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0305-022 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12'-OOO:OQ6547— Property Address: 79�8�53 PPcRKWP__yESPLANADE APN: 609-600-015- - Application .description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3859 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: S MARY ANN KLAUS 79853 PARKWAY LA QUINTA, CA ESPLANADE SOUTH 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/12/12 • . ... Contractor:.. Applicant- Architect or Engineer: PREFERRED PLUMBING H/C P O BOX, 512 0 !t PALM `SPRINGS,. CA 92263 f 1. 2 �® (760)i322=3173 Lic. No.: 457554 -+LICENSED CONTRACTOR'S DECLARATION' WORKER'S COMPENSATION DECLARATION hereby affirm under penalty -of perjurythatd•am:licensed under provisions of Chapier'9'(commencing :with I.hereby affirm under penalty of perjury one of the following declarations. Section 7000)'of Division 3 of the Business d,Professionals Code, and my License is in full force and effect. - 1have and will maintain acertificate of corisent,to self -insure for workers' compensation, as provided _ License Class- C10 C16 C2 •'457554 for by.Section 3700 of the. Labor Code, for the.performance.of the work for which this permit is •issued. Date: �ZWContractor: _ - -' 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 �WJN-�BUILDERDECLAR.ATION insurance carrier and policy number are: - - I hereby affirm'under penalty of perjury that I am exempt from the Co ntractor's'State License Law for the Carrier EVEREST NATL Policy Number ' 7600006445121 . 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, alw;-improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the person. in any manner so as become subject to the workers' compensation laws of.California, permit to file a signed statemen4.that he or. she.is licensed, pursuant'to the provisions of the Contractor's State and agree that, if I shout ecome subject to the .w rs'- compensation ptovisions`'-of'Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor-Ccd shall torthw' mpl wi th - e 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 than4ly' e -hundred dollars ($5001.: Date���— plicant: (_ 1 1, as owner of -the ,property, or my employees withwages as'their sole compensation, will do the work, and -' - the:structure isnotintended'or.offered for sale (Sec. 7044 :.Business and. Professions Code: The WARNING: FAILURE"TO SE RE WORKEUALTI PENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner ofproperty who.builds'or'improves thereon, .SUBJECT AN EMPLOYER TO CRIMINAL'.PAND CIVIL'FINESUP TO ONE HUNDRED -THOUSAND , and who does the work himself or herself through his,or her own employees,zprovided that the D6LLARS'($;t00,000).- IN ADDITION TO'OF. COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements'are not intended or offered for sale. If, 'however, the buildirig or improvement is sold within SECTIOM3706.OF THE LABOR CODE, INTEREST, ANDIATTORNEY'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 I, as owner oftheproperty; 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) kensed 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. 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 abov i orma[ion is correct. I gree 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 structiona ereb u orize representatives of this county to enter upon the above-mentioned property f inspe -ps. Lender's Name: Date497� S' ature (Applicant or Agent): \ Lender's Address: LQPERMIT LQPERMIT - Application Number . . . 12-00000654 Permit . . . MECHANICAL Additional desc . Permit:Fee . . . . 31.50 Plan Check Fee 7.88 Issue.Date . . . . Valuation . . . . 0 Expiration Date 12/09/12 Qty Unit Charge Per Extension BASE FEE15.00 '1.00: 16,.5000 EA -MECH B/C >3-15HP/>100K-500KBTU 16:50. Sp.ecia-1 ;Notes.,and ment,s ,gor .HVAC CHANGE: CONDENSER. 2010 CODES ------ ---------------------------------------------------------- Other 4Fees Other4Fees BLDG'` STDS• `ADMIN (SB1473) -------- ------- 1.00 Fee sinmary Charged . Paid . Credited . D,ue -•----- ------_-. -. ----------- ---------- -- ----- Permit 4Fee Total, .31.5.0, . 00 .00 31f:`50 i P1an,Check`.:Tota1 7.88 .00 Q0.' 7.88 Other.- Fee -Total 1. 00 00 0'0 1.00 .'Grand. Total"': 40.38 .00 0.0 40,.38, LQPERMIT - Simplified Prescriptive Certificate,of Compliance:2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address:En -7 )PA 164q uJ. orcement A ency: A f Is' Date: Permit #: Conditioned- Floor Equipment T e' List Minimum Efficienc • Duct insulation requirement Area Thermostat ❑ Packaged Unit ❑ Furnace ❑ _ ❑ COP 'Over 40 ft of ducts added or replaced in unconditioned space Served by system etback (If not already ❑ I or Coil E ER ER ❑ HSPF ❑ R 6 (CZ 10-13) Z� �sf must be ondensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) present, installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACjor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. 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 worklisted 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 si ed._Beginning October 1, 2010, a registered co of the CF -1R and CF4R' shall also be on, site for final inspection. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF,6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH- 25 -HERS (for CF -4R forms: MECH- 21 and s lits stems MECH-25 _ • Condenser Coil and/or • Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS 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: 0 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 ducts stems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut s: Changeout with new ducts: ' (all l new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22=HERS, and MECH-25-HERS new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 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 113. New Ducts with Replacement Required Forms: • Includes replacing or iristalling 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 Packa ed'Units: Duct leakage < 6 percent . ❑ 4. New D,uctin ,over" 40 feet Required Forms: • Includes adding or replacing mole than 40 linear feet of duct in unconditioned space. CF -6R forms:',MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation A'uthor's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 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 andspecifications submitted to the enforcement a ency for approval with the permit application. Name:Err �� ��.s/ _'.� Signature: Company:-R��� � /"���I� ��tT I ► � � fti � . Date: Address:PQ �d �� Z C Licenser City/State/Zip:' PAW(p S Phone:Q ., c �.,-. -�-3 2008 Residential Compliance Forms March 2010 d7Yii .a r Bin # Citj of La Qu n' to Building 8i Safety, Division P.O. Box 1504, 78-495 Calle`Tarnplco Permit,# La Quints, CA 92253 (760) 777-7012 1:.� Building Permit -Application and Tracking Sheet . Project Address 7 7 rf �A �(N►S N de-.�'� Owner's Name: /y A A. P. Number' Address: 7th g'� �� ��/ S, Legal Degcription t City, ST, Zip: 44 (,w1•P 1A. Ch1' 3 prefrlec Asir s4onditiorii'ng dba Contiactor pr.e.fer.re:d: P..1uinbin Heat.in &A'iTelephone: Address P0. Bp5120j Project Description: f �QjvQ67ilS City; M',Zip Palm,pr_ings% CA 92263 Telephone (76Or) 32-3173 StateLic:#: 4,57654 CityLic:#: Arch,; Etigr. Desigc er Address. ' City..ST:,ZtP Telephone:. Construction ype: Occupancy: State :Lit # 'Project type. (circle one): New Add'n Alter Repair Demo Name 0f Contact Person aE LC ✓d'7V S Sq. Ft.: # Stories: # Units: #''fC 1;3�.'Z'.VI A, Esti t .A V.1 P ��d�0a� Telephone•.,: Q- _ •o - tac . _ ersoq ma,e ue o ro�et c . A ...APPLICANT: DO NOT WRITE BELOW THIS LINE # . Sabm(ttal Reg'd Reed ; TRACKING ' Plan Check gditltted It Structural:.Calcs.,:.:. Reviewed, reedy for corrections PI Called Contact Person PI Energy Celcs. ° Plans ticked up G Flood plain plaq, Plans.resubmitted M Grading plan' :.' . 2°d Review, ready for corrections/issue EI .. $ubeontactorlfst- Called Contact Person Pi Grant Deed .: ` Pians picked up Sa H,U A APProy9L Plans resubmitted Gi IN;130USE: ''d Review, ready for corrections/issue De Plaurting Apprtryal: Called Contact Person A.] . Pub: Wks. Appr ' Date of permit issue . k School Fees PERMYT FEES Amount Check Deposit Check Balance truction ianical rical bang ing oper Impact Fee . Perrult Fees ��r