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10-0913 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000913 Property Address: 81320 KINGSTON HEATH APN: 767-490-020- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4500 Applicant: ; (;(?i-1t4t 4 4 Q" Architect or n ineer: //L# BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License_Class: C20-1236 „ LicenseNo.: 777794 Date: L� �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 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.). (_) 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.). ( ) 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 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: BENNER DAVID A 81320 KINGSTON HEATH LA QUINTA, CA 92253 ( Contractor: J ANTHONY PLUMBING 72216 NORTH SHORE THOUSAND PALMS, CA (760)343-2121 Lic. No.: 777794 HEAT/A. STREET, 92276 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/14/10 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 STATE FUND Policy Number 1932451 _ 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 become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3300 of Labor Code coC-/ those =visions. Date:.- ��� �LA licant:' 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 1$ 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 CIMPORTANT 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 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 that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, andher y authorize repre a atives of this cou to a ter upon the above-mentioned property for ' s n - es. - J Di ? Signature (Applicant or Agentl: ✓ �� Application Number . . . . . 10-00000913 Permit . . . . . . MECHANICAL Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.2S Issue Date . . . . Valuation . . . . ..0 Expiration Date 3/13/11 Qty Unit Charge Per 'Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 ---------------------------------------------------------------------------- Special Notes and Comments A/C CHANGE OUT 5 TON 14 SEER CONENSER AND COIL CHANGE OUT. 2007 CODES ---------------------------------------------------------------------------- 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 LQPERMIT I 0 Packaged Unit V"L"en 'HVAC CF 1R ALT -HVAC O : Permi tk O Furnace 0 AFUE 0 COP Over 40 ft of ducts added or -_ -~ '] q)ndoor Coil RSEER� O.HSPF _ replaced in unconditioned space Served by system Condensing Unit 0 EER p ReSlStance 0 R 6 .(Q 10-13) (lfnotatrettdy O Other 0 R 8 (CZ 14-15)installed) t be 1. Equipment Type: Choose hquipncent being iicsralled ifmore than one 2. Mlrtincum Egttfptnetrt *wem. use anotherCF-IIt-ALT-HVA(-joreach syNem. Efficiencies: 13 SEER, 78•/ AFUE, 7.7HSPFfortypkd residential systems HERS VERIFICATION SUMMARY Listed below are four HVAC altetatinn picks one of the appropriate Options. Each Option lists the HERS°� The installer decides what work is being done and inspection and a that must be conducted A copy of the forms shall be left on site for final cePY given to the homeottrner. 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 Bee hwin October 1 201 a r red co . of the CF 1R anted CF-dR-61" �o pe o site CF.4p"forms (no hand filed CIF-4Rsmeowed) are filled out and 1. HVAC Changeout ection. Required Fortes: • All HVAC Equipment replaced CF -6R forms: NiECH-04,1uPCH 21 -HERS and (for split systems) MECg. 25-Iffin CF -4R forms: MECH- 21 and for • Condenser Coil and/or litstems MECH 25 • Indoor Coil and /or CF -6R forms: MECH-21-HERS and (for split systems) MECH- 25 -HERS • Furnace CF -411 forms: MECH- 21 and (for split systems) MECH-25 For Split SystemsD : uct leakage < 15 pefi RC, CCA 2f300 CFM/ton°ur° Air Flow For Packaged Units: Duct leakage < 15 percent ReQitiremeat), TMAH Exempted from duct leakage testing if - E3 El 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 0 3. . ' -duct ere constructed, insulated or sealed with asbestos 2 -New $VAC stem Repaired Forms: • Cut in or Changeout with new ducts: (all new ducting and all �'� forms: MECH-04, MECH 2O=HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS new a °ant) CF -4R. forms: MECH 20-, end (for split systems)MECH 22, and MECH 25 For S -- -. lit S - ... ....-.._ ....- ... - ....—,._.._.......... ---•----- .._ . . Split ystems• Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TIv1A For Packaged. Units: Duct leakage < 6 percent ii, STMS, and Omer or PSPP. 113: New Ducts with Replacement- - • Includes replacing or.iastauwg all new ducting and/or outdoor condensing unit.and/or indoor coil and/or-ftcmaw. -Not all egyiptmnt changed. For Sp1it.Systems: Duet leakage < 6 percent,- I For Packaged Units: Duct -leakage c6 percen 0 4..New Ductintt over 40- feet • Includes adding or replacinb more ittan 40 linear feet of duct m unconditioned space; For split system or aackaned. unitc•: nitei• tae Required Forms CF -6R fins: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS CF -4R forms: MECH-20 and (for split systems) MECH25 ... W. CCA>_ 300 CFMhon TMau R�tttreti Forms: . CF-61kforms: MECH-04. MECH 21 -HERS CF -4R folies: MECH 21. ge < IS percent.. . stru insulated or sealed with asbestos Contractor (Do cutnentatton Author`s /Responsib !rti lb Designer's. Declaration Statemtnt) • certify that this Cerufttate of Compliance docbrneirttuiot is acctuatc and oompleti • 1 ce eligible underDivisioti 3 of the California Business apd PiofeWons Code to accept respons3aity for the design identified on this Certificate of Compliantx. • l certify that thfth.e" y, features'and performance specifications for the design identified on this Certd"tcate.of Compliance conform to the cequi�rmeiits of TNe 24, Parts t and 6 ofthe California Code o£RegulaIIons_ • The feawres identified on this Ceroficaia of Compiianca ate consistent with the information calculation's,: late and � "fications stibmttted tri the cnfaiameat doctanC°� on other ap I coin lance fb tukslteeu, Name: for vat with i 1tiJ ..1 . G I Signattue5 Company: 1/ICES Date: Address: -- i Manch 2010 Birt # Permit # �,�\5 Project AddresW 3 -ZD A. P. Number. City of La Quinta Building 8t Safety Diets/on P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253. (760) 777-7012 Building Permit Application and Tracking Sheet 7%IJk, Owner's Name: 75 // Address: �I Chi [ T City, ST, Zip: Contractor: iOki Address: 72216 NORTH SHORE ST..STE 101 City, ST, Zip: Telephone--�66 343 "u Z State Lia #: L !. � City Lie. #; �I Arch., Engr., Designer. Address: 1 A A /110 City., ST, Zip: Description: Construction Type: Occupancy: State Lie. #: Project type (circle New one): Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project:L�'� APPLICANT: # Submittal Req'd Recd Plan Sets DO NOT WRITE BELOW. THIS LINE TRACMG PERMIT FEES Plan Check submitted Item . Amount Reviewed, ready for corrections Plan Check Deposit Structural Cates . Truss Calcs., Called Contact Person Plan Check Balance Tide 24 Cates. Plans picked up Construction Flood plain plan Grading plan Pians resubmitted 2•' Review, ready for corrections/issue Mechanical Electrical Subcontactor List Called Contact Person Plumbing S.M.L Grant Deed Plans picked up H.O.A. Approval Plans resubmitted . Grading Developer Impact Fee A.LP.P. IN ROUSE:- ''d Review, ready for correctionvlwuc Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue Schodl Fees I I Total Permit Fees