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12-1049 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12•_00001049 f Property Address: 79085 VIA SAN CLARA APN: 649-400-009- - - Application description: MECHANICAL Property Zoning: ' LOW DENSITY RESIDENTIAL Application valuation: 6565 i Applicant : Architect or Engineer: i BUILDING & SAFETY DEPARTMENT BUILDING PERMIT n � -------------------------------------------------- ` LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjur that I am licensed under provisions of Chapter 9 (commencing with L 7000) of Division 3 of the Bu ness and Professionals Code, and my Lic t. C1 s: C20-1236 Licens 94 '/ .Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit. to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 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).: 1 _ 1 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 Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within 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.). (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of • property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). I—) I am exempt under Sec. , BAP.C. for this reason Date:• Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.)• Lender's Name: Lender's Address: - - LQPERMIT ' Owner: MESZAROS EDWARD J 79085 VIA SAN CLARA LA QUINTA, CA 92253 (760)771-2890 Contractor: J ANTHONY PLUMBING HEAT/ 72216 NORTH SHORE STREET VOICE {760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) .777-7153 Date`. 9/13/12 D Q � uEP 13 2012 IR CITY OE LA QUiNTiA , #1oi FINANCEDEPT. THOUSAND PALMS, CA 92276. (760)328-8096 - Lic. No.: 777794 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 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. • _ 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 insurance carrier and policy mber are: Carrier GRANITE STATE Policy Number WCO65255599 .. _ I certify that, in the performs a of the work for which this permit is issued, I shall not employ any person in any manner sok to become subject to the workers' c of California, and agree that,pshle subject to the work mpensation provisions o ec3_70/0 of the LaI fo with comph those provisions./ 1(3 �vApplicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT - IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. ` 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to -any permit issued as a result of this application, 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. - 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 gd'g mit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state thinformation is correct. I agree to comply with all city and county ordinances and state laws relatin nstruction, ���vv�esof this c my !enter upon the above-mentioned rction pu Date: 1 / Signature -(Applicant or Agent Application Number . . . 12-0000.1049 Permit MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date . . . Valuation 0 Expiration Date 3/12/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 3.00 1 F 5nnn FA MECH R/C r3 15IIr'/s 100IC 500ICDTU 16.50 Special Notes and Comments REPLACE 5 TON SPLIT FURNACE / COIL & CONDENSER 2010 CODES. - - Other Fees . . . . . . ." ... BLDG STDS ADMIN (SB1473) - - - - - -- ---- 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 00 10.13 Other -Fee Total 1.00 .00 .00 1.00 Grand Total `51.63 .00 .00 51.63 LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations• CF -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: 79085 VIA SAN CLARA La Quinta, CA 92253 Enforcement Agency: City of La Quint: Date: Sep 13, 2012 Permit #: Equipment Typel List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit ® Furnace ® Indoor Coil H AFUE 78% ®SEER 13.0 ❑ COP ❑ HSPF [3 R 6 (CZ 10-13) Served by system ® Setback ® Condensing Unit ❑ EER ❑ Resistance 13R 8 (CZ 14-15) sf n not dready present, must be innot i [3 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 Effidencles: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides+hat 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 -511 and registered CF -411 forms (no hand filled CF -411s allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and CF -6111 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or• oil and /or CF -6R forms: MECH-04, MECH-2I-HERS and fors lits stems MECH-25-HERS ) • Furnace ce CF -4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirementi, TMAH Exempted from duct leakage testing if: 0 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or p 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge) ❑ 2. New HVAC System Required Forms: . Cut inor Chanwith new ducts: (alll new new CF -6R lits ( p systems) forms: MECH-04, MECH-20-HERS, and fors stems MECH-22-HERS, and ducting and all new equipment) MECH-25-HERS CF -411 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 0 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor coil and/or furnace. No or some CF -611 forms: MECH-04, MECH-20-HERS, and (for split s+stems) MECH-25-HERS CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. For Split Systems: Duct leakage < 6 percent; RC, CCA 2: 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent 0 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in unconditioned CF -611 forms: MECH-04, MECH-2I-HERS space. CF -411 forms: MECH-21 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 this Compliance. on Certificate of • 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 othe- applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Kevin Robinson I Signature: Kevin Robb sm Company: ] ANTHONY PLUMBING HEATING & AIR CONDITIONING Date: Sep 13, 2012 Address: 72216 NORTH SHORE ST #101 Ucense:'777794 City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-2121 Reg: 212-A0050915A-00000000-0000 Registration Date/Time: 2012/09/13 12:41:20 HERS Provieer: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 a city' Of. La E�clln�a . Building a Safety Division : t P.O. Box.1504,'78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # . Project Address: O $ ! A %%J e ( A -kA- Own s Name: . ' �DIU.420f Ne5z''4405 A. P. Nuinber. Address: . Legal Description Cotttractor. City, ST, ?aP: Telephone: 760 %%� D Address: J ANTHONY SERVICES Cit),, ST, lap: THOUSAND PALMS, CR 92276 Project Description: / S I 0 .N It "� Telephone: c9 L L .CO a' '� (�, �.,�illlt— State Lia # city Lia Arch, BW., Designer. Address: City, ST. Zap: Telephone: State Lia #: - Construction Type:. Occupancy: Project , J type (eirde one): New Acd n Aber Repair Demo Name of Contact Person Sq. Ft.: #Stories # Univ: Telephone # of Contact Person: Estimated Value of Project to APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal plan Sets Req'd Rev'd TRACIUNG PSItMfF FF.FS Plan Check submitted hent Amount Structuial Coles. Reviewed, ready for corrections Pian Clack Deposit. . Trus Cal". Called Contact Person Plan Cbeck Balance _ Title 24 Cales. Pians picked up Constrnedon Flood plain plan Pians resubmitted.. Mecbasiical Giading plan 2'! Revlew, ready for correctionsfrssue Electrical Subeontaetor List Called Contact Person Plumblag Grant Deed. Pians pldced up S,Iy,I, H.O.A. Approval Plans resubmitted Grading HOUSE- ''' Review, ready for correctloaslissoc � Deck per Impact Fee Planning Approval Called Contact Person A.LP.T. Pub. Wks. APPr Date of permit issue Sebool Fees Total Permit Fees