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14-0884 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 14-00000884 Property Address: 81120 SHINNECOCK HILLS APN: 762-340-004- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8892 Applicant: Tiht 4L BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 rofessionals Code, and my License is in full force and effect. License Class: C10 C16 C2 se 457554 Datej 7//Contractor: •-�^p OW ER-BUI ER DECLARATION I hereby affirm under penalty of perjury that I am exempt,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 Contractors 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.). (_) 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 contractorls) 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: l lender's Address: LQPERMIT Owner: ANA SPIOTTO 81120 SHINNECOOK HILLS LA QUINTA, CA 92253 (841)373-9999 Contractor: PREFERRED PLUMBING HTG A/C P.O. BOX 5120 PALM SPRINGS, CA 92263 (760)322-3173 LiC. No.: 457554 'VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/18/14 ----------------------------------------------- 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. 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 EVEREST NATL Policy Number 7600006445141 _ 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 t become subject to the wor s' compensation laws of California, and agree that, if I should b 'me subjectMtworke.mpensauon provisions of Section 3700 of the Labor Code, shall f.rhwitt se p ' '' nn Date• / O Applicant: WAR INE TO SECURE WORKERS' C - EN TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A IVIL 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 ' f mation is correct. I ag e t comply with all city and county ordinances and state laws relating to building n tction, and ori re sentatives of this county to enter upon the above-mentioned property f spectio pur ses. Date:( $ ignature (Applicant or Agent): Application Number . . . . . 14-00000884 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee . . . . 83.4.2 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 12/15/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH FURNACE 35.75 1.00 11.9200 EA MECH APPL REP/ALT 11.92 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - 16.SEER/80AFUE SYSTEM [2008 ENERGY] CARBON MONOXIDE.ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 52.43 Fee summary Charged Permit Fee Total 83.42 Plan Check Total .00 Other Fee Total 143.00 Grand Total 226.42 0 LQPERMIT Paid Credited Due ---------- ---------- ---------- .00 .00 83.42 .00 .0.0 .00 .00. .00 143.00 .00 .00 226.42 I Simplified Prescriptive Certificate of Compliance: 2008 Residential RVACAlterations CF -IR -AL's' -HVAC � Climate Zones 10 to 15 Site Address: ``� Ezzf rce ' nt e )cam)— D e: Permit #: AW nditined Floor Equipment T el List Minimum Efficiencyz Duct insulation re uirement Area Thermostat ❑ Packaged Unit ornate ❑ AFUE Over 40 ft of ducts added or ❑ COP Setback door Coil condensing Unit ❑SEER ❑EER replaced in unconditioned space a ed b system (If not already ❑ HSPF _ p P dY ❑Resistance ❑ R 6 (CZ 10-13) � � � sf present, marc be ❑ Other ❑ R.8 (CZ 14715) installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R ALT HT1AC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPFfor 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 CF4R forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered co2y of the CF -1R and CF -6R shall also be on site for final inspection. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) Iv ECH- 25 -HERS CF4R forms: MECH- 21 and (fors lits stems) MECH 25 • Condenser Coil and/or •• an Indoor Coil and CF -6R forms: 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 For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existina duct systems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERSd fors lit ducts: (all new ducting and all ,an( p systems) MECH-22-HERS, and MECH-25-HERS CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 350 CFM/ton, FWD, TMAH, SIMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement Required Forms: • Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF4R forms: MECH-20 and (for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH For Packer ed Units: Duct leakage < 6 percent ❑ 4. New Ducting -over 40 feet Required Forms: • Includes adding or replacing more than eCF-6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned spare. For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existinp, duct astems 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. a 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 Atr Applicable compliance forms, worksheets, calculations, laps andspecifications submitted to the enforcement 2gency agencyfor approval with the-0 Pc Name: /—T —iD l k ® Signature: Companyr Z� �� ® (mac.: i"i (� _' r ' ate:(011014 AddressTe-1—[2,.`�� ����.{� License: �� �r� g City/State/Zip: ' LK „l �� i`( Pi /► C �p Phone: ��o� �J�A g Bin # Permit ,# City of La Quinn Building U_ Safety Division -P.O. Box 1504, 78-495 Calle Tampico _ :c?if _ , :;��. . !:ir... Project Addres u �ju... w, �..I• JLLJJ — %J WWI /1-/—/V IL -•Building Per mit Application and Tracking Sheet Owner's : 7 TO A. P. Nucriber . Address:NECOGX L"egal�DeScz�pii�t;-<Y��>�:5 ' City, S`I', Zip:L.A Ul 7A e �3 pref`e'rred A`r:'C,onditioning dba �y Conraetor:_pr:e'f` e-d^°P:1 umb i n He a t i n &A i Telephon . %� ,? f 3— Address; pp.'- p = '; Project Description: ci t3' a PT'aITiA �:p;�::f?gs,:; CA. 92.263 Tele hone: 76:Q; ^'3' 2-::3!173 P. �: ) ::: ;2. 4_, Gam' d 7� ✓tr Co r State Lie.'.`: 4::7y5`4:; Arch.;: Etigr: Designer:;�: ,•.. City Lic. #: 3 TD l�.. . - _ . Address: City>.ST; State #_ . '^ ; .. -;: :' `r';. , _ ' • Name .of:Con ct Pe oip: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. FL: # Stones: #Units: Telephone #�o ; giif ctPersqu .; Estimated Value of Project: G APPLICANT: DO NOT WRITE BELOW THIS LINE #'. '-:Sub :' ::.: °<Reg'd Recd TRACKING PERMIT FEES Plap. .• . '' ` .;.. Plan Check fifftittedIte Amount .Strpcturarcalts... Reviewed, ready for correctionsPta Check Deposit Trus Calcs. .: Called Contact Person Pla Check Balance Epergy Calcs.: Plans picked up Can kruction Flood plain pian. Plans -resubmitted M apical Gradlug,pian- ' ... 2"4 Review, ready fbi*correctionMassue Ele teal ,Subeontactor.tist Called Contact Pergon Pinbing GrantDeed Plans picked up S. H.O.A., Approval '. Plans resubmitted Gra ling W ;HOUSE:- m Revlew, ready for corrections/issue Developer Impact Fee PlanninjApprbval_ Called Contact Person,p- Pub. Wks. Appr Date of permit issue School Fe[$ Total Permit Fees -