13-1434 (MECH)+- a
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001434
Property Address: 53560 AVENIDA OBREGON
APN; 774-115-002-2 -000000-
Application description: MECHANICAL
Property Zoning:. COVE RESIDENTIAL
Application valuation: . 19073
Tuvl
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty. of. perjury that I am licensed underprovisions 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'Classj C20 w. License -No.:. 878533
Date: Z?1- Co' ntrac or: ..
V
ER•BUILDER DECLARATION
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 C6de:'-Any city or county that'requires a permit to
construct, alter, improve, demolish; or repair any structure; prior to -its issuance, also requires the applicantfor the
permit to file a signed statement that he or she is licensed pursuant to the provisions oftheContractor's State
License.Law (Chapter 9 (commencing with Section 7000) -of Division 3 of the Business and Profess ionsCode) 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 1 I, as owner of the property, ormy: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 '66br se 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.)..
(_ 1 1, 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.). -
. (_ 1 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
r VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ANGELA VALKOVA
53560 AVENIDA OBREGON
LA QUINTA, CA 92253
(760)812-9182
Contractor:
ONE HOUR A/C & HTG
3030'MYERS, STREET
RIVERSIDE, CA 92503
•(951)276-9744
Lic. No.: 878533
Date: 11/12/13
NOV 12 2013
WO -FU QUINTA
FINANCE DEPT
' WORKER'S COMPENSATION DECLARATION, - -
I hereby affirm under penalty'of perjury one,of the following,declar'ations: -
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.
---73;I-have and will maintain workers kompensation insurance, as required by Section 3700 of the Labor
- Code, for.the performanceofthe-work for which this permit is. issued. -My workers' compensation
insi rance'carrier and policy numberare: - .
Carrier INS CO'OF;WEST Policy Number WV-ES02266100
_ i certify that, in the performance of the work for which this permit is issued, I sha11 not employ any
person .in any manner -so as to become subject to the workers'. compensation la'vs of California,
and agree that, if I should become -subject to the' workers' compensation provisions of Section
3700 of the Labor Code I'shall:f 'th comply with those provisions. -
Ap.
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
QOLLARS($100,000). IN ADDITION TO THE COST OF,COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEES.'
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.
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 1 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 county to enter up/on [he above-mentioned property for i ion purposes.
w
Date: ����ig'nature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 13-00001434
Permit . . MECHANICAL 2013
Additional desc .
Permit Fee . . . . 83.42 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 5/11/14
Qty Unit Charge `Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1::00 11.9200 EA. . MECH APPL REP/ALT.
.11.92
1..00 .35,:7500 EA MECH CONDENSER/COMP
35.75.
JPermit' ELECTRICAL 2013
Additi6 al ,de'sc
Permit Fee 23'.83 Plan -Check ,Fee
'00::
Issue. Date ..- :•;;. ",Valuation
0
Expiration Date .... 5/11/14` _-
Qty Unit Charge Per
Extension•'
1:00 23.8300.; EA,:`' ELEC OTHER EQUIP
23.83
_S ,.
pecial..?Notes `and Comment's
'HVAC -.CHANGE . OUT (1) 18SEER/80AFUE
SYSTEM .,[-200.8. ENERGY];.,"CARBON , MONOXIDE
ALARM;(q) TO BE: 'INSTALLED. 'PRIOR .TO'=FINAL
INSPECTION. 2010 CALIFORNIA.BUILDING
CODES.
"• --- ------------------------=-'--.------------------------------
Other Fees. PERMIT ISSUANCE"M%P/E
...Other
------------
90.
PLAN•CHECK; MECHANICAL-
52.43
Fee summary Charged Paid Credited
Due
Permit Fee Tota -1 107.2.5. .00 .00
107.25
'- Plan Check Total 00 .00 .0;0
.00 .
Other. Fee Total 1<43.00 .00 0.0
143.00
Grand Total 250':25 .00` .00
250.25
LQPERMIT
Ci�yof La Quina
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, pButlAJng tat: Safety DJvis.Ion
PerrrlJfN_
P O. OX";1504, 78-4:95 Calle TampJco_
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La Qtrinta, CA 92253 - {760) M704,21
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Sim lifted Prescriptive Certificate of Com fiance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address: 53560 Avenida Obregon
Enforcement Agency: city of La
Dafe:11-12-13
Permlf N:
Conditioned Floor
Equipment Type'
List Minimum Efficiency2
Duct insulation requirement
Area
Thermostat
x
Packaged Unit
Furnace
x AFUE80%
to
[]COP
HSPF
Over 4011 of ducts added or
relaced in unconditioned space
P
Served b system
Y
El Setback
(If not already
x
indoor Coil
EER
8 Resistance
[ R6(CZ 10.13)
sf
present. must be
x
Condensing Unit
[3EER
R 8 (CZ 14.1 S)
installed)
Other
1. Equipment Type: Choose the equipment being Installed, if more than one system, use another CF-IR-ALT-HVACjor each system.
2. Minimum Equipment Efficiencies.- 13 SEER, 78%AFUE, 7.7HSPFfor 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 fisted on this form was in fact the work completed by the
installer. The inspector also verifies that each appropriate CF -611 and registered CF -4R forms (no hand filled CFARs allowed) are filled out and
sistned. Beginning October 1 2010 a registered copy of the CF -]R and CF -6R shall also be on site for final Inspection.
IM 1. HVAC ChangeoutRequired
Forms:
• CF -6R forms: MECH-04, MECH-21-HERS and (for split systems) MECH- 25 -HERS
•. All HVAC Equipment replaced
CF -4R 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
CFAR forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum AirFlow Requirement), TMAH
For Packaged Units: Duct leakage < I S 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. Existina duct systems arc 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 _wA all
CF-gR forms: MECH 20•, and (for split systeins)MECH-22, and MECH 25
new equipment)
For Spilt 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/or without Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and'(116r split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor coil CFAR forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or.stime equiptitent changed..
For Split Systems: Duct leakage < 6.percent, RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
Iff-4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS CF4R forms: MECH-21
linear feet of duct in unconditioned space.
For splits stem 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.
• l am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the designnidentiftcd on this Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Tide 24,
Parts l and 6 of the California Code of Regulation..
• The design features identified on this Certificate of Compliance are consistent with the information documentegAn other op to compliance forms, worksheets,
calculationsplans and specifications submitted to the enforcement agency for approval with the ocrinit o on.
Name:Jane Recktenwald
ISignature:
Company:Venvest Ballard Inc, DBA One Hour
Date: 1 1-12-2013
Address: 3030 Myers St
License: 878533
_ _City/Statc2ip_Riverside,_CA.92503._________._____.__.__—.__._____.._—_—__—
Phone: 951-276-9744
Mfift Rncfdannnt rmm.tJnn,•o Fnrme MA. -.41 9nin