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07-1582 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO • FAX (760) 777-7011 LA.QUINTA; CALIFORNI,02253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153' BUILDING PERMIT, _ - Date: 5/29/07. Application Number: 07-000O'1582�zz_� Owner: ' Property Address: 49_915. VIA _KATALINA PERKINS DAVID _ APN: 649-500-013- - .49915.VIA KATALINA Application description: MECHANICAL r' LA QUINT_ A, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL f (rte U Appliootion valuation; i. ?nn Contractor: MAY 2 9 2007 Applicant: Architect or Engineer: PALM DESERT AIR CONDI O ING 42081 BEACON HILL CITY OF LAQUINTA _ PALM DESERT,. CA 92211 FINANCE DEPT L (760)346-0677, Y •Lic. No. 374937 . LICENSED CONTRACTOR'S DECLARATION _ • - WORKER'S COMPENSATION DECLARATION - 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 'Division 3 of the Business and Profes ion 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 ss: C20 License No.: 374937 - _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate: � Z onuactor." - I 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 O R -BUILDER G RATION ' insurance carrier and policy number are: - hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number. 1795546-2007 _ following. reason (Sec:T7031.5; 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 7000) of Division 3 of the Business and Professions Code) or 3700 of the Lab Code I shSt-eMP�N7SATI07 those rovisions. • 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:, A c t: . (_) 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 WORKERAGE 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 .. r 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 P 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_ rproperty 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, 1 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 - - - - _ 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 I have read this application and state that the above inf 's-ee ct. 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 o ruction, and hereb uthorize representatives l of this county to enter upon the above-mentioned pr erty r i sp ction pur y - Lender's Name: ��T1t1iYUCt D'_1_ ,y 5665 re (Applicant or A Lender's Address: - _:• " LQPERMIT • .. .. ... _ Application Number . . . . 07-00001582 Permit MECHANICAL ". Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6.00 . Issue Date . . . Valuation 0 Expiration Date .. 11/25/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9'.0000 EA MECH, B/C- <=3HP/100K BTU 9.00 ------------------------------------------------------------------ Special Notes and Comments REPLACE 1 COIL - Fee summary Charged Paid Credited Due Permit Fee Total 24.00, .00 .00 -----24.00 Plan Check Total. 6.00 .00 00 6.00 Grand Total 30.00 .00 .00 30.00 LQPERMIT .. in B# City of La Quinta Building 8r Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. Gcb Project Address: 9�t�. Owner's Nam y .. Address: A. P. Number: Legal Description: City, ST,� > TeleP hone ��y tY.i'/ Project Description: �. Contractor: 42081 BEACON HILL PAW BESER:F, GA 92241 649;L- Address: (760) 346-OW City, ST, Zip: Telephone: State Lie. # ? Arch., Engr., Designer: IVIA Address: City., ST, Zip: Telephone: hone: '` Construction n T o e: Type: ancn Occupancy: P Y• State Lie. #: Project type (circle one): New Add'-a Alter Repair Demo Ft.: # Stories: # Units: Name of Contact Person:Sq. Telephone # of Contact Person: ,3 0/j I% Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd _ Rec'd 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 Construction Flood plain plan Plans resubmitted Mechanica' Grading plan 2nd Review, ready for correction issu N Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- "d 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 9 Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1 R -ALT Projec'tle: Date: ©GaICERTS 2005 Enforcement Agency Use n PrcTrectAddress: Qlimate Zone: Building Permit Al Docu a tion Au!tpg Telephon 0 e: Plan Check Date 'eld Check Data. IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC- ly alteration is macra to an existing home Use one form for each system being altered. This is system # of / systems dtered in this house. Check all lines that apply. Check only lines that apply. Scope of Alterations: 1 ❑ An Air Handler is to be installed or replaced. Duct sealing to be determined. Continue to next line. umace Heat exchanger is to be installed or replaced. Duct sealing to be determined. Continue to neA line. ❑ An outdoor condensing unit is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. cooling or heating coil is to be installed or replaced. Duct Sealing and/or TXV(RCA) to be determined. Continue to next line. 5 ❑ More than 40 feet of new or replacement duct are to be installed in unconditioned space. Duct sealing to be determined. ❑ Check here if the entire duct system is also to be new or replaced. Continue 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 checked. 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 Sectibn 2. 9 ❑ This system was previously sealed and tested, and was certified by a HERS rater. No duct sealing is required. Attach previous CF4R form. Go to Section 2. 10 ❑ This duct system 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 12 and 16: An 0.92 AFUE furnace will be installed in lieu of duct Sealin and TXV if as licable . 12 ❑ In Climate Zones 10, 13 and 15: An SEER 14 AM EER 12 condenser will be installed with TXV(RCA) AND added duct insulation R4 wrap on existing 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 Aha EER 12 condenser will be installed with TXV(RCA) AND a 0.92 AFUE furnace will be installed in lieu of duct sealing. Go to Section 2. 14 ❑ In Climate Zones 2, 9, 11, 12, 14 or 16: An SEER 14 AhM EER 12 condenser will be installed with TXV(Rr..A) AND an 0.82 AFUE furnace will be installed with increased duct insulation in lieu of duct sealing. Go to Section 2. 15 None of lines 7-14 above are checked. Duct Sealing Is Required. Continue. Se ion 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 ❑ This system is in Climate Zone 1 3 4 5 6 or 7. No TXV(RCA) is required. Go to Section 3. 19 ❑ Thiss stem is in Climate Zone 16 and line 14 Is not checked. No TXV(RCA) is required. Go to Section 3. 20 ❑ This s stem is in Climate Zone 16 and line 14 Is checked and not line 18. TXV(RCA) Is required. Go to Section 3. 21 This system Is in Climate Zone 2 or 8.15 and line 11, 16 or 17 Is not checked. TXV(RCA) Is required. Godo Section 3. k 3 - HERS Rater verification JSe� 22If line 15 is checked, HERS verification is required for Duct Sealing. 23 ❑ If line 12, 13, 14, 20 or 21 are checked and not line 16 or 17, HERS verlficaUon Is required for TXV(RCAL 24 ❑ If line 12, 13 or 14 are checked, HERS verlflcaUon Is required for 12 EER. Section 4 - Equipment Efficiencies 25 ❑ If lines 11, 12, 130 14 or 17 are checked, upgraded equipment efficiencies are required. List In Section S. 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 regmirements. 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 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com M Certificate of Compliance Prescriptive Method - HVAC -only Alteration CF -1R -ALT Project T' Date: ©CaICERTS 2005 IMPORTANT: This CF -1 R -ALT form is only for use when an HVAC -only alt�ation is made to an existing home Use one form for each system beingaltered. This is system # /-of systerns altered in this house. Section 6 - Minimum Requirements for Equipment to be Installed/Altered. Installed equipment usl match type/bcation and meet or exceed efficlencies/R-values. 28 Configuration. plit system O Package Unit 29 ❑ Ah Handler ❑Gas furnace. AFUE: OHeatpump FAU ❑Hydronic FAU ❑Other 30 ❑ Heat Exchanger 31 ❑ Outdoor Condensl Unit OA/C OHeatpump bficiency SEER/HSPF: 1EER it read): 32,W Cooling or heating coil OA/C OHeatpump 131-lydronic 33 O Ducts ocation: ILength (ft): R -value: All mandatory measures apply to any altered component. See MF -1 R - ALT form. 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 individual with 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 o uthorized Agent Documentation Author Name:Name: �ZA' A� Addr s: Company Name: City/State/Zip: Address:COMPANY 42081 BEACON HILL PALM DESERT, CA 92211-5107 Phone: City/State/Zip: Phone: Signature: Sign re: Enforcement Agency (Building Department) Notes/Comments: Name: Title: Department: Phone #: Fax #:, Signature or Stamp: Required forms: CF -1 R -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 close permit. Copies to home owner, enforcement agency, HERS rater. CF4R-ALT: by HERS rater. Required to close permit. Copies to home owner, enforcement agency, installer. The CF4R forms for a sample group shall not be released until all testing and verification Is completed and Passed for the entire group. %1-1... no 4n ne - This form can only be used on projects being verified by CaICERTS certified raters. Nage 2 of 2 www.calcerts.com