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07-3115 (MECH)P.O. BOX 1504- r. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 VOICE (760) 777-7012 FAX (760) 777-7011_ BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/10/07 Application Number: 07-00003115 Owner: Property Address: 55257 SHOAL CREEK D.C. RINFRET APN: 775-142-023- 7 55257 SHOAL CREEK, Application description: MECHANICAL LA QUINTA, CA 92253, Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4000 DEC 17 2007 Contractor: Applicant: Architect or Engineer: CITYOFLAQUINTA PALM DESERT AIR COND CO INC FINAlum ncnv 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 Lic. No.: 374937, -------------------------------------------------------------------------------------------------- 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.: 374937 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ate: tractor: issued. - I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor J Code, for a performance of the work for which this permit is issued. My workers' compensation 0%,1NER-BUIUDER 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 STATE FUND Policy Number 1795546-2007 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 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 370b of the 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: re pficant: (—) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and ,Ao- the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS COMPENSATION 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 PENALTIES 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 COMPENSATION. DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . J one year of completion, the owner-buifder will have the burden of proving that he or she did not build or I improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT 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 ther6on,.and who contracts for the projects with a contractor(s) licensedr 1. Each person upon whose behalf this application is made; each person at whose request and for pursuant 19 the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, 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 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. Date: Owner: 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, of cessation of work for 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation. I I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued JSec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county lo enter upon the . !d property for inspection purposes. Lender's Name: �eove-rnentmn, eT Si re (Applicant or Agent): Ap Lender's Address: . y LQPERMIT Application Number 07-00003115 Permit . . . MECHANICAL Additional desc Permit Fee 33.00 Plan Check Fee 8.25 Issue Date, Valuation 0 Expiration Date 6/0.7/08 Qty Unit Charge Per Extension BASE FEE .15.00 1.00' 9.0000 EA MECH FURNACE <=100K 9.00 1.'00' 9.0000 EA MECH B%C <=3HP/100K.BTU 9.00 ------------------------------------------------------------------------------ Special'Notes and Comments REPLACE 1 CONDENSING UNIT Fee summary Charged Paid Credited Due Permit Fee Total 33.00 .00 .00 33.00 -Plan Check Total 8:25 .00 .00 8.25 Grand Total 41.25 .00. ..00 41.25 < LQPERAI IT - . Certific, R11^0%nri _ 1-1VAC_-nniv Alteration CF -1 R -ALT Proj itle: Date: � ', Project Address, Y Climate one: [X� D / Docs entation A thor. Telepnon/ �e: � f Co Na e: © CaICERTS 2005 = r+ar r: EnforcemenhA enc se Onl ; , � '� Building Perms -,g 3 '!`i C k r Y ♦ � �`t;t441a �' 4 yam! < } P4Mani 1i"� �5 + Y . •�,R� YNl >+y., ^ r .t ��e�....i ^"t f; 7<: �Y :r Feld IMPORTANT: This CF -1 R -ALT form is only for use en an HVAC -only alteration is made to an existing home Use one form for each system being altered. This is system # I of . / systems altered in this house. Check all lines that aoaly. Check only lines that-aRply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2 Ig A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 AR An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. A-$ A cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entire duct system is also to be new or replaced.. I Continue to next line. 6 ❑ If none of lines 1-5 are checked,'neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing Ong if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealin and TXV if licable . 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 Ah QEER 12 condenser will be installed with TXV(RCA) D added duct insulation R-4 wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AM EER 12 condenser will be installed with TXV(RCA) D a 0.92 AFUE fumaoe will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 Ala EER 12 condenser will be installed with TXV(RCA) D an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 f;;)i, None of lines 7-14 above are checked. Duct Sealing is Required. Continue. Section 2-- TXV(RCA) (only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ Thiss stem is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is reguired. Go to Section 3. 19 ❑ This s stem is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ This system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 W IThis system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) is required. Go to Section 3. Section 3 - HERS Rater verification 22If line 15 is checked, HERS verification is required for Duct Sealing. 23 If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RCA). 24 ❑ Ilf line 12, 13 or 14 are checked, HERS verification is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ if lines 11, 12, 13, 14 or ,7 are checked, upgraded equipment efficiencies are required. List in Section 6. Section 5- Duct R -Values 26 ❑ lif more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed package D requirements. 27 ❑ If less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R-4.2 Section 6 - see next page Version U3-1u-ub This form can only be used on projects being verified by CaICERTS certified raters. www. calcerts. com f 1 rcr+ifir�+o of r`mmnlianca ProMerintive Method - HVAC -only Alteration CF -1R -ALT Project itle: `!A©CaICERTS GIMPORTA Date: 2005 . This CF -1 R -ALT form is only for use when an HVAC-onnry alteration is made to an existing home Use one orm for each s stem being altered. This is system # of / systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type1location and meet or exceed efficiencies/R-values. 2$ Configuration: ❑ Split system ❑ Package UnA 29 ❑ 'r Handler Gas furnace. AFUE: ❑Heatpump FAU ❑Hydronic FAU ❑Other 30 Heat Exchanger 31 Outdoor Condensing Unit i AIC ❑Heatpump ffiden SEER/HSPF: EER if re d : 32 Cooling or heating coil i C OHeatpump ❑Hydronic 33 ( ❑ Ducts Location: Length (ft): R -value: All mandatory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: i This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts.1 and 6 of the California Code of Regulations: and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing land certification and verification by an approved HERS rater. Home Owner or Authorized Agent I Documentation Author Name: I Name: G� Address: i Company Name: City/State/Zip: I I Address: PALM oESEAT AIR 42081 BEACON HILL Phone: City/State/Zip: PALMSE77A MI 1 07 (760) 346-0677 i Phone: Signature: Signature: _ Enforcement Agency (BuildingDe artmdnt Notes/Comm ts: Name: Title: Department: i i Phone #: Fax #: Signature or Stamp: Required forms: i CFAR-ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency; installer. The CF4R forms for a -sample group shall not be released until 'all testing and verification is completed and passed for the entire group. Version U3-1U-Ub I—U-- This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Bin # City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # \\� Project Address: Owner's Name: A. P. Number: Address: pZ 7 Legal Description: City, ST, Zi P Contractor: Address:42081 BEACON HILL hon .% TeleP ( / Project Description: City, ST, Zip: (760) 346-0677 1 Telephone: s`>::r?`';;fz., City Lic. #•: State Lic. # : 3 Arch., Engr., Designer: Address: City., ST, Zip: • Telephone:<:'.}•:. State Lic. #: .' :: n•K• ivj\ }:i}:!:r'W.:O`}:;:iEif•: •Oi y ;: <: Y; r + Cw%a:+ib:: ; y f:rf:t•: �' t } Yti.t,.y 'h<y.::ti: �r`%�yfjh.,r,. r:k;f; <;,v,M Constriction T ype:' Occupancy: . Project type (circle one): New Add' Alter Repair Demo Sq. Ft.: 7F# stories, #Units: Name of Contact Person: Telephone # of Contact Perso JJ ,D6 Estimated Value of Project: QA APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec''d TRACKNG 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 Title 24 Caics. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsAssue Electrical Subcontactor at Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctionWissue _ Developer Impact Fee Planning Approval Called Contact Person(---" " "" A.I.P.P. Pub. Wks. Appr Date of permit issue Schodl Fees - - - — • -- Total Permit Fees Ca10ERTS Page 3 of 12 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 1 of 8) CF -411 55-257 Shoal Creek - La Quinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address Contractor Name / License No. Contractor Contact 07-3115 Telephone Permit Number Paul Van Vlymen 760-777-1724 HERS. -Rater _ Telephone November 20, 2007 Certifying Signature Date 85959 Sample Group Number CC14-1798426535 Certificate Number Firm: Air Experts Air Conditioning HERS Provider:CaiCERTS, Inc. .__S.tr_eet_Addr_ess.:_-P._0-0Ox_94 ___-.______.__—____--_--Ciiy/State/Zip.LLaQ.uinta-/-CA_/92247 — r,-HERS-P"rov der and-Suir Ing Department This CF -411 has been registered with the CalCERTS® registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provider by the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was ❑Tested R Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must check and verify that the new distribution system Is fully ducted and correct tape is used before a CF -411 may be released on every teststt�d building. The HERS rater must not release the CF -411 until a properly completed and signed CF -611 has been received for the sample and tested buildings. The installer has provided a copy of the CF -611 (Installation Certificate). New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts). New systems where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth harked_ nihher adhesive dud tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT: NEW CONSTRUCTION Duct Pressurization Test Results (CFM @ 25 Pa) Measured values 1 N/A 2 Fan Flow: Calculated (Nominal '•._ -' Cooling '�•_ •' Heating) or •.- Measured Not Tested Enter Total Fan Flow in CFM: 3 N/A N/A ALTERATIONS: Duct System and/or HVAC Equipment Change -Out 4 Enter Tested Leakage Flow in CFM from CF -6R: Pre -Test of Existing Duct System Prior to Not Tested Duct System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow In CFM: Final Test of New Dud System or Altered Duct System 5 Not Tested for Duct System Alteration and/or Equipment Change -Out. 6 Enter Reduction in Leakage for Altered Duct System Not Tested [Line 4 - Line 5] - (Only If Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) Not Tested 8 Entire New Dud System - Pass if Leakage Percentage < 6% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑Pass ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage <= 15% [ 100 x ( Line 5 / Line 2 )]: Not Tested ❑ Pass ❑ Fall 10 Pass If Leakage to Outside Percentage <= 10% [ 100 x ( Line 7 / Line 2 )]: Not Tested 1 Pass El Fail it Pass if Leakage Reduction Percentage >= 60% [ 100 x ( Line 6 / Line 4 )] Not Tested r❑1 LJ Pass ❑ Fall and Verification by Smoke Test and Visual Inspection 12 Pass If Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines *9 through *12 pass ❑ Pass ❑ Fail Ca10ERTS Page 4 of 12 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 3-4 of 8) CF -411 55-257 Shoal Creek - La Quinta, CA 92253 Palm Desert A/C - Heating / 374937 Project Address ( , _ Contractor Name / License No. 07-3115 Contractor Contact I Telephone Permit Number Pawl Van Vlymen 760-777-1724 85959 HERS Rater Telephone Sample Group Number ` �l `- - _._...... November 20, 2007 CC14-1798426535 Certifying Signature Date Certificate Number Firm: Air Experts Air Conditioning HERS Provider:Ca10ERTS, Inc. Street Address: PO Box 94 ! City/State/Zip:La Quinta / CA / 92247. Copies to: Homeowner, HERS Provider and Building Department This CF -411 has been registered with the CaICERTS@ registry in accordance with the Title 24 & Title 20 of the CCR. CaICERTS@ is an approved HERS provideriby the California Energy Commission. HERS RATER COMPLIANCE STATEMENT The house was Tested 0 Approved as part of sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house Identified on this form compiles with the dia nostic tested compliance requirements as checked on this form. 0 The Installer has provided a copy of the CF 6R (Installation Certificate). RITHERMOSTATIC EXPANSION VALVE TXV : Access is provided for inspection. The` procedure shall consist of visual verification that the TXV is installed on the system and installation of the specific equipment shall be verified. {{ HVAC System TXV ❑ Pass ❑ Fall I