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11-0719 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT. VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/30/11 rApplication Number: 11-00000719 Owner: Property Address: 53965 AVENIDA VELASCO ." JOHN M PENN APN: 774-164-024-12 -000000- 53965 AVENIDA VELASCO Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL (760) 564-5465 _ Application valuation: /'� �•�� .5000 Contractor: Applicant: Architect or -Engineer: PALOMA AIR CONDITIONING PO BOX 3501 1 ' J:q PALM DESERT, CA 922610 p (760)347-1212 L i c . No.: 619091 ---------------------------- -------------------------------------------------------- . 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.: 619091 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: C��e Contractor: _ 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 workerscompensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier SOUTHERN INS CO Policy Number WSIO02303402 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a -permit to _ I certify that, in the performance of the work for which this permit is issued, I 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 hat, 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 00,Bf e Labor Code, I shall forthwith 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 ! �G 1a.. _ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: Date p'. V `Applicant: - (_ 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 ISec. 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 throughhis 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 1, 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 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 isued 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 ordinanc and state laws relating to building construction, and hereby authorize representatives of this county to�rit�r�i{n the above-mentioned property for inspection purposes. ^'Date:/ S /i/gnature (Applicant or Agent): LQPERMIT Application Number 11-00000719 Permit MECHANICAL Additional desc . Permit Fee . . . . 30.50 Plan Check Fee 7.63 Issue.Date Valuation 0 Expiration Date 12/27/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 6.5000 EA MECH ------------------- AH <=10K CFM -------------------- 6.50 ------ ------------------------------- Special Notes and Comments REPLACE HEAT PUMP SPLIT SYSTEM. SEER .13.0 HSPF 7:7 ----=-------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged - Paid Credited ---- - - - - -• - - - - - - Due -- - - - - - - - - - - - - - ------------ Permit Fee Total 30.50- .00 .00 30.50 Plan Check Total 7.63 .00 .00 7.63 • Other Fee Total 1.00 .00 .00 1.00 Grand Total 39.13 .00 .00 39.13 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 53-965 Avenida Velasco La Quinta. CA 92253 City of La Quinta Jun 29, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit 0 Furnace 0 Indoor Coil ❑ AFUE 0 SEER 13.0 ❑ COP 0 HSPF 7.7 fl R 6 (CZ 10-13) R 8 Served by system 1400 sf 0 Setback If not already present, must be 0 Condensing Unit ❑ EER ❑ Resistance ❑ (CZ 14-15) installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -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 -411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. 0 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 CF4R; forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Ductle6kage�<;15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH ...-. Exempted from duct leakage:testmg f Q 1 Duet system was documented fo have been previously sealed and confirmed through HERS verification, or 2 Duct systems with less thari�40 linear feet in unconditioned space, or 3 Existing duct systems are constructed, insulated or sealed with asbestos ❑4 Thesystemwill not be Ducfetl (ieDuctlessMmSplit�System) (Also Exemptxfrom,Refrgerant*Charg,e) ...>x*n # .... ,r.�.� :+ ,,:.. , ., ..:der ,:: :- .... K5: ❑ 2. NewHVAC'System Required Forms>k 'r:>.�" . Cut ino�r�Changeout with �(tx new ducts: fall new ductirigx all new h� CF 6R forms MECH 04 MECH,20 HERS and (for split systems): ME-0-2-04QRS and MECH 54 ER . CF 4yR forms MECH 20� ah- j or split systems) MECH 22�and;MECHT25 equipment) �� � + LL u, jA .> , �K ... For Split Systems�xDuct leakage <x6 percent RC CCAq> 350 CFM/ton, FWD TMAH, STMS and either HSPR 6FPSPP For; Packaged Urnts Duct I akage <,,6 percent "'.. ❑;�3,New Ducts with/or without Required Forms: Replacement° .:...:........... ... . Includes replacingor installing all new ducting arid/or outdoor condensing'unit aid/or indoor CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. Noor;"some equipment CF -411 forms: MECH-20 and (for split systems) MECH-25 changed. ":i'ar : 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 -611 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 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: Herman Paredes 4 ignature: Herman Paredes f" Company: PALOMA AIR CONDITIONING - Date: -Jun -29,-2011— - Address: P 0 BOX 3501 License: 619091 City/State/Zip: PALM DESERT / CAT92261 92261 Phone: (760) 347-1212 Reg: 211-A0031924A-00000000-0000 Registration Date/Time: 2011/06/29.20:04:52 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms I July 2010 Bin # City of LaQuin!%7 Building ff Safety Division . P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking.Sheet An+ AAek, P, Permit # Project Address: Owner's Name: 292 A. P. Number: Address: Jr 3 t% Legal Description: City, ST, Zip: , Contractor:Telephone: ;:::•..;:•;:•;:;•:;:;;:n::.:::....... Telephone:i:: ,:::::z:::„v :r•< Address: !if atio Project Description: City, ST, Zip: A D f lM ' .-'yiiT:' 4j{>>u+v:::v:4v1.'.>.•.!^'f,.::;i:'+\i+^Yi:?$rii: Telephone: ... (j'� State Lie. A 00 City Lie. #: Arch., Engr., Designer: Address: . City., ST, Zip: Telephone: State Lie.>r>::: <s: »zz:>:' Construction Type: Occupancy: Pro ject type (circle one): New Add'n Alter Repair Demo Name of Contact Person:pw 0)Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: -7 6 Z Q 222= Estimated Value of Project: 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 Tide 24 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan T'l Review, ready for corrections/issue Electrical Subcontactor List ' Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '”' Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 1n,