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14-0424 (MECH)P.O. BOX 1504 •78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 14-00000424 ' 4-00000424, Property Address: 54516 SHOAL CREEK APN: 775 -071 -077 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 9378 Applicant: Architect or Engineer: ---------------------------------------------_----- LICENSED NTRACTOR'S DECLARATION - I hereby affirm under penalty of perjury that Ia licen der rovisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business an fes 'o de, and my License is in full force and effect. License Class: C20 License No.: 686310 Dat j0 )` Contractor: ca..in.w,/� • - 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 -15500).:-- 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, 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 j 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 Owner: TAE KIM 54516 SHOAL CREEK LA QUINTA, CA 92253 (760)343-7488 Contractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/10/14 ----------------------------------------------- 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. . 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 ZENITH INS CO Policy Number Z071741503 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. ` 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 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. Data 1 Signature (Applicant or Age nt6ogZ g - T ! LQPERNIIT ., Application, Number . . . 14-00000424 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee . . . . 71.50 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date .. 10/07/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH FURNACE 35.75 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 Special Notes and Comments HVAC CHANGE OUT - 14:5SEER/78AFUE 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 47.66, Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 138.23 .00 .00 138.23 Grand.Total 209.73 .00 .00 1 209.73 ' I Pin Permit # (4 Project Address: S y SR- Qty Of La Quin is Building 81: Safety Division P.O. Box. 1504,78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 -'Building Permit Application and Tracking Sheet. . Owner's Name: A. P. Number: Address: c.4 S I lA S� o c.1 Cre-c- Legal Description: City, ST, Zip: Contractor:_702- _c- i c Telephone: '%io0 - 30 Z "lG:�crc. Address: 31170 �e-se-e- �r Project Description: City, ST, Zip: r'i1C7JSGJr\a CA C1 Z27(- (Pe 10aCL I+Vov) -C Col I cio,000 Tele h ne• P o . (00 7 - 7 8� y 4 3 3 -- - a TU yr n CIC-c- StatcLic.,#: G963(0 City Lie. #.: Arch., Engr., Designer. Address: City., ST, Zip: . Telephone: P :::, .:.;.: v:.:.>;.::: ;;:•:�-..:.:::>:. Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person:Sq. Ft.: # Stories: # Units: Telephone # of Contact Person:Estimated Value of Project: c/, 3��- APPLICANT: DO NOT WRITE BELOW THIS LINE N Subniittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan- Check submitted Itcm Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cala. 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 corrcclionsfissue Electrical Subcontactor List Called Contact Person Plumbing C Grant Decd Plans picked up • S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of perrttt issue Scho6lFees Total Permit Fecs N t Simplified Prescriptive Certificate of Compliance: 2008 Residential RVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: Enforcement Agency: Date. Permit #: 5`4S16 1 re-C- C,±j OQ L, Qu�nic 1-4110114 Conditioned Floor EquipmentTypel List Minimum Efficiency 2 Duct insulation requirement Area Thermostat ❑ Packaged Unit ffiCFumace 1R AFUE 7g /. 13 COP Over 40 ft of ducts added or 1$ Setback C Indoor Coil BJSEER H. 13 HSPF replaced in unconditioned space Served by system (Ifnot already 01 Condensing Unit 13 EER 13 Res istance 13 R 6 (CZ 10-13) sf present, must be 13 Other 13R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed,- tf more than one system, use another CF -IR ALT-BVAC for each system. 2. Mutimutn 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 CF -4R 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. �(1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF4R forms: MECH-21 and (fors lit stems) MECH-25 • Condenser Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH-25-HERS • Indoor Coil and/or CF4R forms: MECH-21 and (for split systems) MECH-25 • Furnace 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. Existing 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-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF4R 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 Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. 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 oval with the permit application. Name: C Signature: SL Company: G�ecc,:r Date: -c+[IOity r,c��(0 Address: License: City/State/Zip: h VSGk� a��M ei2Z 7(� Phone: --/3ya:74S5 2008 Residential Compliance Forms July 2010