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12-1076 (MECH)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T -&t 4 4-Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 !�_l Date: 9/19/12 Application Number: �2-0000107_6 Owner: Property Address: -55198-SHOAL CREEK MICHAEL'ARCY APN: 775-142-006- - - 55198 SHOAL CREEK Application description: MECHANICAL 76375 COUNTRY CLUB DR Property Zoning: LOW DENSITY RESIDENTIAL LA QUINTA, CA 92253 Application valuation: 6248 Contractor: Applicant: Architect or Engineer: PREFERRED PLUMBING HTG 'A/C P.O. BOX 5120 J-92012 PALM SPRINGS, CA.92263 (760) 322-3173 C17YOF� LiC. No.: 457554 F1 IV . QU1TT4 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: C10 C16 C2 Lic n e No.: •457554 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is // issued. /Date: �� ontractor: -Ga•. _ -. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor ,,.,,,ate: / Code, for the performance of the work for which this permit is issued. My workers' compensation -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 EVEREST NATL Policy Number 7600006445121 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 that, if I should p come subject to th 0 ker compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Cod „' shall forth 'tf n I r ith lose pro�vISIOns. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ��j� , 191 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (0500).: aterte' pplicant: L (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, andor . the structure is not intended or offered for sale (Sec: 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORK S' CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of ,property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL P ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF OOMPENSATION, DAMAGES AS PnOVIDED FOR IN improvements are not intended or offered for salR. If, however, the building or improvement is suld within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . one year of completion, the owner -builder will have the burden of proving that he or she did not build or -1 ' improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, I—) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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: 1 LQPERMIT 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 1 have read this application and state that thea ve information is correct. I agree to comply with all city and county ordinances and state laws relating to build' construction, and e y authorize representatives of this county to enter upon the above-mentioned grope ori pe o pur e Date: F % i (nature (Applicant or Age LQPERMIT Application Number . . . .A\$ 12-00001076 Permit ... . MECHANICAL Additional desc . Permit Fee 31.50• Plan Check Fee 7.88 ; Issue Date Valuation 0 Expiration -Date -. 3/18/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-50OKBTU 16..50 _ ----------------------------- r Special Notes and Comments HVAC CHANGE -OUT: REPLACE CONDENSER & EVAP. COIL. 2010.CODES. Other Fees . . . . BLDG STDS.ADMIN (SB1473) 1.00 Fee summary ChargedPaid Credited Due --------------------------------------------------------= Permit Fee Total 31.50 y .00 .00 31.50 ` Plan Check Total 7.88 .00 .00 7.88 Other Fee Total 1.00 00 .00• 1.00 Grand Total 40.38 .00 .00 40.38 LQPERMIT Sim lifted Prescri tine Certificate of Com fiance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: Erjoreement Agency: Dal Permit #: D L- - � V,_ /-� 00) C ndi6o d Floor Equipment T ' List Minimum Efficienc 2 Duct insulation requirement Area Thermostat O Packaged Unit ❑ Furnac ©AFUE O COP Over 40 ft of ducts added or �s a� P $EER ,I ❑ HSPF _ replaced in unconditioned space p p O R 6 (CZ 10-13) Served b system Y Y 57&f ((/not already be ondensing Unit D -E'ER ❑ Resistance OR 8 (CZ 14-15) present, must Installed) ❑ Other L Equipment Type: Choose the equipment being installed; tjmore than one system, use another CF -1 R -ALT -HVAC jor each system. 2. Minimum Equipment Ef)4ciencies: 13 SEER, 78% AFUE, 7.7HSPFjor 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 signo. Beginning October 1 2010 a registered copy of the CF -1R and CF -611 shall also be on site for final Inspection. 1. HVAC Chan Bout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -411 forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil and /or CF -611 forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS . • Indoor Coil and /or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Fumace 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: 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. Existing ducts stems 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 iinl all 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, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent O 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. CF -4R forms: MECH-20 anti for split systems) MECH-25 coil and/or furnace. Not all equipment changed. For Spgt Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 vercent ❑ 4. New Ducting over 40 feet Re uired Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -611 forms:' MECH-04, MECH-2I-HERS CF -411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent O EXCEPTION: Existing ducts stems 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. • 1 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 I 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 applies compliance fomes, worksheets, calculationsplans andspecifications submitted to the enforcement agency for approval with the pWmit application. Name:J E,' FF t E A \J . 1 L_ /'nt l�v Signature: m Company ]C- \ J / mh ( Date:. Licens Address:• ( l , �j City/$tate/Zip: L (' Phone: 2008 Residential Compliance Forms March 2010 Bin # CityofLa QU'inta Building U Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777=7012 001 ; •.Building Permit Application and Tracking Sheet Project Address .7 Owner's Name: Mianal t: A. P. Number;? Address: ,5519b s ��( cle6r• Legal Degcijphon ; ,: City, ST, Zip: A. fA C 3 ref'ered Air Conditioning dba P goy 'y0d-%rD Con aetor..pr.eferred Plumbin Heatin &Ai Tele hone: Addiess: -P 0 BOX 5 2:.0 Project Description: City, ST, Zip Pa to Springs,: CA,•92'263 ®r Telephone .(7 6 0) 3 2 2, 317 3 State Lie..# :: 4 5.7 5 5 4 City Lic. #: Arch,;: tot ., Desigiiei:'. Address:' City,.ST; Zip'. Construction Type: Occupancy: State Ltp # Projecttype (circle one): New Add'n Alter Repair Demo Name of Contact Person � L -,e -1W4 5 Sq. Ft.:. #Stories: # Units: PEXWTF FEES Amount Check Deposit Check Balance Impact Fee Permit Fees --�e— Telephone # of gdntitt Person 160 2 —3173 —Estimated Value of Projec APPLICANT: DO NOT WRITE BELOW THIS LINE # . $nbtaittalReq'd Recd TRACKING; Plan Sets ; ::' ' .`:: Plan Check fiftitted - .Structural'Celcs..:. Reviewed, ready for corrections Tins s Calcs...:.: `• Called Contact Person Energy Calcs. „ Plans Dicked up Flood'plaip plan. : Plans.resubmitted Gradingplen' 2°1 Review, ready foi'corrections/issue Subtontactor.Llst Called Contact Person Grant Deed Plans picked up H.U.A Approval . Plans resubmitted INHOUSE:- 7nd Review, ready for correctionsrssue Planning Approval. Called Contact Person r6b. Wks. Appr ' Date of permit issue 6cehool Fees PEXWTF FEES Amount Check Deposit Check Balance Impact Fee Permit Fees --�e—