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11-1114 (MECH)P.O. BOX 1504 787495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: A 11-00001114 (' -81640 TIBURON DR 767-531-007- - MECHANICAL LOW DENSITY RESIDENTIAL 15396 T4hf-4 4 Qum' BUILDING & SAFETY DEPARTMENT . Architect or Engineer: 0(ok BUILDING PERMIT — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lic sed under provisions of Chapter 9 (commencing with - Section 7000) of Division 3, of the Business and Pr sionals Code, and my License is in full force and effect. License Class: C20 icense No.: 686310 Date: ) ttractor: R -BUILDER DECLARATION I hereby affirm under penalty of perjury tha 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 they 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).: (_) 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.). ' (_) 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.). (_) I am exempt under Sec. , BAP.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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/11/11 Owner: GARY "LESSER 81640 TIBURON DRIVE 'D 4 0 LA QUINTA, CA 92253 ' C� 1011 Contractor: GENERAL AIR CONDITIONI? G CITY 0!:;.A r4;fi NlA 31170 RESERVE DRIVE THOUSAND PALMS; CA 92276 (760)343-7488 Lic. No.: 686310 - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — • WORKER'S COMPENSATION DECLARATION 1 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 7600006147101 _ I certify that, in the performance of the wo for which this permit is issued, I shall not employ any person in any manner so as to becom bject to the workers' compensation laws of California, and agree that, if I'should become su t to the workers' compensation provisions of Section 3700 of the Labor Code, I shall fort h comply with those provisions. - --late: 'y. icant: WARNING: FAILURE TO SECURE WOR S' COM ENSATION 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 informa s correct. I agree to comply with all . city and county ordinances and state laws relating to building constructi d hereby authorize representatives of this county to enter upon the above-mentioned property for inspecti poses. ate: L�15i ure (Applicant or Agent):. s Application Number . . . . . 11-00001114' Permit . . . •MECHANICAL Additional desc .. Permit Fee 48.00. Plan Check Fee.. 16.50 Issue Date. Valuation 0 Expiration Date". .4/08/12 ' Qty Unit.Charge Per Extension BASE FEE 15.00 .00 9.0000 EA MECH FURNACE <=1.00K .00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 Y Special Notes and Comments INSTALL 5 TON HVAC CONDENSER AND COIL, AND 3.5 TON HVAC CONDENSER AND COIL AT GROUND LEVEL.' 2010 CODES. -----------------_-_-------------------------------------------------- Other Fees . . . : . BLDG STDS ADMIN (SB1473) - 1.00 Fee summary Charged Paid Credited ---------- ---------- ---------- ---------- Due ----------------- Permit Fee Total 48.00 .00 .00 48.00* Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1,00 :00 .00 1.00 Grand Total 65.50 .00 .00. y 65.50 r LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC - Climate Zones 10 to 15 Site Address: �l pfd %1 �l�rBr► 42 En orcein Agency: Dat • a --t o Perurit u9: 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 " Conditioned Floor Equipment T el List Minimum Efficiency Duct insulation requirement Area Thermostat 13Packaged Unit 11 Furnace ❑ AFUE 80% ❑ COP Over 40 ft of ducts added or • Furnace Setback ndoor Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (lfnot already ndensing Unit O EER / / ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be ❑ Other For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Replacement ❑ R 8 (CZ 14-15) • Includes replacing or installing all new ducting installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R-ALT-HVACfbr each system. 2. Minimum Equipment Efficiencies: 13 SEER. 78% AFUF-_ 7 79,4?PF fnr h.n;rn1 r ;dl t;n1 �­t . 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 mast 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 i ed. Beginning October I, 201.0, a registered co of the CF -IR and CF -6R shall also be on site for final inspection. it1. HVAC Changeout Required Forms: 411 HVAC Equipment replaced CF:6R forms: MECH-04, MECH-21-HERS and (for split systems)-MECH- 25 -HERS• - - - CF -4R forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil and /or • Indoor Coil and/or 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 duct leakage testing if: 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 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 ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 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 ❑ 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 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 linear feet of duct in unconditioned space. CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ 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 ' orm tion documented on other pplic ompliance forms, worksheets, calculations, plans andspecifications submitted to the enforcement a ency for appro al with t e permit application. Name: Cot (ear UJO-t's-bit Si lure: Company: � G,en,era.( Ar Cotu t; f,, o h ,1 ' Date: COD _` Address: 311-70 P ser^v License: &86,3/(v City/State/Zip: �'—�L D G� �SGtrn� �iLLt ►�S. t�l�} / Phone: 760 -.37-) — -7 4 8T Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF -IR -ALT -HVAC - Climate Zones 10 to 15 Siteddress: M ` 6 '%6 &71 E orceme gency: Date: Permit #: Conditioned Floor Equipment T e� List Minimum Efficiency z Duct insulation requirement Area Thermostat _.; Packaged Unit urnace EIAFUE_ COP Over 40 ft of ducts added or 0 Setback door Coil DEER HSPF laced in unconditioned space �] R 6 (CZ 10-13) Served by system sf (Ifnot already present, must be ondensing Unit []EER Resistance Other R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R=ALT-HVAC 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 CF -4R forms (no hand filled CF-4Rs allowed) are filled out and sipted. 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 CF -4R forms: MECH- 21 and fors lits stems MECH-25 • Condenser Coil.and /or CF -6R fomts: MECH-21-HERS and (for- split systems) MECH-2'5-HERS • Indoor Coil and/or CF -4R 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 Pack ed Units: Duct leakage < 15 percent Exempt, xempt d m 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 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 and 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 3. New Ducts with/or without 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/orindoor coil CF -4R forms: MECH-20 and (for split systems) MECH-25 and/or furnace. No or some 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 linear feet of duct in unconditioned space. CF 6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split s stem or packaged units: Duct leakage < 15 percent 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. • 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 I and 6 of the Califomia Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the/C.Ghl tion documented on oche pplicable compliance forms, worksheets, calcu i s lans ands ecificatio submitted to the enforcement a enc fora rovae permit application. Name:Signa re: Company: Date: /OBD-! Address: `l y� b License: 31 0 City/State/Zip:IZZLPhone: 3 f'O � 7 2008 Residential Compliance Forms March 2010 CaICERTS 1'S - CF- R Registration Page Iof1 Public Home Danielle Garcia logged in [Logout] [Home] Secure Home About Us Training Rater Directory CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 81640 TIBURON DRIVE iLaQuinta,CA92253 CEC Registration: 1211-A0052522A-00000000-0000 Forms CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company: HARRISON ENTERPRISES INC Membership Benefits `_"'-_-'— --- ----------------.___..--.____—_ Do you know your HERS Rater? Events If you do, you may want to send this CF -1R to them. Industry Partners CaICERTS Rater ID: OR News My Rater Quick Select:: Energy Driven Solutions, Inc. 'ry Every CaICERTS rater has a license number. To register for our Ifyou need to find the rater by name [Click HERE) to search our directory. monthlySEND QE 113Tq H.ER%9ATER,;>:.,,14_;,I newsletter, please ` click here. [CLICK HERE] to do another Copyright (0 2010 CaICERTS. Inc. All rights reserved. Revised: ,January 11. 2010 [Terms and Conditions] (Privacy Statement) [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us .r' BBB :Find us.00F.aceb.o014®:-� https://www.calcerts.com/public_cfl R.cfm?project_id=142664 10/10/2011 uaiuhK i �) - Lr - t x xegistration Page 1 of l Public Home Danielle Garcia logged in [Logout] [Home] Secure Home CONGRATULATIONS About Us Your CF -1 R -ALT -HVAC Registration is complete! You may want to print this page for your records. Training Site Address: 81640 TIBURON DRIVE Rater Directory La Quinta, CA 92253 CEC Registration: 211-A0052523A-00000000-0000 Forms CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company: HARRISON ENTERPRISES INC -._—'—".---� Membership Benefits -------------------------._.^_—_—. _. Do you know your HERS Rater? Events If you do, you may want to send this CF -IR to them. Industry Partners CaICERTS Rater ID: OR News-- — ----'--•—^—^ My Rater Quick Select: ;•_Energy Driven Solutions, Inc.: Every CaICERTS rater has a license number. To register for our Ifyou need to find the rater by. name [Click HERE] to search our directory. monthly }3,R•.1 M�SEND_CE 1R TQ I'ERSiRATER,c�' ,; 1 newsletter, please click here. [CLICK HERE] to do another Copyright 02010 CaICIUfS. lnc. All rights reserved. Revised: Janus y 11. 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us c �r w _ BBB'.'. BBFirxJuote'FBttQbOOkQ:j start vnm mug 4t..aC.:L:.t_.i`..:z..... ..... ... --s...:.::...:::....:.. https://www.calcerts..com/public—cfl R.cfm?proj ect_id=142665 10/10/2011 Bin # 'a 0ty of LQ Quint &• Safety Dlvislon Box 1504, 78-495 Calle Tampico La Quin ta, CA 92253 - (760) 777-7012 Building Permit Application and. Tracking Sheet •Permit #P.O. ���� 1� Project Address:NLVk Owners Name: �r A. P. Number: Address: F7 Vo tj Legal Description: City, ST, Zip: La- Contractor:b en Telephone: -7690 �g�' S S rf ; • : w ' Address: cm, 'ProjectDescription: r' . City. ST, Zip: Telephone: '� • `;,: :.;: ;.:r::v<.:, %�a�s•: '"�. State Lic. # : 3 City Lic. Arch., Engr., Designer: -71 Address: City., ST, -Zip: ._ ... _-_ ... -.- . ..._._... __...... _. ._ - - - _...... Telephone: ; } ''•w �; �,.,>:>kw�ti 4'. s P State Lic. #: �f";> j Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Stores: Units:at) Sq. FL: Name of Contact•Person: Ala%15 OYU Telephone # of Contact Person: -7&-0 3Y-6 Estimated Value of Project: `�3 � (e • �� APPLICANT: DO. NOT WRITE. BELOW THIS LINE N Submittal Plan Sets Req'd' Recd TRACKING Plan Check submitted PERMIT FEES Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. 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 correctionslissue Electrical Subcontactor List Called Contact Person Plumbing . Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN 7rd Review,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees