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07-1580 (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 -. BUILDINGTERMIT- - Date: 5/29/07 Application'Number, 07-00001580 Owner:' Property Address: 54307 SOUTHERN HILLS : , CICUREL RALPH/LLOUISE _ APN:' 775-101-050--- - ' 543.07 SOUTHERN HILLS Application description: MECHANICAL LA QUINTA, CA 92253 n ' Property.Zoning: LOW_ - DENSITY RESIDENTIAL U Application valuation: 13050 . • ' MAY 9 9 2007 ` - - Contractor: CC Applicant: Architect or Engineer:, r. PALM. DESERT.AIR COND ONIN or L4 ` 42081 BEACON HILL Y* ' PALM DESERT,.CA 92211' !!11 1I (760)346-0677 = N l Lic No.:i 374937 • I J ------------------------------------------- - - - - - _ _ --- - --- ` - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - - I hereby affirm under penalty of perjury that I.am 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 and Profes ' als 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 .License Cl ss: C20' - - 374937 for by Section 3700 of the ILabor Code, for the performance of the work for which this permit is Ufa issued. ate: •� Itr tor: - - - �.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 OWNER -B DECLARATION - insurance carrier and policy number are: • I hereby affirm under penalty of perjury that I am.exemp rom the Contractor's State License Law for the Carrier STATE FUND Policy Number 1795546-2007 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 to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become ' 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 Labor Cod I sha ort ith com id se pro 'sions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany applicant for a permit subjects the applicant to a civil penalty of not more than five hundreddollars ($500).: plican - - • (_ 1 I, as owner`of the property, or my employees with wages as their sole compensation, will do the work, and r the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: ,The - WARNING: (LURE TO S WOR 4 RS' M NS' TIO EIS 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 ES AND CIfL—Flt ES 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".TOTHE 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 3706 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.). - -APPLICANT ACKNOWLEDGEMENT - 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director. of Building and Safety for a permit subject to the - - • 7044, Business. and Professions Code: The Contractors' State License Law does not apply,to an owner -of conditions and restrictions set forth on this application. ' property who builds or improves thereon, andwhocontracts for the projects with a contractor(s) licensed . 1 . ' Each person upon whose behalf this application is made, each person at whose request and for pursuant'to the Contractors' State License Law.)' - � . whose benefit work is performed under or pursuant to any permit issued as a result of this application, am exempt under Sec. , B.&P.C. for this reason 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.. - • ' - Date: Owner:_ 2. Any permit issued as a result of this application becomes null and void if work' is not commenced - _ • , . • - - - - r within 180 days. from date_ of issuance of such permit, or cessation of work for 180 days will. subject "� - • CONSTRUCTION LENDING AGENCY, L .,•: permit to.cancellation. - • • I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the' • I certify that I have read this application and state that the -above information is correct. I agree to comply with all 'work for which this permit is issued (Sec. 3097, Civ. C.).. .-, - city, and c unty ordinance nd state laws relatingto building construc ' n, y out on entatives ` of thi ounty to enter o_n the above-mentioned property f r insp pu oses. ` Lender's Name: . Signature (Applicant or Agent). " ' - Lender's Address: LQPERMIT - - •, . Bin # _t Qty of La Quin LQ Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico 0 Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �)'J" ��,�" Project Address: Owner's Name: A. P. Number: Address: Legal Description: Contractor: PALM RESER R T AIR CONDITIONING COMPANY City, , STi " p: T ele h n � •3 � Q 42081 ElONCON HIM Address: PALM DESERT, CA 92211-5107 Project Description: ' City, ST, Zip: 3 ✓C/�J TeleP ho n • e. State Lic. # :3 City Lic. Arch., Engr., Designer: A -11 -9t - -Address: Address: City., ST, Zip: Telephone: �> State Lic. #: Name of Contact Person:Ajt_�400� Con tr 0 s ucti n Type: P e: Occupancy: Project type (circle one New Add' Alte e ai r DemoR Sq. Ft.: #Stories: #Units: Telephone # of Contact Perso Estimated Value of Project -d? 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 2" Review, ready for corrections/issue Electrical Subcontactor 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 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 Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Proje itle• Date' D2/1 i �� CJ / ©CaICERTS 2005 Enforcement Agency Use Only Pro ress: , mate Zone: Building Permit # Doc me atipn A or: Telephon Plan Check Date O y 7e: I �. Field Check Date IMPORTANT: This CF -1R -ALT form is only for use when an C -only alter tion is made to an existing home Use one form for each system being altered. This is system # ; of 41Z11 systems altered in this house. Check all lines that apply. Check only lines that aooly. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2' Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 � n outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 4 A cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entire duct system is also to be new or replaced. Continue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is checked. 7 ❑ This system is in Climate Zone 1, 3, 4, 5, 6, 7, or 8. No duct sealing is required. Go to Section 2. 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Section 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. . No duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AMQEER 12 condenser will be installed with TXV(RCA) AND added duct insulation R4 wrap on existing ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AHU EER 12 condenser will be installed with TXV(RCA) AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 ANQ EER 12 condenser will be installed with TXV(RCA) ND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 None of lines 7-14 above are checked. Duct Sealing is Required. Continue. S do 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The system being altered is a package unit. No TXV(RCA) is required. Go to Section 3. 17 ❑, This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is r uired. Go to Section 3. 20 ❑ This s stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 2 This system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) Is required. Go to Section 3. Se do 3 - HERS Rater verification 22 If line 15 is checked, HERS verification is required for Duct Sealing. 23 lif line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RCA). 24 Ilf line 12, 13 or 14 are checked, HERS verification is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section 6. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ Ilf less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R4.2 Section 6 - see next page Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT Project T' _ Date: © CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC my aIle tion is made to an existing home Use one form for each system being altered. This is system #� of ystems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed efficiencies/R-values. -• -- 28 Configuratimn plit system ❑ Package Unit 29 ❑ Air Handler. - Gas furnace, AFUE: ❑Healpump FAU ❑Hydronic FAU ❑Other 30 Heat Exchanger 31 Outdoor Conderising Unit AWJC ❑Healpump fticiency SEER/HSPF .40,EER Are d: ^ 32 eEll . Cooling or heating coil 111A/C 131-featpump ❑H dronic 33 ❑ Ducts Location: I Length (ft): R -value: All man datory measures apply to any altered component. See MF -1 R - ALT form. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall project responsibility. The undersigned recognizes that compliance using, duct sea)ing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or AwtIIIiorized Agent Documentation Autho Name: Name: Address: Company Name: City/State/Zip: Address: 42081 BEACON HILL COMPANY . • • PALM DESERT, CA 92211-5107 Phone: City/State/Zip: Phone: Signature: Signature: Enforcement Agency (Building Department) Notes/Comments: 3, `'<"' ' w4• Name: Title: Department: - Phone #: . Fax #: Signature or Stamp: Required forms: CF -1 R -ALT: by anyone. Required at time of permit application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to close permit. Copies to home owner, enforcement agency, HERS rater. CF -4R -ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer: The CF4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group. .version us-iu-uo ;This form can only be used on projects being verified by CaICERTS certified raters. Page 2 of 2 www.calcerts.com f r