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12-1312 (MECH)P.O. BOX 1504 VOICE (760)777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT NSPECTIONS: (760) 777-7153 BUILDING PERMIT Date: 11/05/12 ' Application Number: :12-00001312 Owner: Property Address: '48508 -VIA ENCANTO JACKIE KAUFMAN t D APN: 646-091-048- - 48508 VIA ENCANTO Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL NOV 05 2012 Application valuation: 7325 L u Contractor: CITY OF li4 QUINTA Applicant: Architect or Engineer: PREFERRED PLUMBING HTG A FINANCE DEPT. P.O. BOX 5120 PALM SPRINGS, CA 92263 ' (760) 322-3173 '•J �^ Lic. No.: 457554 • LICENSED CONTRACTOR'S. DECLARATION' - WORKER'S COMPENSATION DECLARATION - +• . t: I hereby affirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - - Section 7000) of Division 3 of thABusines Professional Code dmy License is in full force -and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Lic a Class: C10 C16 C— Li a 57554 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: ontractoI 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 OWNER- UILOER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am from the Contractor's State License Law for the Carrier EVEREST NATL Policy Number .7600006445121 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance ofthe work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuanue, also requires the applicant for the person in any manner so as to jecome subject to the workers' crimpenswinn laws of California.. permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should b e subject to the kers' o pen tion provisions of Section License Law (Chapter -9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, all fort ith com o pro siohs. , 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).: ate:�� e -- pplicant: - ' 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 WARNING: FAIL RET I SECURE WORKERS' MPENSA ION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTI D IVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the - DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _ 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.). APPLICANT ACKNOWLEDGEMENT 1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(sl licensed 1. Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application_ . - (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 0 of La Quinta, its officers, agents and employees for any actor omission related to the work being - ' ` performed under or following issuance of this permit. Date:. Owner: 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 CONSTRUCTION LENDING AGENCY - permit to cancellation. , I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the - " I certify that I have read this application and state that thea a information is correct. I gree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to build; g onstruction, a hereb a or'ze representatives of [his c my%to/enter upon the ove-memioned propert r insp cion p rp se Lender's Name: ign re (Applicant or Agent)• Lender's Address: LQPERMIT - • - Application Number . . . . . 12-0.0001312 Permit . . . MECHANICAL Additional desc . Permit Fee . . 40.50 Pian Check Fee 10.13 Issue Date . . . . Valuation . . 0 Expiration Date 5/04/13 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 HVAC CHANGE -OUT: REPLACE CONDENSER, FAU, -EVAP COIL, 5 TON, 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 - .. Sim lifed Irescri five Certificate of Com fiance: 2008 Residential HVA CAlteradons . CF-1R4LT-HVAC , Cliiaate Zoa;�s 10 to 15 Site Address: 5v VlA �NCAK� IO orcement Agen pr Date: t1 <2-07 Permit #: Co ditioned Floor Eq ui ment Type' List Minimum Efficiency2 Duct insulation requirement Area Thermostat ❑ Packaged Unit ff'�FUE &0 ❑ COP Over 40 ft of ducts added or - etback r Coil P4EPR ❑ HSPF _ replaced in unconditioned space ❑ R 6 10-13) Served by system I (If not already be ondensing Unit ❑EER ❑Resistance (CZ ❑ R 8 (CZ 14-15) !goo sf present, must installed) ❑Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -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 -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and sieVK Beginning October 1, 2010, a reg`stered copy of the CF -1R and CF -6R 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 • Indoor Coil and/or CF -611 forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -411 forms: MECH- 21 and (for split systems) MECH-25 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/tori(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 112. 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 s: Changeout with new ducts: CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS (all new ducting and all new equipment) CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 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: P 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 condensirig unit and/or indoor .CV -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 linear feet of duct in unconditioned space. CF-611forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 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. • I certify that the energy features and performance specifications for the design identified on this Cqrtificate of Complia/conrm to the requirements ofTitle 24, Parts I and 6 of the California Code of Regulations. The design features identified on this Certificate of Compliance are consistent with the inform on documented on othle compliance forms, s eets, calculations, plans ands ecificatious submitted to the enforcement agency for approval with ermi ti . Name: �, ''e F:r�L Q e c� Signature: �+ Codress- PZE� � D 'PLO ka14c— R�ARNG I Date:. YI 1 ZOr Address:��License' j g / ••7 5�Cie/Zip:'_P. ty/Stat ISG epr Z 0 � Phone: `�0 — ZZ, – 3 1 7 -3 HVAC Permit Checklist Y = ComfortConsultant (RSP): Service Order'#: T 44 — �S Owner's Name: Jobsite•Address: — * CAJK� ' r - (�TA " Permit Application Declaration Page: ' ❑.Commercial Residential ❑ Single family residence ❑ Multi-ftmily residence ' Condominium ❑ Other: _ Name of Community: ' LAG cJJk d �� _X PA -z -- Location of pew unit on/in structure: �. G12.a0N)0 ` Plot plan required?: r , Line of sight - screened / parapet / distance from lot line: - Components to be: ❑ installed /> eplaced: like for.li "'or upgrade? (circle one) . w% Condenser - Size (tonnage)} FAU / Air Handler ,1 SEER: + `] Evaporative Coil 4 ❑EER: } ❑ Package unit - PGE or HP - ❑ Other: - . " . :.. y• - a CF4R-A Form: Aw. Project valuation: Date Permit Needed at Jobsite: Other Information: , , r a 130 # City of La Quints Building. U_ Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 -Building Permit Application and Tracking t Permit l Project Address:' .**­Owner's Name: J' c Kl E A P. Number; Address: y�S Y / A �/!%Cf%N iU. . Legal Decripfion 3 > ' `: s' City, ST, Zip: 1-0 L.lv 9.2,P 6r3 pprefrxe A>r= Conditioning dba Con hraetor " ,P-".fer..r.e.:r� ..Plumbin • Heatin &Ai Telephone: �. / 7 Address:':]?0°:Bo;.5:;?0°.' _ Project Description:/3G City,ST;;Zp;Pa'lm ' ;px_:: -digs';:: CA, 9226 S' Cdr►iAe�n/Sa�P U aa?�• Tel hone: 7 6 t) ':3? 2= 3 T 7 State Lie#;.::4::75'54:` CityLic..#: Arch.,°Ei�gr:;'IDesigner Address: `. 13 t�C^ Ci_ty,.ST;