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08-1711 (MECH)` P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001711 + Property" Address: 1 51925 AVENIDA VALLEJO APN:' 773 -171 -021 -9 -000000 - Application description: MECHANICAL Property Zoning: "COVE RESIDENTIAL Application valuation: .3500 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - Owner: CHICOINE ANNE/DEARBORN TAMMI 51925 AVENIDA VALLEJO ' LA.QUINTA, CA 92253 VOICE (760) 777-7012 . FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/15/08 Contractor: . Applicant: Architect or Engineer: DCS HEATING/AIR CONDIT NC 1281, N. GENE A_UTRY TR, PALM SPRINGS, CA 92262 (760)325-1434: ` I Lic. No.: 595145 • 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._ I -have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License ass: C20 - icense No.: 595145 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit. is M.issued. - ate: 1 ontractor. _ V� 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 -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 Law for the - Carrier NORGUARD INS Policy Number DCWC807689 " following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to d _ .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 Id become subject t he workers' compensation provisions of Section License Law (Chapter 9 (commencingwith Section 7000) of Division 3 of the Business and Professions Codel or , 3700 of the Labo Co shall f t ill�c, mply with those provisions. ' that he or she is exempt therefrom and the basis for the alleged exemption. ,Any violation of Section 7031.5 by // 'jry( any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: l© l� upplicant: ' (_ 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:. FAILURE TO SECURE WORKERS' COMPENSATION 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 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 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 such 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 ing construction, and •hereby authorize representatives .- • of this�cy -iter up he above-mentioned pr e f r in pe i n pur ' ses. Lender's Name: e: gnatura (Applicant or Agent). Lender's Address: - - - LQPERMIT - r Application Number . . . . . 08-00001711 Permit . . . . . . MECHANICAL " Additional.desc' '. Permit.Fee . . . . 19.50 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date,. 4/13/0'9 .Qty Unit Charge Per Extension BASE FEE 15.00 1.-00" 4.5000 EA MECH VENT INST/ DUCT ALT 4.50„ Special Notes and Comments REPLACE DUCT WORK IN ATTIC WITH FLEX DUCT Fee summary Charged.- Paid Credited Due, Permit Fee Total 19.50 .00 .00' 19.50 Plan Check Total'.00 .00 .00 .00 Grand Total 19.50 .00 .00 19.50 'LQPERMIT.. Y _ M INSTALLATION 'CERTIFICATE 12) SCF -6R • 2.' Site Address; Permit Number, % lAti INSTALLER,COMPLIANCE S..ATEMENT'FOR DUCT L-•EAKAGE .:} . r ` INSTALLER COMPLI CE STATEMENT r : ;The building "was ,,✓. estedat.Final' ✓ E]*Tested aCRough-in T {" .t` { • mac;. A+. ' wC" INSWALLER.VISUAL INSPECTION.AT FINAL CONSTRUCTION STAGE: t." GXqtim�hivn oe at least one supply and one return register; and verify that the "spaces between the register• boot and the interior: g wall are properly, sealed: w. " ` _ house rough=in duct.leakage test,was conducted without ari air handler"nstalled, inspect the conriection'points we the aii handler and the supply and return plenums to verify.that the conri6diogpoints are properly "sealed: , spect.all joints to. ensure that no cloth`backed'rubber adhesive dubftape is used ' , + New Distributionsystem 'is full ducted, i.e: `does not use buildin cavities as lenums` or latforms returns in lieu of, y ( g p P, _ ducts UCT LEAKAGE REDUCTION yel, _ E{ Procedures or field vert icatMn and dia nostic testihi o air distributions stems are available'in RACM,YfI end& R0.3 . NEW CONST RUCTIONi,M ... _ '' ✓. Duct Pressurization on Test Results (CFM @ 25.Pa) `' • .r Measured'.. ' `. ++, + , . + Values.'_ _ 1 Eni6 Testedleaka e Flow in CFM: g ,f. �- . t • - `IBM Fan Flow: Calculated (Nominal: ✓PrCooling ✓ ❑ Heating) or ✓ ❑,^Measured. _.'... - 2, If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfiii/(kBtu/hr) z Heating Capacity in Thousands of Btu/li'r outF ut, enter total calculated or�measured fan flow in CFIvI'her ry t -✓ ,3 Pass if Leakage Percentages 6% .fot Final or <— 4% at Rough -in: - �. +' ,_ gip, pass ❑Fail 100 x'Line # 1� `/ '' Line # 2 • ALTERATIONS c uct stem and/or HVAC Equip ment.CHange-Out HW, "� f :' 1. NOW Enter Tested. Leakage Flow m.CFM from Pre Teit.of Existing Duct System Prior"to Duct 4 , ':System Alteration'and/orxEquiprnent Change Out.. �7�7 Enter Tested Leakage Flow in CFM from FinalTest of N,ew Duct.System or Altered•Duct : t Y•? System for Duct System Alteration and/or Equipment Change -Out._. Enter Reduction in Leakage for Altered DucfSystem' �+•'` ?` a 6 (Line # 4 • Minus r Lirie =Onl if A lica6le), it r .7. 'Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)- a ; ✓=r"` ✓, '. 8 Entire New Duct System -Pass if Leakage Percentage <_ 6%'for Final " ` r _ 4 Pass ❑Fail ' 100 x Line # 5 / k ` Line # 2 TEST.OR VERIFICATION STANDARDS. For'Altered'Duct System and/or.HVAC:, Equipment Change- � ✓.• ' .. Out.Use:one' of the followingfour Test or Verification.Stan'dards.for co'm 9' ' Pass if Leakage Percentage 15% .[100 x [ '(Line #.5) / t (Line # 2)]j ,. `-❑ Pass ❑ Fail 10' Pass if Leakage to OutsidePercentage <— 10% [100 x� { (Line #.7) / (Lin(i # 2)]] ❑Pass ❑Fail Pass if Leakage Reduction Percentage >_ 60% [ 100 x r (Line # 6)7/ (Line # 4)]] ' r 1 l and ,,Uerification by,Smoke Test and Visual Inspection ❑ Pass ❑ Fail - 12 Pass if Sealin of all Accessible Leaks and Verification by Smoke Test and: Visual Inspection` • ❑Pass " ❑ Fail ` 'Pass if One of:Lines # 9 throw h # 12 ass .❑ Pass D - Fail Lill, the undersigned, :verify that the above diagnostic test results were performed in conformance with the requirements for compliance credit. •I, the undeisigned,'•also certify that.ihe newly.installed or'retrofitAir-Distribution System Ducts' Plenums anAl d Fans comply with Ma^6dat6ry requirements specified in"Section 150 (9m)) of the 2`005.Buil g Energy_ Efficiency standards: r 0 Installing,Subcontractor (Co Name) OR GeneralVD Contractor (Co. Name) OR Owner, , Signature: .. ti Date: t ;r Copies fo:.BUILDIN DEPARTME ;HERS RATER(IF APi Residential Coinplianc•e•Forms' Y: £! BUILDING OWNER AT OCCUPANCY September 2005 CERTIFICATE "OF .,FIELUNERIFICATION & ,DIAGNOSTIC TESTING (Page lo Project�Address Measured ' Builder Name,-, . ,= � Values rA Enter -Tested Leakage Flow in CFM: r `' • .` ' _ � w ~ �, 2' Fan Flow: Calculated (Nominal: ✓, ooling ✓. ❑ Heating) or ✓ ❑ Measured' r. Builder Conta6t7 Enter TotalFan Flow. in CFM: '' �4 Telephone+ Plan Number 3 " Pass if Leakage Percentage <_ 6% ? [.100 x [ (Line # il) / (Line # 2)]]. ��,. � ... � . ❑ Pass 0:Fail ALTERATIONS Duct Sys0h and/or HVAC' Equipment Change -Out HERS Rate Enter Tested Leakage Flow in CFM from CF -6R: Pre=Test of Existing Duc System`Prior to Telephone Sample Group Number' 4 G .� ... 09 a %� -7a Enter Tested Leakage Flow iri CFM:, Final Test of New Duct System or Altered Duct System Corn liance.Method Prescri tive ,- 5' Climate.Zone ..: Certify' g Signature ate Sample House Number ' ' �:. p 4 - Firm,= - ; HERS Provider Tested Leakage Flow in CFM to Outside- (Only.if Applicable),t ' ' �`� 4 ^ 8 Entire New,Duct System-;PassifLeakage Percentage S`6% r • r. , Street AddresS. „' City/State/Zip...,t ' .. - •.. rs - is ;Z - '«� .t `. 9 - " Copies to: BUILDER; HERS PROVIDER AND.BUILDING DEPARTMENT.; '•HERS RATER CO LIANCE STATEMENT Thehouse was: ✓ -Tested ✓q ❑ Approved aspart of sample testing, liut'was ~noftestedAs the HERS rater rovidin' dia nostic testing t p g _g, g and field-Lerification, I certify that the house identified on this fo'rm'complies with � ;N - the diagnostic'tested compliance requirements as checked ✓ on. his form: The HERS rater must check and. verify that the new_ distribution, system is. fully ducted and correct.tape is used beforea CF4R may be released on every, tested building. - The HERS;-. rateum t not release tfieCF 4R until a properly completed and signed CF -6k has been received fortheaample and tested"" build' - .{ ;_ I : i' IYO +l he installer has provided a copy'of CF -6R (Installation Certificate). �' - '• New Distribution system is fully,.ducted (i.e., does not -use building cavities as plenums or -platform returns in lieu of ducts). , NKimbination ystems where. cloth backed rubber adhesive.duct tape is installed, mastic and"draw Bands are used'in with cloth backed;;rubber adhesivetduct tape to seal leaks at duct connections:, ✓EVMINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT i 'procedures for'field verification and'diagnostic testing of air'distribution systems'are available in RACM, Appendix RC4.'3 Duct Diagnostic Leakage Testing$Results NEW CONSTRUCTION: Duct Piessurization Test Results,(CFM"@'25 P) ''' {�� t. _ •,1'. Measured ' . ,= � Values 1 Enter -Tested Leakage Flow in CFM: r `' • .` ' _ � w ~ �, 2' Fan Flow: Calculated (Nominal: ✓, ooling ✓. ❑ Heating) or ✓ ❑ Measured' r. Enter TotalFan Flow. in CFM: '' �4 ✓ ✓ 3 " Pass if Leakage Percentage <_ 6% ? [.100 x [ (Line # il) / (Line # 2)]]. ��,. � ... � . ❑ Pass 0:Fail ALTERATIONS Duct Sys0h and/or HVAC' Equipment Change -Out Enter Tested Leakage Flow in CFM from CF -6R: Pre=Test of Existing Duc System`Prior to e 4 Duct System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow iri CFM:, Final Test of New Duct System or Altered Duct System 5' for, Duct System Alteration and/or'.E merit Clian •`' ui e=Out ' Enter Reduction in Leakage'for.Altered Duct System [ (Line # 4) •Minus (Line #:5)].- 4 6 (Only if Applicable).. ..7 .,Enter Tested Leakage Flow in CFM to Outside- (Only.if Applicable),t ' ' �`� ✓. ✓ '' 8 Entire New,Duct System-;PassifLeakage Percentage S`6% r • r. Pass ❑ Fail 100 x Line # 5 /' ' Line # 2 TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out ✓ Use one of the following four Test orNerification Standards for compliance: 9 Pass if Leakage Percentage < 15%o [100. x [ (Line #•5)'/ r (Line # 2)]] ❑ Pass,0 Fail 10 • Pass 'if Leakage to Outs.'ide' Percentage _< 10%'11 00 x [ r'' (Line # •7) / r '(Line #, 2)]] ❑.- Pass Q Fail Pass`if Leakage ReductionTercentage >_ 60%, 100 x [ Le #,6). /. (Line # 4)]] : ' 0 •Pass ❑ Failn 11 and Verification by Smoke -Test and Visual Inspection 12 - Pass if Sealing -of all Accessible Leaks.and Verification b Smoke Test and Visual Inspection _ ❑Pass ❑ Fail` } Pass if One of Lines # 9 through # 12 pass A ° •£ ❑Pass .❑ Fail Resideiitial Compliance Forms r ' ` Apri12005 Bin # City of La Quints Building 81 Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # r7 1 Project Address: Owner's Name: U A. P. Number: Address: )W Legal Description: Contractor: City, ST, Zip: /1A "�', Telephone: 2 , �ei2 T Address:�� Project Descrip ion: City, ST, Z• IVl yl NloldvVdI/ " Telephon Q State Lic. # : 5 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one New Add'n Alter Repair Demo Name of Contact Person:jwk Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd 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 Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Jnd 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