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11-0482 (MECH)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000482 Property Address: 78780 GRAND TRAVERSE AVE APN: 770-320-059-59 -25389 - Application description: MECHANICAL Property Zoning: MEDIUM DENSITY RES Application valuation: 6700 T4ht 4 a(Pa" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: FARNSWORTH CRAIG L 50780 GRAND TRAVERSE AVE LA QUINTA, CA 92253 Contractor: D J ANTHONY PLUMBING HEAT/AIR 72216 NORTH SHORE STREET, #10 THOUSAND PALMS, CA 92276 (760)343-2121 Lic. No.: 777794 Date: 5/09/11 MAY 1020111D 1A ------'--------------'---------------------------------------------------------------------- - - - - - — I hereby affirm under penalt)T perjury that I Section 7000) of Division 3 bflrie BusipAssA . zlrl S DECLARATION isions of Chapter 9 (c5loyffltricing with and my License is in II rce and effect. 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 hundreddollars($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 foe 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 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: Lender's Address: LQPERMIT 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. 1 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 STATE FUND P icy Number 1932451-2011 1 certify that, in'the performance o he work for which this permit is issued, I shall not employ any person in any manners s t eco t to th workers' compensation laws of California, and agr t, if I sh d b om ubj ,to a rkers' compensation pro ' ' ns of Section 370 of e L r de, s I orth h�co 'with those provisions. WARNING: FAILURE TO SECURE WO ERS' 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 essation of work for 180 days will subject permit to cancellation. I certify that I have read this application an , to that the a ve i r n is orrect. gree to comply with all city and county ordinances and state laws re tin buildi g co tr ion, ereby thorize representatives Xoft my toLenter upon the above -mention rop fo pe tion p p S. te.. a" Signa re (Applicant or A Application Number . . . . . 11-00000482 Permit . . . MECHANICAL Additional desc . . Permit Fee. . . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/05/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH'B/C >3-15HP/>100K-500KBTU 16.50 ---------------------------------------------------------------------------- Special Notes and Comments WOOR HVAC CHANGE -OUT, NEW FURNACE, COIL & CONDENSING UNIT (13 SEER). 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged -------------------- Paid Credited -------------------- Due ----------------- Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .00 - 51.63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -IR -ALT -HVAC Alterations Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 50780 GEAND TRAVERSE AVE La Quinta, CA 92253 City of La Quinta Mar 22, 2011 Duct insulation Conditioned Floor Equipment Typei List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit p Furnace Ea Indoor Coil © AFUE 80% Rj SEER 13.0 [:]COP_ Elsf HSPF El R 6 (CZ 10-13) Served system M Setback If not already present, 0 Condensing Unit E!] EER [:]Resistance ❑ R 8 (CZ 14-15) 2000 must be installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -611 and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signeclAeginning October 1, 2010, a registered copy of the CF -1111 and CF -611 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 -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF -411 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 For Packaged Units: Duct leakage < 15 percent Exempted from duct leagage 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. Exist ingrduc1.tysystems are constructedrinsulated or sealed with -asbestos ❑ 2. New' HVAC f RReq ire For' s: i / �� / %� System/ J F _ , li • Cut in or Changeout with new ducts: (.all ' ` a ' F ~' t I � �. CF;6Riforms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22'-HERS, and MECH-25-HERS �' it 6 new ducting�;all / CF -4R forms: MECHr20; and (for,split systems) MECH-22,,and,MECH_25 c� 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/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor coil CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or furnace. No or some CF -411 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 E9 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 linear feet of duct in CF -611 forms: MECH-04, MECH-2I-HERS unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent E] 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: Kevin Robinson Signature: Kevin Robinson Company: J ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Mar 22, 2011 Address: 72216 NORTH SHORE ST #101 License: 777794 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 328-8096 Reg: 211-A0014843A-00000000-0000 Registration Date/Time: 2011/03/22 14:34:02 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # City of La Q u(n ta -Building 8c Safety Division P.O. Box 1504, 78-495 Calle Tampico ln CA 92253 - (760) 777-7012 Building g ' Perlfl►t Application and Tracking Sheet Permit # Project Address: 62Q O e:::�14UO 'IT -42f} y Owner's Name: A. P. Number. Q Address: Legal Description:City, ST, Zip� ")VY Contractor: Address: Z2216 NORTH SHORE ST ATF I al Telephone: ` /» ��,,<%� Project Description: Pe-7fZ~ ' THOUSAND PALMS, CA 92276 City, ST, Zip: . , d Telephone: State Lic. # : City Lic. k 1050 Arch., Engr., Designer. Address: City, ST, Zip. Telephone: State Lia #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft : �� # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: U V APPLICANT: DO NOT. WRITE BELOW THIS LINE Req'd Recd TRACIMG PERMIT FEES ffSubmittal Plan Check submitted Item Amount Coles. 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 McChanlcal Grading plan 2" Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted . Grading IN HOUSE:- ''' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue Scbodl Fees Total Permit Fees