Application valuation: A BUILDING & SAFETY DEPARTMENT -BUILDING PERMIT 12-0000106;0- Owner: 7,8730 SANITA DR ELLIOTT JAMES ROBERT 604-172-003-98 -23269 - 78730 SANITA DR MECHANICAL LA QUINTA, CA 92253. LOW DENSITY RESIDENTIAL [1�6: 4985 Contractor: Architect or Engineer: GENERAL -AIR CONDITIO31170 RESERVE DRIVETHOUSAND•PALMS., CA•9 > (760) 3'43-7458 C� Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/17/12 SES' 17 2012 .e M LQPERMIT -•---------------------------- ' LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION " �s I hereby.affirnt under penalty of perjury th`at'I am licen'e',sed' under.R revisions of Chapter 9 (commencing with . I hereby affirm under penalty of perjury one,of the following declarations.. - Section 7000) of'Division 3 of'the Business and Professionals C e; 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:.'C20 -. Lice .686310 for by Section 3700 of the'.Laboi Code, for the performance of the work for which this permit is :No. - ate: tractor: } ' ' ~ .issued. ` Wil'tiave'and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for, the performanceofthe work.for which this permit is issued. MY workers' compensation OWNE#'fMILDER DECLARATION. insurance carrier and policy number are: hherebyaffirm under penalty of perjury that Vern exempt from the Contractor's State License Law for, the Carrier ZENITH SINS -CO . _ Policy Number Z071741501 following reason (Sec. 7031 .5, Business and Professions Code: Ariy city or county that.requires a permit to _ I certify that, in the performance of the work for which this permit is issued..1 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 su act to the workers','compensation laws of California, permit to file a signed statement that he or she is iicensed-puisuant to the provisions of the.Contractor's State and agree that, if I'should become subje o the woikers' compensation provisions of Section License Law.(Chapter 9 (commencing with Sectidn-7000)-of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forfhwi omply with those provisions. that he or she is exempttherefrom and the basis for the alleged exemption. Any violation of Section 7031:5 by any applicanf for a'permit;subjects the applicant to a,civil.penalty of not more than five hundred dollars ($500).: e: / 11 / t Z_ cant: (_) 1, as owner of.the property, or my employees with wages as their sole compensation, will do the work, and �~'7� the structure is not intended or offered for sale (Sec: 7044,.Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMP NSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property.who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL 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 COSTbF COMPENSATION, DAMAGES'AS.PROVIDED FOR IN improvements are not intended or offeied for'sale. If; however, the building or improvement is sold within SECTION 3.706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' one yeai-of-completion; the owner -builder will have the burden of proving that he or she did not''build or -sale.). - improve'for the purpose of - - 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 resultof this application, 1 1 I am exempt under Sec. B.&P.C. for this reason 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. Date: Owner:- 2. Any permit issued as a result of this application becomes null and void if work is notcommenced . within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. - I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above i mation is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.)• city and county ordinances and state laws relating to building co tr ction, and hereby authorize representatives of ' "county to enter upon a above-mentioned property for i tion purposes. cou Lender's Name: , Date: '/ f / I LS' ature (Applicant or Agent): Lender's Address: T—T LQPERMIT Application Number . . . . . 12-00001060 Permit . . . MECHANICAL Additional desc . . Permit Fee . . 24.00 Plan Check Fee 6.00 Issue Date Valuation . . . . 0 Expiration Date .. 3/16/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ----------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT: INSTALL NEW FURNACE & INDOOR COIL. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total ---------- - 24.00 .00 .00 24.00 Plan Check Total 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 ..00 .00 31.00 LQPERMIT Bin. # , . . City of a-QuInta Bullding,&r Safety .M1slon P.O. Box 1504"78-49S.Cal(e 7arnplcfl. 1.a.Quln6, CA -922S3 -:(7601777,7012 Building Permit Application and Tracking^Sheet . Permit # Project Address:,. ' Qn1� r Ownei'sName:. J\a1t1� S , A. P. Number. O 03-. Address: IMP Legal Description: Contractor: Telephone: . Address: —' i'(0 £S���C�'�. }�;,�• /, Project iescription: VU1� G O�1 1 Vr,/��1'�'�(t City, ST, Zip: —t s C A R Z 21 6 �• Telephone:660-)343- 74 State Lia # : .6 g G .(Q City Lia #; Archy Engr., Designer. Address: City., ST, Zip: Telephone: Construction Type:. Occupancy: State Lie. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.:. ,Cj # Stories: # Unitg: Telephone # of Contact Person: Estimated Value of Project Lfq, 7 APPLICANT: DO NOT WRITE,:13EL6W THIS UNE # Submittal ReVd Recd TRACMG PERMIT FETES Plan Sets Plan Cheek submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss Cales. Called Contact Person Plan Check -,Balance. Title 24 Cates. Plans picked up Construction Flood plain pian Plans resubmitted Mechanical Grading plan 2° Review, ready for correctionsPissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.11LL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Review; ready for correcdonsAssae Developer Impact Fee Planning Approval Called Contact Person A.U.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance:'2008 Residential HVAC.A/terations CF -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement. Agency: Date: Permit #: 78730 SANITA DRIVE La Quinta, CA 92253 City of La Quinta Sep 14, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ® Indoor Coil ❑ SEER ❑ HSPF ❑ R 8 (CZ 14-15) 1813 sf If not already present, must be ❑ Condensing Unit ❑ EER ❑ Resistance installed) 0 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 -IR and CF -611 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 F8F P1111614,21941111 URIWI Duet leakage -6 15 peFew* Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or [32. 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 syster"ill not be Ducted(ie,�DuctlessKMm�-Spht,•System)z(Also Exempt from,Refrigerant.Charge) ❑ 2. New HVAC System RequicedForms 6C ut in�or4Ctangeout with aglf er « CF 6Riforrns MECH-04 MECH 2O, HERS/andAfbr�split syst&fii) MECH-,' 2LHERS Snd new du& (all new ducting � all new Y * rY, , MECH 25HERS CF 4R -;forms MECH 20 (for MECN22 equipment) and split systems) and .ME5 _ , ` "1) �n ;.. .. I For Split Systemsa'D'uct'leaka'ge<6 percent, RC CCA 2-;350 CF..M/ton,FWDTMAH,tSTM5, and either°HSPP'or"PSPP. For Packaged Units: Duct leakage'e 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -411 forms: MECH-20 and, (for split systems) MECH-25 equipment changed. For Split Systems: Dud leakage < 6 percent; RC, CCA a 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 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: Danielle Garcia Signature: Danielle Garcia Company: HARRISON ENTERPRISES INC Date: Sep 14, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0051173A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2012/09/14 09:57:39 HERS Provider: Ca10ERTS, Inc. July 2010