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12-1164 (MECH)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 12-00001164 Owner: Property Address: 77865 AVENIDA -MONTEZUMAD COACHELLA VALLEY RECREATION & APN: 773-074-002-131 -000000- C/O DON MARTIN Application description: MECHANICAL 75841 CLINTON ST Property Zoning: PARKS & RECREATION INDIO, CA 92201 Application valuation: 6870 D-- Contractor: Applicant: Architect or Engineer: DESERT AIR CONDITIONING, INC. T On 0 2 2012 590 WILLIAMS ROAD PALM SPRINGS, CA 92264 tlTytFUAQUiNYA No: . (760): 283 �y NI r FINANCE FjE�K. Lic. No.276586 LICENSED CONTR TOR'S DECLARATION I hereby affirm under penalty of perjury that I licen u er pr ions of Isapter 9 (commencing with Section 7000) of Division 3 of the Busi s a Prof .o e, nd my .cense is in full force and effect. _ Li se class: C2 C43 ense b.: 6586 Dater(1f1� _ ontractor. - 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 _ 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.). (_) 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.). (_) 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/02/12 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 EVEREST NATL Policy Nu 7600007908121 I certify that, in the performance of the wor for hich this per a fs issued, I shall not employ any person in any manner ob coP t to the workers' ompensation laws of California, and agree that, if dsa cers, co ensation provisions of Section /p T 3 of the Labor de,ortn ywith provisions. �` J�''(p/licant. ' WARNING: FAIL Rll E 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. 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 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 applicatiorfand state that the above information ' c rrect. I agree to comply with all city and county ordinances and state laws relating to con tion, ereby aut orize representatives of th0r(T, l ,to J ?j upon a above-mentioned grope o ' ction ses bat/e://C/J►'C� LSig ture (Applicant or Agent) LQPERMIT Application Number . . . . . 12-00001164 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/31/13 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 HVAC CHANGE -OUT: REPLACE 5 TON SPLIT SYSTEM AT GROUND LEVEL. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ---------------------------------------- Due ------------------ Permit Fee Total 40.50 00 .00 40.50 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 LQPERMIT CERTIFICATE OF COMPLIANCE MECH-IC-ALT-HVAC Prescriptive HVAC Alterations (Pagel of2) Project Name/Address: Date: LA QUINTA COMMUNITY CENTER 77-865 AVE MONTEZUMA #310/02/2012 NAey Enf115 Permit Number. Climate Zone LAoQU I NOTE: This form may be used only for single zone constant volume systems. This form shall not be used for newly constructed buildings, additions, or VA multi -zone systems. Select one "Existing Building Project Type" and complete the corresponding steps listed in the "Complete Steps" column below. Note: After installation of HVAC units and/or ducts, the Installation and the applicable Acceptance Forms are required to be submitted or verification by thefield inspector and a copy shall be made available to building owner. Existing Building Project T select one): Complete Steps: ©x New or Replacement HVAC unit 1, 4, 5 and 6 (If criteria is met), 7 ( When economizer is installed) New or Replacement ducts 1, 4, 5 and 6 (If criteria is met) New Space Conditioning System (HVAC and ducts) 1, 2, 3, 4, 5 and 6 (If criteria is met), 7 (When economizer is installed), 8 (DCV) Ste 1— Ducts and HVAC Equipment Equipment Type, Efficiency Floor Area Distribution Type Duct Insulation Thermostat Configuration and Capacity' Served2 and Location R -Value' Types (Central, Split, Package) HEATPUMP/ AIR HANDLER 2000 ATTIC 4.2 DIGITAL SPLIT 1. Indicate Equipment Type; Air' Handler, Condenser, Heat Pump, Evap. Cooling, Boiler, Electric Resistance, etc. & HVAC Capacity; or Ducts (new or replaced). 2. If the Floor Area Served (per duct system) exceeds 5,000 square feet, skip Steps 5 and 6. 3. Indicate Type and Location (Ducts on roof, ducts in conditioned space, ducts in attic, etc.) 4. Newly installed or replaced duct insulation: R-8 in unconditioned space or in buried concrete slab; R-4.2 in indirectly conditioned space; and R-0 for conditioned space. 5. Existing non -setback thermostats shall be replaced with setback thermostats for all altered units, and all newly installed space conditioning systems requiring a thermostat shall be equipped with a setback thermostat. Setback thermostats shall meet the requirements of Section 112(c). 0 Step 2 — Mechanical Ventilation Calculations Both options (Area and Occupancy Basis) shall be completed to determine the minimum mechanical ventilation rites and Column I must be the greater of either Column E or H. AREA BASIS OCCUPANCY BASIS A B C D E F G H [ Zone/ Type of Use Condition CFM Min Num of CFM Min Design Vent CFM System Area (ft2) Per 112 CFM2 People per CFM' Larger of CxD Person FxG EorH 15 15 15 AREA BASIS L Minimum ventilation rate (CFM/ ft') for the Type of Use in the Table below. 2. The conditioned floor area of the space multiplied by the applicable minimum ventilation rate from Table 4-1 CFM/ftz Column below. For additional ventilation rates, see Table 4-3 and use the values listed in the Required Ventilation Column in the Nonresidential Compliance Manual. This provides dilution for the building -borne contaminants like off gassing of paints and carpets. OCCUPANCY BASIS 2. For spaces with fixed seating such as a theater or auditorium, the expected number of occupants is the number of fixed seats. 3. The expected number of occupants or people multiplied by 15 cfm per person. Type of Use CFM per ft2 Type of Use CFM per W Auto repair workshops 1.50 High-rise residential Ventilation Rates S 1 e b the CBC Barber shops 0.40 Hotel guest rooms less than 500 112 30 cfrd uest room lounges, and 0.20 casinos 0.20 Hotel guest rooms (500 ft' or greater) 0.15 Beauty shops 0.40 Retail stores 0.20 Coin-operated dry cleaning 0.30 All Others 0.15 Commercial dry cleaning 0.45 1. For additional ventilation rates, see Table 4-3 in the Nonresidential Compliance Manual 2008 Nonresidential Compliance Form July 2010 CERTIFICATE OF COMPLIANCE MECH-IC-ALT-HVAC Prescriptive HVAC Alterations (Page 2 of 2 Project Name/Address: Date:1 0/02/201 2 LA QUINTA COMMUNITY CENTER 77-865 AVE MONTEZUMA #3 L L Installation Certificate requirement: The installing contractor shall complete and sign an Installation Certificate (MECH-INST) to certify that the installed HVAC features, materials, components, or manufactured devices (the installation) conforms to all applicable codes and regulations, and the installation is consistent with any required plans and specifications approved by the Certificate of Acceptance requirement: After completing the installation, all required acceptance testing shall be completed and all applicable Certificate of Acceptanceforms are required to be filled out completely, signed, and made available to the enforcement agency at f nal inspection. Copies of the completed signed Certificate of Acceptanceforms shall also be made available to the building owner. 0 Step 3 - MECH-2A -Outdoor Air Acceptance — This testis required for newly installed or replacement HVAC Systems (HVAC equipment and ducts) to verify minimum outside air is provided in accordance with Section 125 o the Energy Standards. 0 Step 4 — MECH-3A - Constant Volume, Single Zone Unitary A/C and HP Controls Acceptance— This test is required for new or replaced constant volume, single -zone unitary air conditioners and heat pumps to verb controls function, including: thermostat installation and ro rommin , sVplyfan, heating, cooling, and damper operation in accordance with Section 125 of the Energy Standards. Step 5 — MECH4A -Air Distribution Systems Acceptance —This testis required when the new or altered system is a sin le zone, constant volume system serving 5, 000 ft2 or less, and 25% or more of the duct surface area is located in the outdoors, unconditioned space, or a ventilated attic in accordance with Section 125 of the Energy Standards. 0 Step 6 - MECH4-TIERS - Air Distribution System Leakage Diagnostic — This test is required to be completed by a HERS Rater when the new or altered system meets the criteria in Step 5 to verify duct leakage in accordance with Section 125 of the Energy Standards. The HERS Rater shall register the MECH-4-HERS Form with an approved HERS Provider. 0 Step 7 - MECH-5A - Economizer Testing Acceptance - This test is required for newly installed or replacement HVAC equipment when an economizer is installed in accordance with Section 125 of the Ene= Standards. 0 Step 8 - MECH-6A - Demand Control Ventilation Systems (DCV) Acceptance - This test is required for newly installed DCV systems or replacement of HVAC equipment with the following characteristics to verify controls and sensors function in accordance with 125 of the Energy Standards.: A. They have an air economizer; and B. They serve a space with a design occupant density, or a maximum occupant load factor for egress purposes greater than or equal to 25 people per 1000ft' (40 square foot per person); and C. They are either: i. Single zone systems with any controls; or ii. Multiple zone systems with Direct Digital Controls CDPQ to the zone level. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: Signature: Company: Dom: Address: If Applicable CEA # CEPE # City/State/Zip Phone: Principal Mechanical Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the mechanical design. • This Certificate of Compliance identifies the mechanical features and performance specifications required for compliance with Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: JACQUELINE D RAT L I F F Signature: Company Name: DESERT AIR CONDITIONING, INC Date:10/02/2013 Address: 590 W I LLAI M S RD License #276586 City/State/Zip:PALM SPRINGS, CA 92264 Phone:760-323-3383 2008 Nonresidential Compliance Form July 2010 C t Bfn.# Qt�( Of La Qutnta Building 8z Safety Division P.O Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Pemdt # PwiwAAdd=. '77-865 AVE MONTEZUMA 'SName-.DESERT RECREAT;ON DISTRIC A. P. Number: Address: 45-305 OASIS STREET Legal Description: Contractor. DESERT AIR CONDITIONING, INC Address: 590 WILLIAMS RD City, sr, zip: I N D I O, CA 92201 Telephone: 760-564-9921 Project Description: REPLACE 5 TOLITCity, ST, Zip: PALM SPRINGS, CA 92264 SYSTEM ON GRD Telephone: 760-323-3383 LIKE FOR LIKE. State Lia # : 276586 City Lic #; 363 Arc&, Engr., Designer: NA Address: City., ST, Zip: Telephone: State Lia #: " Construction Type:. MECH 00cupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. F4: # Stories: #Units: Name of Contact Person: JACQUELINE RATLIFF * Telephone # of Contact Person: 760-323-3383 Estimated Value of ProjectO �- APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACING PERbUFFEI;S Pian Sete Pian Check submitted Item Amount Structural Cake. Reviewed, ready for corrections Plan Check Deposit. . Tress Calce. Called Contact Person Plan Check Balance s Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmltled.' . Mechanical Grading plan 2' Review, ready for correctionelssue Electrical Subeontoctor List Called Contact Person Plumbing Grant Deed Plans picked up S3U H.O.A. Approval Plans resabmttted Grading IN HOUSE.- ''" Review; ready for torreetionsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. " Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees