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HomeMy WebLinkAboutHVRC18-0259City of Palm Desert Building Safety Department PERMIT NUMBER: ISSUED DATE: and 73510 Fred Waring Drive HVRC18-0259 5/7/2018 12:00;00 AM Palm Desert, CA 92260 Appl. Date: 517/2018 Permit Type: HVAC CHANGE OUT RESIDENTIAL. Appr. Date: 5/7/2018 Permit TIER 1-LESS 15 SEER Subtype: Job Valuation: $17,909.00 Exp. Date: 11/3/2018 Project Address: 40960 AVENIDA ARCADA Project Description: APNITract/Lot No: Owner: Contractor: Applicant: 622340008 DEAN L GATONS CERTIFIED COMFORT SYSTEMS CERTIFIED COMFORT SYSTEMS TR 24773-1 40960 AVENI DA ARCADA INC I N C 8 PALM DESERT, CA 92260 42-949 MADIO STREET 42-949 MADIO STREET INDIO, CA 92201 INDIO, CA 92201 (760)360-2202 (760)360-2202 Licensed Contractor Declaration Fee Summary hereby affirm under penalty of periury that I am licensed under provisions of Chapter 9 ARCHIVE FEE - 8.5X11 UP TO 11X17 GL-1100000.34116DO 50.2i3 (commencing with Section 7COO) of Division 3 of the Business and Professions Code, and my license is in full force and effect. GREEN BLDG FEE SB1473 GL-6100000-22810DO $1.00 Initial RESIDENTIAL HVAC CHANGE OUT GL-11000OO-3221100 $135.15 Total Fees Paid: $136,43 Owner -Builder Declaration I hereby affirm under penalty of oedury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) Section 7031.5 Business and Professions Code; Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to 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 Contractors' Stale License Lai Chapter 9(commencing with Section 7000) of Division 3 of the Business Print Name: and Professions Code) or that he or she is exempt 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 ($500L) 1, as owner of the property, or my employees with wages as their sole Compensation, SignatureoIrApplicant or Agent: 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 the property, 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 Date: burden of proving that it was not built or improved for the purpose of sale.) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a licensed contractor pursuant to the Contractors' Slate License Law.) I am exempt from Licensure under the Contractors' State License Law for the following reason: Date/Signature, of property owner or agent Workers' Compensation Declaration 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 ($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. I Wool all under the Denaltv of Deoury QNE of the f.11.,ving declarations: have and will maintain a certificate of consent to selfAnsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section Initial 37DO of the Labor Code, for the performance of the work for which this permit issued. Policy No. 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: Initial Carrier d Policy Number Expiration Date I certify that in the perferrnance of the work forwhich this permit is issued, I shall not any person in any manner so as to become subject to the workers' compensation laws of California and agree that if I sh ecome subject to the workers' co ensation provisions of Secti 3700 the bor Cade, 1 forthwith cpmpifiywil s Eprt}visl0ns. .,7 i 9V Applicant Memploy llni�tialDate City of Palm Desert Department of Building and Safety Buildinq Permit Application Project Address: (For' Office Use Only) W JOB ID: rzaR r do15ef PLANS FILED: Suite # Total Value of work: $ ! -U U (Vote: Plan Review Fees may be adjusted after Plan Review Project Description (be �6�� lo' - Contractor Business Name Y h Property Owner Name Address t M�� /►n ` Address city c� t f Zip Zip Phone Phon Fax Fax E-mail E-mail Contractor License No. i]Architect Name ©Designer Name Engineer Name Address Address City Zip city zip Phone Phone Fax Fax E-mail E-mail License No. License No. Applicant4qarfie Signature Date Contacf�t ephone'umber E-Mail PLEASE COMPLETE THE REVERSE SIDE 73-510 Fred Waring Drive, Palm Desert, CA 92260 • (760) 776-6420 • (760) 776-6392 fax • www.cityofpalmdesert,org -f fn :;o A n co !o M 00 fD O V C rCD '�• @ N � y v � 3 d 7 R N fL � O C F+ rn a, o rn v 0 rD fD 7 (D Ol fl m m O Ln 0 o � an 6 a Y ro N 6n1 +n A n co m NJ O Z� a � n 3 a CD H O � 3 0 � 0 L3� 0 O 3 r- 0 y to Oa n vy ° u, a y N to N n� m cu Bh a n N T � n m O CD W Of O Ln CD N n M {' 7 H F r W �* n m.,fD 3 CL M (A a •y as n n -S o y a mACD y o;:....,.. y �• 3, {.R i .. _.......... d Oq. l O DO R 01 3 tr a •C fD R Q1- a fD R v fD O M LM V... , O LL :i• a (C Q- fD Vk a rc 00 .. fD m as m =.:E O ; m m O�0 n fD o w Q O aq '{ n b O O b o -n -n. 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(D N m ro :3 CY7 co oa v om 7 S W1 C .rt �C- 1,0 ,P S cr, P C T .,7 =, fo rp 0. m 3 N d IL j y U 70 a Q N v C •G f - mn a ro rr a ? 0, N CD _ O n Lib m m � ^n O N O Oa v CA c �. 3 n ° 3 p v m a o: H N G C rb r m v /° a D f1 rr rf o S ro )6 Ol ro w O w n m T a m m O T O n Z n m City of Palm Desert Department of Building and Safety Phone; (760) 776-6420 mmi-ciWo-f0almde,gerwore SMOKE AND CARBON MONOXIDE ALARM RETROFIT VERIFICATION I' LefL and i, �(Print�MPOrty�Owne�esNamie)�' (Tenant's Marne - If ame as Owner who own and/or live in the dwelling located at: C 1 If,� Ivy ��� 1 i /, lf,�' r verify that the smoke and carbon monoxide alarms required by the California Residential Code (CRC) have been Installed in the dwelling, In compliance with the code and with the manufacturer's instructions and further: that they have been tested and do function properly. In an effort to enhance life safety within dwellings, CRC Sections R314.6, R315,2 and CBC 420.4 requires the retrofit of these alarms in existing dwellings when alterations, repairs or additions requiring a permit ands exceeding $1,000 In value are made. Generally, the alarms must be hard wired (110 volt) with battery back-up. and all alarms are to be Interconnected. If the installation of the alarms will require the removal of wall or ceiling finishes or there is no access by means of attic, basement or crawl space, then alarms may be solely battery operated and not interconnected. Alarms must be installed in ZU of the following locations within the existing dwelling: • In all bedrooms (Only require Smoke Alarms) • Immediately outside of each separate bedroom (require Smoke and Carbon Monoxide Alarms) • In each story level of the dwelling, including basements and habitable attic rooms (require Smoke and Carbon Monoxide Alarms) And; Shall be current within 10 years from the date of manufacture marked on the unit,_ or replaced if the date of manufacture cannot be determined. Shall be equipped with a 10 year battery if a conventional ionization smoke alarm. These safety devices must be installed by the time a final inspection Is requested for your project. I understand the above requirements and certify that we now have smoke alarms and carbon monoxide alarms Installed that comply. We agree to comply with the CRC In regards to smoke alarms, carbon m0rnLoxi lar s. i' Signature Owner Date Signature of Tenant Date ATTENTION OWNER - OCCUPANT: This Is a Voluntary Smoke and Carbon Monoxide Alarm verification procedure. if you prefer a Building Inspector to perform the verification, you must arrange to have an adult present of the time of Inspection. NOTE. This Verification Is only used when normal access to the Interior of the dwelling by the Clty of Palm Desert Building Inspector Is not achieved during the course of project construction. It is normally used for projects such as re -roofing, re -siding, patio covers, swimming pools and the like.