10-1409 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1'6--00001409
Property Address: 78590 HIGHWAY 111
A_PN: 604 -080 -999 -
Application description: MECHANICAL
Property Zoning: COMMUNITY COMMERCIAL
Application valuation: 6000
c&ht 4 4aumrw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SHOVLIN MICHAEL J
Contractor:
Applicant: Architect or Engineer: COOL FLO INC,
79469 COUNTRY CLUB DR, #H
v BERMUDA DUNES, CA 92203
(760)345-6606
Lic. No.: 438781
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 Prgje§sionals Code, and my License is in full force and effect.
Licensee Cla s: CIO License No.: 438781
Date:/ Contractor:
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 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, 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 contractors) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
rl Date p'2
tJD17 2
d'
WORKER'S COMPENSATION DECLARATION
1 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 NORGUARD INS Policy Number COWC129001
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 s blect to the workers' compensation provisions of Section
700 of the Labor Code, I 111 f th comply with those provisions.
`Date: J O Applicant
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 15100,0001. -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 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 constructio and hereby authorize representatives
of this count to ter upon the above-mentioned property for ins ectio purposes.
Date: Signature (Applicant or Agent) rf
LQPERD1IT
Application Number . . . 10-00001409
Permit . . MECHANICAL
Additional desc .
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 6/26/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000.EA MECH
FURNACE <=100K
9.00•
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00 .
------------------------------- --------------------------------------------
Special Notes and Comments
REPLACEMENT OF EXISTING A/C UNIT.
5 TON
PACKAGED UNIT. APPROVED PER A.J.
-
---------------------------=------------------------------------------------
Other Fees . . . .'. . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total 33.00
.00 .00
33.00
Plan Check Total 8.25
.00 .00
8.25•
Other Fee Total 1.00
.00 .00
1.00
Grand Total 42.25
.00 .00
42.25
CERTIFICATE OF COMPLIANCE MECH-IC-ALT-HVAC
Prescriptive HVAC Alterations (Pagel of2)
Project Name/Address:
Date:
Enforc men Agency:
Permit Number:
Climate Zone
151LO WG U
11.5
.
NOTE. This form may be used only for single zone constant volume systems. This form shall not be used for newly constructed
buildin s, additions, or VAV 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 for verification by thefield inspector and a copy shall be made available to building owner.
E'ng Building Project Tye select one): Complete Steps:
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) /, 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
Served
and Location
R -Value°
Types
(Central, Split, Package)
5 TOY Nr AUP Pah QIV/
OD aXJyC0AV11r01J
,qcx 6
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 beequipped with a setback thermostat. Setback thermostats shall meet the requirements of Section 112(c).
Step 2 — Mechanical Ventilation Calculations
Both options (Area and Occupancy Basis) shall be completed to determine the minimum mechanical ventilation rates and Column I must be the
rester of either Column E or H.
AREA BASIS
OCCUPANCY BASIS
A
B
C
D
E
F
G
H
1
Zone/
Type of Use
Condition
CFM
Min
Num of
CFM
Min
Design Vent. CFM
System
Area (ftz)
Per 2
CF M2
People
per
CFM'
Larger of
yKti•tir
C x D
Person
F x G
E or H
R r
on ,
s
Ind
15
15
15
AREA BASIS
1. 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/ft2 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 elm per person.
Type of Use CFM per ft'
Type of Use CFM per ft'Auto
repair workshops 1.50
High-rise residential Ventilation Rates
Specified by the CBC
Barber shops 0.40
Hotel guest rooms less than 500 ft') 30 cfm/ uest room
Bars, cocktail lounges, and 0.20
Hotel guest rooms (500 ftz or greater) 0.15
casinos
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:
S0 a LOA Y 78-Scl'O HUJ Y f I L.Q.
Date:
_00
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 Acceptance forms are required to be filled out completely, signed, and made available to the
enforcement agency at final inspection. Copies of the completed, signed Certificate of Acceptance forms shall also be made
available to the building owner.
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 of the Energy Standards.
El 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 verify controls function, including: thermostat
installation and ro rammin , supplyfan, heating cooling, and damper operation in accordance with Section 125 of the Energy Standards.
Step 5 — MECH-4A - Air Distribution Systems Acceptance — This test is required when the new or altered system is a single
zone, constant volume system serving 5, 000 ft1 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.
Step 6 - MECH-4-HERS - 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.
Step 7 - MECH-5A -Economizer Testing Acceptance -This testis required for newly installed or replacement HVAC equipment
when an economizer is installed in accordance with Section 125 of the Energy Standards.
rJ Step 8 - MECH-6A - Demand Control Ventilation Systems (DCV) Acceptance - This test is requiredfor 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 1000 f (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 (DDC to the zone level.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name: `C P+,,1�F5/ ' 6AIV614j1,
Signature:
Company: DO /,O /v�
C
Date: /0 2 % lD
Address: /� /��/ /� ,(�
7(� ( C� oolvr 1` �L U� I
If Applicable
tJ� /
CEPE #
CiM/'CUOM Z)Zjl � � Ci O_?
Phoy®,'r�^
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: 1c/ A,6 /j 1114jVe!;A1t1
Signature:
Company N 10 0 Lf L® c
Date: / 21---)711'O �,7 /O
Address:
'- yG�coUirlr�yc cue
License #
y7S/
1-)0
City/
KvU 9U,LC//T �3
Phone
:2R0 3yf' O// y/02
2008 Nonresidential Compliance Form July 2010
1,
Cityof La Quinta
Building 8T Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
U Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: Owner's Name: ,A,(jQ16QN Ap
A. P. Number:
Address:
Legal Description: City, ST, Zip.
Contractor. Coo G .V, Telephone: 7 33 y, -
Address: q69 el ovw/C y Project Description: QG 6-1t/7— 6%
City, ST, Zip: tq Fd tcJ 541 MAIL ' Q AlI
Telephone:%(ex.
State Lic. # : 11397911 City Lie. #: .
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lia #: Project type (circle one): New Add'n epair Demo
Name of Contact Person: Sq. FL: # Stori# Units:
Telephone # of Contact Person:
N
Plan Sets
Structural Cales.
Truss Cales.
Title 24 Cales.
Flood plain plan
Grading plan
Subcoutactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Estimated Value of Project: UCL/
APPLICANT: DO NOT WRITE BELOW THIS UNE
Recd TRACIMG
PERMIT FEES
Plan Check submitted Item Amount
Total Permit Fees
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
Review, ready for correctionsAnue
Electrical
Called Contact Person
Plumbing
S.M.L
Plana picked up
Plans resubmitted
Grading
Review, ready for correedons/issue
Developer Impact Fee
Called Contact Person
A.LP.P.
Date or permit Issue
Total Permit Fees