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13-0433 (MECH)Al� k P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4wf 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 13-00000433 Property Address: 81255 GOLF VIEW DR APN: 762-390-027- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7970 Applicant: Architect or Engineer: ------------------ 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 License No.: 686310 Date: 414113 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 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 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.). ( 1 I am exempt under Sec. , 8.&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: KLEIN MICHA C 0(9 Contracto. e/%'qy �elj GENERAL AI B NG 31170 RESERVE THOUSAND PALMS, CA (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/08/13 ----------------------------------------------- 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. i5i&?,1 have and will maintain workers' compensation insurance, as required by Section 3.700 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 ZENITH INS CO Policy Number Z071741502 _ 1 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:Applicant: 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. 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. r Date: �� Signature (Applicant or Agent): �_� 3c; Application Number . . . . . 13-00000433 Permit MECHANICAL Additional desc . Permit Fee . . . . 42.50 Plan Check Fee 10.63 Issue Date . . . . Valuation . . . . .0 Expiration Date . . 10/05/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA MECH FURNACE >100K 11.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE -OUT - REPLACE 4 TON AIR CONDITIONER 13 SEER (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 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 42.50 .00 .00 42.50 Plan Check Total 10.63 .00 .00 10.63 Other Fee Total 1.00 .00 .00 1.00 Grand Total 54.13 .00 .00 54.13 LQPEIN1IT 04/08/2013 09:46AM 8187353575 IPERMIT ERATERS PAGE 06/06 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAI rations CF-iR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: I 812SS GOLF VIEW DRIVE La Quinta, CA 92253 City of La Quinta Apr 8, 2013 Duct insulation Conditioned FI ior EquipmentTypel List Minimum Efficiency2 requirement Area Thermostat 13 Package Unit Q Furnace ® Indoor Coil d AFUE ® SEER 13.0 13COP p HSPF1 Q R 6 GZ 10-13) Served by sysA em I& Setback If not already present, must be H Condensing Unit p EER Resisnce [3ta 0 R 8 (CZ 14-15) 3811.6 sf, installed) 0 Other 1, Equipment Type: Choose the equipment beinjo Installed; if more than one system, use another CF 1 R -A T -HVAC for each system. 2. Minimum Equipment Efficiencies., 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. er decides what work is being done HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The Instal and picks one of the appropriate Options. Each Option lists the HERS measures that must be c nducted. A copy of the forms shall be left an site for final inspection and a copy given to the, homeowner. At final, the inspector v rifies that the work listed on this form was In fact the work completed by the installer. The inspector also verifies that each app oprlate CF -611, and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, registered copy of the CF -IR, and CF -6R shall also be onsite for final inspection. ® i. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) N ECH-25-HERS replaced CF -4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) V ECH-25-HERS . Indoor Coil and /or CF -411 -forms: MECH-21 and (for split systems) MECH-25 . Furnace For Split Systems: Duct leakage��;,15 percent; RC, CCA 5 300 CFM/ton (Minimum Air FlowRequirement), TMAH Exe bM.frorr).duct.leakag'a:,testln �;. .,; • ri�'v1135:docume fed to have been revlousl sealed and confirmed throw ste previously g HERS verification, or :.6pcEsl!st6hts .with' less th 440 linear feet In unconditioned space, or .[ &yis,are•y isitucted, insulated or sealed with asbestos .3';�iclSting:duck.4y .. 4 ..Ttfe Il,not b.e Ru (ie" a? • xe e rge R iii ..:: O z,::r� eq ,k`: • Cut i n.geout wi BCH -04;1• H.€RS sY EC ERSnd: :. new iatl ew ducti1.11' all n ECH- 0; "r5 tomequi : .� �•,• For Split: :.r.:,;.;.. �.c r,:...._.... uct For;pdcage �.Clnits: 9 - ntlr eh,;. o p ITS, 1 %nP.`witii`ori Required Forms: . Iiieludes''•repla'cing or.installirig:•2k.Iti)ew duc8fig and/or outdoor.itit den r unit CF -6R forms: MECH-04, MECH-20-HERS, ai id (for split systems) MECH-25-HERS and/or Indoor coil and/or:ftirpa 'No- or some CP -411 forms: MECH-20 and (for split syste s) MECH-25 equipment changed. For Split Systems: Duct leakage .c 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For packaged Units: Duct leakage < 6 percent ❑ a. New Ducting over 40 feet I 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 Q EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statemen ) • 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 foi, the design Identified on this Certifleete of Compliance. • I Certify that the energy features and performance specifications for the design identified on this Cer-afic ate cf Compliance conrorm to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identifled on this Certificate of Compliance are consistent with the information docu ented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for appy val with the permit application. Name: Danielle Garda Signature: pQnialle 6orcia Company: HARRISON ENTERPRISES INC Date: Apr 8, 2013 Address: 31-170 RESERVE DRIVE STE A License: 686310 CIN/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488 Reg: 213-A002o661A-000000000-0000 Registration Date/Time: 2013/04/08 12:28:.441 HERB Provider: Ca10ERTS, Inc.. 2008 Residential Compliance Forms July 2.010 04/08/2013 09:46AM 8187353575 IPERMIT ERATERS PAGE 05/06 U -LMM AN lila City. of* La Qutnta Food Oft ptia sE-Wely DMmm ouadcal . . 0�4 W+a P.a. Ila 1504,'7049S Cge T �ml . ➢ermft -17 *moi La gfta, CA 922S3 -f760) 77770 . S Md. H-O.A. Appnr+:l Budding Permit AopItcadon and Tra Sheet Pt*atA4dcx= 81255 Golf View Dr Owaa':Nema. MICHAELLt=IN . A. P Nwnbu:.762390027- Address: 8.1255 Golf View r Pair. Wis Appy calx, sr, ztp: LA QUINT k, CA 92253 Coamm r.. GENERAL A/C & HEATING Addras 31170 RESERVE DRIVE PrgjaxDesaiptboa CHAIY E OUT (1) A/C UNIT 4TON Chy. -FL M : THOUSAND PALMS, CA 92276 Tohl Perk Foca TekOumc 760-343-7488 SR&Liir-1. 688633110. c J , SliEa Lie f: PYo} (oilale one): K Abd n � AIS Kopek Demo Name of G�otPm= iNJV R k C— l'-- sa 1;t.: 3816 1 i UnttF Toone t of Coma Pa mm . - Eabonntod'va5�a of PtojovC 7970.00 AMMAW: DO NOT VWFM SHAW TW LPN -LMM AN lila ewo pica or . Food Oft ptia Ruff rtoduNw- ouadcal . . 0�4 W+a 7r! Revtew, t+o�dy 8x over�ae�sm+an �ml . wcoaee w u:A Ctltod OoabQ Yawa *moi Grnal Dood Pham pk>ocd ap S Md. H-O.A. Appnr+:l Pleas 1 �� . 1twleri bd7 [ff mtrscti name Developer Iatpaet Fel 13tadadApp.vM Gs&d:CC l ttPm a A" -P. Pair. Wis Appy date of perx�B tstae • W od You Tohl Perk Foca