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10-1343 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ClL0 00.00-1.343 Property Address: 45160 SUNBERRY CT APN: 604-412-011-20 -23995 - Application description: MECHANICAL Tit 4 4-Q�AAl BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3140 X Apcant: / . Architect or Engineer: A4 ----------------- 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: . Licensee Class: C20 License No.: 374937 Date: (��'� �c Co'n_tractor. P Owner: JACKSON DARRYL 'L 45160 SUNBERRY CT LA QUINTA,' CA 92253 (760)275-5199 OWNER -BUILDER DECLARATION 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 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, 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 contractorls) licensed pursuant to the Contractors' State License Law.). (_) 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: LQPERAIIT Contractor: PALM DESERT AIR COND CO 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677 Lic. No.: 374937 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/09/10 PE*- 09 2010 CITU OF LA s; iNTA 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 SOUTHERN INS Policy Number WSIO036802-01 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 Labor Code, I shall forthwith ply with those provisions. . Date/ g t 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 ($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 isnot 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and reb authorize representatives of this county to enter upon the above-mentioned property for inspection purp D� Date: � f!-SignBtuie (Applicant or Agent)':�­50— S - LQPEn11T Application Number 10-00001343 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00, Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Expiration Date .'. 6/07/11 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 INE (1) AIR CONDITIONING SPLIT SYSTEM. 16.00 SEER Other Fees . . . . . BLDG STDS ADMIN. (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00. .00 8.25 Other Fee Total 1.00 .00 .00 1.00. .Grand Total '42.25 .00 ..00 42.25 LQPEn11T Sim" lified Prescri five Certificate of Com liance: 2008-ResidentiOHVACAlterations CF-M-ALT-RVAC, Ci inate:Zones 10 to 15 JAC;KSUN, DARRYL SVstPm• tt Site.A,ddress: 45=160 SUNBERRY CT., LA QUINTA, CA 92253 En iorcemeni!Agenc : City of La Quina Date: 12/13/2010 Permit M. Equipment Typei List Minimu Efficiency, Duct insulation requirement Conditioned Floor AreaThermostat 11:Packag6d Unit ® Furnace ® AFS80 % o 11 cop Over 40, ft of ducts added or ®-Setback ® Indoor.Coil ® SEER 16.00 ❑ .HSPF replaced in unconditioned space Served by system pfnot alkeady. ® Condensing.Unit> ❑..Other ® EER: 13.00 ❑ Resistance ❑ R G (C7,10:--13) OR 8 ,(CZ 14-15) sf present, must be installed) 1. Egt4 meW Type: ChooseJhe equipment being installed; if more than one system, use another CF-1R-AL.T. -HVA C fdr each system. 3. Minima» Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor typical residential Systems. HERS VERIFICATION SUMMARY .Listed below are fourHVAC alteration. Options. The installer decides what work.is being done and picks oneof 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 mspect►on 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 inspecfor;also verifies; that each appropriate CF -6R and registered' CF -4R forms. (no hand filled CF-4Rs allowed),are filled out and ' signed: Be nin "October 1, 2010; a registered copy of the CF -1R and CF -6R shall also be on. site for final ins ection. 0l.;HVAC Changeout: Required Forms:. ® Al -I HVAC Equipment replaced. CF -6'R forms: MECH-04, MECH.-2'1.-HERS and (.for spl.itsystemn) MECH-.25-HTRS. CF-4R'forms: MECH- 21 and fors lits stems MECH-25 ® Condenser Coil and /or ® .indoor Coil and/or CF -6R forms: MECH-21-HERS and 'fors lits stems MECH- 25 -HERS ® Pomace: CFAR forms: MECH-:2 1. and (for split systems) .MECH-25 For`SplitSystemsc Duct leakage <I S percent; RC, CCA > 300 CFM/ton(Minitnum AirFlow Requirement), TMAH For Packaged Units:.Duct leakage < 15 .percent Exempted from, duct leakage teshng;if ' O L Ductsystem was documented to have:been previously sealed and con, f tmed through HERS verification, or 0.2. Duct systems with less than 40" linear feet in unconditioned space, or O'3.;Existing duct systems are constructed, insulated'or sealed with. asbestos ❑ 2. New HVAC Systern '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,dycting and all new equipment) CF -4R forms: MECH 2O-, and (for split systems)MECH-22, find, MECH 25 For Split Systems: Duct leakage <6 percent; RC, CCA _>350 C.FM/ton, FWD, TMAH, _-SIMS, and.either HS PP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3: New Ducts wiith/oitwithout 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 coil CFAR forms: MECH-20 and (for split systems) MECH-25 and/or furnace. Noor some equipment changed. For'Spfit Systems: Duct leakage <:`6 percent, RC, CCA > 300 CFM/ton, TMAH For Faeka ed Units: Duct leakage < 6. ercent 114. New Matin over 40 feet Re wired Forms: ❑ Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF -61Z forms: MEC14-04, MECH-21-HERS CF -4R forms:. MECH-21 For"spfit system. or packaged, units: Duct leakage < 15 percent: ' 0 EXCEPI'I6m Ddstin educt" stems constructed, insulated or sealed with asbestos. Contractor (D(icumentation Author's./Responsible.Designer's Declaration Statement) ® 1 ceitify that this Certif cate of Compliance documentation is accurate and complete. 10 L -am eligible under Division 3 of. the California Business and Professions Code to accept responsibility Tor the design identified on this Certificate of Compliance.. ® 1 certify,thatthe energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts t and 6 of the.Califomia Code of Regulations. ® the design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms; worksheets, ciilculations, plans ands ecificationssubmitted to the onforccinent agency for approval -with the e 'i a " lication. Name: KARL BROWN Signature: Desert Air Conditioning& Heating Company Date:Company:Palm 12/13/2010 Address: 42-081 Beacon Hill License: 374937 City/State/zip:-Palm Desert, CA 92211 Phone: (760) 346-0677 Loud acestaentiat compliance Forms March 2010 ` P.O.`Box1504 •.78=495 Calle Tampico, • La Quinta, California,92211- Tel: (760)'J 7-7012 • Fax: (760):777-7112 Website: www:La-Quinta:Org • Email: Build ing"@La-Quinta.Org .... ,o�_;a Bin M Permit #`.0-1� Building Permit App1iication'', Tracking Sheet Project.Address 45-160 SUNBERRY CT. Owner's Name: JACKSON, DARRYL A. P .Number-. Address:- 45-160 SUNBERRY CT. Legal DescnPtion: City, State, Zip: LA QUINTA, CA 92253 ;Go."ntractor.: Palm Desert Air Conditioning & Heating Company Telephone: (760) 275-5199 Address: 42-081 Beacon Hill Project Description: Gity„State; Zip: Palm Desert, CA 92211 REPLACE ONE (1) AIR CONDITIONING SPLIT SYSTEM. Telephone No::(760) 346-0677 :State: Lic` # 374937 City Lic. #: , 100886 I. Arch;/Eng'r.%Designer: , Address: r" :City; State'. Zip:, s,f , �r ;� a Telephone Nor. F , c'� '.Construction Type: Occupancy: ... .� • .1I - _ �- ti'�..Project.Type- O New ® Add':n - UAlter• 3 Re air 7 -Deno Name '-of "Contact Person: KARL BROWN Sq. Ft:#Stories: #'Units: ;C6ntact.T6le046ne.No::' (760) 346-0677 Estimated Valuebf Project: $7,140.00 APPLICANT.DO NOT WRITE BELOW THIS LINE r I I I I I I ( Total Permit Fee's Submittal. Re q' -d Recd Tracking Permit Fee's, Plan* Sets Plan Check Submitted Item Amount Structural Calix.: Reviewed, Ready for Corrections, Plan Check,Deposit Truss Calcs: Called;Contact Person Plan Check Balance, Title:24 Galcs. Plans Picked Up. Construction Flood Plain, Plan . Plans. Resubmitted Mechanical Grading Plan: .2"d.Review, Ready for Corrections Electrical. Siibcontractorlist Called Contect*Person• Plumbing .Grant Q6 d Plans Picked Up S.M.I. H.O.A.: Approval Plans;Resubmitted Grading, IN HO.USE,, 3rd Review, Readyfor-Corrections Developer tmpactFee Planning Approval Called Contact Person A.I.P.P-.. Pub: Works Appel Date of Permit Issue •School Fees' I I I I I I ( Total Permit Fee's