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11-1197 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA.QUINTA, CALIFORNIA 92253 Application Number: 11 00001197m" Property Address: 5.�6078_PkLMS:,!QR .APN: 764-01310-004�- A pplication Aescription: MECHANICAL .Property Zbning: LOW' -DENSITY RESIDENTIAL Application valuation: 18400 J Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: JACK -SU RBER 56078 PALMS DRIVE LA.QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 77.7-7011 INSPECTIONS (760) 777-7153 Date: 11/03/11 �inim Contractor: GENERAL -AIR CONDITIONING 3117,0 RESERVE DRIVE;. -THOUSAND PALMS, -CA 92276 760.343 7488 Lic-. No.: 686310 ----------------------------------------- --------- ------------- 7 ------------ ----------------------- UCENSED=NTRACTOR'S DECLARATION -WORKER'S COMPENSATION DECLARATION" "I hereby affirm under penalty of. perjury that I amm'cens6.6nder provisions of Chapter (commen cing with hereby affirm under penalty ofperjury one of the following declarations: SeEiidn 7000) of:Divisioh 3 of the"Busines'y- s and 6fe�sionals Code, and my is in full force and effect. I have and will maintain a . certificate . I o . f concent to self -insure for Workers' compensation, as provided Lic n Class: C20 10> I have and will maintain - workers' compensation insurance, . rance, as required by.Section 3700 of the Labor License No:: 686310' for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. r: n Code, for the performance of the work for which this permit is issued. My workers' compensation OI NER-BUILDER DECLARATION insurance carrier and policy number are: I herebyaffirm under pen I alty of perjury that) am exempt irom_the Contractor's State License Law for the Carrier ZENITH INS CO Policy Number Z071741501 following reason. (Sec. 7031.5, Business and Professi6ns Code: 7 Any city or county that requires a'permit to I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as.to becomylubject to the, workers'. compensation laws of California, ,,d b peimit to file a signed statement that he or, she is lipansed, pursuant to.the provisions of theContractor!s State and agree that, it I should ecomesuff.,,o the workers' compensation provisions of Section I I f License Law:(Chapter 9'(commencing with Sectim7000)'of Division 3 of.the Business and Professions Code) or 3700 of the Labor Code, she[ forth fi comgjy 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 applicantfor a. permit sdbjects -the applicaht to a civil penalty of, not more than five hundred dollars ($500).: ,d<ae-. A-P'P*Iicant: 1 1, as owner of the - prppeky, or my.employees with wages,as their sole compensation, will do the work, and the structure I is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' ilf 6AP E SATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' Stat6 License 'Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND.6VIL FINES UP TO. ONE -HUNDRED.THOUSAND- and who does the:woik himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITIONTO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvemen . Is are not-iniend6d or offered for sale. If, howev . er, the building or improvement is sold within SECTION 3706 OF THE LABOR ABOR 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. impr6ve for the.purpose of sale.). APPLICANT ACKNOWLEDGEMENT 1, as owner of the property, am exclusively'contricting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety fora 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 Coniiractors' State License Law;). whose benefit work is performed under or pursuant to any permit issued as a, result of this application, I am exempt under Sk. BAP.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 not commenced within 180 days from date of issuance of such permit, or cesisan 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 informati is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordi nances and state laws relating to building construction, hereby authorize representatives . s s_ is county to entfe;rilpon the above-mentioned property for inspection p ses. Lender's Name: 14K5/l.VSignature (Applicant or Agent): Lender's Address: 7-7— elf". LQPERMIT LQPERMIT Application Number . . . . . 11-00001197 Permit MECHANICAL Additional desc . Permit Fee 66.00 Plan Check Fee 10.13 Issue Date Valuation . . . . 0` Expiration Date 5/01/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.•0000 EA MECH FURNACE <=100K 18'.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-50:OKBTU. 33.00' ----------------------------------- .7,7 '- "'Special Notes and Comments -------_---------------------.------. SYSTE:•2010 CONDENSERS.- COILS & FURNACES CODES • "; .. --- - - -- -- - -'•- - - - - -- --- - 71 --- - - - - - - -- --'-- --------------- Other ; Fees_. , BLDG BIDS ADMIN, (SB1473) ------------ 1.0.0 Fee summary Charged'._ Paid Credited ''Due Permit Fee Total. 66`.00 00 :`00 66.00. Plan Check -Total 10.13 00 00 K .10 13 ,Other Fee. Total.' .1.00 00. .00 "1.00 Grand•. Total;... 17.13 00: 00`, .. 77:13 ; Sim lifted Presc.ri tive Certificate -of Compliance:- 2008,,kesidential,HVA'CA!ierations CF -1R -ALT -HVAC Climate Zones 10 to 15 "� All HVAC'Egitipment replay ed— CMR forms: MECH-04, MECH-21•-ITERS and (for -split systems)-MECH- 25 -HERS CF -4R forms: MECH- 21 and for split sstems) 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 Exempt d f om duct leakage testing if: ' 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 0.3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System . Required Forms: with new • Cut s: al Chang outducting ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS 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, f WD, 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 -41Z 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 <6percent' ❑ 4. New Ducting over 40 feet Required Forms: ' • Includes adding or replacing more than linear feet of duct in unconditioned s ace. e. 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 ducts stems 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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the ' orm tion documented on other pylic ompliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for a to al with t e 'ermit application' Name: lfeel1 wo—tcsOn Sig tuie: I Company: n n>PhAeraj r t_Otlet! Bron,` Date: Address: 3070 %2�5e(*U� ��t t/� License: City/State/Zip:---A_ot-,5a-P--t Pa(_fm—s, G,q Phone: Simplified. Prescriptive Certificate -of Compliances 2008 Reside M11 HVACAIjeratiom CF -IR -ALT -HVAC Climate Zones 10 to 15 2008 Residential Compliance Forms March 2010 • 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-21-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 Exempt m duct leakage testing if: VO-Ductsystem 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: al Chang outducting g and new ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20=HERS,and (forsplit systems) MECH-22-HERS, and MECH-25-HERS 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 "Replacement Required Forms:. • Includes replacing or installing all,new ducting CF -6R forms: MECH-04"'.. ECH-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 C14. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than linear feet of duct in unconditioned sace.e. CF -6R forms: MECH-04, MECH-21-HERS CF -4R forms: MECH-2.1 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constntcted, 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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the ' orm tion "documented on other pplic ompliance forms, worksheets, calculations, plans andspecifications-submitted to the enforcement agency fora ro al with t e ermica application. Name: l(ee`I UJO-ts-bel Si lure: Company- p Y-t�'0�1d.t Date: Address: 311702,!t Ser UQ ��` ✓� /1 t License: 68�3�v City/State/Zip:-�� G� 9' Phone: 760 -3 'V3 - 74ff8 2008 Residential Compliance Forms March 2010 Ca10ERTS - CF -1R Registration Page 1 of 1 Public dome Danielle Garcia logged in [Logout/ [Home] Secure Home CONGRATULATIONS • About Us Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Training Site Address: 56078 PALMS DRIVE Rater Directory La Quinta, CA 92253:' CEC Registration: 211-A0056991A-00000000-0000 Forms CF-IR-ALT=HVAC: CLICK HERE TO DOWNLOAD Assigned Company: HARRISON ENTERPRISES INC . Membership Benefits — — ------ ---------'— -- ----- ' --- Do you know your HERS Rater? Events you do,.you may want to -send -this CF.AR to th=.'.- Industry Partners CalCERTS Rater ID: OR News --- - -- -- —_ My Rater Quick Select: Energy Driven Solutions, Inc_ Every CaICERTS rater has a license.number. To register for our Ifyou need to find the rater by name [Click HERE] to search our directory. monthly jam,•„xSENQ�CF 1R TO HERSsRATER; _tyl newsletter, please click here. [CLICK HERE] to do another Copyright 02010 CalCEiR'fS. Inc. All rights reserved. Revised:.lanuary I L 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us Y BBB `! irtd;va on 68ttt3bdkk®. sort wan Dui 1�rx�.e4.q'Y.1.`a...,.t<.3.:.:Y::43�.:i� https://www.calcerts.com/public—cfl R. cfm?proj ect_id=1473 59 11/2/2011 Ca10ERTS - CF -1 R Registration Public Home Secure Home About Us Training Rater Director — Forms Membership Benefits Events Industry Partners News To register for our monthly newsletter, please click here. Danielle Garcia logged in [Logout] [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 56078 PALMS DRIVE La Quinta, CA 92253 CEC Registration: 211-A0056992A-00000000-0000 CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company:] HARRISON ENTERPRISES INC _ Do you know your HERS Rater? yo.u..dQ,._y-ou may—want to.send.th]s CE -1R to, them._ Ca10ERTS Rater ID: OR My Rater Quick Select: Energy Driven Solutions, Inc.. Every Ca10ERTS rater has a license number. If you need to find the rater by name [Click HERE] to search our directory. lutis wzriz$END CF .1 R TO�HERSRATEf23 [CLICK HERE] to do another Copyright U no can.,wrs. Inc. All rights reserved. Revised: January 11. 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877 -HERS -RSR, (877-437-7787) Fax: 916-985-3402 Contact Us r BBB , :Firrd Facebook(j' ..._ sun mm nvu ,... �,. ,v:: •.... •�;... ... .c, ;.... https:Hwww. calcerts. com/public_cfl R. cfm?prof ect_id=1473 60 11/2/2011 FINANCING THROUGH: 4 * Air Conditioning & Heatingh *'* r 31-170 Reserve Drive • Thousand Palms, CA 92276 (760)' 343=7488 • Fax, -`,(7'60) 343-7494 www.calliliegene 'al.c'om Residential Com'f iwe INSTALL DATE JOB# CUSTOMER# l0 7S� NAME CITY STATE--' ZIP CODE PHONE -7, 190 5-& 4 CELL - ` FAX SEPARATE BILLING ADDRESS? VYES ❑ NO' O► zc��e NEW EQUIPMENT EXISTING EQUIPMENT COND k'G-;�- t — 0 6 6 SLS--SUt>bf-O 1oXvlea � FAU Sc,�Bv U Ef D 9px U(o OG COIL TSTAT FILTRATION M-elk.y L (o MISC PERMIT'YES 0 NO DUCT WO RK NOTES COND M•# S # FAU M• # S #- COIL"M # S #_ UNIT LOCATION: CRANE? � 0 YES Q. NO SIZE WARRANTY 'LO —/0 PLATFORM SIZE ATTIC HEIGHT OPENING , Q. FINANCING DAYS ,❑ CREDIT CARD 4 Q C Q:D. ❑ COST, Bin # C tv,of La Quin a Builtfing r ,Safety Division P.O. Box 1504, 78-495 Calle Tampico r La Qulnta, CA 92253'- (760);777-7012 Building Perm t:Applicat on and�Track 0 Sheet _ Permit # ' Project Address: 7 Owner's Name . A. P. Number: 'Address Legal Description: City, ST, Zip:' Contractor: '^�' Telephone: [ (EO s,-& Address: TPro � � eet Descri tion: - J .. _ P /'�- 'T Li'l . ClilLaL City, ST, Zip: Telephone::`` State Lic. # : Arch., Engr., Designer: ?`;'.: �• City Lie. Address: .City., ST, Zips'- Telephone: State Lic. #c ' �`�«��3,%r., ,i`��Sil�;^.i�;� �,;•'�` ,i:��f:V:.,W�� f�' f ♦ .• Mfr-••,.`f'��f}�� t } !� ' •tri, ✓ '�, Construction Type: Occupancy: r. Pro'ect e' .circle one):. New . Add'n Alter Repair . Sq. Ft.:" # SEones: # Units: Demo Name of Contaet•Person: Cp,(,(� e"I (1L`�ec%{ vyV . Telephone # of Contact Person: 7<o O 3 '1-3 % �' $ . Estimated ,Value of Protect:: APPLICANT: DO.:NOT WRITE: BELpW�TNIS.,UNE' i.. # Submittal Req'.d' Ree'd TRACIEIIVG PERMIT FEES Plan Sets; Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections = Plan Check Deposit Truss Calm Called Contact Person `` Plan Check Balance Title 24 Cafes. Plans picked up Constrdction 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.I. H.O.A. Approval Plans resubmitted ; Grading. INHOUSE:- 1rd'Review,.ready for correctioOtlssue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr Date, of permit issue School, Fees "Total Permit Fees