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12-0721 (MECH)r-� 4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: >12-0'0000721 Property Address: 80751 SPANISH BAY APN: 775-310-025- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3911 Applicant: T4tyl 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 ��- '�seNo.: 374937 /ate: 1 i �"� � ontractor: -L 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 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 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.). ' (_ 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 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.I. Lender's Name: Lender's Address: LQPERMIT Owner: HUSCROFT PATRICIA 80751 SPANISH BAY LA QUINTA, CA 92253 lJ Contractor: PALM DESERT AIR COND CO 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 Lic. No.: 374937 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/28/12 r GB"fl!d�� i:Ii!a��► 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 andwillmaintain 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 MID CENTURY Policy Number A09454905-12 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 should become subject to the workers' compensation provisions of Section /f 03700 of tf Labor Code, I shall forthwith co pl those provisions. _.G�'' . 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. 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 construction, and hereby authorize representatives oft s county to enter up the above-mentioned _pr.op�erty/fo�r ,inns-pection pur ses. ate L l2 gnature (Applicant or Agedfl: �"r> n ''� Application Number . . . . . 12-00000721 . Permit MECHANICAL Additional desc . Permit Fee . . . . 31.50 Plan Check Fee 7.88 Issue Date . . . . Valuation' 0 Expiration Date } 12/25/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 16:5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ------------------------------------------------------------------ Special Notes and Comments ---------- REPLACE (1) AIR CONDITIONING CONDENSER. 2010 CODES. ----------------------------------------------------.------------------ Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) - 1.00 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 31.50 .00 .00 31.50 Plan Check Total 7.88 .00 .00 7.88 Other Fee Total 1.00 .00 .00 1.00 . Grand Total 40.38 .00 .00 40.38 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 80-751 SPANISH BAY La Quinta, CA 92253 City of La Quinta Jun 28, 2012 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ❑ Furnace ❑ AFUE ❑ COP ❑ R 6 (CZ 10-13) Served by system o Setback [3 Indoor Coil m SEER 13.0 ❑ HSPF [I R 8 (CZ 14-15) 2000 sf If not already present, must be m Condensing Unit [I EER [3 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-111 and CF-611 shall also be on site for final inspection. m 1. HVAC Changeout Required Forms: a- • All HVAC Equipment CF-6R 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 • Indoor Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS Furnace CF;jlk forms: MECH-21 and (for split systems) MECH-25 • am. For Split Systems: Duct leakage <<_15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted,from duct leakage testing if. p 1 Duct-system,was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2:Ductsystems with less than,40 linear feet in unconditioned space, or ;p,3.'Existing duct systems arelconstructed, insulated or sealed with asbestos E]'4: The system will not be Du d,(i64Ductless I ini;Split,5ystem)g(AIso Exempt from�Refrigerrant"Charge) ❑ 2. New HVAC; System Requiieerd i F6rms. .Cut injor Changeout'with'"''*1 new (611 new &6s. t r--MECH dull - *1'+%mss r= "" , °� + +f „ .., .r a �� .{ , ' .: , CF 6R!forms (MECH-04; MECH-20 HERS, and!(for split systems) MECH 22-HERS, and w~ 25' HERS` ;,�1!ti ,•: ,,� ..� -�•, „ c3' ducti n news 01447 r CF'4Rforms MECH 2O,,and'(for splitsystems)rMECH-22; anTMECH5 r9 iequipment).. rI� y : t _ :-r-+ a �k .a :., � � _� F°Y: , t M �r ' 7 For Split Sfs-tejris:�1Duct l'eakagef,<06'percent,�RC;.CCA >_i350:CFM/ton; FWD;3TMAH STMS�endieither'HSPP;or PSPP"V—""tom For Packaged Units: DucCleakage< 6 percent)nn.� ` ❑:3.'NewcementDucts with/or without. 'c Required Forms: Replaf `- . Includes-replacing ori nstalling'all'new ducting and/or outdoor condensing' nit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or f_6r`nace.,No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. �,.,�,,,, W64 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-61k forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-411 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 other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Karl Brown Signature: Karl Brown Company: PALM DESERT AIR CONDITIONING CO INC Date: Jun 28, 2012 Address: 42-081 BEACON HILL License: 374937 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 346-0677 Reg: 212-A0034183A-00000000-0000+- Registration Date/Time: 2012/06/28 05:40:26 tHERS Provider fCa10ERTS, Inc. 2008 Residential Compliance -Forms' �"`' July 2010 P.O. Box' 150.4 78495 Calle Tampico,.- La .Quints, Califorriia 92211 .Tel:#60,) 777 -7.01:2, -Fax: (760) 777;7112.a% x , . Y `�v —:CM�«��ERT— we' bsite: WWWW.La-Quinta.Org • Email Building@La.=Quinta.Org 'y��pF Bin #: Pe,rrnit #: .Building Permit.ApplidMion & Tracking Sheet Project Address: 80-751 SPANISH BAY Owner's Name: HUSCROFT, PATRICIA A.P-. Number: Address: 80-751 SPANISH BAY Legal Description: City, State,,Zip: LA QUINTA, CA 92253 Contractor: Palm Desert Air Conditioning & Heating Company Telephone: (7 60) 771-5090 i Address: 42-081 Beacon Hill Project Description: City, State, Zip: Palm Desert, CA 92211. REPLACE (1) AIR CONDITIONING CONDENSER. ' Telephone No:: (760) 346-0677 State: Lic. #: 374937 City Lic. #: 100886 Arch:/Eng./Designer: :Address: City, State, Zip: ' :l Telephone No:: ' `: , 4, '' Construction -Type: Qccupancy:-• State:: Lic. #: , ' Project Type: ❑ New- :®Add'n - 13 -Alter 0 Repair ❑Demo Name of •Contact Person: KARL BROWN Sq. PC: #'Stories: # 0'if" : ContacCT6lephone No.:. (760) 346-0677 Estimated Value of Project: $3,911.00 APPLICANT: DO NOT. WRITE. BELOW THIS LINE # Submittal Req'd Recd Tracking Permit Fee's. Plan Sets Plan.Check Submitted Item Amount, Structural Cales. Reviewed, Ready for Corrections Plan Check Deposit Truss Calm Called Contact Person Plan Check Balance, Title.24.Calcs. Plans,Picked Up Construction Flood Plain.Plan Plans. Resubmitted Mechanical Grading Plan 2".°'Review, Ready -for Corrections: Electrical Subcontractor List Called Contact Person Plumbing Grant Deed Plans Picked•Up. H.O.A. Approval Plans.Resubmitted Grading IN HOUSE , 3n0 Review, Ready for,Corrections Developer Impact Fee Planning.Approval Called Contact Person A'.I.P.P. Pub. Works Appel Date.of Permit Issue School Fees t Total .Permit Fee's