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10-0871 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: -- -10-0000087.1 Property Address: 47785 VIA FIRENZE APN: 643-130=00.1-1. -26152 - Application description: MECHANICAL' Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT_ BUILDING PERMIT Owner: LANE DAVID 47785 VIA FIRENZA LA QUINTA; CA 9225 ( Contractor: J ANTHONY PLUMBING 72216 NORTH SHORE THOUSAND PALMS, CA (760)343-2121 Lic. No.: 777794 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153. Date: 9/07/10 - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with. I hereby affirm under penalty of perjury one of the following declarations: Section 700 9) of Division 3 of the Business and Professionals Code, and m License is in full force and effect. . Lice CI s: 20-C36 License N . 77794 _ 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. Date W .Contractor. _ I have and will maintain workers' compensation insurance, as required by Section 3760 of the Labor " - Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION ,. insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1932451 following reason (Sec. 7031 .5, Business and ProfessionsCode: Any city or county that requires a permit to - _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any - construct, alter, improve, demolish,.or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit td 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 become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3 00 of the Labor Code, I shall forthwith comply with thseovisions. ' 7� that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 9/ 7 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: - Date: - "�� Applicant: - (_) 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 WARNING: ,FAILURE TO SECURE WORKERS' COMPENSATION 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 PENALTIES AND CIVIL 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 - ( ) 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(s) 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, (_) I am exempt under Sec. , 8.&P.C. for this reason 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. Date: Owner: - 2. Any permit issued as a result of.this application becomes null and void if work is not commenced r 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 the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097 Civ. C.). - - city and county ordinances and state laws relating to building construction, and hereby authorize representatives _ Lender's Name:. of t co my t enter upon the above-mentioned property f spection p s. Cp9s� ` `� f �+� - Da tCt SignaturefApplicant or Agent): Lender's Address: "- LQPERMIT Application Number 10-00000871 Permit . . MECHANICAL. Additional desc _ Permit Fee 33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 3/06/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.0.0 ---------------------------------------------------------------------------- Special Notes and Comments INSTALLATION NEW HVAC CHANGE OUT 4 TON 14 SEER UPLFLOW SPLIT SYSTEM CHANGE OUT SAME FOR SAME IN ATTIC 2007 CODES.' --------------------------------------------------------------- ---------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due"- Permit Fee Total. 33.00 .00 ---- .00 33.00 Plan Check Total 8.25 00 .00 .8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT I [:Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R ALT -HVAC Climate Zones 10 to 15 iY 1 5 VIA�j ` `\ -z_ . f rA Permit #. —Equipment Type' O Packaged Unit List Minimum Efficiency' Duct insulation requirement Conditioned Floor Area ermostat M'S'etback EYFurnace ndoor � FUE �b O COP Over 40 ft of ducts added or Coil , EER FF O HSPF replaced in unconditioned space Served by. system of not already ET Condensing Unit _ l7 EER O Resistance O R 6 (CZ /0-13) sf rc prent,'must be O Other OR 8 (CZ 14-15) installed) !. EquipmentType: Choose the equipment being installed. if more than one system, use another CF -1 R -ALT -HVAC for each system. 2. Minimum Egs*ment 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 condutxed. A Dopy of the `orms shall be le@ for onsite final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this formw&4 in.fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF411 forms.(no hand filled CF-4Ps are allowed) filled out and sign9d. Beginning October 1 2010,a realftered copy of the CF -1R and CF=6R shag also be on site for finalInspection. 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 -411 forms: MECH- 21 and for split stems MECH-25 • Condenser Coil and /or • Indoor Coil 'and/or CF -6R forms: MECH-21-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 < 1'5 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow 116quirement); TMAH For Packaged Units: Duct leakage < IS percent Exempted from duct leakage testing if O 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or, O 2. Duct systems with less than 40 linear feet in unconditioned space, or O 3. Existin duct are constructed, insulated or sealed with asbestos . 0 2. New HVAC System Required Forms: with new • Cut in or Chang ducting duan: (all new dudutg and all CF -6R fors: MECH-04, MECH-20-HERS and (for split systems) MECH-22-HERS, and MECH-25-HERS 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,: SIMS, and either HSPP or PSPP. For Packaged Units: Duct leakage <.6 percent 03: New Ducts with Replacement* Required Forms: • Includes replacing or installing all new ducting CF -6R fors: MECH-04, MECH-204EERS,and.(for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor . CF -41K 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 c:6 percent O 4. New Ductin over 40 feet Regittred Forms: or replacing more than'40 • linear feet dingof - linear feet of duct in unconditioned ce. CF -6R forts: MECH-04, MECH-2I-HERS CF -4R Farms MECH-21 For split system or packaged units: Duct leakage < 1.5 percent . . O EXCEPTION: Existing duct s*Ys-tems`c'0nis*tructe4 insulated or sealed with asbestos. Contractor (Documentation Author's /Responsiblb Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is acauate.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 design the identified on this Certificate of Compliance conform to the requiretttetits of Title 24, Parts I and 6 of the Catifontia.Code of:Regulations. • The design features ndennified on this Certificate of Compliance arc consistent with the information documented on other applicable compliance forms�oiicsheets, calcul dons, lans ands ifications submitted to the enforcement for approval with the lic ition. Name: . Lt U. ( � �. Signature:. < 1� Company: Date: / RVICES: Address: 72216 NORTH SHORE ST.'STE 101 Vim; USAND PALMS CA .9.W6 —7. 9 1 City/StatrJZip: _ Phorie:-7; ZUU6 Kesidential Compliance Forms March 2010 Bin # Cit/ Of La Quint Building 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:L Ti'i6- V 1 A lFC Owner's Name: CA(J L Q U—N KJIE A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: 72216 NORTH SHORE ST.,STE i09 Address: Telephoner( (- , , Project Description: —1 +& N (-4 5 6 6.(Zl City, ST, Zip:!`' LkP joSPU-1- 3--(S rr M Telephone.(7✓ ��� `Z,l City Lie. #; ` U TTI L, C [J10 K V OiAL State Lie. # :. 7 Arch., Engr., Designer, Address: City., ST, Zip: Telephone: ' p State Lie. #:' .f 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: APPLICANT: DO NOT WRITE BELOW THIS LINE tl Submittal Req'd Recd TRACKING TERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. 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 Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Ud Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A,LP,P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees