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13-1170 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253' BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/17/13 Application Number: 13-00001170 Owner: Property Address: 78671 TALKING ROCK TURN RICHARD JAFFE APN: 770-300-027- - - 78671 TALKING ROC Application description: MECHANICAL LA QUINTA, CA 922 Property Zoning: LOW DENSITY RESIDENTIAL(760) 275-6710 C11 j l 2013. Application valuation: 12098 _ Contractor: CITY OF LA QUINTA FINANCE DEPT. Applir,pnt: Architect or ngineer: GENERAL AIR CONDIT O G l� 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 LiC. No.: 686310 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Date: cj LT 1'j Contractor: OWNER -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).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot 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 _ 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.l. 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 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 Policy Number Z071741502 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the LaborCode, I shall forthwith comply with those provisions. Date: 9 l7 )3 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date: 9 I7 (3 Signature (Applicant or Agent): LQPERAUT Application Number . . . . . 13-00001170 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee . . . . 71.50 Plan Check Fee .00 Issue Date Valuation 0 Expiration'Date 3/16/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH FURNACE" 35.75 1.00 -35.7500 EA MECH CONDENSER/COMP 35.75 - - ---- Special Notes and Comments HVAC CHANGE OUT - 16.5 SEER/78 AFUE, 3 TON A/C & COIL. (2008 ENERGY] CARBON MONOXIDE.ALARM(S) TO BE INSTALLED PRIOR TO.FINAL INSPECTION. 2010 CALIFORNIA _ BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.5.7 PLAN CHECK, MECHANICAL' 47.66 Fee summary .. Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 139.23 .00 .00 139.23 Grand Total 210.73 .00 .00 210.73 LQPERAUT 6in.# City of La Quinta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Per if # 3 /I / �/n I ��/ Project Address: --7$(oDlT��k�h 1�0�-k 1vrv� Owner's Name: .c�arc� Sc.�� c A. P. Number: Address: -7$b7 2 Legal Description: City, ST, zip: Lc- CA Q 2 253 - Contractor: -ne—f 1 A:r Cor �� i Tele hone: - — P 71x0 Z%S fo-710 Address: e �SeC V Project Description: city, sT, zip: C1,ovsa�d1m G ZZ Ito !� lc«c 3-�o,r.A Telephone: P `7top-3`-i3-��'� ice gOk. 3Tv vcr�c.ce State Lic. # : City Lie. #•: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: ;<;:;:;:<::;::;;;:<:::.:;;z:s;;:::<;;::;::<:: Construction Type: Occupancy: State Lie. #: Project circle one • New Add'n Alter Repair Demo J h'a � )• P P Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone #,of Contact Person:. Estimated Value of Project: 12 D 9 8.00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2qd Review, ready for corrections/issue t Electrical Subcon(actor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential RVAC Alterations CV -1R -ALT -HVAC Climate Zones 10 to 15 Site Address: ._ Enforcement Agency: Date: Permit #: Ck0� LC,viVACL q -1 t3 Conditioned Floor Equipment T et List Minimum Efficiency 2 Duct insulation requirement Area Thermostat 13 Packaged Unit I$Fumace iB�AFUE 78 �� • 13 COP Over 40 ft of ducts added or )I2[ Setback M Indoor Coil 1ISEER(o .S ❑ HSPF replaced in unconditioned space Served by system (If not already IRCondensing Unit ❑ EER _ ❑ Resistance ❑ R 6 (CZ 10-13)\%� ❑ R 8 (CZ 14-15) Z'3 sf present, must be 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% AME, 7.7HSPF for typical residential syslems. 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 signed. Beginning October 1, 2010, a registered copy of the CF -IR and CF -611 shall also he on site for final inspection. M1. 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 lit stems MECH-25 • Condenser Coil and/or CF -6R 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 • Furnace 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: ❑ 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 duct systems are constructed, insulated or sealed with asbestos 0 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 CF4R 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 0 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 0 4. New Ducting over 40 feet Required Forms: 1 iclude - ore�l'mt 4 CF-- forms: MECH-0 7, MECH=2I=HERS linear feet of duct in unconditioned space. 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 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, calculationsplans and specifications submitted to the enforcement age f approval with the permit application. Name: P� Signature:. Company: /� 11 Date:. I i1 Address: 31-70 ��servt �c. License: . �S(�3io City/State/Zip: 7a\m5 CQ a2Z7(o Phone: '7(,x_3443--7z4g9 2008 Residential Compliance Forms July 2010