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10-0889 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000889 Property Address: - 78625 FORBES CIR APN: 604-223-004-47. -23268 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 3800 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ANDERSON ERIC 78625 FORBES CICLE LA QUINTA, CA 92253 ( Contractor: Applicant: Architect or Engineer: HYDES �� '� 77825 WILDCAT STREET PALM DESERT, CA 92211 (760)360-2202 Lic. No.: 906115 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I 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: C20 C36 �' e No.: 906115 r _! b -lo / 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 sheis 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 155001.: (_) 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: - 9/10/10 tSt 0 2010CITY OF LA QUINTA WORKER'S COMPENSATION DECLARATION 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 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which 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 NORGUARD INS Policy Number CEWC133676 _ 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 become subject to the workers, compensation provisions of Section /737700 of the Labor Code, 47all thwith�Y�hose provisions. Date: , ` ^�,UApplicant: 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 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 corr/agremply with all city and county ordinances and state laws relating to building* construction, and heresentatives of this county to enter upon the above-mentioned property f�inspectionposes. Date: �-J b^Sgnature (Applicant or Agent): Application Number . . . . . 10-00000889 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 33..00 Plan Check Fee 8.25 Issue.Date . . . . Valuation 0 Expiration Date 3/09/11 Qty Unit Charge Per Extension BASE FEE 15.00 1-001 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9..0000 EA MECH APPL REP/ALT/ADD 9.00 ---------------------------------------------------------------------------- Special Notes and Comments COIL AND HVAC CONDENSING UNIT CHANGE OUT 15 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 LQPERMIT Simplified Prescriptive Certificate of Com fiance: 2008 Residential HVAC Ahe.,an!ons CF -1 R-ALT-HYA.0 Climate Zones 10 to 15 Sae,4d�eu: L 1 rc�lor.98-auy: I n �^ G v per„ il: rack aged Unit I Over 40 ft of ductsadded ar I IWnQtI&W* Sefack rmFuce ECOP replaced in unewdifzon ed spaec ` Served by systrm, Indoor Crn1 EER © HSPF�® R 6 (CZ 10-13) I -U sf � >� be ondetasin� Unit ®��ce R 8 lCZ 1¢15) °'#a04 1 Rmu V, Choke rice egrtrprnerrt beim iicrtalled ffmore tlrmr one system, use owther CF -I R ALT HVACfor each *tV- . 2 firma arm E+1uo� Endes 13 SEER 78•* AFUE. 7.7HSFFfor typical residential systems LM- . VERIFICATION SUMMARY Listed below ate four HVAC aln�sation Options_ The installer decides what work is being done and one ofthe appropriate Options- Each Option lists rhe HERS meastnes that mast be A copy ofthe fomes shall be left on sine for final ction and a copy giventothehouxeowmm At final, the inspetXor verifies thatthe wo* listed on this form was m fact the work completed by theler. The inspectoralso verifiesthateachappropriate CF -6R and registeredCF-iR foams (no hand fined CF-4Rsallowed) are filled out and October L 201 a co • of tyre CF -1R and CF -6R shall also be on site for ftuaf ' i n_ HVAC Cb,=V out Required Forms: • All HVAC Egtupaiem replaced CF -M farms: MECH-K MECH 2I FIER.S and (for split systems) MECH- 25 -HERS CF -4R farms: MECH-21 and (for split MECH-25 • Condenser Cott and /or CF -6R forms: MECH-2I-HERS ands for ht •Indoor Cort and /or ( p �) MF�i- �-�S CF -4R forms: MECH- 21 and (for split systeum) MECH 25 • Furnace For Split Systems: Duct leakage < 15 percent; RC_ CCA >_ 300 CFM/ton(Mm=um Air Flow Requiremmt), TMAH For Fax:Lcaged Units: Duct leakage < 15 percent L......-...w..i &..... ii....' IM ®I. Duct system was doamoimsed to have been previously sealed and through HERS verification or 2 Duct systems with less than 40 bear feet in unconditioned space, or 3. Exs=g duct systems are conMuct4 insulated or sealed with asbestos ® Z_ New HVAC System Required Forms: • Cut in or Cnew d o ti with new CF -6R forms: MECH-04, MECH-20-HERS.aad for MECH 5 duds (ail new ducting and all ( SPS s, ) TZ HERS, and MECH,25-HERS CF -4R forms. MECH 20-, and (for lit and CH 2 new eat) systtaas)MF.CH 22, and MECH ZS For Split Systems: Dud leakage < 6 percent; RC, CGP, 2:350 CFMhork FWD, TMAH, STMS, and either HSPP or PSPP. For Pa tied Units: Dant leakagae < 6 percent ® 3. New Duds with Repfacemeat Required Forms: • Indudes replacing or iastaIIizg all new duarng CF -6R forms: MECH-04, M ECH 7A-HERS,mnd (for split systuns) MECH-25-HERS and/or outdoor condensing mit and/or indoor CF -4R fbi MECH-20 and (for split syr) MECH 25 coil and/or fianace. Not all For Spirt Systtxns: Dud leakage < 6 percent, RC, CCA 2:300 CFM/ton, TMAH For Padkaged Units: Duct 1 e < 6 percent 4. New Da ' over 40 feet aired Forms: Indudes adding or replacing mole than 40 linear feel Ofd= in un000ncd Spar. CF -6R forms MECH-04, MECH 214TRS CFVR forms: MECH-21 For split or packaged units: Duct leakage < 15 percent EXCEPTION: Existing duct r ysteins construcmd, insulated or sealed with asbestrts. Contractor (Documentation Author's /Responslble Designer's Declaration Statement) • I cer* that tins Certfuate of Compliaice domini mon is atxtaaze and complete. • I am eligible under Division 3 oftbe California Business and Professions Code to aoceptresponstbil y for the design idw if ed on this Cettificaw of Compliance. 1 certify that the eaergv femur and perfonim= spedfiadons for the design identified on this Catificaae of Compliance Conform to the regrurrme m of Tttle 24. Pam I and 6 ofthe California Code ofRegttiatiotu. • The design fermnes idrnufied on this Cert firam of Compliance ate eonsiseat with the mfo manon decunented on othc applirab3 iance forms, wodisboem w1culaiiom D1ata and submizzed to the enfor=cgt 4gency for aaptoval wide the t» Nao= Michael Hyde Signattin C°�r Hyde's Air Conditioning Dates Atm 77-899 Wildcat Drive 906115 CitY/state/Zip- Palm Desert, CA 92211 Photic: (760) 360-2202 2008 Residential Compliance Forms March 2010 Bin # City of La Quinta Building & Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application .and Tracking Sheet Permit #P.O. OR Project Address: -- 6 Z �o �/5 C I ��� Owner's Name: A. P. Number: Address: -7 z1 ` W4Y Legal Description: L Contractor. City, ST, Zip: Telephone: Address: LVILJ 3, Project Description (j 1 Gt�2r CGn L©�l� City, ST, Zip= Telephone: t! OO -Z20Z State Lic. # : City Lic. #: d `2 Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft: # Stories: -7T; Units: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2°4 Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SdbLL $O-AL Approval Plans resubmitted Grading IN HOUSE: '"Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person I.Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees