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11-1067 (MECH)P.O: BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00001067 Property Address: 43870 GENOA DRl APN: 609-521-015-2 -28457 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4000 Applicant: T4ht 4 4 Q" Architect or Engineer: p [A BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Profe ' a Code, and my License is in full force and effect. License Class* B C2 C9 C1 License No.: 550253 ate: ntractor: 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.$, 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.). (_ 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.). (_) 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 Owner: ROLLER CONNIE 43870 GENOA DRIVE LA QUINTA, CA 92253 Contractor: OB GENERAL CONTRACTORS 79915 COATBRIDGE COURT INDIO, CA 92203--0 (760)250-5850 Lic. No.: 550253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/29/11 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 EXEMPT Policy Number EXEMPT 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 sho0shalth to the workers' compensation provisions of Section 370 of the Labor Codcomply with those provisions. /: �� plicant: WAR ING FFAILURE TO SECUREATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI AL 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 �ate: y and county rdinances and state laws relating to building cone i ,and hereby authorize representatives tis county enter pon the above-mentioned property f i c ' n purposes. ure (Applicant or Agentl: Application Number . . . . . 11-00001067 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 24.00 Plan Check Fee .. 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/27/12 Qty Unit Charge Per' Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 ---------------------------------------------- Special Notes and Comments - ------------------= ------------ HVAC CHANGE -OUT: FAU, NO CONDENSER. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee.summary Charged Paid Credited Due Permit Fee Total 24.00 .00 .00 24.00 Plan Check Total 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total . 31.00 .00 .00 31.00 LQPERMIT Shit liked Prescti tive CertiQicate of Coin lian&-,J,008 Re'siden'tial Hl!AC'A1terations• '" CF411rALT=HVAC.' Climste'.Zones 1.0 to IS Sit Address- n ` Enf rceme t Agency: Date. Permit #: �{/i . a f- Conditioned Floor Equipment T ' List Minimum Efficienc •Z Duct insulation requirement Area Thermostat O Packaged Unit O Furnace O AFUE_ ❑ COP Over 40 ft of ducts added or ❑ Setback O Indoor Coil OSE£R ❑ HSPF replaced in unconditioned space Served by system (If not already O Condensing Unit O EER ❑Resistance ❑ R 6 (CZ 10-13) OR 8 (CZ 14-15) sf present. must be installed) ❑ Other I 1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -I R -AL T -HVA Cfor each system. 2. Minimum Equipment Effteiencies: 13 SEER. 78% AFUE, 7.711SPF 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and signed. Beginning October 1, 2010 a registered copy of the CF -111 and CF -6R shall also be on site for final Inspection. 1. 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 fors lits sterns MECH-25 • Condenser Coil and./or ECH-2I-HERS and (for split systems) MECH- 25 -HERS • Indoor Coil and /or ECH- 21 and (for split systems) MECH-25 0�� • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1 Duct system was documented to have been previously sealed and confirmed through HERS verification, or O 2. Duct systems %vith less than 40 linear feet in unconditioned space, or ❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos ❑ 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 > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage <6 percent ❑ 3. New Ducts with Replacement Required- Poring: • Includes replacing or installing all new ducting CF -6R forms: 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 ❑ 4. New Ducting over 40 feet Required Forms: • Include; aiding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 linear feet of duct in unconditioned space. For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certifL 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. r 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 I and 6 of the Cal ifomia Code of Regulations. • i'ign features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets. calculations, plans andspecifications submitted to the enforcement agency for approval with the permit !2plication. Name: &! / A 7 Signature: Company: D� Date: Address: / 5 _ License: City/State/Zip: � _ (34 '206 Phone: 2008 Residential.Cotmpliance Forms March 2010 Bfn.# City Of La Quintd Building 8T Safety Division P.O. Box 1504,'78-49S Calle Tamplco La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 1413 Owner's Name:. A P. Number. 7ICity,ST,Zip: Address: .�� ap ��7cJ0 .4 �� l c)C Legal Description: Contractor. D 6 'Telephone: Address:� / +1°.! q) 4Lq E � C=/ Project Description: City, ST, Zip: Z2-) Telephone:a o2s SFfS i State Lie. # : �Z � City Lic, #: Arch„ Engr., Designer Address: City., ST, Zip: Telephone: MEMO State Lie. #: „ Construction Type:. Occupancy: 5 F� Project type (circle one): New Add'n Alte Repair Demo Sq. Ft.:#Stories: #Univ Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project c� APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Rcq'd Recd TRACMG PERMIT FEES Plan Sets Pian Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Chcck Deposit. . Truss Cala. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Pians resubmitted.. Mechanical Giading plan 2'' Review, ready for. correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing Graut Deed Plans picked up S.M.L H.O.A. Approval Plaus resubmitted Grading IN HOUSE:- '^` Review; ready for correctionslissne Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees' Total Permit Fees