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12-0133 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: t Property Address: APN: Application description: Property Zoning: Application valuation: . Applicant: 12-00000133 51745 AVENIDA RUBIO 773-121-018-5 _000000 - MECHANICAL COVE RESIDENTIAL 12000 TAh , t44Q*& Architect or Engineer dG o BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DOROTHY COTTLE 51745 AVENIDA RUBIO LA QUINTA, CA 92253 / Contractor: to AL ONE'S ONE HOUR A/.0 & HTG ` #712 E. LA CADENA DRIVE �f t�%RIVERSIDE, CA 92507 / (951)276-9744 LiC. No.: 878533 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 Class: C20 License No.: 878533 D.te 2-F1,41-— tractor: O ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I a empt 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).: (_) 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 _ 1 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 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/14/12 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. A—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 INS CO OF WEST Policy Number WSD500334901 _ 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. ty Ap nt: 0 WARNING: FAIL RE�CURE WORKV PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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 willsubject 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 county to enter upon the above-mentioned prope�or inspection purposes. �Z- iLA 12- S' ature (Applicant or Agent): LQPERMIT Application Number . . . . . 12-00000133 Permit . . . MECHANICAL Additional desc . Permit Fee . . 45.00 Plan Check Fee 6.00. Issue Date Valuation 0 Expiration Date 8/12/12 Qty Unit Charge- Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT.. 4.50 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ------- Special Notes and Comments REPLACE 3 1/2 TON 13 SEER PACKAGE HVAC UNIT & DUCTWORK (SAME EXISTING ROOF MOUNTED LOCATION). 2010 CODES. -----------------_-_-------------------------------------------------------- Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited --- ------ ---------- ---------- ---------- Due ----------------- Permit Fee Total 45:00 .00 .00 45.00 Plan Check Total 6.00 .00 .00 6.00 Other Fee Total 1.00 .00 .00 1.00 Grand Total. 52.00 .00 .00 52.00 LQPERMIT r Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: . 51745 AVENIDA RUBIO La Quinta, CA 92253 City of La Quinta Feb 9, 2012 " Equipment Tyliel List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area - Thermostat p Package Unit , ❑ Furnace ❑ Indoor Coil G1 AFUE 80% p SEER 13.0 ❑ COP ❑ HSPF [I R 6 (CZ 10-13) Served by system 2 Setback , If not already present must be [ICondensing Unit [I EER ❑ Resistance R gCZ 14-15)EER 1400 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. I • - 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 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.Beginning October 1, 2010, a registered copy of the CF -111 and CF -611 shall also be on site for final inspection. 10 1. HVAC Changeout Required Forms: . • All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS and (f ff Split Systems) P49GH it HERS replaced CF -4R forms: MECH-21 11 IYESand (a.. split systems) MECH 2 • Condenser Coil and /or • Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS aREj (fnr split systems) ^EG • 25 HE -� -�- - - -- - - . Furnace CF -4R forms: MECH-21 ;Ra (f ff split syst ws) P49GH 2 , F8F Split Systemsil Duct leakage -;49 pereeRti RG, GGA 6 399 AiF New ReqWiFeffleRli), T4AA* For Packaged Units: Duct leakage < 15 percent r 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 duct systems are constructed, insulated or sealed with asbestos [14. The system will not be Ducted (ie.,DucEless:Mini=Split System)'(Also'Exempt-from!Refrigerant Charge) .. _ ..- - - 112. New HVAC System Required Forms: . Cut in'or. Changeout with.. new ducts: (all new ' r. CF 6R forms: MECH-04, MECH=20-HERS, and (for split systems) MECH-22-HERS, and , ducting and all new. equipment), MECH-'25`HERS r' �{ �, g' _, �� ,�`' -• �+^"°{�` i CF -4R fOrms,MECH 20, and fors lit systems) stems MECH-22 and MECH-25'. �r C (y^P ) l-yr�l...+ _y �. t_ti. •r •�-`'f �:,..; 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 113. New Ducts with/or without. Required Forms: Replacement • -1 ' + . Includes replacing or installing all new ducting and/or outdoor condensing unit CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 - equipment changed, For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH , For Packaged Units: Duct leakage < 6'percent " 1:14. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS linear feet of duct in unconditioned space. CF -4R forms: MECH-21' ' 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) • I certify that this Certificate of Compliance documentation is accurate and complete. ` • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Jim McEligot Signature: Jim McEligot ' . • • Company: VENVEST BALLARD INC Date: Feb 9, 2012 Address: 2712 EAST LA CADENA DRIVE License: 878533 City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951)276-9744 Reg: 212-A0007229A-00000000-0000 Registration Date/Time: 2012/02/09 15:22:29 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms - t �' July 2010 Bin # Cit/ Of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 12•d33 Project Address: 5 �'� ys Q�(�`� b Owner's Name: A. P. Number: �.yJ farms _ Address: G,n Legal Description: Contractor:S 'b' � Q City, ST, Zip: Telephone: s MINI, Teleph n >;�;; y AM Address: 2� Z E� . Project Description: City, ST, Zip: `\ 'S�\ "nl2-FJr-)1 Telephone: –lt•'J�� � ?�.�;,;��,,�s,�;>:,;z�;s%'i�:'y!�'..;c, • YfOt:., ; orf•`:. 3}.{;..f :> o�Y,"h State Lic. # : � rJ3 3 City Lic. #,.\ Arch., Engr., Designer: ` Address: '— City., ST, Zip: w} y.;� � t •� {vim •.: •: ar .,;, . ,. Telephone: p State Lic. #: _ter^I Name of Contact Person: Construction Type: Occupancy. Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: It 'Z, Cm APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Caics. 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 Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees