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11-1006 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00001006 Property Address: 81250 GOLF VIEW DR APN: 762-390-017- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 16000 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 andfessionals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Date 1 ( iContractor: 'WNER-BUILDER DECLARATION 1 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 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 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 sale3. - (_ 1 1, 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 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: A Lender's Address: P LQPERMIT Owner: PAT BOLGER 81250 GOLF VIEW DRIVE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/19/11 D Q Q Contractor: 1 f GENERAL AIR CONDITION G V E D 9 2091 t 31170 RESERVE DRIVE THOUSAND PALMS, CA 921,27 �IYY Fr (760) 343-7488 a A4il7►VgA Lic. No.: 686310 ---------------------- 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 EVEREST NATL Policy Number 7600006147101 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 subj to the workers' compensation laws of California, and agree that, if I should become subject a workers' compensation provisions of Section 3700 oftheLabor Code, I shall forthwithVith those provisions. ate: /tp'plicant: WARNING: FAILURE TO SECURE WORKERS' C NS TION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 become null and void if work is not commenced within 180 days from date of issuance of such permit cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above i rmation is correct. I agree to comply with all city and county ordinances and state laws relating to building con ction, and hereby authorize representatives oft j��re the above-mentioned property for in ctio urposes. Cate: (Applicant or Agentl: Application Number . . . . . 11-00001006 Permit MECHANICAL Additional desc . _ Permit Fee . . . . 45.00 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3117/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL NEW 2 TON HEAT PUMP AND REPLACE 40' OF DUCT WORK. 2010 CODES. Other Fees . . . ----------------------------------------------- . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total -------------------- 45.00 ----------"---------- .00 .00 45.00 Plan Check Total 10.13. .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 56.13 .00 .00 56.13 LQPERMIT [Sim lifed Prescriptive Certificate of Compliance:- 2008,Residential HVACAlterations CF -IR -ALT -HVAC, Climate Zones 10 to 15 Site Address: Enforcer rt Agency: Date: Permit: Conditioned Floor Equipment T et List Minimum EfficienCy2 Duct insulation requirement Area Thermostat ❑ Packaged Unit Furnace ❑ AFUE $O% ❑ COP Over 40 ft of ducts added or Setback door Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (If not already ondensing Unit fther ❑ EERY_ ❑ Resistance ❑ R 6 (CZ 10-13) ❑ R 8 (CZ 14-15) sf present, must be installed) 1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -1 R-AL.T-HVACfur 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 _nstallerdecides what work is being done and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducte6. 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 I, 201.0, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection. 1. HVAC Changeout Required Forms: e 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 • Condenser Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Indoor Coil and/or CF -4.R forms: MECH- 21 and (for split systems) MECH-25 • 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 Exempte om duct leakage testing if: 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 ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split.systems) MECH-22-HERS, and MECH-25-HERS 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 Fqjr Packs ed Units: Duct leakage < 6 percent 4. New Pluctingover 40 feet ' Required Forms: •Thcludes 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 ducts stems 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 I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the • orm tion documented on other optic ompliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency fora ro al with t e pcMit application. Name: CD I(eeh wo-*s-bn Si cure: Company Gr Gon ,en,era.( �t Gonda 0,1i � r Date: Address: ,31170 fitt . ��� License: �8�3ry City/State/Zip:-�k0 � ��5, G/} G���7� '/ Phone: -W-343` 74ER Bin # 0ty Of LQ QUIi�� Building iii Safety DMslon P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 BuildingPerm- - erm-it-Appiication and. Tracking Sheet Permit # Project Address: _W Owner's Name: A. P. Number: Address: �� GSD i U ; ecz) Legal Description: City, ST, Zip: Contractor:Teephone: Address: L 7L �MINN. �-11 Project Description: City, ST, Zip: } ^� Telephone: ,�5:-; �",,;;�Qr,,<; .>• ff�<r�,�//�J: 3 1. •}:il??f<nff //n\/ynCr%F /�^) �/y/(�/\� V� State Lie. # : j City Lie. #; l0(7 {o Arch., Engr., Designer: Address: City., ST, Zip: Telephone:. State Lie.#: F y .' F?� ., µ ? if - y �---� . A �4 Construction Type: Occupancy: ` Project type (circle one): New Add'n .Alter Repair 'Demo Name of Contact Person:Gcc%5 7 q. : Stos:�t # Units: Telephone # of Contact D 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 Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan tad 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:- Jrd Review,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P.. Pub. Wks. Appr Date of permit issue Schodl Fees FITotal Permit Fees