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13-0374 (MECH)J P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000374 Property Address: 53830 AVENIDA JUAREZ APN: 774-151-004-21 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 7175 T4hf Qum& VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/28/13 Owner: WILLIAMS THOMAS M 53830 AVENIDA JUAREZ LA QUINTA, CA 92253 ( Contractor: Applicant: Architect or Engineer: MAPLE LEAF PLBG P.O. BOX3653 PALM DESERT, CA (760)346-6758 Lic. No.: 481393 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Cla : C2 -C36fe—%_ License No.: 481393 Date:°f LaJ Coiltractor:-X �>r�✓� 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, 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, 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.). - ( ) 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 (Sec. 3097, Civ. C.). Lender's Name: \ �/ Lender's Address: 1 fly\ 1 . LQPERMIT HEAT/F 92261 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. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor LY Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier BBSI Policy Number 2246 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 sho become su 'ect to the workers' compensation provisions of Section 3700 of the Labor Co e, I s II f t 1 mply with rhos pr visions. 7 r�u / �.. t0ate:�/ Applicant: � 1 v�� J— � vy\ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 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 co struction, and hereby authorize. representatives of this cco ty to ter upon the above-mentioned prope or ' pection purposes. 111—ate: 3 ' :IVJ Signature (Applicant or Agentl: Application Number . . . . . 13-00000374 Permit MECHANICAL Additional desc.. Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/24/13 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 HVAC CHANGE OUT - 13SEER SPLIT SYSTEM (2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING 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 sin. Q Of, La QufI1� Bu11d1ng.8r Safety Division P.O. Box 1504,78-495 Calle Tamploo ta.Quinta, CA 92253 -:(760) 777-7012 Building Permit' Application'and Tracking Sheet Permit # a t ` Project Address: �3— t G ' r, vtv�'s Name:. (/l� A. P. Number. Address: r/1 Lege[ Description: c sin. Q Of, La QufI1� Bu11d1ng.8r Safety Division P.O. Box 1504,78-495 Calle Tamploo ta.Quinta, CA 92253 -:(760) 777-7012 Building Permit' Application'and Tracking Sheet Permit # a t ` Project Address: �3— t G ' r, vtv�'s Name:. (/l� A. P. Number. Address: r/1 Lege[ Description: City, ST, Zip: f'„!^ y Contractor. ftat' R � e �. ' J Ih-. b I'f Telephone: " ,w Address: -v 3& 3 Project Description: I .2 ( 14 C City, ST, Zip: T IDf-�� G 1 2-7—(K t t, Telephone )q(e (P� State Lia # : $ 3 City Lir-- , Engr., Designer. Address: City, ST, zip: Telephone: State Lic. #: Name of Contact Person: �, f�- /US ' 2ti - Construction Type:. Occupaaey: Project type (olvele one): New Add'n Alter Repair Demo t.: #Stories: # Univ FEWmaW Telephone # of Contact Person: d v 2r{ ^t Value of Project % %r, rc) . APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACIQIaIG PERM TFEES Plan Sets Pian Check submitted Item Amount Structural Cases. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Mde 24 Calc' Ptans picked up Constrnedon Flood plain plan Plans resubmitted. • Mechanical Grading plan 2'! Review, ready for correctionsrwue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL ILOAL Approval Plans resubmitted Grading -IN KOUSE:- ''d Reviews ready for correcdons/issue Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks: Appr Date of permit issue School Fees i Total Permit Fees Prescriptive Certificate of Compliance: Residential CF -1 R -ALT Residential Alterations Page 1 of 1 Project Name: �W\ VV ,N Climate Zone # of Stories General Information: Site Address:�i3'j Je6n,Cu UC/a2 ate Enforcement Agency: 3 1- t 3 Buildin�Typ. ingle Family ❑ Multi Family Front Orientation: ❑ N ❑ E ❑ S fXW Project Type: ❑ Alteration RHVAC Replacement ❑ Duct Replacement ❑ Conditioned Floor Space (CFS): NOTE: This form is not to be used for new construction or additions. HVAC Systems — Heatin : Duct Insulation Thermostat Configuration (Split Equipment Type Capacity AFUE HSPF R -Value Type or Package) HVAC Systems — Coolin : Pipe Insulation Thermostat Configuration (Split Equipment Type Capacity SEER EER R -Value Type or Package) owe-, HERS Ve ification Summary: Duct Sealing & Testing — HERS verification is required for this measure. ❑ Yes ❑ No In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned _ space,.the ducts are to be sealed,per §152(b)1 Dii and the newly installed ducts are to be insulated per §151(f)10. ❑ Exception: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ Yes ❑ No In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per §152(b)1 Di. es ❑ No In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per §152(b)1 E. U Exception: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ Exception: Duct systems with less than 40 linear feet in unconditioned space. ❑ Exception: Existing duct systems are constructed, insulated or sealed with asbestos. R2fingerant Charge — Split System — HERS verification is required for this measure. INYes ❑ No In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per 152 b 1 F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of §150 o do not apply to existing residential homes. Acted Split Systems — Air Conditioners and Heat Pumps: Airflow — HERS verification is required for this measure. )U es ❑ No In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per 152 b 1 Ci to meet the requirements of §151 7& Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and corn Name: Signature: ,---� Svc, Company: Date: Address: p. C) . � I , 3 City, State, Zip Code: I M �� -I Phone: 7kv 3`f - 62 —; , c Registration Number: Registration Date & Time: HERS Provider: 2.008 Residential Compliance Forms PDAC January 2010