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13-0605 (MECH)1 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/13/13 Application Number: 13-00000605 Owner: Property Address: 55516 FIRESTONE DON HEARN APN: 775-151-073- - - 55516 FIRESTONE Application description: MECHANICAL LA QUINTA Property Zoning: LOW DENSITY RESIDENTIAL LA QUINTA, CA 92253 A Application valuation: 2625 D Contractor: MAY 13 2013 Applicant: Architect or Engineer: GENERAL AIR CONDITIONIN 11 31170 RESERVE DRIVE THOUSAND PALMS, CA 9227 CITY OFIAQUINTA (760) 343-7488 FINANCE DEf .. N Lic. No.: 686310 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 C� lass: �C20 License No.: 686310 Date:..CJii.311� Contractto% fi 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 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 thepurposeof 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. , BAP.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: DA Lender's Address: ` ` LQPERD1IT 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. 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 V insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741502 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 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. '�2J � Date:� �Applicant: / �y 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. I certify that 1 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 cou ty to enter upon the above-mentioned property-f�inspection purposes. c yr' Date 3 D Signature (Applicant or Agent��L���2� c Application Number . . . . . 13-00000605 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 42.00 Plan Check Fee 10.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/09/13 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 4.5000 EA MECH VENT INST/ DUCT ALT 27.00 ----------------------------------------------------7----------------------- Special Notes and Comments REPLACE (6) DUCT RUNS. 2010 CALIFORNIA BUILDING CODES. -----------------------------------------------------=---------------------- Other Fees . . .. . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited -------------------- Due ----------------- Permit Fee Total -------------------- 42.00 .00 .00 42.00 Plan Check Total 10.50 .00 .00 10.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 53.50 .00 Ao 53.50 LQPEIN1IT Bin.# City, of La Quinta Buliding & Safety Division P.O. Box 1504,78-495 Calle Tamp1w - 1.a Wail, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Perinit # �n " Project Address: o i tG'S Owner's Name:. b o h Cw�t L C Y`% A. P. Number. Address: re111G . Legal Description: City, ST, Zip: CA Cl ZZS 3 ' Contractor. aTelephone: ym ( Address: 3\00 Project Description: City, ST, Zap: GA Telephone: State Lic. # : (o City Lir #: Arch, F.nfr., Designer Address: City., ST. Zip: Telephone: State Lic. #: Construction Type: _ Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq: Ft.: # Stories: # Unit;: Name of Contact Person: Telephone # of Contact Person: Estimatod Value of Project 2 &,,:2-5. 00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACING PERMITFEES Pip Sets Pian Cheek submitted Itrm Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit. . F_ Truss Calci. Called Contact Person Plan Cheek Balance Title 24 Calci. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan P! Review, ready for correctionsfiissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SMI. II.O.A. Approval Plans resubmitted Gradlog IN HOUSE:- ''� Review; ready for corrections/issue Developer Impact Fee Plaool" Approval Called Contact Person A I P.P. Pub. W.ks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential RVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: Enforcement Agency: Date: Permit #: e C- �N OF L -5 13 13 Conditioned Floor Equipment T el List Minimum Efficiency 2 Duct insulation requirement Area Thermostat Packaged Unit Furnace � AFUE � COP copHSP Over 40 ft of ducts added or 0 Setback Indoor Coil SEER 8 re laced in unconditioned space R 6 (CZ 10-13) Served by system sf (If not already present, must be POther Condensing Unit g EER Resistance R 8 (CZ 14-I5) installed) c— -5 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% AFTIE, 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 fortes 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and signed. Beginning October 1 2010 a registered copy of the CF -1R and CF -6R shall also be on site for final inspection. [3 1. HVAC Changeout Required Forms: CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • All HVAC Equipment replaced CF -4R forms: MECH-21 and fors lit 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: 8 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 El 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 s ce. For splits stem or packaged units: Duct leakage < 15 percent Lj 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, calculationsplans and specifications submitted to the enforcement a a oval with the it application. Name: 7iSignature: S za S - Company.. Cjeh�rc�\ A�� �1 Date: S l3 13 1 Address: License: City/State/Zin: T�ov �r.� m A 9 2 2 7 Phone: 3N 3_ 74 $S 2008 Residential Compliance Forms July 2010