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12-1313 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO_ LA QUINTA, CALIFORNIA 92253 Application Number: f --'12--00001313 Property Address: _-78329 TERRA COTTA CT APN: 604-022-015- - - Application description: MECHANICAL Property Zoning: •LOW DENSITY RESIDENTIAL, Application valuation: 5820 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LY,,TULIE 78329 TERRA COTTA COURT LA QUINTA, CA 92253 r VOICE (760) 777-12 FAX (760) 777-7011. INSPECTIONS (760) 777-7153 . Date: 11/05/12 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 [,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 of improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ I 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 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 statAtheab rmation is correct. I agree to comply with all city -and county ordinances and state laws relatinction he y aut rize representatives of�ttis county to enter uponth above-mentionedti pur DDate�%--Sign re (Applicant or Age Contractor: Applicant: Architect or Engineer: PREFERRED PLUMBING HTG A/C [rte P.O. BOX 5120 PALM SPRINGS, CA 92263 05 r (760),322.-3173 2011 . Lic. No.: 457554 Ciryo FS UT �cE QAlTq DOPY. ----'--------------------------------------------------------------------------------------------- " LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury that 1 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 d 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 Lice se Class: C10 C16 C2 i nse o. 45755 , for by Section 3700 of the Labor Code, for the performance of the work for which this permit is �3— ontractor:' - � issued. P"'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 W ER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am a pt 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 become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant wthe provisions of the Contractor's State and agree that, if I should come subject to the worker 'com ensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the L bor Cod shall forthwith com it t se rovisions. - that -he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7631.5 by _ _ .any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate:�A icant:. 1 _ 1 1; 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 WARNING: FAILU E TO SE RE WORKERS' COQ ENS TION 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 A IVIL 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 3766 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 improve for the purpose of sale.)., ( 1 [,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 of improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ I 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 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 statAtheab rmation is correct. I agree to comply with all city -and county ordinances and state laws relatinction he y aut rize representatives of�ttis county to enter uponth above-mentionedti pur DDate�%--Sign re (Applicant or Age LQPERMIT Application Number . . . . . 12-00001313 Permit MECHANICAL Additional desc . Permit Fee . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation 0 Expiration Date 5/04/13 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 Special Notes and'Comments HVAC CHANGE -OUT: REPLACE CONDENSER & AIR HANDLER 2010 CODES. ---------------------------------------------------------------------------- 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 Shri lified Prescriptive Certificate -of Com fiance: 2005 Residential HVA CAlteradons . CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: 32 TEEP-A 601TA C -F En orcement Agency: MjMIA Date: z6iz Permit #: Conditioned Floor E ui ment Type List Minimum Efficienc. 2 Duct insulation requirement Area Thermostat ❑aged Unit uroace ❑ AFUE_ ❑ COP Over'40 ft'of ducts added or etback ❑ Indoor Coil Zi!SnR 15 ❑ HSPl replaced in unconditioned space ❑ R 6 10-13) 'Served by system 7 3 (If not already be Condensing Unit Z?V-ER I ❑.Resistance (CZ sf present, must ❑ Other ❑ R 8 (CZ 14-15) installed) 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%o 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 si Beginning October 1 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final ins ection. 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 • Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/tori(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 ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut s: Changeout with new ducts: (all l 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: o 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. 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. • I certify that the energy features and performance specifications for the design identified on this Cgrtificate of Complia4conrm 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 inform on documentedonothle compliance forms, w s eets, calculationsplans and specifications submitted to the enforcement agency for approval withermi ' ti . Name: Te F: r-7 Q FM 5 Signature: Company-� c� Date:. .I I,// 120f2_ Address: S- Z C� License: '-�� -7 5 5--F City/State/Zip: NGS n f� 1 _ Phone: '-+60 r ZZ - 3 ( 7 Big # Cl/ of La QU'inta Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Qulnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Proj'et Addiess:".,,.`:.;: Owner`s Name: A. P. Number*... _.. `. ,,.`;: .:. ' : Address: tegal-Decziptiggi ? -3ti City, ST, Zip: L/3 QC/,AIT c� �ao�S 3 ppre'€'fir ed A r dh'ditioriing db Contractor.. ' ° T � �.;•. ;rs':.' ` :P>'e'ferr:e:: U, m-: Heatin &Ai Addiess; }?Q::'B'Os.`.`5;?`Q.` Telephone• Project Description: e City, ST:ZiPPam.pgs;::;CA, 9226 Ga'� Co5 /�HID Telephone:.(!.7.6::)=x,32;=31`73..i2 State 16C City Lic..#: Arch,; Eigr: Designer :,.. Address: City,.STT: Telephone;..; State,Lip # _ _ _ <. Conslriietion Type: Occupancy: Project type (circle one): New Ad&n Alter Repair Demo Name of:, pip P_ - .L is r iyQ ytr� Sq: Ft: #Stories: #Units: Telepboi�e-'#>'oi wCQ itaerEersou . j�.Q j�a 3/ %.3 Estimaied Value of Project: ,S��p2 r; ;;. •. APPLICANT: DO NOT WRITE BELOW THIS LINE # . $nbpitttal ; ::::i.,. • `-' ,::Reg'd:. . Beed TRACKING,, PERMI<T FEES YIan,S�ts::°<:: Plan Checkl;ellmltted IteAmount Stroetural'Cal�s.. Reviewed, ready for corrections Plar Check Deposit Tru s Calcs..',..... • Called Contact Person Flat Check Balance E4ergy Cabs.' Plans Dicked up colAtruction 01ood,platn plaq% Plans.resubmitted M6C isinical Grad[ng plan' ':.. . 2"d Review, ready for'correetionsrssue EIe cal ,Su6eontactor.Itst Called ContactPergon No btng Grant Decd . Plans picked up S.M H.O,A Approval Plans resubmitted Gra ling Review, ready for corrections/issue Developer Impact Fee Plannl.qg Apprbval: Called Contact Person p. Pub. Wks. Appr ' Date of permit issue Sebool Fens ' Tot YermltFees r city-of'a uin a -495 78CALLE TAMPICO LA*QUINTA, CALIFORNIA' (760)-777-7012 {FAX] (760) 777-7011: INSPECTION RECORD Permit* 9808=002 STRUCTURAL RETROFIT OF UNIT ADDRESS DATE. INSPECTION [YES/NO] 78 - 52% _79. 4A 11-5-99 FRAMING/HARDWARE PLAN TYPE: /-,ter - 98 INSULATION V/,/- /LSHEAR Contractor. WERMERS MULTI -FAMILY CORP.' SHEARNAILING /- /Q - 9B DRYWALL mrZ ,(Q •.� /2-/1- 98IOB FINAL , COMMENTS/NOTES: �4•) �QoF .&A,o1,e.5 6�,0,/ c 7-"=Z) to 98 4.,;r . 4) MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253