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13-1273 (MECH).� 4 XP � P.O. BOX 1504 Qum VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT �. Date: 10/07/13 Application Number: 13-00001273 Owner: Property Address: 81473 GOLDEN POPPY WY MYRA THOMAS APN: 764-280-999-122 -300236- 81473 GOLDEN POPPY WAY Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: MEDIUM HIGH DENSITY RES ( Application valuation: 3400 n Contractor: Applicant: Architect or Engineer: PREFERRED PLUMBING HTG A/ P.O. BOX 5120 OCT 0 2013 PALM SPRINGS, CA 92263 (760) 322-3173 CITY OF ' LiC. No.: 457554 FINANCEIEPWTQ 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 a d Professionals Code, and my License is in full force and effect. License Class: C10 C16 C2 /� is o.: 457554 i 9 ;Date:W71J3 Contractor: COWNE UILDER DECLARATION I hereby affirm under penalty of perjury that I am exemp from the Contractor's State License Law for the following reason ISec. 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 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 ($5001.: 1 _ 1 1, 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 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: LQPERD1IT 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. Vl 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 r insurance carrier and policy number are: Carrier EVEREST NATL Policy Number 7600006445131 _ 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 a to become subject to the workers' compensation laws of California, and agree that, if I shout become subje- to orkers' compensation provisions of Section 3700 of the Labor Cod sha f hwit mp wi diose r visions. Date: �U Applicant: `--� WARNING: FAILURE TOSCURE WORKERS' CO ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL'TI ND 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 ab velnformation is correct. I agree to comply with all city and county ordinances and state laws relating to buildi c p. tructio , an er au hart representatives of this county to enter upon the above-mentioned propertyr insp c[io purpos . Date: /e % Signature (Applicant or Agent): C 1 LQPERMIT Application Number . . . . . 13-00001273 Permit MECHANICAL 2013 Additional desc . Permit Fee . . . . 35.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date .. 4/05/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH AIR HANDLER 35.75 ---------------------------------------------------------•------------------- Special Notes.and Comments HVAC .CHANGE OUT - 10 SEER, CHANGE OUT AIR HANDLER IN FURNACE (2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees .. . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 - PLAN CHECK, MECHANICAL 11.92 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 35.75 .00 .00 35.75 Plan Check Total .00 .00 .00 .00 Other Fee Total 103.49 .00 .00 103.49 Grand Total 139.24 .00 .00 139.24 LQPERMIT Bin # Permit #La Cid of La QU'inta Building lit Safety Division ` P.O. Box 1504, 78-495 Calle Tampico Quints, CA 92253 - (760) 777-7012 Buildiri Permit Application and Tracking Sheet Project Address:::; `.>: Wv Owner's Name: A. P. Number;:. Address: FI Y 7.3 c� d IC2' til! /d LegalD�Scp:A'. w> ;:' ;; ..• d i t i on i n g dba" 'f City, ST, Zip: 1./9 Ov/,a/5 c9oZo1S3 TeControoP?cr lephone: � ZAfr.. Addiesst PQ::•'B:o. Project Description: City:; S ' ;z P P'a'1`?m ;aw —, :z?9s :; .CA. 2 2 6 I�9lCl> /r//e 11AM0 Telephone:.(: 7:6;q) ' 3` =;2 -3:x` 7 3.. / �C i�/N To uw� StafeLie...# ;4:x:75'5:4°<;':.,. Arch.; BiSgr: Desigie�; CityLic.#: Address: _ . City..ST. Telephone;. :.:::, ; State -Lip # : .='::,;: ;:-;;;:. ;_,'_:'. Constnlotioa Tyge. Occupancy: Project type (circle one): New Add'n Alter Repan Demo ame of:Conact,'.PeFsou` Sq. Ft.: #Stories: # Units: Telephone:# ofCocCFerson:: " Estimated Value of Project: 3 yQQ APPLICANT: DO NOT WRITE BELOW THIS LINE RQ..'d • Rec°d TRACKING PERMf T FEES Plan Check fifftitted Ite Amount $trpetpral'Calcs..: Reviewed, ready for corrections Plai Check Deposit Called Contact Person PIai Check Balance Ege�gy Cabs.:. Plans ticked up Con itruction F190.0. ain plap., !. '. Plans. Mechanical Grading pian' •' : •, . 2"d Review, ready foi'corrections/issue Ele rival $ubc fttactor.Last . Called Contact Pergon Plui ibing Grant Deed .' Plans picked up S.M I. H.O A, Approy6l Plans resubmitted Gra ling IIv;HOUSE:- "Review, ready for corrections/issue Dev Ioper Impact Fee PlanrilpgApprbval: Called Contact Person A.I..P. Pub. Wks. Appr ' Date orpermit issue School Fecs ' Total Permlt Fees - Simplified Prescriptive Certificate of Com fiance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 SL'W Address: 4-3. G��N Imo �A Enfor erne t A e Date: joy Permit #: Conditi ned Floor Equipment T e' List Minimum EfficienCY2Duct insulation requirement Area Thermostat ❑ Packaged Unit umace I�4L f" AFUE ❑ COP Over 40 ft of ducts added or etback ❑ Indoor Coil ❑SEER ❑ HSPF replaced in unconditioned space Served by system (if not already ❑ Condensing Unit ❑ EER - ❑ Resistance ❑ R 6 (CZ 10-13) ❑ R 8 (CZ 14-15) sf present, must be installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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 sieqeK Beginning October 1, 2010, a registered copy of the CF -1R 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 stems MECH-25 o Condenser Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Indoor Coil and/or CF -4R forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/toti(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 ❑ 2. Duct systems with 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 Forms: • 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 CF -4R 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: • Includes adding 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 duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) e 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 ofcompliance, • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance con rrn 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 inform on documented on other plica le compliance forms, w s eels, calculations, plans andspecifications submitted to the enforcement a en for approval with pfi4 permijAJ&Watiga Name: ,, Te Fr eJ Signature: /�� Company:P2_���C..T-r�t 1�iG 6 Date: I v f� Address:_Dn �© �- License: 5 _ City/State/Zip:'_P, 06 S /]V I ZZ (o 3 Phone: '460 y ZZ , 3 7