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13-0951 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDI.NG & SAFETY DEPARTMENT SC�ED .INSPECTIONS (760) 777-7153. BUILDING PERMIT _ Date: 7/30/13, Application Number: 13-00000951 Owner:.' D Property Address: 78620. VIA MELODIA RACHEL MANSFIELD Q APN: 646-290-032- - 78620 VIA MELODIA Application description: MECHANICAL LA QUINTA, CA 92253 r�IJj Property Zoning: LOW DENSITY RESIDENTIAL ` r Ahd6 ®� �D�✓� Application valuation: 8768 CITYQ�� ®�Il�lTq. Contractor: F/�A14CE DEpT Applicant: Architect or Engineer: , GENERAL AIR CONDITIONING 31170 RESERVE DRIVE .,' THOUSAND PALMS, CA 92276. (760)343-7488' r . Lic. No. 686310 - - - - - - - - -.- - - - - - -f- - --- - -r - ---- - - - --- - - - - - - - - - - _ - -- - - -- - - - - — } - "LICENSED CONTRACTOR'S DECLARATION • * WORKER'S COMPENSATION DECLARATION - - 1 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: 4 ." 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.: 686310 - for. by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Z 13 Contractor:L<Z�� -Fhave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor C-1 - - - r+.r -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: • 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier" ZENITH INS CO Policy Number Z071741502 •' • following reason (Sec. 7031 .5, Business and Professions Coder 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 _ i 'construct, alter, improve, demolish,. or repair any structure, prior to its issuance, also requires the applicant for the -'Y ,r' : person in any manner sous to become subject to the workers' compensation laws of California; '. ♦ F:' 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 s 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 ~^any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)-.:' r Date: -a Z 1 1pplicanC- ,(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and Cf 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-builderwill have the burden of proving that he or she did not build or improve for the purpose of sale:). APPLICANT ACKNOWLEDGEMENT - 1, 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, Y ` 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. , B.&P.C. for -this reason •^: the owner, and the applicant, each agrees to, and shall defend, indemnity and hold harmless the City .�. - _ - of La ouinta, its officers, agents and employees for any act or omission related to the work being • - performed under or following issuance of this•permit. , t 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. - 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 of thiscountyto enter upon the above-mentioned property for inspection purposes. Lender's Name: Date,:_ Z 13 Signaturb_O pplicant or Agent): a� ?__ ? " Lender's Address: - - - • '` LQPERMIT Application Number . . . . .. 13-00000951 • Permit . . . MECHANICAL 2013 Additional desc . Permit Fee' 71.50 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 1/26/14 Qty Unit Charge Per Extension 1.00 35.7500 EA • MECH FURNACE 35.75 'o. X1.00 35.7500 EA MECH CONDENSER/COMP --'-------------------------------------------------------- 35.75 ' _ -----Special Notes and Comments HVAC CHANGE OUT - 13SEER/78AFUE, REPLACE ' 3 TON HVAC SPLIT SYSTEM [2008 ENERGY] ' CARBON MONOXIDE ALARM(S) TO BE INSTALLED �. PRIOR TO FINAL INSPECTION. 2010 ' CALIFORNIA BUILDING CODES. -------------------_----- -- ------------------------ Other Fees BLDG STDS ADMIN (SB1473) 1.00` +. PERMIT ISSUANCE M/P/E 90.57 . PLAN CHECK, MECHANICAL 47.66 - Fee summary Charged. Paid Credited` Due « ' - - • — — —.— — - — _ — — - — — — — ,— — — — — — — - - — e. —.— - — — — — - — —. — - — - — — — — — — — — — - —.— — — —. .- ♦ �4 -Permit 'Fee Total 71.50 .00 .00 71.50 - Plan Check Total.00, .00 .00- .00 } z•',. Other Fee Total ' 139.23 _ , :00 .00 , 139:23 r Grand Total 210.73 .r .00v , _, .00 210.73 . .. .. - LQPERMIT Din # r Qty .Of La Q u(n to Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit '# ( 1 QJ � I Project Address: •2 e (o2.O V j c�._ (Y) ei 0Cj; G Owner's Name: A. P. Number: Address: CZ - Legal Description: City, ST, Zip: (_r, , 'A Q ZX53 Contractor: e Y�ercA A;c- %rc�i�� Telephone: P »> Address: 3\ \ -7 CJ Ze Se c v e �c v e Project Description: City, ST, Zip: �1r�ov s ave d -7 �o,\m 5 CA Q2ZIG _Re \ ace 3 k or Ac- £ 70 � Telephone: C_ C_ C_ State Lic. # : (08(03 (v City Lic. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone:hone: ........................... Consucti n Type: ancY Occupancy: • State Lic #• Pro'ect a circle one): New Add'n Alter Repair Demo J h'P ( ) P Name of Contact Person: 2uG� Sc�Y\i - Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 9S 1- Z4(1- (o8 7(o Estimated Value of Project: %R' -?(08-00 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 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:- '"' Review, ready for correctionstissue . Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees n zJ Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address. Enforcement Agency: Date: Permit #: �8(Ozv V c. me -lock- -)z-k I 13 Conditioned Floor Equipment Type' List Minimum Efficiency 2 Duct insulation requirement Area Thermostat ❑ Packaged Unit WFumace 181 AFUE Z ❑ COP Over 40 ft of ducts added or jIf Setback X Indoor Coil l�SEER 13 ❑ HSPF replaced in unconditioned space Served by system (Ifnot already 0 Condensing Unit ❑ EER ❑ Resistance ❑ R 6 (CZ 10-13) ❑ R 8 (CZ 14-15) sf present, must be 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and signed. Beginning October 1, 2010, are 'stered co of the CF -1R and CF -6R shall also be on site for final inspection. JI 1. HVAC Changeout Required Forms: CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS • All HVAC Equipment replaced CF4R 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 CF411forms: 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. ❑ 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 ❑ 3. Existing duct systems 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 CF4R 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 CF4R 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 snace. For split system or packaged units: Duct leakage < 15 percent ❑ 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, calculations plans and specifications submitted to the enforcement agency for approval with the permit application. Name: � tear�r Sc1�r�iBref Signature:` /� Company: A� � �.ov.c��i�rn 1 Y� Date:i(2G 113 Address:License: 31170 Pe-serve-1�c,. Ggb310 City/State/Zip: T�OvS C1 �G�m S G� ,Q 2-z--7(,Phone: -7(p0 3cI3- 4,'fir 2008 Residential Compliance Forms July 2010