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13-0717 (MECH)P.O. BOX 1504 78-495 CA LLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000717 Property Address: 51750 AVENIDA DIAZ APN: 773-161-001-24 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 2000 Applicant: Architect or Engineer: 44 BUILDING & SAFETY DEPARTMENT i� BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licens nder provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a rof si aIs Code, and my License is in full force and effect. License •lass:`B-/C336-C20 License No.: 704414 fZate: &— V OContractor: WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I Jexempt 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 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.). (_) I, 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 1 I am exempt under Sec. , BAP.C. for this reason 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: LOPERM IT Owner: LAUNETTE CAPULLI 51750 AVENIDA DIAZ LA QUINTA, CA 92253 ( VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/06/13 Contractor: D a RELIABLE ENERGY MANAG T, IN Jl�� 0 f Z01� 7201 ROSECRANS AVENUE 6 PARAMOUNT, CA 90723 (562) 984-5511 CITy0F Lic. No.: 704414 eurAf. — UINTA i WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ,, issued. 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 STATE FUND Policy Number 9039439 I 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 beco s bject to the workers' compensation provisions of Section 3700 of the Labor C e, sIt fo with comply with those provisions. Date: ��� Applican� 91 WARNING: FAILURE TO SECURE WOR ERS' 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 Building and Safety 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 the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building truct' d hereby authorize representatives of this county to enter upon the above-mentioned property r spe on f rp ,0te: _Jo �J Signature (Applicant or Agen ): Application Number . . . . . 13-00000717 Permit . . . . . . MECHANICAL 2013 Additional desc . Permit Fee 35.75 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 12/03/13 Qty Unit Charge Per Extension. 1.00 35.7500 EA MECH FURNACE 35.75 -----=---------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT (1) HEATER ONLY FOR A 3 TON 78AFUE SPLIT SYSTEM. [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPCTION. 2010 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 23.83 Fee summary Charged Paid Credited ----------------- Due ---------------------------------------- Permit Fee Total 35.75 .00 .00 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 115.40 .00 .00 115.40 Grand Total 151.15 .00 .00 151.15 I,Qrr warm 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 # Project Address:.51750 Xag1J1,14 I/J Z Owner's Name: A. P. Number: 1- ©C) j Address: 7Z— Legal Description: Legal City, ST, Zip: Z* (� a.2 S`3 / Contractor: eI �`f� �� SIV pe Address: 7 eCho�y„�S roject Description: City, ST, Zip: /9✓/`Fm o ti %67 3 rxq Telephone: s State Lic. # ; Q / City Lic. #; e Arch., Engr., Designer: LQC D� Address: City, ST, Zip: j ' •Y: •:y:ii:}':•i:4.�}4 �ii:ii�i::iSt SnTelephone: State Lic. #: Construction Type:S Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: 410 44 C I Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 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 Tide 24 Cities. 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 correctlonstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 5 i led, Prescrlptiye Certificate: of Compliaitcec 2008 Residential AC :4tteratiolts Zones 10 to 15: C F -i R -ALT -HVAC S/te Address Enforcement agency: Date: Permit #: 6�/3 sr 7 (_ Conditioned Floor _Lquipment Type' List Minimum Efficiency' Duct insulation requirement 12Z 9 Area Thermostat O Packaged Unit Fumace Q O AFUE42 % O COP Over 40 ft of duds added or O Setback replaced in unconditioned space Served by system (If not Indoor Coil OSEER O HSPF already O Condensing Unit O EER O Resistance OR 6 (CZ 10-13) 1 zz sf present. must be O Other O R 8 (CZ 14-15) installed) I Equipment Type: Choose the equipment being installed: if more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER. 78%AFUE, 7.7HSPFjortypical residential systems. HERS VERIFICATION SUMMARY Listed below ate four HVAC alteration Options. The installer decides what wo* is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the ferries 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 CF4R forms (no hand filled CF-4Rs allowed) are filled oui and signed. Beginning October 1 2010 a rt&ttredeopy of the CF -1R and CF -6R shall also be on site for final inspectlom qkl. 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 for split stems MECH-25 an • Condenser Coil and/or • Indoor Coil and CF -6R fomes: MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forms: MECH- 21 and (for split systems) MECH-25 • urnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct'leakage < 15 percent f eempted from duct leakage testing if O 1 Duct system was documented to have been previously sealed and confirmed through HERS verification, or O 2. Duct systems with less than 40 linear feet in unconditioned space, or O 3. Existing ducts stems are constructed, insulated or sealed with asbestos 1 0 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA 2:350 CFMhon, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage <6 percent C1 3. New Ducts with Replacement RequIlred Forms: • Includes replacing or installing all new ducting CF -6R fours: 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 O 4, New Ducting over 40 feet Required Forms: • include: adding or replacing more than 40 feet duct in CF -6R fonts: MECH-04, MECH-2I-HERS CF4R forms: MECH-21 linear of unconditioned s ce. For split system or packaged units- Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certih, that this Certificate of Compliance documentation is accurate and compleu. • 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. 1 cenif} that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts t and 6 of the California Code of Regulations. - •"i tic ile.tgn feawresmnut ice on this Certiftcateof Compliance arc consistent with the informationu on other applicable co -plias -forms. worksheets. calculations, fans and s ifications submitted to the enforcement a for Val with the it tion. . Name: Signature: Company: Date: �� iQ 6 � — ( -1 Address:% License: �v / os ee as ©Yy" C. itylStatcll ip: a f Phone: 2008 Residential Compliance Forms March 2010