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11-0222 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: :11700000222-) Property Address: 78181„AVENIDA LA FONDA APN: 770-125-003-82 -000000- Application description: MECHANICAL Property Zoning:- LOW DENSITY RESIDENTIAL Application valuation: 800 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT — — — — — — — — — — — — — — — — — — — — — — — — — — — - — — — — — — — — — — — — — — — — ` LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my.License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by a^��pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS 5001.: ( 1� I, 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within 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.). 1 _ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reaso Date 7j[hE_/-Owner: CO STRUCTION 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/04/11 Owner: FISCHER MICHAEL A Contractor: Owner --------------- c�?0j WORKER'S COMPENSATION OEOtol roKGO 1 hereby affirm under penalty of perjury one of the following declarations: ^^'�`.�� I have and will maintain a certificate of consent to self -insure for worcompens ion, as provided for by Section 3700 of the Labor Code, for the performance of the work f'o`rt h this permit is 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 insurance carrier and policy number are: Carrier Policy Number certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become su kers' compensation provisions of Section / 3700 of th ab or Code, I f ith comply with h %cose provisions. Date: ! pplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of BuildingandSafety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, 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. 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 th rmation is correct. I agree to comply with all city and ounty ordinances and state laws relating building constru ion, and hereby authorize representatives oft ' .,co, enter upon�ttfe abov opeMy for inspe on purposes. Application Number . . . . . 11•-000.00222 Permit MECHANICAL Additional desc . - Permit Fee . . . . 51.00• .Plan Check Fee 12.75 Issue Date . . . . Valuation 0 Expiration Date 8/31/11 Qty -Unit Charge Per Extension BASE FEE 15.00' 2.00 9.0000 EA MECH.FURNACE <=100K 18.00 2.00 9.0000 EA -MECH B/C <=3HP/100K BTU 18.00 ---------------------------------------------------------------------------- Special Notes and Comments . A/C CHANGEOUT TO WALL UNITS IN APTS. 3 & 4. 2010 CODES. ------------ - ----_-_------------------------------ Other Fees . . . . BLDG-STDS ADMIN (SB1473) - 1.00 Fee summary Charged -Paid Credited Due Permit Fee Total 51.00 .00 .00 51.00 Plan Check Total 12.75 .00 .00 12.75 Other Fee Total 1.00 .00 .00 1.00 Grand Total 64.75 .00 .00 64.75 LQPERMIT Prescriptive Certificate of Compliance: Residential CF -1R -ALT - Residential Alterations (Page 5 of 5 l Project(,1Aame: e/ /O r-z��alA � Climate Zone # . � f Stories AW Ival HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -41? Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Te, Ong HERS verification is required for this measure. D YES El NO YES: In mate Zones 2 and '-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, t ucts are to a sealed per §I52(b)1Dii and the newly installed ducts are to be insulated per §151(010. Q EXCEPTION: g duct s' ems that ar etlilecT, wh ci h are constructed, insulated or sealed with asbestos. YES NO YES: In Climate nes 2 a 9- ngast4 paconditioning system (HVAC equipment and ducting) is replaced, the ducts re to b sealed er § I 1 D Q YES NO YES: In Cli Zo es 29 16, if t ; 'tin�HVAC �replaceduding the replacement of the air handler, outdoor o Sing it of a split yste cooling or heaheat exchanger) the ducts are to be seale §1 (b)1 CEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigera t harge -Split System HERS verification is required for this measure. Q YES O YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per 152(b)I F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of § I50(o) do not apply to existing residential homes. Ducted Split stems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. Q YESO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per § 152(b)1 Ci to meet the requirements of § 151(f)7B. 'Documentation Author's Declaration Statement • 1 certify that this Certificate of Compliance documentation is accurate and complete. Name: M�� [ S �� Signature: Company: Date: Address: �/' /�'� U!4 6) If Applicable CEA orE]CEPE [ l/ (Certification #): City/State 'p: Vim' �� . _ vl fid. Phone: Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building 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. building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and submitted to the enforcement agency for approval with this bu'Idin ermit anolication. Name:+ Signature *- Company: Date: Address:� /� � �� AVA-V License: City/State/Zip. (/ Ph one: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Registration Number: 2008 Residential Compliance Forms Registration Date/Time: HERS Provider: August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations (Page 1 of 5 Project Named _Climate Zone # # of Stories - . - 1 l t of � &&� 1 S__ 5;^1W, General Information Site Address: !6 (8 lA �I17A �A Enforcement Agency: Date: Building Type (©Single Family Multi Family Circle the Front Orientation: N, E, SW)or degrees Conditioned Floor Area (CFA): 2ORReplacement Project Type:'' : Alterations i- EnvelopeLJ Fenestration . Roof. HVAC Tag/ IDS or Change Out 7 Duct Replacement 0 Water Heater NOTE: This form is not to be used for Newly Constructed Buildings or Additions Insulation Values For Opaque Surfaces (for. Furring use the Mass and Furring Strips Construction table below) Assembly Alteration Opening of framed cavity alone—Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H. Q Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package- D insulation values in Table 151-C. Fill in Columns A —J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. A B C D E F G H 1 J Proposed See Note Standard Values From JA4 Table Tag/ IDS Assembly Name or Type 2 Framing Thickness; Material Spacing, and Size2 or Other3 U- factor Framed Continuous JA4 Table Cavity Insulation Numbers R-value6 R -Value? JA4 Assembly Cell Value Proposed Assembly U-factor9 :° T7 Assembly v N o = t $ o F U_. F- `o ,,, t� > > Final Mass Name or JA4 Table Note: For furred assemblies, accounting for Continuous lnsulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and Furring Construction table below. 1. For Tag//D indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... Indicate in column G the Frame material and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24 "OC; or Other for all other assembly description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4. Based on the Climate Zone; enter the equivalent U factor found in JA4 Table based on the R -Value from Table 151-B, C or D 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0". 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0". 8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J 9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply. Furring Strips Construction Table for Mass Walls Onl A I B I C I D I F G H I J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5, 4.3.6, 4.3.7 Joint Appendix Table 4.3.13 :° T7 Assembly v N o = t $ o F U_. F- `o ,,, t� > > Final Mass Name or JA4 Table E E o v Assembly Thickness' Z Type Numbe ¢— = U-factor6.7 Comment Registration Number: 2008 Residential Compliance Forms Registration Date/Time: HERS Provider: August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations (Page 4 of 5 ProjectN e: Climate Zone # # of Stories 'HVAC SYSTEMS - HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all component packages in all climate zones. Minimum Duct or Piping Configuration Heating Equipment Efficiency Distribution Insulation Thermostat (Central, Split, Type and Capacity" 2,3 (AFUE or HSPF) Type and Location" R -Value Type Space, Package or H dronic) c N Sh Water Heater Type/Fuel Type' l1, 0do Number In System 1. Ind cate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.) 2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity < 2 KW or 7,000 Btadhr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(6)3 exception. 3. Refer to the HERS Verification section on Page 4 of the CF -1 R -ALT Form for additional requirements and check applicable boxes. 4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc) .HVAC SYSTEMS - COOLING Minimum Efficiency Duct or Piping Configuration Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central, Split, T e and Capacity 1•2 COP) Type ano Location R -Value Type S ace, Pack a or H dronic 0 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank and pipes shall be insulated to meet the requirements of §1506). 1 1. Indicate Cooling Type (A/C, Heat pump, Evap. Cooling, etc) 2. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes. 3. Indicate Type or Location (Ducts, H dronic in Floor, Radiators, etc. WATER HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all component packages in all climate zones. External Tank Water Heater Type/Fuel Type' Distribution Type (Standard, Recirculating)Z Number In System Tank Capacity (gal) Energy Factor or Thermal Efficiency Insulation R-Value3 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank and pipes shall be insulated to meet the requirements of §1506). SPECIAL .FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written 'usti ication and documentation and special verification. NEW ROOF ASSEMBLY - Radiant Barrier The radiant barrier requirement of $151 2 does not apply to roof alterations. Slab Edge (Perimeter) Insulation F.1 YES Q NO YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required. Heated Slab Insulation i YES QNO YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation UYES [:] NO YES: In Climate Zones 1, 2, 11, 13, 14 & 16, R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D. Thermal Mass To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach. Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009 PERFORMANCE 1 WINDOW OPENING X• E _ m LL m m N X - L N_ � m C71 Oi O > O N 2QU2R 01 D) C C tm O) G C C .2 QfC NA ZT C C y 2 O co N L C '75 �OA , O) UC O m 2C a U U y G mUL C C Om . O CC N od G y y m 0 mm UJ c a o v a �2 W U m m W Q. Q i Q Q y d cc Q Q Il Q (n Q �j 2 m 2 m Z WINDOW AIR CONDITIONERS AZ3R05F2A N 150 5000 - 9.7 0.8 118 115 4.8 - 515 - 10 A N 2 Way 2 N N M 16'/ 13'/ 12 5/6 16'/2 - 36 13 34.2/39.7 AZ6R05F2A N 150 5000 - 9.7 0.8 118 115 4.8 - 515 - 10 A N 2 Way 3 Y N 16'/4 13'/ 12 5/6 16'/2- 36 13 34.2/39.7 AZ7R05F2A Y 150 5200 - 10.7 1.1 147 115 4.5 - 485 - 10 A N 2Way 3 Y N ' 16'/ 15'/4 12'/6 16'/z 36 13 38.6/44.1 AZ6RO6F2A N 200 6000 - 9.7 1.3 147 115 6.1 - 620 - 10 A N 4Way 3 Y N * 16'A 15% 12 5/6 16'/2- 36 13 39.7/45.2 AZ7R06F2A Y 200 6000 - 10.7 1.3 147 115 5.4 - 560 - 10 A N 4 Way 3 Y N * 16'/4 15'/ 12'/6 16''12- 36 13 46.3/52.9 AZ6R08F2A N 340 8000 - 9.8 1.7 224 115 7.4 - 815 - 10 A Y 4 Way 3 Y N 19 !/ 15'/ 12% 21 15/6 - 36 14 46.3/52.9 AZ7R08F2A Y 340 8000 - 10.8 1.7 224 115 7.0 - 740 - 13 A Y 4 Way 3 Y N ' 19'/a 15'/ 12% 19%-36 14 59.5166.1 AZ6R10F2A N 450 10000 - 9.8 2.4 295 115 9.4 - 1020 - _13 A Y 4 Way 3 Y N * 1911/6 19 14'/ 22'/,6 36 14'/ 58.4165 AZ7R10F2A Y 450 10000 - 10.8 2.7 295 115 8.8 - 930 - 15 A Y 4 Way 3 Y N * 19 "/6 20'%6 14'/4 19 "/,6- 36 14'/4 82.7/91.5 AZ7Y12F2A Y 550 12000 - 10.8 2 280 115 9.7 - 1110 - 15 A Y4 Way 3 Y Y * 22% 21 '/6 15% 22'/6- 36 16'/ 82.7/90.4 AZ7Y12F7A Y 550 12000 - 10.8 2.2 280 230 4.9 - 1130 - 15 B Y 4 Way 3 Y Y 22% 21 '/6 15% 22'/s - 36 16 % 99.2/111.4 AZ7Y15F24 Y 800 15000 - 10.7 3.8 460 115 12.0 - 1410 - 15 A Y 4 Way 3 Y Y * 23% 251/2 17'/,6 23'/1- 40'/ 18'/2 105/119 1000 AZ7Y18F7A Y 18000 - 10.7 5.5 460 230 7.7 - 1730 - 15 B Y 4 Way 3 Y Y 23 5/ 25'/2 17'/6 23'/6 40'/z 181/2 122.3/136.6 AZ7R24E7A Y 1400 24000 - 9.4 8 530 230 11.6 2660 20 C Y 4Way 3 Y Y * 26'/6 26 5/ 18'/ 26 "/,6 42 19 73.2/80.9 HEAT/COOL WINDOW AIR CONDITIONERS AZEY08F2A Y 340 8000 3500 10.8 1.5 280 115 6.6 8.9 740 1050 13 A Y 4 Way 3 Y Y 22% 21 7/6 15'/ 227/a- 36 16'/4 73.2/80.9 550 22 5 21 1 s AZEY12F7A Y 12000 11000 10.82.2 _ L 280.230 _ 4.9 15 1130. - _ 3500 ._ 20 ._ C .� .. Y 4 Way 3 Y . Y * 15% 22'A - 36 16'/4 85/92.5 Y 1000 18000 22 Y .� * 235/ , 25''A 17'/,6 AZEY18F7A 16000 9.7 -9.7- 5.5 460 230 8.4 1900 4900 25 D Y 4Way 3 Y 23'/6-40'A 18'/2 105/119 AZEY18F76 Y 1000 18000 10200 5.5 ! 460 230 8.4 15 1900 350_0 20 C Y 4 Way, 3 Y Y 23% 25 %z 17'/,6 23'/6- 40'/2 18'h 105/119 AZER24E7A Y 1400 24000 16000 9.4 8 530 230 11.6 22.5 4900 25 D Y 4 Way 3 Y Y * 26 9/16 26 5/a 18'/ 26 "/6- 42 19 128/142.2 THROUGH -THE -WALL AIR CONDITIONERS AZ7T08W2A Y 340 8000 - 9.4 1.8 283 115 8.0 - 850 - 10 A N 4 Way 3 Y Y ** 241/6 20'/ 14'/2 N/A N/A 59.5/70.6 - AZ7T10W2A Y 450 10000 - 9.4 2.6 283 115 9.8 - 1060 - 15 A N 4Way 3 Y Y ** 24'/16 20'/ 14'/2 N/A N/A 65/75 AZ7T10W7A Y 450 10000 - 9.4 2.8 295 230 5.1 - 1060 - 15 B N 4 Way 3 Y Y '* 24'/16 20'/ 141/ N/A N/A 60.6/70.6 AZ7T12W2A Y 550 12000 - 9.4 3.3 295 115 11.1 - 1240 - 15 A N 4Way 3 Y Y ** 241/16 20'/ 14'/ N/A N/A 67.3176.1 AZ7T12W7A Y 550 12000 - 9.4 3.5 295 230 6.3 - 1270 - 15 B N 4Way 3 Y Y 24'/6 20'/ 141/2 N/A N/A 68.4/78.3 AZET12W7A Y 550 112000 10600 9.4 3.5 295 230. 6.0 15 1330 3450J 20 C N 4 Way 3 Y Y ** 24'/16 20'/ 14 %: N/AN/A 72.8/82.7 AZ6T14W7A N 700 14000 - 9.0 4.3 31812301' 18 230 7.4 - 1550 - 15 B N 4Wa 1. 3 Y Y ** 24'/16 20'/ 141E N/A N/A 68.4/79.4 < • THROUGH -THE WALL AIR CONDITIONERS FOR A/B SLEEVES AZ7A09W2A - Y - 400 - 9200 - 9.8 2.4 280 115 8.6 - 940 - 15 A N 4Way 3 Y Y ** 26 16'/6 15 5/ N/A N/A 84/97 AZ7Al2W2A Y 550 11800 - 9.4 32 280 115 11.6. 1260 - -- 15 , A - N 4Way 3 Y Y ** 26. 16'/6 15 % N/A 84/97 AZ7Al2W7A Y 550 11800 - 9.8 3.2 280 230 5.6 - 1200 - 13 B N 4Way 3 Y Y ** 26 16'/a 15 5/ N/A _N/A N/A 84197 PORTABLE AIR CONDITIONERS = '` Q' AZ6P09S2A N 400 - 8.8 3 185 115 9.5 - 1080 - 15 A N 1 Way 3 Y - '*' 17'/6 151E 31 5/6 N/A N1A 66/75 b _9000 AZ6P12D2A N 550 12000 - 10 4 235 115 10.8 - 1300 - 15 A N 2 Way 3 Y - «*** 18'/ 18 5/6 36 5/ N/A N/A 79194 _ . - • AZHP12D2A N 550 12000 11000 8.7 4 235 115 10.8 11 1300 1250 15 A N 2 Way 3 Y '*** 18 76 18 5/6 36'/ N/A N/A 79/94 4 Note 1 The square feet of cooling area listed is based on average room conditions in a moderate climate. Some exceptioins are kitchens (add 4,000 BTU), high ceilings or unusual floor 1plans = increase 10%), warmer climates increase 10-20%). ADDITIONAL FEATURES M Mechanical control, no remote control. * Full function remote control, 24 hour timer on-off, Sleep mode, Energy Saver mode, LED display, C/F display change, Filter check (250 hours), Auto -restart function, Operation Mode: Cool/Fan/Dry/Auto, Easy mount window kit ** Full function remote control, 24 hour timer on-off, Sleep mode, Energy Saver mode, LED display, C/F display change, Auto -restart function, Operation Mode: Cool/Fan *** Sim le remote control, 12 hour timer on-off, LED display, Auto -restart "** Sim le remote control, 24 hour timer on-off, MUM— restart C Models and specifications are subject1 change without notice.1/- 4.+s4xt11 ?i1Vif t�itlii �Tti t`�electroniccontrols 1 control 1 1 otherwise. 230vmodels 208/230 volt and specificationsd are at 230v. www.fedders.com P.O. Box 1504 A QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 PROPERTY OWNER'S PACKAGE FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits I0"TAIWI NOTICE TO PRQPERTY OWNER Dear Property Owner. An application for a building permit has been submitted in your. name listing yourself as the builder of the property improvements specified at We are providing you with an Owner -Budder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of Back provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OVWER'S ACKNOWLEDGMENT AND VERMCATTON OF WORNA N DIRECITONS. Read and initial each statement below to signify you understand or verify this information. . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I.. as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. _�V`. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. V 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on- permi icontracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 6. I understand if I am considered an "employee' under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide woikers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. Iunderstand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. �8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personalWyuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employee" from the li*"al Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand 1 may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. Z10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially tespOusibbfor pr Me constructio clivi at the following address: �I I. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders w well as employers. °V 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does riot have a license, be Contractors' State License Board may be tenable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for You to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property; you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Coe tors, YOU will be responsible for verifying whether or not those Contractors are property licensed and tate status of their workers' compensation insurance coverage. Before a building permit can be issued, oris form must be completed and signed by the property owner and returned to the agency responsible for issala tie permit. Note: A copy of the property owner's driver's I&Mc i faux xetaedpOl M or other verifccation acceptable to the agency is rigaired to,,be,presented when tke permit is isrued to verify the property owner's signature. Signature of property owner Z Date:V514 ILI Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHAL Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): �L� �� G� A l (�J//1Y�� U t , ►-� Project Location or Address: -n l �4 !/-C L,/� ��'�it�J/A a1� Name of Authorized Agent: [ )b1___[ (SG�t Tel No 7 /y ��� Address of Authorized Agent: Oma` 7 `% �&fln o Na /L/' fOGV 4 ?)- k3 I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A co driver's license, form notarization, or other verif cation acceptable to the agency is required to be .ted when the pe it is issued to veriVtheproerty owner 's signature. Property Owner's Signature: Date: Bin # City of La Quinta Building 8r Safety Division P.O. Box 1504, 78.495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 1 1 :Project Address: U ' �—a7pd�r ame:� L ��� S� A. P. Number: ip: Contractor: ? 3jla>:>::>:<:'•.;•`;':?:<::>r> Address: Project Des6ripti6n*'&VA City, ST, Zip:• <v:<<>:»::: Telephone:::<:>:.;>:r>:;.i;::.i:.::::;;:.;;:.:;•.:.:.:: t-A AIA U dV AD State Lic. #.: City Lic. #; Arch., Engr., Designer:Ufl oxi Address: EIM 6 VO IR 0 IeS(O I✓A �G, I Y� �� "G 1 City., ST, Zip:D. 0- G (- C L r �v �C r Telephone: «:>::z:.>wY::::':•':?> ''?:`•°>.,f::»>:a: X•:i:4:•$iri:ti •:ii•i:ii:4 •::»>:<.:::fi:::::::<.<. •�ti;:;:;;G:v::+:ti:±':SL'i:!:vriJ'::�lii::n'i}�:i� <::«:<>•>>::>:>.;;::;> •`•:N<::::#z::>;:s:'.>:»:z<%->:::<:.>:>:i;' Construction Type: Occupancy: 1�� YV Project type (circle one): New Add'n . Alter Repair Demo State Lic. #:: Name of Contact Person:e / Sq. Ft.: �� # Stories: s"f L # Units: Telephone # of Contact Person: Estimated Nalue of Project: , DO 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