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11-0005 (MECH)! �4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application. Number! 11-0000,0005 Property Address: 78805 W HARLAND DR APN: 604-23.2-007-136 -2.3268 Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 139.24 I Architect or. Engineer: PJ A LICENSED CONTRACTOR'S DECLARATION M BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that I am licensedunder, provisions of Chapter9 (commencing,with Section 7000) of Division 3 of the Businessland Professionals Code, and my. License is in full'force:,and effect. License Class: C/20 icense.No:: 595145 Date:. � ` ontractor: , 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 tothe '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 exempttherefrom,,and the basis =for 'the alleged exemption. AnyNiolation ofSeetion,7031.5 by any applicant for a permit subjects the applicant;to:a civil penalty of not more tharifive hundred dollars 1$5001:: 1 _7 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 througty s or her own employees„provided that the improvementsare novintende&or offeredforsale. If, however, the building or improvement is sold within one.year of completion, the owner -builder will have theburden 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•ISec, 7044, Businessa4Professions Code: The Contractors' State License LawAoes not apply to an owner of property who builds orimproves�thereon, and who contracts for the.. projects with a contractor(sl licensed pursuant,to,the Contractors” State License Law.), (_ 1 .(,ani exempt under Sec. ; W&P.C, for this,reason Date: Owner CONSTRUCTION LENDING AGENCY I hereby.affirm under penaltyofperjury that there is 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:, wj� :iJ:JLiii Owner: VIRGIN KIM ALLEN 78805 WEST HARLAND DRIVE LA QUINTA, CA 92253 Contractor:; DCS HEATING/AI'R CONDITONNG 72078 CORPORATE WAY, #101 THOUSAND PALMS, CA 92276 (760)343-5566 Lic. No.: 595145 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/03/11 WORKER'S COMPENSATION'DECIARATION I hereby affirm under penalty of perjury one ofthe following:declaratiortsr I have. and will maintain a.certificate of consent iorself4nsure for workers' compensation, as provided for by Section; 3700:of the Labor Code, for the'performance,of the:work for which;this permTis 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 HARTFORD INS Policy Number 72WECLS7.131 _ I certify that, in the performance:of'the work for which this permitis issued, I,shall notempjoy 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 theworkers' compensation,provisions of Section 1 3700�of th Labor .shall.fI-eorthw' omply: with those provisions. ate: 1 ,/6 G� , pplicant: - - WARNING: FAILURE TOSECURE.WORKERS' COMPENSATION COVERAGE IS,UNLAWFUL,.AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES:UP'TO'ONE HUNDRED THOUSAND DOLLARS (9:100,000). IN ADDITION TO TH&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: an& Safety for -a permit subject -to the conditions and restrictions set forth on, this application. 1.. Each personupon whose beha(bthis application is made, each 'person at whose request and .for whose benefit work js.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 Lai Ouinta, its officers, agents and employees for any act or omission related to the work tieing performed undevor 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 perniit;,or cessation of'work :for 180 days will subject, permit to cancellation: I certify that I have readthisapplication 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 - 'county to nte_r`u nthe atiove,mentioned property f9 in pur oses. ate:ignature (Applicant or,Agent): (// f _ I;.6. Application Number . . . 11-0.0000005 Permit. . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation 0 Expiration Date . . 7/02./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 INSTALL NEW 5 TON 16 SEER COMPLETE SPLIT. SYSTEM- 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 .0.0 .00 10.13 Other Fee Total 1.00 .0`0 .00 1..00 Grand Total 51.,63 .0.0 ..00 51.63 LQPERMIT -- MR, City of La Quints itfift-at Safety`'DhWw P.O: Box 1504, 78=495 Cale Tamploo- [a (Nfta, .CA.92253 - (760) 777--7012 Buiiding Permit Application and Tracking Sheet Project Address: � G� �/�Sf- G„ �/ Owne#'sName: ,'" i.r A.P. Number: Address: We 4 Legal Description: City, ST, Zip:/,q Cofar101 Telenkone: Address: WV S O ( Projekx Doskziption ox c 5 -4 -en 16 Sttr city, ST, Zip. . 41-5, 1123-76 It, le ; . s Telephone: 7 Ong etc, -e City'I.% #; Arch, Engr., Desiper, Address: City, SP, Zip: Telephone: State Lid. #: Nameof Contact:Person: ((�,. o, „ Construction Type: j/ Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Et:: # Stories: # Units: Telephone#.of Contact Person: Estimated Value of Project 1'�{ APPLICANT: DO NOT WFdTE BELOW THIS UNE. # , Submittal RWd Beed TRACMG PERMIT FEES Plan Sem' Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact'Person Pian Check Balance Mde 24 Calce. Phins Od ed up Construction Flood plain plan Plans resubmitted Mechaakxl Grading,plan 20! Review, ready for eorreetionrliosue Electrical Subcontaetor list Called Contact Person Plumbing Grant Dad Plans packed up H.O.A. Approval Pians resubmitted Grading IN-HOUSE:- ''a Review, read* for eor ectionaftwe B"Ooperr Impact Fee Planning Approval Called Coateet Person A.I.P:P. Pub., Wks. Appr Date of permlt issue . 'SchoolFees Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -1R -ALT -HVAC Alterations Climate Zones 10 - 15 Site Address: Enforcement,Agency: Date: Permit #: 78805 West, Harland dr La Quinta, CA ,92253 City. of La Quinta ]an 3, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum. Efficiency2 requirement Area Thermostat ❑ Package Unit ❑ Furnace ❑ AFUE ❑ COP ° ❑ R 6 (CZ 0 Setback 0 Indoor Coil0 Condensing, Unit❑EER SEER 13.0 ElHSPF 10-13) ❑ R 8 i Served by system 1500 sf If not already present, must, be 0 0 Other Furn Heat Exch ❑ Resistance 1'4-15) installed) i. Equ/pment'Type: Choose:the'equipment being installed; if more than one system, ;use -another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efflelencles: 13 SEER, 78°x6. 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 6R and registered CF -411 forms (no hand filled CF-4Rs allowed) are'filled out and signed.Beginning October 1, 2010, a registered copy of the. CF -111; and CF -611 shall also be on site for final inspection.; 0 1. HVAC Changeout Required Forms:; . All HVAC Equipment CF -6R 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: MEC -H-04, MEC -2I -HERS and (for split systems) MEC_ H=25 -HERS. . Furnace CF -4R forms: MEC -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 unconditioned space, or ❑ 3. Exisiing'�ductxsystems are.co strudted-;; insufated-orseal.ed, with -asbestos -- - -? ❑ 2. Nevv HVAC 4Requir Tormk: V ' System' , ? ,, Cut i_ or Changeout ducts: I) r 1 J CF 6Rfiorms;: MECH-04 ME H=20 -HERS,, and (for split sys ems) MECH-22'HERS and' with new �� �MECH-25-HERS new ducting and.411 7 j; J I CF -4R forms: MECH'2. , a d, (for'Splitsystems) MECH- 2ZZ,-and MECM 25_ �- ;' " i. new equipment), - Foe! 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 E13. 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 -6R forms: MECH-04, MECH;20-HERS, and (for split systems) MECH-25-HERS and/or furnace. No or some CF -4R 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 ❑ 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. C04R 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,forthe design identified,on this Certificate of Compliance conform'to the requirements ofTitle .24, Parts and!i6_ofthe California Code of Regulations. . The design; features identified on this Certificate of Compliance are conslstent.,W6 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: Chris Brown Signature: Chris grown Company: D C S HEATING &,AIR CONDITIONING INC Date: ]an 3, 2011 Address: 72-078 CORPORATE WAY STE 101 Ucense: '595145 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone; (760) ,343.5566 Reg;: 211-A0000077A-0:0000000-0000 Registration Date/Time--2011/01/03 121:'44-5,4 HERS Provider: Ca10ERTS, Ina: 2008 ResidenE:ial Compliance Forma July 2010.