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12-1194 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00001194 Property Address: 54775 WINGED FOOT APN: 775-110-003- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL, Application valuation: 6820 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: STEVE & ELLEN WILCOX 54775 WINGED FOOT " LA QUINTA, CA 92253 V ( VOICE (760) 777- FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: ' 101/09/12 Contractor: 7NN Applicant: Architect or Engineer: PALM DESERT AIR COND CO INC 242081 BEACON HILL,y`� PALM DESERT, CA 92211 01(760)346-0677 C1Lic. No.: 374937 FT� LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION 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 o the Business and Professionals 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 o.: 374937 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is t issued. /ate: �� (� ontractd.r: 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 OWNER -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 theCarrier MID CENTURY Policy Number A09454905-12 . following reason (Sec. 7031 .5, BusinessandProfessions 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 thq Labor Code, I shall forthwith comp) ith those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by PP� any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: A : licant. • (_ 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 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, . 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 _ - 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: PIP LQPERMIT within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. , certify that I have read this appI' tion and state that the above information is correct. I agree to comply with all , city and county ordinances and ate laws relating to building construction, and hereby authorize representatives 7f,county to enter upon eabove-mentioned property forinspection purposei " 74ture (Applicant or Age ntT1 - f Application Number . . . . . .12-00001194 Permit MECHANICAL Additional desc . Permit Fee33.00 Plan Check Fee 8.25 Issue Date . . . Valuation 0 Expiration Date 4/07/13 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 CHANGE-OUT:-REPLACE-(1) SPLIT- - SYSTEM, FURNACE, CONDENSER, INDOOR COIL. 2010 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 54-775 WINGED FOOT La Quinta, CA 92253 City of La Quinta Oct 8, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback IM Indoor Coil I@ SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 1400 sf If not already present, must be IN Condensing Unit [3 EER [3 Resistance Installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for 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 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 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-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 ..- r -OF Parskaged Unmfw. fl... -t 1....1.-xge r 15 p Exempted from duct leakage testing if: ❑ 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 duct systems are constructed, insulated or sealed with asbestos ❑ 4. The system=w,ill not be Duccted (ie Ductless9Mini-Split.,System)-(Also•Exempt,from Refrigerant=Charge) ❑ 2. New HVAC System Required.Forms: 1, . Cut irnror Ch-angeout with;r ;;. - CF 6R forms: MECH-04, MECH=20-HERS, and (for split s Items) MECH-22=HERS and new ducts:'(all new_ ducting and all new MECH=25. HERS an _ % CF 4R forms:. MECH 20, d (for split systems,) MECH-22, and MECH-ZS equipnieht) For Split Systems: Duct leakage<°6 percent; RC, CCA z 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or`PSPP. `..-, �. For Packaged Units: Duct leakage. < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. 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 >_ 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 -6R 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 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: Karl Brown Signature: Karl Brown Company: PALM DESERT AIR CONDITIONING CO INC Date: Oct 8, 2012 Address: 42-081 BEACON HILL License: 374937 City/State/Zip: PALM DESERT/ CA / 92211 Phone: (760) 346-0677 Reg: 212-A0055939A-00000000-0000 Registration Date/Time: 2012/10/08 11:14:23 % HERS Provider: CalCERTS, Inc.J 2008 Residential Compliance Forms July 2010 (r r e 4� P.O. Box .1504 •78=4"95 Calle Tampico, • La Quinta, Callforn-a9221µ1' Tel: (760).777-7012 • Fax.: (760)777-7112 . CFA,gfWtlFSERT- k Website: www.La-Quinta.Org • Email:.Building@La-Quinta.Org `F�'OFt��wv� -Bin #: Permit#.110Building Perm it.Ap:plication &Tracking Sheet' ProjectAddress:•54-775 WINGED FOOT Owner's Name: WILCOX, STEVE & ELLEN A.P,. Number: 'Address: 54=775 WINGED FOOT, Legal Description. `, City; State, Zip: LA QUINTA,.CA 92253 Contractor: palm Desert Air Conditioning & Heating Company Telephone: (760) 564-5903 . Address:. 42-081' Beacon' Hill' Project Description: City, State; Zip:, Palm Desert, CA 92211 REPLACE (1) AIR CONDITI DNING SPLIT SYSTEM. Telephone No:: (760) 346-0677t"ryy t� ' !i% • R 1.OJ".='�~•tRttil�.fist1'�i.t3 }"!:d'"L.''iie .State: Lic'. #: 374937} City Lic. #: 100886 _ - • : - Arch.:%Engr./De'signer: c - N City, State,>Zip: Thone Na; eleancy: p �� a. _ Construction Type: Occup State:' Lic #: All � �� :Project Type: 0 New •'® Add'n • B Alter 13 Repair 0 Derno, tr _. Name of`Contact-Person: KARL BROWN Sq: Ft.: # Stories: #`Units:. Contact Tetephane No.: (760) 346-0677 Estimated Value, of Project: $6,820.00 APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Req'd Recd Tracking +' ,• R Permit Fee's Plan Sets _ Plan Check Submitted Item Amount Stivawal Calcs. ; Reviewed, Ready for Corrections. Plan =heck Deposit .Truss Calcs. , CalledContact Person F Plan Check Balance. ' Title.24 Calcs. r r ' Plans Picked Up ? Construction 1 . Flood Plain.Plan Plaris.Resubmitted Mechanical ' Grading Plan 2nd Review, Ready for Corrections Electecal Subcontractor List • i,Called Contact Person' ' Plumbing Grant Deed Plans Picked Up " S.M.I: , H.O.A..Approval.. Plans Resubmitted Grading , ! i IN HOUSE 3"; Review, Ready for Corrections : ` Developer Impact. Fee Planning.Approval ,, Called Contact Person' A.I.P.:?. Pub. Works Appr'I .' Date of Permit Issue • + , A - School. Fees _ Total ?ermit Fee's