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13-1497 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001497 Property Address: 43605 GALAXY DR APN: 609-560-001-1 -23773 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 16000 Applicant: 011" T4ht 4 e(Pa" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED C C R'S DECLARATION I hereby affirm under penalty of perjury that I a ce under p visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business 7Prionals Code, and my License is in full force and effect. LicenseeClas C20 License o.: 416394 Date: W Contractor: OexenA 71m the DECLARATION I hereby affirm under penalty of perjur that I am exe m the Contraaor's State License law for the following reason (Sec. 7031.5, Bu ' ess and Profes s 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 IS500).: (_ 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 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. , 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. Lender's Name: Lender's Address: LQPERMIT Owner: SAM WILLIAMSON 43605 GALAXY DRIVE LA QUINTA, CA 92253 (805)340-9475 Contractor: BREEZE AIR CONDITIONING INC 75145 ST. CHARLES PLACE PALM DESERT, CA 92211 (760)346-0855 Lic. No.: 416394 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/22/13 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. 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 INS CO OF WEST Policy Nupib WS 502405400 I certify that, in the performance person in any manner s to bec and agree that if I s uld become 9 1 0 the Labor ode I shall fo 7 i� Date: 1 I�`��" Applicant: r which t is permit is issued, I shall not employ any ject to the o�se rs' compensation laws of California, to the worke m�sation provisions of Section comply wi provisions. WARNING: FAILURE TO SECURE WOR S' COMP N TION VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN ENALTIES DCIV FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). IN ADDITIO O THE COST F C PENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CeDE, INTEREST, AN TTORNEY'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 w is not ammenced within 180 days from date of issuance of such permit, or cessation of rk for 18 days will subject permit to cancellation. certify that I have read this application and state that the abov ' ormation i rrect. I agre to comply wit city and county ordinances and state laws relating to buildin onstruction, a ereby authoriz represe Ives of this ounty to en�1(�1r upon the above-mentioned prope for inspection p as. Date:/Signature (Applicant or Agent): Application Number . . . . . .13-00001497 Permit . . . MECHANICAL 2013 Additional desc . . Permit Fee . . . . 166.84 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/21/14 Qty Unit Charge Per Extension 2.00 35.7500 EA MECH FURNACE 71.50 2.00 11.9200 EA MECH APPL REP/ALT 23.84 2.00 35.7500 EA MECH CONDENSER/COMP 71.50 ----=----------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - (2)13SEER/78AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 104.86 Fee summary ----------------- Charged Paid Credited ---------------------------------------- Due Permit Fee Total 166.84 .00 .00 166.84 Plan Check Total .00 .00 .00 .00. Other Fee Total 195.43 .00 .00 195.43 Grand Total 362.27 .00 .00 362.27 LQPERMIT uin if City of La Quinta Building 81: Safety'Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: q'3(005 ` `J f_ Owner's Name: S M I , C, w, Ov\ A. P. Number: .Address: Legal Description: City, ST, Zip: - C C 2, -Z 3 Contractor: e Telephone: r - �cription`: Address: - l q'5 S+. C � //1- S P-r�oject Des City, STC, Zip: c� eS1Z / ?2l / ' I wa J S e"h'1 (/1 ri ©U\—. Tel h ne rt7 5 ep o lrr � L � S >w:::y;::;;;.,?.; :.;.,•::.>. . State Lic. # : 1 City L•ic. #: n ov- Arch., Engr., Designer: �. �1 (v h C -L Address: IV1 0 S T City., ST, Zip: Telephone: ` `"" "'q:;:y:, '+'''"'`'"` "r'`'`" Co nstruction Type: 5 Occupancy: t �...."ry"" State Lic. # Project a circle one): New Add'n Al Repair Demo Name of Contact Person: , Sq. Ft.: a #Stories: ` # Units: Z 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 Cafes. 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:- ''d 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 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 43-605 Galaxy Dr. La Quinta, CA 92253 City of La Quinta Nov 22, 2013 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit H Furnace IM AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback I@ Indoor Coil ® SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 1600 sf If not already present, must be ® Condensing Unit [jEER [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 -11111 and CF -6111 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 . Indoor Coil and /or CF -611 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 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,will not be Ducted (ie.,Ductless Mini -Split System),(Also Exempt from; Refrigerant, Charge) ❑ 2. New HVAC System Required Forms: 1, J V j : j ., ' I ' . L' a 1 . Cut in'or Changeout with: I' I forms: MECH-04, MECH-20#HERS rand (for split systems) ME6-22-HERS, and new ducts: (all new/MECH ducting and all new 25 =HERS CF -4111 forms: MECH2O and (for split systems) MECH-22, arid MECH-25 '- , equipment) For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 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 -611 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 5F -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4111 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: Joe Cocker Signature: Joe Cocker Company: BREEZE AIR CONDITIONING INC Date: Nov 22, 2013 Address: 75-145 ST CHARLES PLACE License: 416394 City/State/Zip: PALM DESERT/ CA / 92211 Phone: (760) 346-0855 Reg: 213-AO08833BA-000000000-0000 Registration Date/Time: 2013/11/22 18:41:10 HERS Provider: CalCERTS, 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: 7 Permit #: 43605 Galaxy Dr La Quinta, CA 92253 City of La Quinta Nov 22, 2013 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ® Indoor Coil ® SEER 13.0 ❑ HSPF [I R 8 (CZ 14-15) 1600 sf If not already present, must be ® Condensing Unit ❑ 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.Beg inning 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 -4 leakage .4 15 peFeeRt 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,will not be Ducted (ie.,Ductless,Mini-Split-System)�(AIso-Exempt:from;Refrigerant Charge) [12. New HVAC System Required Forms: V I' . Cut in'or Changeout with: new ducts: (all new CF-6R forms: MECH-04, MECH-20-HERS!and (foi split systems) MECH-22=HERS,-and ducting and all new/( i MECH-25; 1/ •'�' `� `tet_ CF -4R forms:' MECH-20, and (for split systems) MECH-22,,and MECH-25 1 ., equipment) "l' { ,! -'/'r_ ::+i� -- _�-.� i 5 s? For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 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: Joe Cocker Signature: Joe Cocker Company: BREEZE AIR CONDITIONING INC Date: Nov 22, 2013 Address: 75-145 ST CHARLES PLACE License: 416394 City/State/Zip: PALM DESERT/ CA/ 92211 Phone: (760) 346-0855 Reg: 213-A0088335A-000000000-0000 Registration Date/Time: 2013/11/22 18:38:58 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010