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11-1277 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 7.77-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/28/11 Application Number: 11-00001277 Owner: Property Address: 43621 PALERMO CT GONZALES GERARD ID Y (j APN: 609-521-003-13 -28457 - 78451 TORINO DR iP�lUl� _ �Jt� Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL (2 06) 295-66952 61 Application valuation: 6775 t %:a i I i Contractor: C(TY OI�- `•:A' -Kill? IA Applicant: Architect or Engineer. PREFERRED PLUMBING HTG A/C7---�.e�.,. •_ _,., .______ _ ! P . O . BOX 5120 PALM'SPRINGS, CA 92263 (760)322-3173 Lic. No.: 457554 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 following*declarations: Section 7000) of Division 3 of the Business a Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided �\ License Class C10 C16 -C2 - .Licens : 457554 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. nt- Date: / Coractor: _�L,_ _ 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 .. � NE LDER DECLARATION -BUIinsurance carrier and policy number are: - I hereby affirm under penalty of perjury that I am axe t from the Contractor's State License Law for the Carrier EVEREST NATL Policy Number 7600006445111 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 come subject to the woiker ' ompensation 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 hall fo hwith com ly wit se pr isions. 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): Dater/ Applicant: ( 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 WAR ING: FAILURE TO SECURE WORKERS'CO NS TION 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. El 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 (_) 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 contractor(s) 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 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 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 ' ormation is correct. I agr to comply with all city and county ordinances and state laws relating to building c n iruction, and by'au ori re esentatives of this count to enter upon the above-mentioned property for pection pu oses. Date: !� �/ Signature (Applicant or Agent): Application Number . . 11-00001277 Permit . . . MECHANICAL. Additional desc ., . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation. 0 Expiration Date 5/26/12 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 REPLACE EXISTING FAV , AC & COIL LIKE FOR LIKE GROUND 13 SEER 2010 CODES. -----------------_----_---------------------------- Other Fees . . . BLDG STDS ADMIN (SB1473) 1.0.0 Fee summary Charged Paid Credited. Due Permit Fee Total 40.50 .00 .00 4.0:50 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 Sim filed P,rescri •five C fificate'of Com Tane:.Z008.ResidentialHVACAlterations CF-IR-ALT-�HVAC,,. Climate'Lories 10 to 1.5 Site:4ddress: ' :. A Enforcement Agency: ' LA ol Aj, tA Date: r Permit #: . Equipment T et List Minimum EfficiencyZ Duct insulation requirement Conditioned Floor Area Thermostat ❑ Pa gid Unit urn.ce ❑ AF ❑COP Over 40 ft of ducts added or back or Coil ❑SEER ❑ HSPF _ e ,placed in unconditioned space ❑ R 6 (CZ 10-13) Serve•i b system (Knot already Y be ondensing Unit 13 EER ❑Resistance sf prevent, must ❑ Other _� 1 ❑ R 8 (CZ 14- ]S) installed! 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -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 tie 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 Cd•4Rs allowed) are filled out and si ed. eginning October 1, 2010, a registired copy of the CFAR and CF -6R shall also be on site for final inspection. . HVAC Changeout Required Forms: • All HVAC Equipment replaced CF-611forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS C17411forms: MECH- 21 and fors lits sterns) 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 Requ_rement),, TMAH For Packaged Units: Duct 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 feet in 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 spl t 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 Forms: 'Required • Includes adding or replacing more than 40 linear feet duct in CF -6R fonns: MECH-04, MECH-2I-HERS CF-eR forms: MECH-21 of 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. • 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 Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance arc consistent with the information documented on o r applicable compliance forms, worksheets, calculations plans and specifications submitted to the enforcement agency for approval with the permiLapplicatioA Name: J�FrF L6 -A V= A/) Signature: /, Companyp,,, Ul)ate: Address: U D� License: City/State/Zip: P&AA, AW6,5 64•, .3 Phone: _ Z21 2008 Residential Compliance Forms March 2010 Bin #City of La Quinta >; .::;..::r:♦ •::::_',>:: `' :. Building U Safety Division Permit•# P.O. Box 1504, 78-495 Calle Tampico , La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address( i I�L� .. lU �j '� Owner's Name: 'RA'� � �� 2 05 A. P. Number Address: 7', 4 S 7 0;z i t,,!0 Legal Description City, ST, Zip: A �; N,4 `• �A ZZ 52 l?refer ed;, Aire,°Cdit 'ming dba Address: PO,.:..B;ox..;;;:5;1,2:0;:.... Project Description: City, ST,Zim CA92.2i3 rAJ i Telephone :.(7 6 0) 3 2'2 317 3 '. L = Fc� 2 L i G ti0 13 State Lic,: #: 4 5 7 5 5 4 City Lic. #': Arch.;:Eegr:; Desgiie<<;.: Address: ' Telephone :: State Llp Name of:Contact,Peson.: , 1�F �:(: Vjay Construction Type: Occupancy: Projecitype (circle one): New Addln Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone #°of Contact. Person;-� (v (,� - % - Estimated Value of Project: t: 7 �] -- e� APPLICANT: DO NOT WRITE BELOW THIS LINE #'.S.gbmittat - .. -:. RegId Recd TRACKING ; PERMIT FEES PIan;9Pts`, ; ` : Plan Check AeBmitted Ite Amount Structural'Calcs.,. • ' Reviewed, ready for corrections Fla 11CheckDe posit Trpss t:alcs:..., - Called Contact Person Plar Check:13alance Energy.Cal,s.. Plans Dicked up Con itructim " Floud'plain plan• Plans -resubmitted Mechanical: Grading plan' ;. .,' 2°a Review, ready foi 'corrections/issue Ele tical Subeontaetor.Ust Called Contact Pergon Plu bang Grant Deed .; Plans picked up S.M I. H.O.A. Approval Plans resubmitted Gra ling INHOUSE - ''" Review, ready for corrections/issue Dev loper Impact Fee Fin Called Contact Person A.I. .P. Pub. Mks. Appr ' Date orpermit Issue School Fees ' Tote I Pcrmi' Fees