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12-0582 (MECH)P.O. BOX 1504 78-495 CALLETAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-0000 0582 Property Address: 79500 TOM FAZIO LN N APN: 766-031-017- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 12287 Applicant: LOV4wha in Ti&t 4 4 Qubtz Architect or Engineer: N14 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENS , ONTRACTOR'S DECLARATION I' hereby affirm under penalty of perjury that I am Iii prised under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P rssionals Code, and my License is in full force and effect. License Class: C20 icense No.: 686310 /, Dater - 12 - Contractor: ,.Date: ` 0 NER-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 ($500).: (_ 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 pursuant to the Contractors' State License Law.). ( 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: ROSSI,FRANK A & SANDRA 79500 TOM FAZIO LN N LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 K TRUST Date: 5/24/12 Contractor: GENERAL.AIR CONDITIONING a 31170 RESERVE DRIVES'D Q THOUSAND PALM, CA.9227 (760)3488 6•IHl 24 2012 Lic. NO..:: 6 686310 Hq CITY OF LA QUINTA 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 PolicyN mber Z071741501 • _ I certify that, in the performance of the w r for which this permit is issued, I shall not employ any person in any manner so as to become r ject to the workers' compensation laws of California, and agree that, if I should become su to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forth i co y -with those provisions. Date.f�?,}/12_ Applicant: WARNING: FAILURE TO SECURE WORK S' 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 inf tion is correct. I agree to comply with all city and county ordinances and state laws relating to building const t on, and hereby authorize representatives of this county to enter upon the above-mentioned property for ins on purposes.. Date: ignature (Applicant or Agent): r Application Number . . . . . 12-00000582 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/20/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K .9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 -----7----------7----------------------------------------------------------- Special Notes and Comment's . HVAC CHANGE OUT - 13SEER/78AFUE SPLIT SYSTEM (2008 ENERGY] CARBON.MONOXIDE ALARM(S)-TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. May 24, 2012 1:16:16 PM AORTEGA ------ -------------------_---------------------------------- Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ---------- ------ Due ----------------- Permit Fee Total 40.50 .00 ..00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .00 51.63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 k Site Address: Enforcement Agency: Date: Permit #: 79500 TOM FAZIO LANE N La Quinta, CA 92253 City- of La Quinta May 23, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ' ® Furnace ® AFUE 78% ❑ COP ❑ R.6 (CZ 10-13) Served by system ® Setback ® Indoor Coil - ® SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 2167 sf If not already present, must be ® Condensing Unit ❑ EER ❑ Resistance . 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-4R forms (no hand filled CF-4Rs allowed) are filled out and sig ned.Beginning October 1, 2010, a registered copy of the CF-111 and CF-611 shall also be on site for final inspection. ® 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 CF-4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct lea kageiz<.15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH` -Q 15 PerGeRt Exempted from duct leakage testing if: ;; ❑ 1—Duct system was documented to have been previously sealed and confirmed through HERS verification, or [12. Duct systems:with.less than 40 linear feet in unconditioned space, or [13. Existing duct systems are constructed, insulated or sealed with asbestos 0"4. Thesystem=w,ill not be Ducted (ie,Ductless Mini-Split.System)=(Also.Exempt,fromKRefrigerantTCharge) 112. New HVAC System Required Forms . Cut in'or:Chan eout witW - 4 ` � ` � Alit systems) MECH-,22an_d M --- CF-6R forns:,MECH-04,, MECH-20 HERS and°(for s new ducts-."(all new all ne.w {fit MECH-25 HERS R "� CF-4R forms: MECH-10 and (for systems) MECH and�'ME - euuil me� split 2�� For Split Systems: Duct leakage -<,6'ercent• RC :CCA 2: 350 CFM/ton; FWD,-,TMAH; STMS, and either, HSPP orPSPP. For Packaged Units: Diict leakage < 6 percent • 03. New-Ductiwith/or without` Required Forms: * a Replcement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 114. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF-6R 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: Danielle Garcia • Signature: Danielle Garcia , Company: HARRISON ENTERPRISES INC Date: May 23, 2012 Address: 31-170 RESERVE DRIVE STE A License: 686310 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 212-A0026472A-00000000-0000 Registration Date/Time: 2012/05/23 21:44:50 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms. July 2010 Birt.# City. of .La Qu1nta Building a Safety Division P.O. Box 1504,79-495 Calle Tampico 4.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 0 ToM f d-Z1 O U) - N • Owner's Name:. �j'yyG n A P. Number. Address: .S vtt I rG Legal Description: Contractor. 00n0val N[ 0a)dtMo City, ST, Zip: Telephone: W' 96 p Project Description: W hC Cil ot Address: Q�(�� �• • City, ST, Zip: `w7�1 1d Pdln'�� C qu-10. s S — r. O Y un, 0► 1 Telephone• f ro State Lic. #: -beb. City Lie. #; Amfi., Engr., Designer. Address: City,, ST, Zip: Telephone: State Lic. #: Q Name of Contact Person: .Raimo Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft! # Stories: # Units: Telephone # of Contact Person a LD 3-� 4qq? Estimated Value of Project 22 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKNG PERMITFEES Plan Sets Plan Check submitted. item Amount Structural Calla. Reviewed, ready for corrections Plan Check Deposit. . 'ISrass Calcs. Called Contact Person Plan Check Balance Tide 24 Cates. Plana picked up Construction Flood plain plan' Plans resubmitted Mechanical Giradlug plan 2'! Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plant resubmitted Grading IN HOUSE:. '"' Review; ready for correctionsAssae Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees