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11-1005 (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 - 7c: Application Number: ,w 11-00001005)" � Owner: D Property Address: _47910' VIA'' ZURICH" BARBARA TRAVISAPN: 643-140-059-81 -26152 - 47910 VIA ZURICHn71`11 Application description: MECHANICAL LA QUINTA, -CA 92253 20.11 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8972 !! C0T1r(atyA{4iNiq — ' Contractor: Applicant: Architect or Engineer: GENERAL AIR CONDITIONING 31170 -RESERVE DRIVE - THOUSAND PALMS, CA 92276- / ` (760)343-7488 Lic. No.. 686310 " ; - 111. .. ' * Y• • ' ,. - - -- - --- - -" -- - -- - - - -- - -- - - - -- - - - - -- - -- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with(- 1 hereby affirm under penalty of,perjury one of the followingdeclarations: a _ Section 7000) of Division 3 of the Business a Professionals Code, and my License is in full force and effect. ' t• - 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. --• " Nate:/� —1�(1 C�"^,'tractor. ` • ~ 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 y - - insurance carrier and policy number are: - I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the ° ; •Carrier EVEREST NATL Policy Number 7600006147101 - - - following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to - I certify that, inthe performance of the wor 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 forthe •, _t person in any manner so as to become ject to 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 t _ .; .and agree that, if I should become subj 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 Labor Code, I shall forthw comply with those provisions.. +• that he or she is exempt therefrom and the basis for the alleged exemption. Any violation -of Section 7031.5 bye`, • - any applicant for a permit subjects the applicant to a"civil penalty of not more than five hundred dollars ($500).:- e: `,� pplicant: 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 WORKS SATION 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 PINES UP TO ONE HUNDRED THOUSAND „. and who does the work himself or herself through his or her own employees; providedthatthe - 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 "_) 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. - .+ . property who builds or improves thereon, and who contracts for the projects with a contractorls) 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 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 andstate that the abov n rmation incorrect. I agree to comply with all .. - work for which this permit is issued (Sec. 3097, Civ. C.I. - city and county ordinances and state laws relating to building c s uction, and hereby authorize representatives, Zat ' county toenter-upon the above-mentioned property for s ction purposes. Lender's Name:1 �S' atu re (Applicant or Agent): Lender's Address: - LQPERMIT Application Number . . . . 11-00001005, Permit • MECHANICAL Additional desc Permit Fee 40.50 Plan Check Fee 10.13 Issue Date . . . Valuation . . 0 Expiration Date 3/17/12 Qty Unit Charge .Per Extension" BASE FEE 15.00 1.00*9.0000 EA MECH FURNACE <=100K 9.00 1•.00 16.5000 EA MECH'B/C >3-15HP/>100K-500KBTU, 16.50 Special Notes and Comments INSTALL NEW 4 TON HVAC SYSTEM, FURNACE," CONDENSER .& COIL AT GROUND LEVEL. 2010• ;. CODES. ---------.------------ -- - - -- ----------------------------------- Other Fees , BLDG STDS ADMIN (SB1473) ------------- 1:00 Fee summary Charged' Paid Credited - ----------- -----40.50 Due :. Permit Fee Total 40:50:`-,00 00 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 _ .. Sim lifted Prescri tiwe Certificate,o:f Com liance: 2008..Residential HVACAlteratiotis. .' CF- IR -ALT -HVAC_ Climate Zones 10 to 15 Site Address: l 0 Uo CIL Enforcem Agency: Date: 01� Permit a: ., Equipment T et List Minimum Efficiency 2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Packaged Unit Furnace ❑ AFUE Bo% ❑COP Over 40 ft of ducts added or Setback Indoor Coil ❑SEER / 3 ❑ HSPF replaced in unconditioned space P P Served b system Y Y (if not already ondensing Unit ❑ EER / / ❑ Resistance ❑ R 6 (CZ 10-13) sf present, must be Other ❑ R g (CZ 14-1 S) installed) 1. Equipment Type: Choose the equipment being installed: iJmore than one system• use another CF- l R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 73% 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 -611 and registered CF -411 forms (no hand filled CF4Rs allowed) are filled out and si ed. Beginning October I, 201.0, a registered copy of the CF -1R and CF-6R'shall also be on site for Ilnal inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment replaced CF -6R forms: MECH- _94, 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 -411 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 Exempt d from duct leakage testing if: rDuct system was documented to have been previously sealed and confirmed through HERS verification, or 2. Duct systems less than 40 linear feet in with 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 ducts: (all new ducting and all CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS 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 ❑ 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 ❑ 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 ❑ 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. • 1 am eligible under Division 3 of the Califomia 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 I 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 Pplic ompliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for appro al with t e permit application. Name: Meeh W0_*6-Dn Si ture: Company: n t G,en �era,( 4 r Conti! f. O s7 , Date:✓� Address: ,31170 /2eSet^U� �/`t` ✓� License: (oCy(o3/b City/State/Zip:- —�D � �L S� G g���� Phone: 7/0-31V3_-74ff9 Bin # . Permit - �1 t'0. Project Address: 79 /0 r rI�^1 fnt. Qty OI LQ C�1.�'a Building &r Safety Division P.O. Box 15.04, 78.495 Calle Tampico La Quinta, CA 92253 - (760). 777-7012 Building Permit Application and. Tracking Sheet c 71, ,� Owners Name: baro— `r'r �"► A. P. Number: I Address: LI RJO Uo 45;C Legal Description: City, ST, Zip:tA— 04 Contractor: Address: City, ST, Zip: x..' ``i` Telephone: ,,:s; , 3 Project Description: a C� liC� Telephone State Lic. # : 3 :> :�: •rf • , City Lie. #;. ` (o(� 4P �y � Arch., Engr., Designer: Address: City., ST, Zip:..... __... Telephone: State Lie. `'Construction > µ, v c !� • ; Type: Occupancy: Project type (circle one): New Add'n .Alter Repair Demo Name of Contact•Person: . .. cc) U(g � l�u� c7yV Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: -7& D 3'13 %• $ Estimated Value of Project: 8� % APPLICANT: DO. NOT WRITE. BELOW THIS LINE, # Submittal Plan Sets. Req'd' Rec'•d TRACKING Plan Check submitted PERMIT FEES Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked no Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2na 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:- 'r° Review,.ready for corrections/issue Developer Impact Fee Planning Approval- Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees