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12-0383 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application .Numbe_r: 12-00000383 Property Address: 79816 OLYMPIA FIELDS . APN: 775-051-031- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Apolle8tioll VdIUddull. 7392 T4'!t 4 4 Qum& Applicant: Architect or Engineer: Nle -------------------- LICENSED C NTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licen under provisions of Chapter 9 fcommencing with - Section 7000) of Division 3 of the Business and Profe nals.Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Date: 10 �`C,ontra.ctor: OWN -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License L'aw 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 ($500).: (_ 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.). (_ I 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: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LQPERMIT Owner: NORMAN RESIDENCE 79816 OLYMPIA FIELDS LA QUINTA, CA 92253 Contractor: GENERAL AIR CONDITION 31170 RESERVE DRIVE . THOUSAND PALMS, CA 92 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7.011 INSPECTIONS (760) 777-7153 Date: 4/10/12 APR 102012 D CITY OF LA QUINTA I WORKER'S COMPENSATION DECLARATION I 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 ZENITH INS CO Policy Number Z071741501 I certify that, in the performance of the work for hich this permit is issued, I shall not employ any person in any manner so as to become su6je t o the workers' compensation laws of California, and agree that, if I should become subject t e workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith c ly with those provisions. `Date: 4 l C _ Applicant: , WARNING: FAILURE TO SECURE WORKERS' COMPENSA ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS f$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 Quinta, 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 d void if work isnot commenced within 180 days from date of issuance of such permit, or ce s tion of work for 180 days will subject permit to cancellation. I certify that'I have read this application and state that the above inform n is correct.' 1 agree to comply with all city and county ordinances and state laws relating to building construct' and hereby authorize representatives of this county to enter upon the above-mentioned property for inspecti urapee Date: q O 1" Signature (Applicant or Agent) Application Number 12-00000383 Permit MECHANICAL Additional desc . Permit Fee 24.00 Plan Check Fee 6.00 Issue Date Valuation . . . 0 Expiration Date .10/07/12 . 'Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH B/C <=3HP/100K-BTU 9.00 __-------,----------- Special Notes and Comments HVAC REPLACEMENT 4 TON HORIZ SYSTEM, FURNACE IN ATTIC. 2010 CODES 7 ----------------------------------------------------------------- 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 . _ .. Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations Climate Zones 10 - 15 Site Address: - Enforcement Agency: Date: Permit #: 79816 OLYMPIA FIELDS La Quinta, CA'92253 City of La Quinta Apr 9, 2012 Equipment.Type1 List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system El Setback ® Indoor Coil ® SEER .13.0 ❑ HSPF ❑ R'8 (CZ 14-IS) 1500 sf If not elready present, must be ® Condensing Unit ❑ EER ❑ Resistance installed), ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-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-1R and CF-6R 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 lea kage!;<.15, percent; RC, CCA-<_ 300 CFM/ton (Minimum Air Flow Requiremert), TMAH FGF Parskaged-Unks. 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 .� p 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 f ommF frigerra�nt_Charge)' 112. New HVAC System Re uired Forms �°• `' . Cut infior Changeout with"',, new ductsi'(all " YN.•., s , CF-6R forms MECH-04, MECH-20. HERS, and (for split systems) MECH-22 HERS, and - - - new ducting;jj6 .all new MECH; 25 HERS CF'4R forms MECH 20, and (for split systems) MECH=22, andMECH-25 r x. e w meat .., For Split Systems;-:Duct leakage 6 percent; RC,:CCA > 350 CFM/ton, FWD, TMAH, SIMS, and either-1HSPP `or PSPP For Packaged Units: Duct leakage;< 6 percent": ❑ 3. New:Ducts with/or without: !: , Required Forms: Replacement `>•-',t , Includes replacing or installing ell 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 fur'nac`e.-No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. . ' . °-N--­ • 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-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 ether 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, Apr 9, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 CF-iR-ALT-HVAC _x5 Reg: 212-A0017562A-00000000-0000 Registration Date/Time: 2012/04/09 20:12:52 HERS Provider: Ca10ERTS,,Inc. 2008 Residential Compliance Forms July 2010 .a• Reg: 212-A0017562A-00000000-0000 Registration Date/Time: 2012/04/09 20:12:52 HERS Provider: Ca10ERTS,,Inc. 2008 Residential Compliance Forms July 2010 Bin # Permit • City of La Qurnta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 BuildingPermimpli it ' cation and. Trcf�ib Sf�eet Project Address: Owner's Name: maria novmoln A. P. Number: Address: Legal Description: City, ST, Zip: L 22 Contractor: •+ Address: City, ST, Zip:'— Telephone: '3 S� Project Description: ItUDIC . V �• G'e S ! ^ N •;�•; hwo,� .�;F' ' State Lic. # : 3 City Lic. #; (off {2 Arch., Engr., Designer: Address: C;fi• . ST, Zip; :... Telephone: Construction Type: Occupancy: State Lic. Project .type(circle one): New Ad,J'n Alter Repair Demo Name of Contact Person: p G(;8 6s1 �u � � Sq. FL :# Q( #Stories: #Units: Telephone # of Contact Person: -7lo D 3 '�(-b % Estimated Value of Project: ' -72 - 0� APPLICANT: DO. NOT WRITE. BELOW THIS LINE !� Submittal T Req'd' Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Pian Check Deposit Truss Cates. Called ContactPerson Plan ChOck Balance. Title 24 Cates. Plans picked up Construction. Flood plain plan Plans resubmitted Mechanical Gradiing'plan 2"" Review, ready for corrections/Issue Electrical Subcontactor List Called Contact Person Plumbftq, . Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks..Appr Date of permit issue School Fees Total Permit Fees