13-0959 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00000959
55282 OAK HILL
775 -161 -029 -
MECHANICAL
LOW DENSITY RESIDENTIAL
4800
Architect or Engineer:
VAp
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 lassC20 �enseNo.,:�878533
Da a Contractor
O ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I ex mpt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Pro sions 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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
( I 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: - % A
Lender's Address
LQPERMIT
Owner:
MOONEY ROBERT
55282 OAK HILL
LA QUINTA, CA 92253
(208)890-0369
Contractor:
ONE HOUR A/C & H
3030 MYERS STREE
RIVERSIDE, CA 92
(951)276-9744
Lic. No.: 878533
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/31/13
JUL 312013 ID
OF LA QUIPITA
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.
. -have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
'Cade, for the performance of the work for which this permit is issued. My workers' compensation
surance carrier and policy number are:
Carrier INS OF WEST Policy Number WVE502266100
_ 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
3700 of the Labor Code, I shall forthwith comply with those provisions.
r
Date:' , Applicant r .�
WARNING: FAILURE TO SECURE WORK S'' MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P ES 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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT 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 Ouinta, 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, and hereby authorize representatives
of this cor my o enter upon the above-mentioned prop rt for inspection pur ses:
Da ., ,�`"Signature (Applicant or Agent
Application Number 13-00000959
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee 35.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
0
Expiration Date 1/27/14
Qty. Unit Charge, Per
Extension
1.00 35.7500 EA MECH OTHER EQUIP
35.75
------------------------------------------------------------------------------
Special Notes and Comments -.
HVAC-- RELACE-:ALL DUCTING WITH': NEW FLEX
DUCT SYSTEM; �_ [ 2-0 0 8 ENERGY] CARBON
• MONOXIDE ALARM-(S') TO BE INSTALLED PRIOR
TO _.FINAL INSPECTION. 20,10 CALIFORNIA
BLJILDING CODES-:'
.---------------- -'-------------_--- -------------------------
Othe'r' Fees BLDG;'.STDS ADMIN (SB1473Y
--------------
1.00
PERMIT''-ISSUANCE.M/P/E
90.57 .
Fee summaryCharged Paid Credited
Due
Permit.,-Fee Total 35'.75 .00 00
35:7.5
Plan . Check Total - .00 .00 .-00..
00
Other''Fee"Total, 91.57 .s00. .00
91.57
- - Grand Total` 127:32 0`0, .00
127.32
LQPERMIT
Bin #
City of La: Quinta
Building BT'Safeh' _ Division
P:o. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building'Permit Application and -Tracking Sheet
Permit #
Project Address: 55
Owner's Name: 'bob
A. P. Number:
Address: �j�j 2 Z
Legal Description:
City, ST, Zip: as
Contractor:.
telephone:
Address: 3o
Project Description:
City, ST; Zip: 51 1050to
1 5
Telephone: _ 1
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�1 \- 4
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State Lic. # : �"1 �53j
City Lie. #;
Arch., Engr., Designer: oil
Address:
City., ST, Zip:
Telephone:
:>...;
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State Lie. #: "'<<>`< .>``'<`'%%l`r
S
Co stru ti on Type: Occupancy:
:
� Project type (circle one): New Add'n lte Repair Demo
Name of Contact Person:5
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: % ,-1-Ri L4 4
.Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
/ .. PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical.
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subco.ntactor List
Called Contact Person .
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jnd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue,
School Fees
Total Permit Fees
Certificate of Compliance: 2008 Residential H VAC Auermons %Ir-iA-ru, it -n v
Site.Address:
Enforcement Agency;
Date:' l
Permit #:
Conditioned Floor
Equipment Type' List Minimum Efficiency'
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit Over 40 ft of ducts added or setback
❑ Furnace ❑ AFUE_ ❑ COP replaced in unconditioned space Served by system (If not already
❑ Indoor Coil ❑SEER ❑ HSPF _ 6 (CZ 10-13) sf present• mix be
❑ Conde sing UnitEER ❑ Resistance ❑ R 8 (CZ 14-15) imiallcd)
1%Other
1. Equipment Type:4Chothe equipment be ng installed;if [note than one system, use another CF-1R-ALT-HVACfor each system1. Equipment T�Ype:
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUNEWARY 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 -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
signed. Begimog October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
❑ 1. HVAC Changeout
Required Fortes:
CF -6R forms: MECH-04. MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH- 21 and (fors litsystems) MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and /or
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA>_ 300 CF1V1/ton(Minimum Air Flow Requirement), 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
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all
CF -4R 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: 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 CFNVEon, TMAH
For Packaged Units: Duct leakage < 6 percent
4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04. MECH-2l-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Complia»ce
• 1 certify that the energy feawres and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Tule 24,
Para 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the infWnation documented on other applicable compliance forms, worksheets,
calculations. plans and specifications submitted to the enforcement ac for val with the t lication_
Name: V— Signature:
Company:
U db
Address: Io
'[j
License- �
City/Stwe/Ziipp:
Phone: 1 -4-71A_ 41 -in
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