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13-1412 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number._-- 13-.00A01412 Property Address: 79925 DOUBLE EAGLE WY APN: 775-250-008- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 9500 Applicant: Architect or Eng' ear: r 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: JENSEN RESIDENCE 79925 DOUBLE EAGLE WAY LA QUINTA, CA 92253 ( Contractor: PREC H & A INC P.O. BOX 11090 PALM DESERT, CA 92255 (760)776-1550 Lic. No.: 818759 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/05/13 D � Nov o 2013 c1TY of LA QUINTA ------------------------------------------------------------------------------------------------- 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 Professi nals 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 Ci : C20 C36 License No.: 818759 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 Deter e:� Contractor:- _ 1 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 UILDER 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 TRUCK INS EXCHN Policy Number N 2008 71 19 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 become subject 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, shat forthwith 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).: _Oat Applicant: 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 WARNING: FAILURE TO SECURE WOR ERS' COMPENSA ION 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 CRIMINA 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 t0an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractors) 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. , BAP.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPE"I IT 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 c9nstruction, and hereby uthorize representatives of this county to enter upon the above-mentioned property for Qjspgption purposes. 1 LQPERMIT Application Number . . . . . 13-00001412 Permit MECHANICAL 2013 Additional desc . Permit Fee . . . . 143.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/04/14 Qty Unit Charge Per Extension 2.00. 35.7500 EA MECH FURNACE 71.50 2.00 35.7500 EA MECH CONDENSER/COMP 71.50 ----------------------------------------------------------------------------- Special Notes and Comments (2)HVAC CHANGE OUT'SYYSTEMS 78% AFUE 13 SEER BOTH 3 1/2 TONS 2008 CODES GY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. ---=-----7------------------------------------------------------------------ Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 95.32 Fee summary Charged Paid Credited --------------------------- Due ------------------------------ Permit Fee Total 143.00 .00 .00 143.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 186.89 .00 .00 186.89 Grand Total 329.89 .00 .00 329.89 a Bin # City Of % Quinta Building 8i SafetyDivision Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: Submittal Owner's Name: Rec'd A. P. Number: PERMIT FEES Address: �qqAg , ovl Plan Sets Legal Description: City, ST, Zip: pry •6 Contractor: r S h ill' % P6 I % Telephone: Structural Calcs. Address: �, gDj� II�� Project Description: City, ST, Zip: T" C q2 �Cafid fko C01 Truss Calcs. Telephone: C100) 776X.. C100) Called Contact Person State Lic. # : g Ig -t q City Lic. #; It7 f 3 Title 24 Calcs. Arch., Engr., Designer: Plans picked up Address: Flood plain plan City., ST, Zip: Plans resubmitted Telephone: . State Lic. #: l.iii{�i'%^Y^.:.ryJ:�'••�fiiii::��?•Li'}��Sj�A��. v:i4::f4:Y' �4iriiLi: . :«<: ,; ;:;:r >;r;::>> <<<:<?`: :.. anc Construction T Occupancy: Project type (circle one): New Add'n ter)Repair Demo Name of Contact Person:�{( e Sq. Ft.: #Stories: Units: Telephone #,of Contact Person: — I Estimated Value of Project: S . APPLICANT: DO NOT WRITE BELOW THIS LINE I # 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 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 correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlteratfons CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date:Permit: 79925 Double Eagle Way La Quinta, CA 92253 City of La Quinta Nov 5, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served system ®Setback If not already present; must be ® Condensing Unit E3 EER ❑ Resistance ❑ R 8 (CZ i4-IS) 1400 sf installed) ❑ Other 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 Effrclendes: 13 SEER, 78010 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 work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-611 and registered CF-411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111 and CF-611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: • All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF-6R forms: MECH-04, MECH-21-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';e 15.percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH Fon n-�.-La..e.l nr.�F1.:-1,.�.F::'�. �c 1�..:.... .. ..t a+:.:. Exempted from duct leakagetestingzf>:;: ❑.1":Ductsysferii;was: c1bturrierited:to have been previously sealed-and confirmed through HERS verification, or ss wikh less than?40 linear feet in unconditioned space,.or 112. Duct sytem :03. Existing duct systems are constructed insulated or sealed with asbestos 4 Thesystftwlll, not be Ducted (re Ductless;IMlnl spht Systecrlf) (Also Exer4a; frr mgrs gerranhtGharge) ❑ 2.NewYH1fAC S "stem y Requlr.icy ed�Forms s" *x hti • Cut m or Changeouf witVA ht new ducts : all new X� ( GE�6R� o ms MECH 04 MECH 20 HERS aandgfo split syst M-s)` MECH 22";HERS :and � A G �� 1 , =ri 4 : MECH 25-HERS.:. t ducting and all new equrpmenta. ". x';au CFi4Rfor s�MECH 20 :a'd�?(for:splitsystems) MECH22�and MECH 25a: g�. ` L` «- a For Split S stems Duct leaks e < 6 ercenr`RC CCA > 350'CFM/ton FWD TMAH STMS and; either HSPP`6t`,PSPP: 44 "#T* ' yx,,_ = ga 9 rp a j For Packaged tinits: Ductdeakage <,6percent ..: 04:' Required Forms: . Includes replacing'or installing all ri'ew ducting and/or outdoor condensing�h init CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or fu:rna`e No or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed.''' For Split Systems: Duct leakage<'6 percent; RC, CCA z 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF-611 forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-4R forms: MECH-21 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 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, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Gerald Dobbins Signature: Gerald Dobbins . Company: PREC H &A INC Date: Nov 5, 2013 Address: P O BOX 10991 License: 818759 City/State/Zip: PALM DESERT/ CA/ 92255 Phone: (760) 776-1550 Reg: 213-A0083648A-000000000-0000 Registration Date/Time: 2013/11/05 12:04:46 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date:Permit #: 79925 Double Eagle Way La Quinta, CA 92253 City of 3urupa Valley • Nov 5, 2013 Duct insulation Conditioned Floor EquipmentTypel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil 111 AFUE 78% ® SEER 13.0 13 COP ❑ HSPF ❑ R 6 (CZ 10-i3) Served by system ®Setback If not already present, must be ® Condensing Unit [3 EER ❑ Resistance ❑ R 8 (� 14 15) 1400 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-1R-ALT-HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 7Wo 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 work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-611 and registered CF-411 farms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111 and CF-611 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or CF-611 forms: MECH-04, MECH-2I-HERS ancI for split systems) MECH-25-HERS . Indoor Coil and /or CF-411 forms: MECH-21 andfors lit ( p systems) MECH-25 . Furnace For Split Systems: Duct leakagef< 15 percent; RC, CCA 5 300 CFM/ton, TMAH Minimum Air Flow Requirement), ( q ) For- nom.-kaaad nAitd;- p Rt Exempted from duct leakage testing if . ❑ 1"Duct=system 'was documented.to have been previously sealed and confirmed through HERS verification, or rjnV' . . ❑ 2. Duct systems:w:ith.less than�40.linear feet in unconditioned space, or 03.Existing duct-systems are constructed insulated or sealed with asbestos 4 The system will not be Duet `ii(ie0uctl6ss Minig`Spltt�System) (Also Exempt from Re igerant4Charge) ❑ 2. New HVAC System Requ�red,Forms: ° e It Al ue. l..x.. �tyVis.' w'.'1 Yc..t`oi'SS.s.Ca?ci� ..N M.'�. .�G'Y�ycarL Cut intorkChan soot with "sem yam' '�� i .. .._.. CF 6 tforms }MECH 04 MECH 2O�.HERS,Xand (foflsplit systems) MECH 22 HERS,�and , new ducts allgnew M(: s ductin and.all new h MECH 25'=11ERS� a ' a7 � � � C � � u aa�fss) MECaH M?5��..{{, app equipment)• kjg�:dyy l'MRms�MECX:. For Sol S stems Duct leaks e < tib cent RC' CCAS>"350KCFM/tonFWDTMAHx STMS and either HSPP o� PSPP: P Y For Packaged Units:. .Duct leaks a <ercerit�� f .. rte., .'... ❑ 3. New Ducts"wiih/orwithouY° ` Required Forms: . Indudes replacing or, install,ing all new ducting and/or outdoor coridensmg unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or'furnate��No; or some CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage <*6 percent, RC, CCA 2 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF-611 forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF-4R forms; MECH-21 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 certify that this Certificate of Compliance documentation Is accurate and complete. . I am eligible under Division 3 of the. California Business and Professions Codeto 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, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Gerald Dobbins Signature: Gerald Cabbim . Company: PREC H & A INC Date: Nov 5, 2013 Address: P O BOX 10991 License: 818759 City/State/Zip: PALM DESERT/ CA/ 92255 Phone: (760) 776-1550 Reg: 213-A0083651A-000000000-0000 Registration Date/Time: 2013/11/05 12:06:13 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010