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13-0361 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 13-00000361 53677 VIA BELLAGIO 772-510-052- - MECHANICAL LOW DENSITY RESIDENTIAL 6416 Tld!t Qglla BUILDING & SAFETY DEPARTMENT BUILDING PERMIT i Architect or Engineer: ------------------ 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 my License is in full force and effect. License Class: C20 License No.: 686310 4e:._4312& 1 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).: (_) 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, 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 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: LQPERAI IT Owner: MAVREDAKIS 53677 VIA BELLAGIO LA QUINTA, CA 92253 (310)993-5354 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Daie: 3/26/13 Contractor: ! ClTyQP GENERAL AIR CONDITIONING F1NANe QUID 19,y 31170 RESERVE DRIVE EDEpT THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 ----------------------------------------------- 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. 15��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 y insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741502 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 3700 of the Labor Code, I shall forthwith comply with those provisions. 1 � ccam-__ Da 3Zb L3 .Applicarit:�^^�Y�/L 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 ($100,0001. 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. _ ��r� Date: 3 � (� Signature (Applicant or Agent): ' Application Number . . . . 13-00000361 Permit MECHANICAL Additional desc . Permit -Fee 40.50 Plan Check Fee 10.13 Issue Date Valuation . . . . 0 Expiration Date 9/22/13 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 - REPLACE 4 TON AIR HANDLER & COIL ONLY,. 78 AFUE-[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 i0.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total. 51.63 .00 .00 51.63 LQPEPMIT , Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations .. CF-lR-ALT-HVAC Climate Zones 10 - 15 + Site Address: Enforcement Agency:, Date: Permit #: 53677 VIA BELLAGIO La Quinta,'CA 92253 ` City of La Quinta Mar 21, 2013 Equipment Typel List Minimum Efficiency? Dud insulation requirement Conditioned Floor Area - Thermostat E3 Package Unit ' ® Furnace ® Indoor Coil - • ® AFUE • Q SEER - /o p COP' . [3HSPF E3 R 6 (CZ 10-13) Served by system If of already present, must be 0 CondensingUnit Q EER p Resistance , [3,118 (CZ 14-15) - 4235 sf installed) p 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 SEEP, -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 -611 and registered CF -411 forms (no hand filled CF -411s allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the. CF -111 and CF -6R 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 . Indoor Coi! and /or CF -6R forms: MECH-04, MECH-2I-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 CFM/ton (Minimum Air Flow Requirement), TMAH 465 peF68At Eemptedfrohi duct leakage testirig.if { � ' • �. ❑ L: butt system:was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2: Duct'syste-iiis with fess than'?4iJ linear feet in unconditioned space, or - - ❑.3. Existing duct systems are constructed, insulated or sealed with asbestos •Q`4::The_,systean'�ill not be Duct4-(ie'Ductle s Mini- litx rstem Alss r xerr t f> Refrgerant: li rge) �':. ❑ 2. NeuV VAC Re ui ,as = j:... system q . Cut ttk>'3 � � ��t �.,�. � ���' x ::.. "°;� ............ - .: 6R��forrts ME.CH-04, MEC i-21 HERS fid (for splrt'systemQ. MECH.22 -HERS; fid :::.:;:;::::::;::. -------- new dusts (all new 25IE4L5:.=_ ..�<duct[: ��;': nn � all e_- - + Pl Y CH- '0 rt for ` ",:.:: a s` t: e: ss. st m Ftd:2� ad>q W r.}.::. :...�.. - 1, � For 5 it ` ' ems:; [)uct lea age <^ 6 percent 2C� CGA �"�350 CFl�l ton; fWD; -MAtt, 53 i�FS, anrt e4fi�f er ISPP'or PSPP. ' For. ckaged: hits:,Duct leakage6::pertent::=` :... .. ❑ 3.. Piemr:;DuctsiElr/or wittrout:?;;.:: Required Forms: _ . in dudes rep -lad ng or iristalfing a ll.opw - ducting and/or.outdoer. condensing:unit CF -6R forms: MECH-04, MECH-207HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furr►=3ce.;No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 • equipment changed. . For Split Systems- Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH - For Packaged Units: Duct leakage < 6 percent .. 174. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-21=HERS ICF linear feet of duct in unconditioned space. -411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent , E3 EXCEPTION: Existing dud systems constructed, insulated'or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement), L . 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 Compffance. " . • . I certify that the energy features and performance specifications for the design Identified on this Certlfpte 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: Danielle Garcia Signature: Danielle Gorcio Company: HARRISON ENTERPRISES INC Date: Mar 21, 2013, Address: 31-170 RESERVE DRIVE STE A License: 686310, City/State/Zip: THOUSAND PALMS/ CA/ 92276 - Phone: (760) 343-7488 Reg: 213-A0017346A-000000000-0000 Registration Date/Time:•'2013/03/21 20:31:45HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms • July 2010 r `. I 13in. # Of La Qutf hta Bu11d1ng.8t Safety Division. ' P.O. Box 1504,78-495 Calle Tampico ta.Quinta, CA 92253 - (760) 777-7012 Building Permit Application' and Tracking Sheet Permit ProjectAddcess: S3(a�-I Vo, B,4\cx5j,a. Owner's Name:. nc,,.vr-r d0.1G A P. Number. Address:5 3(0� -% �/ i loll C, r Legal Description: City, ST, Zip: A ci 2 -z S3 ' Contractor. �ir. •n :y Telephone: 310 -943 -L -3S Address: 311107 jZ. sexv(-- 71br Project Description: City, ST, Zip: QZZ-1(o e �Gi�t_ yLo,-, sf' 4 e -4- W� i Telephone: -7(0p.. State Lia # : "$ 63 l D. City Lic #; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person Conduction Type: , Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft : #Stories: -TO Univ Telephone # of Contact Person: Estimated Val'ae of Project: 6,1416 , CX7 . APPLICANT: DO NOT WRITE BELOW THIS UNE 0 Submittal Req'd Reed TRACICIPIG PERMPPFEES" Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Play Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance.. Title 24 Cales• Plans picked up Construction Flood plain plan Plans resubmitted.'. Mechanical Giading plan 2`! Review, ready for correctionsrissue Electrical Subcoataetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Gradiag ilY KOUSEt- '"' Review, ready for correetlonsgssae Developer Impact Fee Planning Approval. Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees