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12-0491 (MECH)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: 5/03/12 �Appllcatio t Number 12-00000491 ., ,j Owner: `Prope try Address: ~47330-VIA -RAVENNA LEGGETT RESIDENCE APN: 643-100-007-186 -26152 - 14- CORTE CAPISTRANO Application description: MECHANICAL SAN RAFAEL, CA 94903 , Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 12000 D Lr�� a Contractor: MAY. Applicant; Architect or Engineer DESERT MIST MECHANI L MAY •O3 20,1 80175 AVENUE 52 LA 'QUINTA, CA- 92253 CITY OF LAQUI_NTA (760) 777-7700 FINAPICEDEPT. Lic. No.: 939172 Nfl LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing withereby 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 LicenseClass- C4-C20-C36 - License o.: 939172 for by Section 3700 of -the Labor Code, for the performance of the work for which this permit is /o issued. - ( Date -ontract _ _ �S� �C..��j /,� 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 _ OWNER-BUILDER DECLARATION irisurance carrier and policy number are: _ hereby of rm under penalty o perjur hat I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy. Number' EXEMPT . following reason (Sec. 7031. , B ass and Professions Code: Any city or county that requires a permit to - _ Lcertify 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 shout come subject to the workers' compensation provisions of Sectio License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the Labor C e, I s all f hwith co m ly with those provisions. - that he or she is exempi 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)-.: Date: Applicanti- (_) 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 WARN(/-FA;LURE TO S4DN XOERS' COMPENSATION COVERAGE IS UNLAWFUL, D LLContractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECTEMPLOYER TNALTIES 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 ($100,006)..IN 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 LAE, INTEREST, AND ATTORNEY'S FEES. , one yearofcompletion, 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, 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 fora 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 contractors) 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. , 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 isnot 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 information is correct: 1 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 authori - epresentatives - of this county to enter u on the above mentioned propy or inspection purp er ...::.. . .. Lender's Name: - ' Da _ TGfe aIApjantot A Lender's Address: � - ` ... - -- a ./ LQPERMIT ._ - Application Number 12-00000491 ' Permit . . . .MECHANICAL. a Additional desc . Permit Fee . . . . 33.00 Plan :Check. Fee 8.25 Issue Date Valuation' 0 Expiration Date,. 10/30/12 - Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU--------------------------------------------------------------------------- 18.00 Permit . . . MECHANICAL Additional desc . Permit Fee 33.00 Plan Check Fee 8.25 Issue Date Valuation . . . 0 Expiration Date'. 10/30/12 Qty. Unit Charge � Per • . Extension BASE FEE 15:00 2.00 9.0000 EA MECH FURNACE <=100K 18.00.:. ` Fee summary Charged Paid --Credited Due Permit Fee Total 66.00 .00 00 '66.. 00 Plan Check Total 16:50 .00 00 16.50 -,Grand Total . 82.50 00 .00 82.50 _ .. LQPERMIT Sine ' Clintr tett rreseriptt� a Certilicafe of Cotnplij.-2008 A Z6nes 1016.15 erre rtaaress:'. ' Enforcement en 7 o V•` ��, ' f . Agency: Date: Permit #: Conditioned Floor Equipment T List Minimum Efficiency Z Ducl insulation re uirement Area Thermostat ❑ Packaged Unit , ,I�-��`mace O AFUE ❑ COP Over 40 ft of ducts added or etback . t(tsrndoor Coil .. OSEERZ ❑ HSPF replaced inunconditioned space Served by system (/jrton a ready �ndensin Unit O EER OR (CZ 10-13) &�04 sf g � Resistance present. must be 8 ❑Other O R 8 (CZ 14-/S) installed/ / Equipment T}•pe: Choose the equipment being installed: ijmore than one system, use another CF -1 R -ALT -HVAC jor each system. 2. Minimum EquipmentEfficiencies.. /3 SEER. 7801.AFUE. 7.7HSPF jortypical 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 be must conducted. A copy of the fortes shall be left on site,for fatal inspection and•a copy given to Ute 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 (tio hand filled CF-4Rs allowed) are filled out and signed,.Seginning October 1, 2010 a registered copy of the CF -IR and CF -6R shaU also be on site for final [ tion. . H VAC 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 ifors lit stems MECH-25 • Condenser Coil;and /or • Indoor Coil and /or CF-61kforms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFMhon(Minimum Air Flow Requirement), TMAH. For Packaged Units: Duct leakage < 15 percent 1:xern pted from duct leakage testing iF ❑ 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 ❑ 3. Existing ducts stems are: constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R fortes: MECH-04, MECH-20-HERS,and for ducts: (all new ducting and all ( split systems) MECH-22-HERS, and MECH-25-HERS new equipment) CF4R 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: • Includes replacing or installing all new ducting CF -61t 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 --linear feet of duct in unconditioned space. CF 6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21 For split system or packaged units:,, Duct leakage < 15 percent 0 EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) 0 1 certify that this Certificate of Compliance documentation is accurate 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. r I certify that the energy features and performance specifications -for design the identified on this Certificate of Compliance conform to the requirements of Title 24, Paris I and 6 of the Califomia Code of Regulations. i h< <ie.ign earl urns idenu ,ed on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets. calculations, plans and s cifications submitted to the enforcemen fora a enc oval with it application. Name: ' �Signa _ Compan Date: Address:,Z�>, / q4 -177l ! License: � � l City/Statc/Zip: G�- V �� Phone: 6 6 '7 77 '72-0 a 2008 Residential Compliance Forms March 2010 t , r . $tni levied .Prescri trve Certtii�ate ofCom Itaif&:1.2008 adehtral L�i�;4C Aflterations CF-1R-AI, L-AVg 5 Climate 2ories 1`046.15: Res Site Address:'. Enfg7emen1 Agency: Dater Perm/t #: r Conditioned Floor Equipment T tListMinimum EM Z Duct insulation requirement Area Thermostat ❑ Packaged Unit G- umaceO AFUE_ ❑ COP Over 40 R of ducts added or CLSetback 046'door Coil OSEER_ /_ ❑ HSPF _ replaced in unconditioned space Served by system (if not already �ensin Unit O EER OR 6. (CZ 10-13JSl-9m sf g 1� ❑ Resistance present, must be ❑ Other ❑ R 8 (CZ 14-15) �� 6 o installed/ l Equipment T)pe: Choose the equipment being installed. if more than one system, use another CF-1 R-ALT--HVAC for each system. 2. Minimum Equipment E0dencies: /3 SEER. 78.0 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 appropiiate.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" form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF4R forms (ho hand filled CF4Rs allowed) are filled out and signed. 'Beginning October 1, 2010,'a registered COPY of the_ CF-1R and CF-611 shall also be on site for anal Inspection. C14. HVAC.Changeout Required Forms: • All HVAC Equipment replaced CF-6R forms:. MECH -04, MECH-2I-HERS and (for split systems) MECH- 25-HERS • Condenser Coil and/or CF-411 forms: MECH- 21 and fors lit s sterns MECH-25 • Indoor Coil and /or CF-61kforms: MECH-2I-HERS and (for split systems) MECH- 25-HERS • Furnace CF4R forms: MECH- 21 and (for split systems) MECH-25 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 ducts stems are constructed- insulated or sealed with asbestos ❑ 2. New HVAC S stem Required Forms: • Cut in or Chai geoutducts with new CF-6R forms: MECH-04, MECH-20for lit stems MECH-22-HERS, and MECH-25-HERS .ducts: (all new ducting and all ( split systems) 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 O 3. New Ducts with Replacement Regtdred Forms: ' • Includes replacing or installing all new dulling CF-61R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS and/or outdoor condensing unit and/or indoor CF411 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 C1 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 Linear feet of duct in unconditioned space. CF-611 forms: MECH-04, MECH-2I-HERS CF41R forms:. MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts sterns constructed,insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate 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. I certifi that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Pars I and 6 of the California Code of Regulations. --- —•� i he :ie ian eafiurrs idenufted on this Certificate of Compliance are consistent with the information documented on other applicable compliance rms, worksheets. calculations, laps ands cifications submitted to the enforcement agerKy agencyflor approval vth4k permit awl ication. Name: , tet--` Signa Company-/ Dat a Address- Z License: s� l7 City/StatclZ ip: Phone: 2008 Residential Compliance Forms March 2010