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13-0705 (MECH)r_7 „ , 7 ?? P.O. BOX 156” t ' ' " VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7611' LA QUINTA, CALIFORNIA 92253, BUILDING•& SAFETY DEPARTMENT. INSPECTIONS (760) 777-7153 s BUILDING PERMIT Date: 6/04/13 Application Number: 13-00000705 Owner: Property Address: S666S VILLAGE DR ,. JOHN & LINDA CAHOON APN: T 764-OSO-018- - - 56665 VILLAGE DRIVE Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL (760) 777-7812, Application valuation: 4000 Contractor: Applicant: Architect or Engineer: D GENERAL AIR, CONDITIONING �� ®� 31170 RESERVE DRIVE s j � �\,/� 2019 THOUSAND PALMS, CA 92276 1J(\ (760)343-7488 CI�Q�4�QUINTA Lic. No.: 686310 FINANCE DEPT. s 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 I hereby 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 conseni 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. 0 Contrac� ��-�� 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 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 ZENITH INS CO Policy Number Z071741502 - . following reason (Sec. 7031 .5, Business and Professions Code: 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 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 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 - 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 ,�+� i 1 ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Dater Applic✓tv ( 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 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 -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. 4 , property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf thisapplication 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. - • s 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 and state that the above information is correct. I agree to comply with all q 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 this county to enter upon the above-mentioned property for inspection purposes. Lender's Name: `bC ` + t ., eDat �} 3. Signature (Applicant or Agent)!4 %l� —+ Lender's Address: - /r" • . - -LQPER1%11T r _ `Application Number• 13-00000705 }= c, Permit MECHANICAL*:201.3 Additional desc' Y• f • " Permit -Fee" 35.75 Plan .Check Fee .00 Issue.Date' Valuation• 0 '. Expiration Date ` 12/01/13 . Qty Unit Charge Per Extension 1. 0.0 35..7500 EA MECH CONDENSER/COMP 35.75 ------------------------------------- -------- -------- ---------------------------- .. Special Notes and Comments •_ ' ,".HVAC CHANGE OUT (1) 3.5 TON SYSTEM 13SEER ,[2008 ENERGY]. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL _ - INSPECTION. 2010. CALIFORNIA BUILDING . CODES. ' Other Fees BLDG STDS ADMIN (SB1473) 1A0 ' PERMIT ISSUANCE M/P/E- 90.57 PLAN CHECK, MECHANICAL 23.83 - Fee.summary Charged Paid Credited -'---------- Due '• ---------------------=------------------ ' Permit Fee Total 00 .00 35.75 ,35.75 Plan Check Total 00 .00 ' .00 .00 , Other Fee Total 115.40 .00 .00 115.40 - Grand Total y •151.15 00 .00 151.15 LOPERMIT.- Bfn.N Cray Of 1.Ci Quinta BullcMt a Safety Division Box 1504,78-495 Calle Tampico La.Qufnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Y t � ' A. P. Number. Bfn.N Cray Of 1.Ci Quinta BullcMt a Safety Division Box 1504,78-495 Calle Tampico La.Qufnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Perrnit #P.O. 1 Project Address: j(p(o(,S Vi llo. OwneesNaine:. A. P. Number. Address: 5GG65 V �1l 0. e—'t�cl. Legal Description: City, ST, Zip: c ZZ5�3 �, u�h�e.. Gil Contractor .ere,rr,. ACDrc��.`�bn� Telephone: --) Address: 311-�� v Project Description: City, ST, Zip: Telephone: -760--343-74RE State Lie. # :City Lia #; Arch., Engr., Designer. Address: City., ST, Zip: Telephoner State Lie. #: Construction Type: _ Occupancy: Project type (circle one): New Add'a Alter Repair Demo Sq. Ft.: # Stories: # Units: Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRAC MG PERMff FEES Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calm Plans picked up Constrnedon Flood plain plan Plans resubmitted Mecharilcal Grading plan 2" Review, ready for correctionsfrssue Electrical Subcoutactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. i H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Review; ready for cor•recdonsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Com liance: 2008 Residential RVACAIterations CF -IR -ALT -HVAC Climate Zoaes 10 to 15 Site Address: S wo(0S i 1\ Fafbrce--t Agency: G- Ln, Dade: I Permit #: a C- e- o& Q:-n{c. to -; 13 Conditioned Floor Equipment T en List Minimum Efficiency 2 Duct insulation requirement Area Thermostat _ Packaged Unit Furnace � p�E ®Cpp Over 40 ft of ducts added or ®��k Indoor Coil Condensing Unit ®SEERS EER ® HSPF Resistance replaced Z unconditioned space R 6 (CZ 10-13) Served by system sf reser already p must be Other R 8 (CZ 14-15) installed) stupe 1. Equipment Type: Choose the equipment being installed if more than one system, use another CF -IR -AL T -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 fad 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. October 1_2010, a = of the CF -IR and CF -6R shall.also be an site for fmal inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment laced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS 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 CF4R forms: MECH-21 and (for split systems) MECH-25 • Furnace For Split Systems: Dud leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH For Packaged Units: Dud 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 fed 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: ME0I-04, MECIi-20-1-IER.S,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: Dud leakage < 6 percent 3. New Ducts with Replacement R€qusred 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: Dud leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH For PacluWd Units: Duct leakage < 6 percent 4. New 22SgM over 40 fret aired Forms: • Includes adding or replacing more &an 40 CF -6R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21 linear feet of duct in unconditioned space. For splits sten or paced units: Dud leakage < 15 percent EXCEPTION: Existing dud systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Ccrtificate of Compliance documcntation is ac curs and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design idmtifted on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Cetificate of Compliance conform to the requsements of Title 24, Parts 1 and 6 of the Calif amia 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 enfarccinentagencyforapproval with the permit appticah— Name: ��hh��e1' Signature: Company: � �\ r ` \ � Date: Address: 31\ �y License: `,Q \��• `' t City/State/Zip: L�V50.re� �0.�rCl S . CA C(ZZ%(o 1 Phone: -7(,0-3q3- —74,3. 1 2008 Residential Compliance Forms July 2010