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12-0696 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/25/12 Application Number: 12 00000696 Owner: Property Address: 53275�AVENIDA NAVARRO LA QUINTA HOUSING AUTHORITY APN: 774-094-014-2 -000000- PO BOX 1504 Application description: MECHANICAL LA QUINTA, CA 92247 Property Zoning: COVE RESIDENTIAL Application valuation; 4000 li Contractor: ! (� Applicant: Architect or Engineer: PRIORITY ONE A/C & HEATING CO jUN 2.---) 2912 P.O. BOX 1681 PALM DESERT, CA 92261 CITY 0!:A0 pN71A (760) 773-0811 Lic. No.: 752180' LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury that I am licensed under provisions 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 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: C20 License No.: 752180 f6r by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate>�, 2- 2 D ntractor: 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 .. WN -B ILDER DECLARATION . insurance carrier and p6licy number are: I hereby affirm under penalty of perjury that I am xem f m the Contractor's State License Law for the Carrier SOUTHERN 'INS CO Policy Number PWC00181212-12 following reason (Sec. 7.031 .5, Business and Profe 'ons ode: Any 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 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 become 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 Lab o hwith 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 ($500).: Dat ICS 11licant: - ( 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: F LURE TO SECURE RKEQALTIES 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 CRIMI AL PND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the workhimself or herself through his or her ownemployees, provided that the - DOLLARS (5100,000)• IN 'ADDITION TO F 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, INr D 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.). APPLICANT ACKNOWLEDGEMENT - 1 _ 1 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 result of this application, (_ 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 - 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: LQPERMIT 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 mg construc , and hereby authorize representatives of tfD4 county to enter upop�the above-mentioned roperty for �e on urposes. - (Applicant or Agent): Application Number. . . . . . 12-00000696 'Permit . . . MECHANICAL Additional desc . Permit Fee 40.50 Plan"Check Fee*. 1.0.13 Issue Date Valuation . . . . 0 Expiration Date 12/22/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=1OOK 9.00 1.00 16.5000 EA MECH B/C ,>3-15HP/>10QK-500KBTU 16,:50 Special Notes and Comments HVAC CHANGE -OUT: INSTALL HEAT PUMP , _ SYSTEM WITH A/C: FURNACE, CONDENSER, INDOOR COIL. 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alteratiors CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 53275 Avenida Navarro La Quinta, CA 92253 City of La Quinta Jun 3, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit 0 Furnace Indoor ❑ AFUE 0 SEER 13.0 ❑ COP 0 HSPF 7.7 ❑ R 6 (CZ 10-13) Served by system 0 Setback If nor already present, must be 0 Condensing Unit (3 EER [3 Resistance [3 R g (CZ 14-15) 1400 sf insta.led) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC fir 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 thet 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 -6111 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 -411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct lgakagpV4'5:Percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing •if p'1 Duct system, as'documented;ao have been previously sealed and confirmed through HERS verification, or ❑'2: Duct systems with less than linear feet in unconditioned space, or p 3. Existing duct systems are constructed, insulated or sealed with asbestos 4 The: a will not be Duet d (iexDucttess iii=Spyste =a pi o Exer€ ige t -ea,rge) ❑ 2. Nevii'j•HVACSysteiir RequieFrrt;ox .Cut in or Changeout wit R M �'" CF 6R orms: MECH-04, 20 HERS and' 'or t sy terns) MECt22-#iERS and new acts `(all new. "�-.; x r, MEC 25 HERS ductingr rall n w r CFS ME R;forals MECH 0- .and {:for s it�systexYa MECH22, and $ equipment):#Y_ .' a A For Split Sysfems 'Duct leakages< b�pereenr, RC-; CCA > 350CFMIton jFMIDTMAH,SSTMS, and either HSPR of'tPS .,P, For Packaged Umts::Ruct leakage=:< ❑ 3:.NewaDucts with/or.wrthout' Required Forms: Replacement . Includes replacing or installing 41L6ew 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:rN6or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. -6 For Split Systems: Duct leakage< 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 dentified on this Certificate of Compliance. . I certify that the energy features and performance specifications for the design Identified on this Certificate of Comp lance 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 ocher applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Roy Meghnagi Signature: Roy Meghnogi Company: PRIORITY ONE AIR CONDITIONING AND HEATING CO Date:: Jun 8, 2012 Address: P O BOX 1681 License: 752180 City/State/Zip: PALM DESERT/ CA/ 92261 Phone: (760) 773-0811 R='J; z1z-AVVG1045A-000VVUVU-UUUU Registration Date/Time: 2012/06/08 16:21:22 HERS Pro -.rider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 CaICERTS - Cf' -1 R Registration 1 ' J https://www.calcerts.com/pubiic_cflR.cfm?project_idY 192871 h � Public Home Roy Meghnagi logged in [Logout] - [Home] secure. Homei CONGRATULATIONS ' Your CF -IR -ALT -HVAC Registration is complete! .about us . You may want to print this page for your records. � TrainingSite Address: 153275 Avenida Navarro c �La Quinta, CA 92253' • Rater Directory CEC Registration: 1212-A0029643A-00000000-0000 r CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD y Forms _—_Assigned Company:IPRIORrry ONE AIR CONDITIONING AND HEATING CO ' f Do you know your HERS Rater? Membership Benefits If you do, you may want to send this CF -1R to them. 1 r - CaICERTS Rater ID: ' Events OR My Rater Quick Select: --Select From List . I 'Indust ty Partners Every CaICERTS rater has a license number.If you need to find the rater by name [Click HERE] to search our dl.ectoryr • News _ �' SEND'CF RTO HERS RATER To register for ' [CLICK HERE] to do another - our monthly newsletter, ^ r please click here.. I j Copyright © 2010 CaICERTS, Inc. All rights reserved. Revised: January 11, 210 [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 BBBOO 4 1. of l 6/8/2012 1:21 `PM Ism # Permit # -\T JC Project Address: 3 _ Z') 77 A. P. Number: Legal Description: Contractor: Address: c) +� City, ST, Zip: Telephone: State Lic. # Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: A Telephone # of Contact Person: # Submittal Req'd Plan Sets Structural Calcs. Truss Calcs. Title 24 Cales. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracki:yg Sheet Mon11 V wner's Name: L Address: City, ST, Zip: Q C elephone: L. (P. 0- 4 f Z y��'7,fF Z(- J Description: =: M: --M I , "all I I Total Permit Fees 11 Construction Type: P Occupancy: P aney: Project ec Pe (circle le th one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd TRACKING FEESPlan Check submitted ItemAmount ;PERIMMT Reviewed, ready for corrections Plan Check DeEJE Called Contact PersonPlan Check, Ba Plans picked up Construction Plans resubmitted i cchanicsl 2nd Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S.M.I. Plans resubmitted Grading d Review, ready for corrections/issue eveloper Impact Fee Called Contact Person 4A. I P P Date of permit issue Total Permit Fees 11