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12-1477 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 / BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT --- - -- .---� Date: 12/26/12 Application Number: x_12-00.0014-77 Owner: Property Address: 79786 OLYMPIA FIELDS J CRAVELLO ALLAN APN: 775-051-036- - 79786 .OLYMPIA FIELDS D Application description: MECHANICAL .LA QUINTA,-CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL (760) 574-4612 Application valuation: 6612 ��'(+ rp 2,012 Yv Viv [U!C Contractor: Architect or Engineer: DESERT AIR CONDITIONING, INC C. CITY OF LA QUINTA 590 WILLIAMS ROAD F!NANCFnPOT, PALM SPRINGS, CA 92264 (760)323-3383 Lic. No.: 276586 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION .1 hereby affirm under penalty of perjury that I am li ensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Divisi3 f the Busines an fessionals Code, 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: C-29-.&30 License No.: .276586 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is �. - � / issued. - - ��:Oate:r V,�Contractor:-_ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EVEREST NATL Policy Number 7600007908121 following reason (Sec. 7031 .5, Business and Professions Code: 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, 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 subject to the workers' compensation laws of California_, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - - and agree that, if I should.bec a subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or -'�, 3700 of the Labor Code, I sl I f rth comply 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 applicant for a _permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: Date:- (_ 1 1, 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN' improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE. LABOR 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 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 1 I am exempt under Sec. , B.&P.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 fSec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT 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 holdharmless 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 and v Id if work is not commenced within 180 days from date of issuance of such permit, or cessati of work for 180 days will subject permit to cancellation. " I certify that I have 'read this application and state that the abov informatio is correct. I agree to comply with all city and county ordinances and state laws relating to building ruc 'o and hereby authorize representatives of this county to enter upon the above-mentioned propert nspe purposes. ' DaTlen ,d Z ,Te gnature-(Applicant or Agent): Application -Number . . . . 12-0000,1477 . r Permit . . . MECHANICAL Additional desc . Permit'Fee . . . . 40.50 Plan Check Fee.. 10.13 - Issue Date Valuation 0 Expiration Date .. .6/24/13 Qty Unit Charge Per Extension _ BASE FEE 15:00 1.00 9.0000 EA MECH'FURNACE <=100K 9.00 1.00. 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16,50 --- ----------------------- Special Notes and Comments REPLACE 5 TON SPLIT SYSTEM FURNACE, INDOOR COIL;.CONDENSING.UNIT ON ROOF, - LIKE FOR LIKE 13 SEER.2010 CODES. --- - - - - -- _ - -- -------------------- Other Fees . . BLDG.STDS ADMIN (SB1473) ------------- 1.00 Fee summary. Charged Paid Credited Due -- ---------- ---------- ---------- Permit Fee.Total 40.50 _00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 :" .00 51.63 _ F LQPERMIT _ • - .. tY ���M�T _vel' 'SMl'A .. .. 4 Y� •- r Y � * _._ implified•Prescriptive Certificate of Compliance: 2008 ,Residential HVAC Alterations CF-1R-ALT-Hlbe Climate Zones 10 - 15 . Site Address: Enforcement Agency: Date: Permit 79-786OLYMPIA FIELDS La Quinta, CA 92253 City of La Quinta ' . Dec 19, 2012 Dud insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirementArea Thermostat p Package Unit® Furnace ® AFUE 78% [3 COP® Indoor Coil E3 R 6 CZ 10-13 Served b s stem ® Serback ® SEER 13.0 ❑ HSPF ( )• yy If not alread®Condensing Unit .0 EER ❑ R 8 (0214 -IS sf Y Present must [3 Other O Resistance ) _ �-�� - installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC foxeach system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, Z 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 -611 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 -611 shall also be on site for final inspection. ® 1. HVAC Changeout . ` Required Forms: . All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for,split systems) MECH-25-HERS - replaced CF -411 forms: MECH-21 and (for split systems). MECH-25 . Condenser Coil and /or _ CF -6R forms: MECH-04, MECH721-HERS and (for split systems) MECH-25-HERS . Indoor Coil and /or -4R forms: MECH-21 and (for split systems) MECH-25 . Furnace CF For Split Systems:. Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton,(Minimum Air Flow Requirement), TM.AH Exempted from'dud leakage testing if: .. { ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS veri=ication, or O 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos p'4. The system •will not be Ducted (ie Yu -Hess Mini Split -System) (Also>Exempt from;Refngeiant Charge) ' 2. New HVAC System • Required Forms: Mi' .Cut in:or Changeout with! _«W;v CF -6R forms ?MECH-04 MECH,20=HERS Aand (for split systems) MECH'=22' H2RS and new ducts: (all new r4i ; ductin } MECH 25filiERS g. all new K y r equi meat 6µ r CF -4R forms MECH 20, and fors ht s stems YMECH 22a d MECH-25 ,0 P ) _ ,tir+r_ -p , ;yam ) Y+ . For Split Systems:, Duct leakagef< 6 percent; RC, CCAZ> 350 CFM/ton, FWD,'`TMAH, SIMS, and either hSPP of'PSPP. For Packaged Units: Duct leakage '< 6 percent 13 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' -sy's'tems) MECH-25-HERS -' - and/or indoor, coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 y _equipment changed: ', - _ _ - For Split Systems: Duct leakage < 6 percent; RC, CCA 1, 300 CFM/ton, TMAH I For Packaged Units: Duct leakage < 6 percent O 4. New Ducting.over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS I linear feet of duct in unconditioned space. CF -411 forms: MECH-21 { For split system or packaged units: Duct leakage < 15 percent t ❑ 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. I Name: Jacqueline Zabik Signature: Jacqueline Zabik . f, Company: DESERT AIR CONDITIONING INC - Address: 590 WILLIAMS ROAD Date: Dec 19, 2012 City/State/Zip: PALM SPRINGS / CA / 92264 License= 276586 Phone:. E760) 323-3383 .. Of }. Reg: 212-AO071534A-000000000-0000Registration ` gistration Date/Time: 2012/12/19 14:24:57 2008 Resident . HERS Prov der: 'Ca10ERTS, Inca ial Compliance. Forms - -• _ , -July 2010 Bin.# City�f 1.Ci Quinta. Building 8r Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit •Application and Tracking Sheet Perinit # i1 "t G ProjectAddcess: 79-786 OLYMPIA FIELDS Owner'SNwne:.ALLAN CRAVELLO A P. Number. Address: 79-786 OLYMPIA FIELDS Legal Description: Couftwtor. DESERT AIR CONDITIONING, INC City, ST, Zip: LA QUINTA, CA 92253 Telephone: 760-574-4612 Address: 590 WILLIAMS RD Project Description: City, ST, Zip:PALM SPRINGS, CA 92264 REPLACE 5 TON SPLIT SYSTEM ON ROOF Telephone: 760-323-3383 LIKE FOR LIKE . State Lic. # : 276586 City Li, #; 363 Arch., Engr., Designer: NA Address. City., ST, Zip: ' Telephone: State Lir. #: Constructiontype, . MECH tq�upanqy: Project type (circle one): New Addie Alter Repair Demo Name of Contact Person: JACQUELINE RATLIFF'Sq. Ft: #Stories #Unit Telephone # of Contact Person: 760-32373383 Estimated Value of Project: $6612.00 . APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal ReWd Reed TRACMG PERMIT FEES Plan Sets Pian Cheek submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan CbccA Deposit. . Truss Calan. - Called Contact Person Plan Check Balance Title 34 Calcs. Plans picked up constrMer.ou Flood plain plan Plans resubmitteV . MechafikA Giading plan 2" Review, ready for corrections/issue Electrical! Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE.- 3" WvLew, ready for correetionslissue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr - Date of permit issue School Fees Total Permit Fees