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11-0234 (MECH).;t - (a P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 1:1--00000234- Property :1-00000234- Property Address: 81672 IMPALA DR APN: 764-270-999-80 -300232- Application description: MECHANICAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 7985 Tit!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: HEFFLER RONALD 81672 IMPALA DRIVE LA QUINTA, CA 92253 ( VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/09/11 Contractor: ( " Applicant: Architect or Engineer: GENERAL AIR CONDITIONING r 31170 RESERVE DRIVE ,R THOUSAND PALMS, CA 92276 l! (760)343-7488 Lic. No.: 686310 ` OF 1AQUIIVrA ------------------------------------------------------------------------------------------------- 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 Fykfessionals 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 Class: C20 License No.: 686310 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: 3� 1 Cot ntrac or. - - _ 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 NER-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 EVEREST NATL Policy Number 7600006147101 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 becosubject 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 shat hwnh 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 ($500).: —Date: 3R /, , _-Applicant: (_) 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 (_ 1 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, 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 f 0' ff' I f related to therkb'n 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: LQPERMIT o La umta, its o iters, agents and emp ogees or any act or omission re a e o work ei g performed under or following issuance of this permit. ' 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 permit to cancellation. I certify that I have read this application and state that the above inf rmation is correct. I agree to comply with all city and county ordinances and state laws relating to building const ctaon, and hereby authorize representatives of this county to enter upon the above-mentioned property for insp ti n purposes. Date: 3& Signature` (Applicant or Agent): t� - F,. Application Number . . . . 11-00000234 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/05/11 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. HVAC & FURNACE CHANGE OUT 13 SEER 2007 CODES. ---------------------------------------------------------------------------- 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 J LQPERMIT Sim lified Prescri tive Certificate of Compliance: -2008 Residential HVAC Alterations CF -IR -ALT -HVAC' Climate Zones 10 to 15 ► Site Address: k Po � .T a.& Dr t ✓-e- Enforcement Agency: La- Qu. : .� Date: 3-F-11 Permit #: Equipment T et List Minimum Efficient 2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Packaged Unit o ❑ AFUE 80 �v ❑ COp Over 40 ft of ducts added orSetback furnace door Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (1j'not already ondensing Unit ❑EER / / ❑Resistance ❑ R 6 (CZ 10-13) sr present, must be ❑ Other ❑ R 8 (CZ 14-15) installed) /. Equipment Type: Choose the equipment being installed: if more than one syslem, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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 work listed 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 sired. Beginning October I, 2010, a registered copy of the CF -IR and CF -:6R shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and fors 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 • Furnace CF -4R forms: MECH-'21 and (for split systems) MECH-25 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. ❑ I. 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 duct systems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: with new • Cut s: al Chang outducting ducts: (all 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 ❑ 3. New Ducts with 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 CF4R 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 Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned space. FRequired 611 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 Author'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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the ' orrn tion documented on other pp" ompliance forms, worksheets, calculations, plans ands specifications submitted to the enforcement a enc fora ro al with t e ermit a lication. Name: Co Cleen WO-IL66� 1 Sig cure: Company: , G�' ,en,eru,( , r Con d� �-, o n , Date: 3- g `� Address: _ n ' 3070 n,eserve_ l�_tt t/e., License: &8(o3/v City/State/Zip:—rkot,-Sl�� pa cc , GR 9���� / Phone: -�60_343_74ek 2008 Residential Compliance Forms March 2010 CaICERTS - CF -1R Registration Page 1 of 1 Home .1fxi�a tie �f'tainirb Rater Director Forms n��m!,«atP tSe.oF,c. Industry Partners To register for our monthly newsletter, please click here. Danielle Garcia logged in [Logout) [Home] CONGRATULATIONS Your CF -I R -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 81672 IMPALA DRIVE La Quinta, CA 92253 CEC Registration: 1211-A001240OA-00000000-0000 CF-IR-ALT-HVAC:jCLICK HERE TO DOWNLOAD Assigned Company:jHARRISON ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -I R to them. CaICERTS Rater ID: OR My Rater Quick Select: The Energuy CA LLC Every CaICERTS rater has a license number. If you need to find the rater by name [Click HERE] to search our directory. SEND CF -1R TO HERS RATER [CLICK HERE] to do another Copyright :x• _010 Ca10ERT3, Inc. All ri his reserved. Rvviscd: ,I:uutaq• 11.'-f110 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us '_ y BBB https://www.calcerts.com/public cflR.cfin?project id=102990 3/8/2011 i Total Permit Fees Bin # City of La Quint'a Building 81' Safqy Division Permit # . P.O. Box 15.04, 78-495 Calle Tampico �n l La Quinta, CA'92253 - (760) 777-7012 \' Buildingg Permit -Application and Tracking Sheet Project Address: 001 t'o7 b�I n _ ald ��r Owner's Name: K A. P. Number: Address: �'I(o 7dL a �a `dam Legal Description: City, ST, Zip: ' g Contractor: Address: 3 City, ST, Zip: Tele hone: ?:}•,....,:..:,.:•} �h>.N,.f%n� �f,:?�< Project Description: .l Telephone: State Lic. # : 3 ?s:: :w}.:{>;.>:«::z:::'•::»;s:;:»> :':`±<>:>:n:= J:•}................:• .ry.Ylf?moi` City Lic. #•: Arch., Engr., Designer: Address: City., ST, Zip: Telephoner }>. {. �• <}''{. ;{i y::n`%}...:.>:..;t 55 `':<s>•�f;`:w`:4 fig.,>:}cZg:,{u: . 2i4>•'+�U ��:?i:}:yti:�;:}ni{�r•?.vfjf+il': t.' + {}:.:. i:L {{.y�.iri�::C •}' :li 5inky State Lic. M �. { uctionTyPe: Occupancy: Project type circle one): New Add'n Alter Repair Demo Name of ContactPerson: Sq. Ft.: # Stories: TV Units: Telephone # of Contact Person: Estimated Value of Project: 78S• oO APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd RWd TRACKING PERMIT FEES Plan Sets . Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance. Title 24 Cafes. 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:- 1rd Review,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P.. Pub. Wks. Appr Date of permit issue School. Fees Total Permit Fees