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10-0969 (MECH)P.O. BOX 1504 q, 78-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 10-00000969 Property Address: 80355 TORREON WY APN; 777 -330 -052 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4500 Applicant: Architect or Engineer: �C!y ' �Y✓C�& - - lwd-- ----------------------7-------------------------.-- LICENSED CONTRACTOR'S DECLARATION I 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 m License is in ice and effect. Licen CI s: 0-C36 is nseN 779 "Date � Contractor: 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.). ' 1 _ 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 _ 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 (Sec. 3097, Civ. C.). Lender's Name: , Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153. 9/21/10 Owner: -�'— STARLET SUZAN 80355 TORREON WAY �( LA QUINTA, CA 9225! (760)296-3010 S�e �%2©��� Contractor: V J ANTHONY PLUMBING JEAT/ 72216 NORTH SHORE S&FF.5 THOUSAND PALMS, CA 92276 (760)343-2121 Lic. No.: 777794 -------7--------------------------------------- WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain 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 STATE FUND Policy Number 1932451 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 C lifornla, an agree that, if I should become subject to the workers' co ensation provisio Section 3 00 of the Labor Code, hall with ply with provi /Date: �a Applicant: 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 cly with all city and county ordinances and state laws relating to building constructio nd hereby authoriz resent es of thisG7clou y �tnteriupon the above-mentioned propertyf p es. Date: f 2Sgnature (Applicant or Agent): Application Number . . . . . 10700000969 Permit . . . •MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date Valuation . . . . 0 Expiration Date 3/20/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH"APPL REP/ALT/ADD 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 Special Notes and Comments A/C CHANGEOUT 3.5 TON CONDENSER AND COIL - IN ATTIC -2007 CODES. Other Fees . . . . . . .. . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 33.00. .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total' 42:25 .00 .00 42.25 a Simplified Prescriptive Certificate of Compliance: 2008 ResidendalHVACAkerations CF iR ALT-H'VAC Climate Zones 10 to is -ro Q ; n p N v� Enforceirser►t Agency. pate,/ o vPermit *. I u Ment T ' List Minimum Efficiency' Conditioned Floor E3 Packaged Unit Duct insulation requirement Area Thermostat O Furnace ❑ AFUE_ 0 COP Over 40 ft of duos added or ❑ Setback M jndoor Coil 1BS�EER ❑ HSPF_ replaced in unconditioned space Served by system afnot already Condensing Unit 0 EER ❑ Resistmtce 13 R 6 (CZ 10.13) sf present. mtvt be O Other E3 8 (CZ 1¢/S) lastalled) 1. Equipment Type Choose theequipment being installed.• ifmore than one system, use another CF -JR -ALT-HVACforeach 4Wem. 2. Minimum Equlpetent Eff&tencles: orf • l3 SEER 78%AFUE, 7.7XSPF - typical resideirtial systems. HERS VERIFICATION SUMMARY Lasted 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 forms shall be left on site for final inspection and a copy given to ft -homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the instal r. The inspector also verifies that each appropriate CF -6R and registered CF.4R'forms (no hand filled CF -411s all si Beginning October_ -I 2010 a r red co of the CF -1R and CF -63t -shall also be on site for final inspection. filled � and 1. HVAC Changeout . Required Forms: • All. HVAC Equipment replaced CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH-21 and for Plit . stems MECH 25 6 Condenser Coil and /or • Indoor Coil and/or CF -6R fortis: MECH-21-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH_ 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFMhon For Packaged Units: Duct leakage < 15 percent (IvGnrmttm Air Flow Requirement), TMAH Exempted from duct leakage testing if O 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or. O 2- Duct systems with less than 40 linear feet in unconditioned space, or O 3. Existinduct are construed, insulated or sealed with asbestos © 2 New HVAC System Required Forms: • Cut in or Changeout with new ducts: (all new ducting and all CF -611 forms: MECH-04, M ECH 2O-HERS,and (for split systems) MECH22dBRS;and MECH-25-HERS new a 'Ment CF -4R forms: MECH 20-, and (for split systems)MHCH 22, and MECH 25 or Split Systems: Duct leakage < 6 percent; RC CCA > 350 CFMhon FWD For Packaged Units: Duct leakage <,6 tient .TMA SIMS, and either HSPP or PSPP. D 3. New Ducts with Re laeement _ Required Forms: • includes replacing or installing all new ducting CF -6R forts: MECH-04, MECH_ and/or outdoor condensing unit and/or indoor CF -4R forms: MECH 20 and (for split terns) (for splitms) MECH FHM coil and/or' furnace. Not all -equipment changed. Far split -Systems: Duct leakage < 6 percent,RC, CCA >_ 300 CFM/ton, TMAH For Packs ed Units: Duct -leakage <:6. ercent 4•.New:Ductin ovt:r40 feef . Re: abet} Forms:. -- • Includes.addine or replagn more than 40 -- linearfeet'of duct. in unconditioned space.* CF -611 -forms: MECH-44, MECH-2I-HERS CF -411 foiats::.MECFi2i For split system or packeged..nntts:: Duct leakage < 15 percent [J EXCEPTION:, duct Stems •constru insulated or sealed with asbestos: Contractor (D.ocumentatiou Author's /Resp(insiblb Designees: Declaration Statement) • 1 certify that this Certfccate of Compliancedocumentation is accurate and complete,': • 1 am eligible under.Drvcswri 3 of the California Business and Piofessioris Code to acc* responsibtli�g fol the design identified on this,Certificate of Compliance. I certify that the epbrgy feattues and petfbrmance specifications for the design identified on this Certificate.of Compliance eoaform to die reguit�teiits'of Title 24, Para t and 6 of the Califomia Code of Regulations ' • Thr design feawra identified on this Centfreate of compliance ate consistent with die informationdocumented on -other applicable compliance fomu� tvorksiteets� calwlations;. and ifrcanons submitted to the a ent -for val.with a lication Name 1 N V Signature: Company: .1 AMO SIERVICES Address: 7?216 N01. ' SHORE ST ST- 109, M . License PALMS CA 92276 City/StatdZip: M Photit3 `Z 6 2008 Residential (`o»rpliatice Forms March .2010 - Bin # City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # {� Project Address:'K() :? 5 lbR,lf 0 fJ Owner's Name: JZA Sr A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Address: 72216 NORTH SHORE ST. STI;'101 Telephone: Project Description: City, ST, Zip: GW f'��S�U� • . � Telephone:-710 -3q3 .3 ZU 2-1 ¢ , " e JG7J �i� ►v� State Lie. # --7-77-7. TLJ City Lie. #, 65-65541 A Arch., Engr., Designer. Address: City., ST, Zip: Telephone: i Construction Type: Occupancy: f U. State Lie. Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Proj ('t s«U =� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"d Review, ready for correctionOssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees