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11-0927 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000927 Property Address: 81675 DESERT WILLOW DR APN: \,764-270-999-41 -300231- Application description: MECHANICAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 18700 Applicant: c&ht aF4w Architect or Engineer: r`V BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 ProfessAnals Code, and my License is in full force and effect. Licens Class: C20 License No.: 686310 ate: Z omractor: 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 1$5001.: (_ 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 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: LQPERMIT Owner: KAREN BROWN 81675 DESERT WILLOW DRIVE LA QUINTA, CA 92253 Contractor: GENERAL AIR CONDITIONING 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/29/11 D Q � AUG 292011 CITY OF LA QUINTA ' FINANCE DEPT p 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. ➢l I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor i' 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 beVb bject to the workers' compensation laws of California, and agree that, if I should becomto the workers' compensation provisions of Section r� /3700 of the'Labor Code, 1 shallfcomply with those provisions. Date: 'S� pplicant: WARNING: FAIL RE TO SECURE WOR ERS' C MPENSATION 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 Ouinta, 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 above inf ation is correct. I agree to comply with all city and county ordinances and state laws relating to building cons on, and hereby authorize representatives of tr* county to�enter up the above-mentioned property for in tion purposes. aD te:�1/ I( 'nature (Applicant or Agentl: I (t LQPERMIT Application Number . . . . . 11-00000927 Permit MECHANICAL Additional desc . Permit Fee 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/25/12 Qty Unit Charge Per Extension BASE - FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ---------------------------------------------------------------------------- Special Notes and Comments CHANGE OUT 2 HVAC SYSTEMS, (1) 3 TON AND (1) 4 TON: CONDENSERS, FURNACES & COILS AT GROUND LEVEL. 2010 CODES. ------------------------------------7--------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee.summary Charged Permit Fee Total 66.00 Plan Check Total 16.50 Other Fee Total 1.00 Grand Total 83.50 Paid Credited Due .00 .00 66.00 .00 .00 16.50 .00 .00 1.00 .00 .00 83.50 Sim lifted Prescriptive Certificate of Compliance:- 2008 Residential HVACAlterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address. i � � jEnforre t Agency: Date: Z/ I! � Its Permit 4., Conditioned Floor Equipment T et List Minimum Efficiency z Duct insulation requirement Area Thermostat ❑ Packaged Unit Furnace D ❑ AFUE 80 �v ❑ COP Over 40 ft of ducts added or Setback Indoor Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (if not already ondensing 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, 73%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 ed. Be innin October 1, 2010, a re istered co of the CF -1R and CF -6R shall also be on site for final ins ection. . HVAC Changeout if, 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 • 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/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from 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 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 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. • 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Tille 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the • orrn tion documented on other optic ompliance forms. worksheets, calculations, plans ands specifications submitted to the enforcement a enc fora ro al with t epen-nit application. Name: Co r!teen uj�-S6n Si lure: /� Company: e_jie('a.C' 41r t�Di1G�e �.`D �7 t` / Date: 9-24-0 Address: 30-70 12eseeoe & `tt✓t✓ License: 6810366 City/State/Zip:-��p PALlr—S, Cq ga-"A7 Phone:-74,0..3lyl3_-74U Simplified Prescriptive Certificate of Compliance: -2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: — s G—.� \ forcem gency: Dat ]ry ?�- Permit Permit €l: g1 W� IrY C.X3 l V' J I"'N (,J y(„J Conditioned Floor Equipment T et List Minimum Efficiency Z Duct insolation requirement Area Thermostat ❑ Packaged Unit D o 417umace ❑ AFUE 80 A ❑ COP Over 40 ft of ducts added or Setback ndoor Coil ❑SEER 13 ❑ HSPF replaced in unconditioned space Served by system (if not already ensing Unit ❑EER 1 / _ ❑Resistance ❑ R 6 (CZ 10-13) sf present, must be ❑ Other ❑ R 8 (CZ 14-15) installed) 1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -IR -ALT -HVA Cfor 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 -6R and registered CF -411 forms (no hand Filled CF-4Rs allowed) are filled out and si ed. Beginning October 1, 2010, a registered copy of the CF -IR and CF -611 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 • 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/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exemp ed rom 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 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 Re uired Forms: • includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2i-HERS CF -411 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) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 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 pplic ompliance forms, worksheets, calculations, plans ands specifications submitted to the enforcement agency fora ro al with t e permit applicatior Name: lfeeh Si ture: , Company: n,e41'r n,e�a.( L.�t' r Condi �'� on t Date: Address. 3ll-7o Peyer ue APn'vPi License: 6004,3(o City/State/Zip:—r—kDt1,5a411( Ay—t5, GF} g9J74 Phone: 7&0-343--74F9 CaICERTS - CF -1R Registration Page IofI Public Home Danielle Garcia logged in [Logout] [Home] Secure Home About Us Training Rater Directory CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 81675 DESERT WILLOW DRIVE Quinta, CA 92253 CEC Registration: 1211-A0044381A-00000000-0000 Forms CF-IR-ALT-HVAC:ICLICK HERE TO DOWNLOAD Membership Benefits Events Industry Partners News To register for our monthly newsletter, please click here. Assigned Company: I HARRISON ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -IR to them. CaICERTS Rater ID: OR My Rater Quick Select:Energy Driven Solutions, Inc. Every CaICERTS rater has a license number. Ifyou need to find the rater by name [Click HERE] to search our directory. fes _ SEND`CFIR�TOHERS5RATER ;I [CLICK HERE] to do another Copyright Q© 2010 CaICERTS, Inc. All rights reserved Revised: January 11, 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us if T BBB .#iredlusonat;gbOpk�:� httns://www.calcerts.com/public cf1R.cfm?Droiect id=134440 8/26/2011 CaICERTS - CF -1R Registration Page 1 of 1 Public Home Danielle Garcia logged in [Logout] [Home] Secure Home CONGRATULATIONS About Us Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Training Site Address: 81675 DESERT WILLOW DRIVE Rater Directory La Quinta, CA 92253 CEC Registration: 211-A0044383A-00000000-0000 Forms CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company: HARRISON ENTERPRISES INC Membership Benefits Do Do you know your HERS Rater? Events you do, you may want to send this CF -1R to them. Industry Partners CaICERTS Rater ID: OR News My Rater Quick Select: Energy Driven Solutions, Inc. Every CaICERTS rater has a license number. To register for our If you need to find the rater by name [Click HEREJ to search our directory. monthlyI. SEND GF -1-g —TQ-REFSaRATERal newsletter, please click here. [CLICK HERE] to do another Copyritrhi (0 2010 CaICERTS. Inc. All rights reserved. Revised: January Ill: 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Offide: 916-985-3400,Toll Free: 877-HERS-R8R, (877-437-7787) Fax: 916-985-3402 Contact Us BBB;,flrtpttrgan.hgQgttQd�t,� httDS://www.calcerts.com/public cf1R.cfm?nroiect id=134442 8/26/2011 Big # Cit/ Of La Quinta • Building &r Safety Dh4sion .O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit- Application and Tracking Sheet . Permit #P Project Address: I IMA) Owner's Name: A. P. Number: Address:, ��5' �('01Av Legal Description: City, ST, Zip: Contractor: #1 Telephone. '? �:✓,..`' Address: 3 Project Description: City, ST, Zip: 1 Telephone: State Lic. # : 3 k') CityLic. #;, 3-60040 �^ Arch., Engr., Designer: Address: City., ST, Zip: Y F.v�'+�f .. Telephone:{f .y ,+ State Lic.-�s� Construction Type: Occupancy: Project },tee (circle one New Add'n Alter Repair Demo Name of Contact Person: p U(g >-1 60,z,:1L5 OYh Sq. Ft.: #. Stories: # Units: Telephone # of Contact Person: - Estimated Value of Project; E.77 00 19p APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal Req'd' Ree'.d TRACKING PERMIT FEES Plan Sets: Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person )Plan Check Balance. Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan tad Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review,.ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P.. Pub. Wks. Appr. Date of permit issue School Fees Total Permit Fees