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08-0740 (MECH)Y "gin •t•TAiyl 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: 5/02/08 Application Number: 108-00000740__ Owner: Property Address: ^47575 VIA FLORENCE ROSSMAN I APN: 643-110-022-221 -26152 - 47575 VI 0 -Application description: MECHANICAL LA QUINT 922 Property.Zoning: -LOW DENSITY RESIDENTIAL Application valuation: 5000 Contract r: RAY 0��% Applicant: Architect or Engineer: PALM- SERTC COND ?t308NC 42081 ONP PALM DESERT, 41 /iyjq (760)346-0677 Pj. �V 1' Lic. No.: 374937 ------------------------------------------------------------------------------------------ ' LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION r 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 7000) of Division 3 of the Business and Professionals Code, and my License is'in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided License Class: C20 License No.: 374937 for by Section 3700 of'the Labor Code, for the performance of the work for which this permit is _ (('`QQ issued. ate: 2`�CE ntractor: I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor ���1111 Code, for the performance of the work for which this permit is issued. My workers' compensation NER-BUILDER DECLARATION - insurance carrier. and policy number are: I hereby affirm under penalty of perjury that 1 am a empt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 238-0004656-07 following reason (Sec. 7031.5. Business and Professions Code: 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 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 become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7060) of Division 3 of the Business and Professions Code) or - - 3700 of the Labor Code, I shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of.Section 7031.5 by �•-- ^^�II�� - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: te:J'�-�O Ap ant: ( ) 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 WOR S. 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 NALTIES 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 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN , improvements are not intended or offered for sale. )f, 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' StateLicenseLaw 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.• , BAP.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 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 1-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 • of this county to, enter upon the above-mentioned property for inspection purposes. . Lender's Name: .. Date:' Siture (Applicant or Agent): Lender's Address: LQPERA4IT Application Number . . . ... 08-00000740 ,Permit . . . . . . MECHANICAL Additional desc . Permit:Fee- 33.00 Plan Check Fee 8.25 Issue Date . . . Valuation 0 Expiration Date 10/29/08 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 9.00 Special Notes and Comments REPLACE 1, 4 TON SYSTEM SPLIT SYSTEM (15 SEER, 80 AFUE) Fee `summary Charged Paid •Credited• Due." Permit Fee Total 33.00 00 .00. 33.00 Plan Check Total 8.25 .00 .00 8.25 Grand Total 41.25 .00 .00 41.25 LQPERAIIT - .. Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Proj tie: Date: / © CaIC=RTS 2005 EnOrA forcement%A Use OnI" Pro)ect Address: Climate Zone: Byidmg Perrot# " '74 4 ///l o n ame: J /� Field Check IMPORTANT: This CF -1R -ALT form is only for use when an , C- my alteration is made to an existing home. Use one form for each system beingaltered. This is system # I oy systems altered in this house. �eope. of Alterations: IORE Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. Furnace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to next li ie. 3 outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined Continue to next line. 4� 'cooling or heatingcoil is to be installed or laced. Duct Sealingand/or TXV(RCA) to be determined. C•xdinue to next line. 5 103 more than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be da;termined. ❑ Check here if the f111im duct system is also to be new or replaced. Contuiue to next line. 6 ❑ If none of lines 1-5 are checked, neither Duct Sealing nor TXV(RCA) are required. Go to Section 5. Section 1 - Duct Sealing (Only if any of Lines 1 2 3 4 or 5 are checked. Skip if Line 6 is check --d. 7 ❑ This system is in Climate Zone 1 3, 4 5, 6, 7, or 8. No duct sealing is required. Go to Section 2.- 8 ❑ This system has less than 40 feet of ducts in unconditioned space. No duct sealing is required. Go to Sectior 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF -4R form. Go to Section 2. 10 ❑ This ducts stem is sealed or insulated with asbestos. No duct sealing is required. Go to Section 2. Note: If the entire ducts stem is to be new or replaced, Lines 11-14 do not apply. 11 ❑ In Climate Zones 2,42 and 16: An 0.92 AFUE furnace will be installed in lieu of duct sealing and TXV if applicable). 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 ARD EER 12 condenser will be installed with TXV(RCA) D added duct insulation R-4 wrap on e)dsting ducts, R-8 new ducts in lieu of duct sealing. Go to Section 2. 13 ❑ In Climate Zones 9, 10, 11, 13, 14, or 15: An SEER 14 AbQEER 12 condenser will be installed with TXV(FlCA) D a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14. ❑ In Climate Zones 2, 9111. 12, 14 or 16: An SEER 14 AdQ EER 12 condenser will be installed with TXV(RCA) 15 U an'u.oz Nr ur rumace will ue 11 IJlaIIClI-- None of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Section 2 - TXV(RCA) (Only if Lines 3 or 4 are checked, otherwise got to Section 3 16 ❑ The system being altered is a package unit. No TXV RCA is required. Go to Section 3. 17 ❑ This system is in Climate Zone 8 and a 14 SEER air conditioner or 0.82 AFUE furnace is being installed. No TXV(RCA) is required. Go to Section 3. 18 ❑ is system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3.- .•19❑ 190 This system is in Climate Zone 16 and line 14 is not checked. No TXV(RCA) is required. 'Go to Section 3. 20 is system is in Climate Zone 16 and line 14 is checked and not line 16. TXV(RCA) is required. Go to Section 3. 21 is system is in Climate Zone 2 or 8-15 and line 11, 16 or 17 is not checked. TXV(RCA) is required. Ga to Section 3" Sectiin 3 - HERS Rater verification 2 If line 15 is checked, HERS verification is -required for Duct Sealing. 2If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verification is required for TXV(RC/y. 2 ❑ lif line 12, 13 or 14 are checked, HERS verification is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 13, 14 or 17 are checked, upgraded equipment efficiencies are required. List in Sectio■ 6. Section 5- Duct R -Values 26 ❑ If more than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed Package D requirements. 27 ❑ If less than 40 feet of duct is being installed or replaced, duct R -value must meet or exceed R-4.2 Section 6 - see next page Version u3-lu-ub • -y- . — ` This form can only be used on projects being verified by CaICERTS certified raters. w".calcerts.com Certificate of Compliance Prescriptive Method `HVAC -only Alteration CF -1R -ALT Project itl : Date: ����� • m CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only al eration is made to en existing home Use one form for each system being altered. This is system #_-_L- of t systems altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment must match type/location and meet or exceed of iicienaes/R-values. 28 Configuratio plit system O Package Unit 29 ❑ Air Handler P16as fumace, AFUE: OHeatpump FAU OHydronio FAU OOther 30AR' Heat Exchanger 31(4B Outdoor Condensing Unit C OHeatpump kfficlency SEER/HSPF: 1EER Of 32 ctZ;0 Goofing or heating coil AWIRC OHeatpump OHydronic 33 ❑ Duds Location, length (ft): R -value: All mandatory measures apply to any altered component. See MF -1 R - ALT forn. Compliance Statement: This certificate of compliance lists the building features and specifications needed to comply with Title 24,'Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individualwith overall project responsibility. The undersigned recognizes that compliance using duct sealing, verification of refrigerant charge, and TXV require installer testing and certification and verification by an approved HERS rater. Home Owner or Authorized Agent Documentation Aufhor Name: Name: Address: Company Name: City/State/Zip: Address: PALM DESERT AIR doNOrrIONING CWpAW Wit I Phone: City/State/Zip: PALM DESERT, CA 92211,610, (760) 346-0677 Phone: + Signature: lg re: Enforcement Agency (Building Department) Notes/ m ents: Name: Title: Department: Phone #: Fax #: Signature or Stamp: , Required forms: CF -IR -ALT: by anyone. Required at time of permit'application. Copies to home owner, enforcement agency, HERS rater. CF -6R -ALT: by installing contractor. Required to Gose permit. Copies to home owner, enforcement a-3ency, HERS rater. CF -4R -ALT: by HERS rater. Required to Gose permit. Copies to home owner, enforcement agency, installer. The CF -4R forms for a sample group shall not be released until all testing and verification is completed and passed for the entre group. version U3-lU-Ub rage c of c This form can only be used on projects being verified by CaICERTS certified raters. www.r-aloerts.com ul;r ' f City of La Quinta Building 8i' Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # C Project Address: 7-sz_ Owner's Name: A. P. Number: Address: ' S Legal Description: City, ST, Zip: r Contractor: Tele hone: P SAL Address: 42081 BEACON HILL` s City, ST, Zip: (760) 346 0677 . . Project Description: Telephone: City Lic. #: State Lic. # 3 Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ons Ctruction Type: yp Occupancy: :::''C: 4ti?i$:;:sF..4�r}�j:yj)n:•i:}{:}r'i':;M`v.}{ State Lic. #:''^r >%>:>'• :i . % i ° '< Project type (circle one): New Add'n Repair Demo Name of Contact Person: Sq. Ft.: # Stories: #Units: / Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT 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 Constructioa 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:- '"' 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 ,v^a10ERTS CERTIFICATE OF FEEL 47-575 Via Floren Project Address Contractor Contact Certifying Signature Firm: Ai Street Address: Pt Copies to: HOM60i This CF -411 has bee CaiCERTS® is an al HERS RATER COM The house was 9 1 As the HERS rater pro diagnostic tested corn system Is fully ducted release the CF -411 unt The Installer has New Distribution New systems wh backed, rubber e Page 1 of 2 of Palm Desert A/C - Heating / 374937 Contractor Name / License No. 08-740 Telephone Permit Number '7-1724 114189 Telephone Sample Group Number 15,2008 CC14-1798454771 Date Certificate Number HERS Provider:Ca10ERTS, Inc. City/State/Zip:La Quinti / CA / 92247 registered with the CalCERTS@ registry in accordance iroved HERS provider by the California Energy Commi: LIANCE STATEMENT the Title 24 & Title 20 of the CCR. ted DApproved as part of sample testing, but was not tested. ng diagnostic testing and field verification, I certify that the house Identified on this `orm complies with the nce requirements as checked on this form. The HERS rater must check and verify th.3t the new distribution J correct tape Is used before a CF -411 may be released on every tested building. The MERS rater must not properly completed and signed CF -611 has been received for the sample and tested buildings. wided a copy of the CF -6R (Installation Certificate). dem is fully ducted (i.e., does not use building cavities as plenums or platform returis in lieu of ducts). cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are use•i In combination with doth sive dud tape to seal leaks at dud connections. uw!- n"tMvlr. MMINIMUM REQUIREMEN115 rvic MIUB Lxftn#%%x& ..�.......-�-••----- NEW CONSTRU4 TION Measured Dud Pressuriza ion Test Results (CFM Q 25 Pa) Values N/A 1 - fes, Fan Flow: Cal la ted (Nominal'.' Cooling �_ Heating) or'-_' Measured 1600 2 Enter Total Fan Flow in CFM: D/A N/A 3 IF Leakage mtage -c- 6qb ALTERATIONS: uct System and/or HVAC Equipment Change -Out Enter Tested kage Flow In CFM from CF -611: Pre -Test of Existing Dud System Prior to 4 Dud System All tion and/or Equipment Change -Out. Enter Tested kage Flow in CFM: Final Test of New Dud System or Altered Dud System 'a71 5 for Dud Syste Alteration and/or Equipment Change -Out. 6 Enter Reductfor in Leakage for Altered Duct System [Une 4 - Une 5 - (Only if Applicable) 7 Enter Tested U 3kage Flow in CFM bo, Outside (Only if Applicable) 8 Entire New Du System - Pass if Leakage Percentage < 6% [ 100 x ( Une 5 / Une 2 )]: ❑ Pass ❑ Fall TEST OR VERI CATION STANDARDS: For Altered Duct System and/or HVA. Equipment Chalige-Out, use one of the following four Test or Verification Standards for c 3mpliance: ❑ Fail 9 Pass if Leakag Percentage < 15% [ 100 x ( Une 5 / Une 2 )]: 1&94% Pass 10 Pass if Leakage to Outside Percentage <= 10% [ 100 x ( Une 7 / Une 2 )]: El Pass El Fail Pass If Leakage Reduction Percentage >= 60% [ 100 x ( Une 6 / Une 4 )] ❑ Pass ❑ Fail 11 and Verificatlor by Smoke Test and Visual Inspection Pass If Sealing 3f all Accessible Leaks and Verification by Smoke Test and Visual Inspection Pass ❑ Fall 12 Pass if One of Lines #9 through #12 pass � Pass ❑ Fail CaICERTS CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING Pa a 3-4 of 81 CF-4R 47-575 Via Florence - La QuInta. CA 92253 Palm Desert A/C - Heating / 374937 Contractor Name / Ucense No. Project Address 08-740 Contractor contact Telephone Permit Number PpW Van VI men 760-777-1724 114189 H RSXtater Telephone sample Group Number 5, 2008 • J v - CertUying signature CC14-1798454771 Date Certificate Number Firm: Al Experts Air Conditioning HERS Provider:Ca10ERTS, Inc. Street Address: P Box 94 City/State/Zip:La Quanta / CA. 92247 ies-to:-Zea er, MFRS pj%xvi er_and Act p . artment _. CaICERTSO registry in accordance with the Title 24 & Title 20 of the CCR. This CF-4R has beer registered with the ICERTS is M.2 roved HERS provider by the Califomia Energy Commission. HERS RATER COM PLIANCE STATEMENT The house was R T sted ElApproved as part of sample testing, but was not tested. I certify that the house identified on this form complies with the As the HERS rater proi ding diagnostic testing and field verification, c tested comp lance requirements as checked on this form. nE Installer has i rovided a cop of the CF-6R (Installation Certificate). MOSTATI EXPANSION VALVE : Access is provided for inspection. The procedure shall consist of visual verification that the TXV is installed on the s stem and installation of the specific equipment shall be verified. HVAC System TXV © Pass ❑ Fail