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11-0728 (MECH)C" P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. "—Application -Number. ----------'11:=000007-28_ Property Address: 78450 -VIA SEVILLA APN: 604-211-006-27 -23971 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 9449, Applicant: Architect -or Engineer: LICENSED CONTRACTOR'S DECLARATION 44 -BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: PATRICIA DOUGHERTY ALLEN 78450 VIA SEVILLA LA QUINTA, CA 92253 (760)345-0942 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/05/11 I hereby affirm under, penalty of perjury that I am lice ed under provisions of Chapter 9 (commencing with ' Section 7000) of Division 3 of. the Business and Prof sionals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Date: Contractor. O ER -BUILDER DECLARATION - I hereby affirm underpenalty 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 (5500).: (_ 1 1, 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 yeat 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.). - ' (_) I, 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.). 1 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY - I hereby affirm under penalty of perjury that there is a construction lending agency for theperformance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: " Lender's Address:. LQPERMIT 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 number are: Carrier EVEREST NATL Policy Number 7600006147101 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to becomes Nect to the workers' compensation laws of California, ' and agree that, if I should become sub' c to the workers' compensation provisions of Section . 3700 of the Labor Code, I shall forth comply with those provisions. —Date: s' ApplicantC- WARNING: FAILURE TO SECURE WORKER ENSATION 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 fromdateof issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state t4rma tion is correct. I agree to comply with all city and county ordinances and state laws -relating ction, and hereby authorize representatives of thiscounty to enter upon the above-mentioned ption purposes. Date: $ l Signature (Applicant or Agent Contractor: GENERAL AIR CONDITIONING q ��•.(; ��1� 31170 RESERVE DRIVE ;'" THOUSAND PALMS, CA 922761 ^"" (760)343-7488 y Lic. No:: 686310 I hereby affirm under, penalty of perjury that I am lice ed under provisions of Chapter 9 (commencing with ' Section 7000) of Division 3 of. the Business and Prof sionals Code, and my License is in full force and effect. License Class: C20 License No.: 686310 Date: Contractor. O ER -BUILDER DECLARATION - I hereby affirm underpenalty 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 (5500).: (_ 1 1, 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 yeat 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.). - ' (_) I, 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.). 1 1 I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY - I hereby affirm under penalty of perjury that there is a construction lending agency for theperformance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: " Lender's Address:. LQPERMIT 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 number are: Carrier EVEREST NATL Policy Number 7600006147101 _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to becomes Nect to the workers' compensation laws of California, ' and agree that, if I should become sub' c to the workers' compensation provisions of Section . 3700 of the Labor Code, I shall forth comply with those provisions. —Date: s' ApplicantC- WARNING: FAILURE TO SECURE WORKER ENSATION 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 fromdateof issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state t4rma tion is correct. I agree to comply with all city and county ordinances and state laws -relating ction, and hereby authorize representatives of thiscounty to enter upon the above-mentioned ption purposes. Date: $ l Signature (Applicant or Agent Application Number 11-00000728 _ Permit . . . . MECHANICAL Additional desc . Permit Fee 33-.00 Plan Check Fee 8-25 Issue Date Valuation 0 Expiration Date 1/01/12 Qty, Unit Charge' Per Extension BASE FEE .15.00 T.00 .9..0000 EA MECH FURNACE <=100K 9.00 ' 1:00 9.0000 EA MECH B/C c=3HP/100K BTU 9.00 ------ ----------------------------------------------- Special Notes and. Comments HVAC CHANGEOUT 5 TON, FURNACE, INDOOR COIL AND CONDENSING UNIT. 2010 CEC -------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN .(SB1473) 1.00 Fee summary Charged Paid Credited Due -- -.------------------------ Permit Fee Total 33.00 .00 .00 33.00 Plan Check.Total '8.25• 00 .00 8.25 Other Fee Total 1.00 .00 .00 '1.00". Grand Total 42.25 .00 .00 42.25 Sim lifted Prescriptive Certificate of Com fiance:' 2008. Residential HVAC Alterations CF -1R -ALT -HVAC Climate Zones 10 to 15 Site Address: n t E orcein t Agency: Date: Permit #: 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 CF -4R forms (no hand filled CF-4Rs allowed) are filled Out and Z 1. HVAC Changeout Conditioned Floor • All HVAC Equipment replaced Equipment T e[ List Minimum Efficiency Duct insulation requirement Area Thermostat 1:1 Packaged Unit ❑ AFUEBo ❑COP Over 40 ft of ducts added or For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH `IXSetback LR,mace oor Coil ❑SEER ! 3 ❑ HSPF replaced in unconditioned space Served by system (lfnot already ndensing Unit ❑ EER / / ❑ Resistance ❑ R 6 (CZ 10- 13) sf present, must be ❑ Other and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25 ❑ R 8 (CZ 14-1.i) installed) 1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF- l R -ALT -HVAC fur each system. 2. Minimum Equipment E/ftcienc•ies: 13 SF_ER_ 78% AFt1F 7 7MRPF M,r t„„'* ,,/ ,•oma: tom,: t ,­,,.,,.. 2008 Residential Compliance Forms AX—A, M11) HERS VERIFICATION SUINIMARY 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 mast 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 CF -4R forms (no hand filled CF-4Rs allowed) are filled Out and si ed. Beginning October I, 201.0, a registered co of the CF -IR and CF -6R shall also be on site for final inspection. 1. HVAC 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 fors lits stems) MECH-25 • Condenser Coil and /or • indoor Coil and/or CF -6R forms: 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 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 1'5 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 uncondifioned 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 CF -4R 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 CF -4R 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 114. 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 space. For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing ducts stems 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. • f certify [hat 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 ' orm, tion documented on other zpplic ompliance forms, worksheets, calculations, plans ands specifications submitted to the enforcement agency fora ro al with t e Perrnit application. Name: �l�eh �cSD Sig tore: Company: p y. C�eyl•eraj 41'r CDKde �•`Of1 t` Date: Address: 30-70 License- icense:City/State/7ip:---�S�C City/State/Zip: G1�. �'•7� Phone: 2008 Residential Compliance Forms AX—A, M11) CaICERTS - CF -1 R Registration Page 1 of 1 Publio Home seouxe Homy About. Us Tral,ning Rater Dirwary ]=arms ,>rteiuberreip Oe��zs Evrots tnduzrry 4'ann[eK Resys To register for our monthly newsletter, please click here. Danielle Garcia logged in [Logout) [Home] CONGRATULATIONS Your CF -IR -ALT -HVAC Registration is complete! You may want to print this page for your records. Site Address: 78450 VIA SEVILLA La Quinta, CA 92253 CEC Registration: 1211-A0032388A-00000000-0000 CF -IR -ALT -HVAC: CLICK HERE TO DOWNLOAD Assigned Company:IHARRISON ENTERPRISES INC Do you know your HERS Rater? If you do, you may want to send this CF -IR to them. CaICERTS Rater ID: OR My Rater Quick Select: Energy Driven Solutions, Inc. Every CaICERTS rater has a license number. If you need to find the rater by name [Click HERE) to search our directory. I SEND CF -1R TO HERS RATER_ I [CLICK HERE] to do another Colryriglu (0 2010 Cal(.TR fS. Inc. All rights reserved. Revised: January 11. 2010 [Terms and Conditions] [Privacy Statement] [Class Cancellation Policy] CaICERTS, Inc., 31 Natoma St Suite 120, Folsom, CA 95630 Office: 916-985-3400,Toll Free: 877 -HERS -RD, (877-437-7787) Fax: 916-985-3402 Contact Us •� h . BBB fired us ort, Face, baokU httns-//www.calcerts.com/public cf1R.cfm?nroiect id=122382 7/1/2011 Dill it I'Perml City.of U Quinto l Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA'92253 - (760). 777-7012 Building Permit Application and. Tracking. Sheet # . Project Address: ZSws�e Owner's Name: A. P. Number: Address: �� Legal Description: City, ST, Zip: Contractor: Tele hone: a<:.;>.•r..::r; >.. ,:,:,.. c:f:: Address: ✓fi ^,\` \ 4 City, ST, Zip: I/ `►[1V'7 4-v Project Description:',_���� " — Telephone: O �?yvi4N{•.'.•�j:fi:�:i<}:?{:":.+.�?:i�;h.,^.fr �.',F.Si�l State Lie. # : 3V City Lie. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: VV ;;'« ° ': f": •::: •:r• ` ` State Lie. #: .;�:: �::::,�;�;f;:;.�::,r;; v�W%I :•hfi: i::iv,}.'•:iii}::v:4:: +�'' .::*•: Construction Type: Occupancy: Project Project type � /• a circle one`1. New Add, n Alter Repair Demo Sq. Ft.: 17-Storie's: # Units: Name of Contact-Person:�.0- © Telephone # of Contact Person 764) 3`1p 3 ^ 7-168. Estimated value of Project: v'7•`Z�i V /( APPLICANT: DO. NOT WRITE. BELOW THIS LINE # Submittal, Req'd Recd TRACMGPERMIT FEES Plan Sets Plan Check submittedItem Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs., Called Contact Person an. 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 IiOUSE:- '`d Review,.ready for corrections/issue Developer Impact Fee Planning.Approval Called Contact Person A.LP.Y. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees