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07-0691 (MECH)P. -O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00000691 Property Address: 540.87 SOUTHERN HILLS APN: 775 -101 -039 - Application description: MECHANICAL. Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: , 4.600 VOICE (760) 777-7012 FAX(760)777-.7011 BUILDING& SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 -BUILDING PERMIT Date: 3/06/07 Owner: WOLSTENHOLME DEREK/DEBORAH 54087 SOUTHERN HILLS LA QUINTA, CA 92253 D u: Applicant: —Architect or Engine �Qn CITY OF 6A 61NINTA 1 , PIWAid Contractor: PALM -DESERT AIR CONDITIONING 42081 BEACON HILL PALM DESERT, CA 92211 (760)346-0677. Lic. No.: 374937 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 Professionals Code, and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C20 License No.: 374937 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is l :3 -(e —c �-•-I ` Co ctor: 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 - - WNER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License L'aw 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 subject to the workers' compensation 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 Code, I shall forthwith comply with those provisions. 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 1$500)-.:: te. _ Lw Arrant: ' 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: FAILURE TO SECURE WORK ERSNICOMPENSATION 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 AND CIVIL FINES UP TO ONE HUNDRED THOUSAND --'and whodoesthe 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 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 _ I, 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, and who contracts 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, (_ 1. I 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 . within 180 days from date of issuance of.sucb permit, or cessation of work for 180 days will subject ' -- CONSTRUCTION LENDING AGENCY permit to cancellation.. _ 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 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. - Lender's Name: ta: J yC51 Sjgr(ature (Applicant or Agent): ,OdLender's Address: LQPERMIT - . 4 m Application Number . . . 07-00000691 Permit MECHANICAL. Additional desc Permit'Fee 33.00 Plan Check Fee 8.25 •,. - Issue Date . .. Valuation . . . 0 - Expiration Date 9/02/07 Qty Unit Charge Per Extension r BASE 'FEE 15.00 - 1.00 9.0000 'EA MECH_FURNACE <=100K_'' 91.00 1.00 9.0000 EA ME.CH B/C <=3HP/100K BTU. 9.00, Special Notes and Comments - REPLACE HVAC SYSTEM WITH NEW•4 TON - SYSTEM - _ _ Fee summary -Charged Paid Credited Due - Permit Fee Total 33.00 .00 ,.00 33.00 -•- -• -Plan Check Total 8.25 .00 :00 8.25 ' Grand Total 41.25 .00 .00 41.25 LQPERMIT - Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Pr It Title: ate:©CaICERTS ��0, 2005 ent A en Use Only Enforcement r0ect dress: , imateZone: -D /S Building Permit # Docu tion r: L� Telephon ,60 %Z oa Came: Plan Check Date Field Check Date IMPORTANT: This CF -1 R- LT form is only for use when AC -only alt ration is made to an existing home Use one form for each system being altered. This is system # of systems altered in this house. Check all lines that apply. Check only linea that aooly. Scope of Alterations: 1 ❑ n Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. 2 A Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next line. 3 An 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 ❑ Thiss stem 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 seated 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. Not 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 Adm EER 12 condenser will be installed with TXV(RCA) AND added duct insulation R-4 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 AM 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 ANa EER 12 condenser will be installed with TXV(RCA) -JAND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 1 5X3JNone of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ hes stem 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 required. Go to Section 3. 20 ❑ hiss stem is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) Is required. Go to Section 3. 21 WIThis 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. Section 3 - HERS Rater verification 22,%&P 23�f If line 15 is checked, HERS verification Is required for Duct Sealing. If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification Is required for TXV(RCA). 24 ❑ lif line 12, 13 or 14 are checked, HERS verlflcation 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 If less than 40 feet of duct Is being installed or replaced, duct R -value must meet or exceed R-4.2 Section 6 - see next page "— w I V Pagel 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 -1 R -ALT Proje Title: L ov�© CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alteration is made to an existing home Use one form for each system being altered. This is s tem #--/ of systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. installed equipment must match type/location and meet or exceed efticiencles/R-values. 28 Conrguretion4%:. plit system O Package Unit 29 ❑ Ac Handier PGas furnace, AFUE: OHeatpump FAU OHydronic FAU OOther 30 )9P Heat Exchanger 31 Outdoor Condenstrxi Unit Jlil&C 'OHeatpump kfficiency SEER/HSPF• EER d d: 3 cooling or heating coil AWC OHeat um 01-lydronic 33 ❑ Duds ovation: IlLength (ft): R -value: All mandatory measures-appiy 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 sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification byan approved HERS rater. Home Owner Authorized Agent Documentation Author Name: Name: Add ess: City/State/Zip: Address: 4/ Phone: Ci to . Phon�f h. / Signature: Signature• :Z z4oz4z, Enforcement Agency (Building Department). Notes/ mments: Name: Title: Department: Phone #: Fax #: Signature or Stamp: Reauired forms, CFAR-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 CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entire group Version 03-10-06 This form can only be used on projects being verified by CaICERTS certified raters. Page 2 of 2 www.calcerts.com Bin # City of La Quinta Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet PermlVNILa Project Address A. P. Number:Address: Owner's N Legal Descripti City, ST, Zi . .; x.>>::>:::;:r;:>::>:«:>..:i•..:.:i::.,i...v �:�:%r.m:::<.>^`,:^^:4���c<>::,s•N ContractoTelephone: Address: Project Description: City, ST, Zi !/ Telepho : 7�Q J` �j:}i::4 {•r;;::ii�t: iii... >. ;{,:c;r„h<:> :�•: State Lic. # City Lic. C Arch., Engr., Designer: Address: City., ST, Zip: Telephone:Mµ: State Lic. # Name of Contact Person: it's r"v :: i1<i:�•.v� ...f?{<'i riii:•iN:>:•{4f.. }f'4:;n' Construction Type Occupancy . Project type circle one): New Add'n A ter a air Sq. Ft.: # Stories: #Units: Demo Telephone # of Contact Person: Estimated Value of Project: t.,PC) 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 correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees