13-0752 (MECH)P.O. BOX 1504
73-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000752
Property Address:
78233 BIRKDALE CT
APN: -
770-280-025- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4000
Applicant:
Td�t 4 VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT - INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/18/13
Architect or Engineer:
0 \n
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: C2200/�. �r License No.: 878533
cpa-(Q�d r J
Contractor ,7
OWN -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 ($5001.:
1 _ I 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 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: w
Lender's Address: ,\
LQP13RA7f7•
Owner:
TERRANCE SNYDER
78233 BIRKDALE COURT
G
D
LA QUINTA, CA 92253
(
JL""'1:J
2013
Contractor:
Cliy p
ONE HOUR A/C & HTG
_� IANCE
),P1 NTA
3030 MYERS STREET
RIVERSIDE, CA 92503
(951)276-9744
Lic. No.: 878533
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.
ave 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 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.
Dat -6140A 8-t'7 Applica
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 ($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 as 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. .
1 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 pr/op�erbty for insp cion purposes.
Date:, Lgnature (Applicant or Agent): -r
Application Number . . . . . 13-00000752
Permit . . . . .
. MECHANICAL 2013
Additional desc .
Permit Fee
71.50 Plan Check Fee
.00
Issue Date . . .
. Valuation
0
Expiration Date
12/15/13
Qty Unit Charge. Per
Extension
2.00 35.7500 EA MECH CONDENSER/COMP
71.50
----------------------------------------------------------------------------
Special Notes and
Comments
HVAC CHANGE OUT
(2) MINI SPLIT SYSTEMS
1 1/2 TON 13SEER
[2008 ENERGY] CARBON
MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary
-----------------
Charged Paid Credited
----------------------------------------
Due
Permit Fee Total
71.50 .00 .00
71.50
Plan Check Total
.00 .00 .00
.00
Other Fee Total
139.23 .00 .00
139.23
Grand Total
210.73 .00 .00
210.73
1'QPj--Pm19'
Bin.# city Of Ld Qillhta
Building $i Safety Division
Permit # P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
•��� Building Permit Application and Tracking Sheet
Project Address: �g 33 Y Owner's Name• . I wu n
A- P. Number. •'� �,
���
Address 8� e
Legal Description:
City, ST, Zip:
Contractor. 01a\ 04k , s
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Telephone: (
Address: ,303 Iv`
Project Description: �1
City, ST, Zip:T�1� e
(+� C l'�YMM
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Telephone.N L� r`
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State Lie. # : V00 3�7
CityLie. C
Arch, Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Construction Type:. Occupancy: .
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project: ;
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG PER W FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit. .
Truss Calcs.
Called Contact Person Plan Check Balance _
Title 24 Cales.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mecbarilcal
Grading plan
2" Review, ready for corrections/issue Electrical
Subcontactor List
Ca1led ContactPerson Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IPI IIOIISE:-
'"` Review, ready for correetionsfissae Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -1R -ALT -
Climate Zones 10 to 15
Site Address: 78233 Birkdale Crt
Enforcement Agency: City of LQ
Date: 6-18-2013
permit #:
Conditioned Floor
Equipment T e'
List Minimum Efficiency 2
Duct insulation requirement
Area
Thermostat
Packaged Unit
Furnace
Q AFUE
AFUEEER_a
� COP
C
Over 40 ft of ducts added or
®x Setback
Indoor Coil
Unit
EI
[]EER
PF
E] Resistance
re laced in unconditioned space
R 6 (CZ 10-13)
Served by system
soo sf
(/f not already
present, e, must be
ondensing
-- R 8 (CZ 14-15)
installed)
-_.
Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for 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 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 -6R shall also be on site for final inspection.
IX 1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and fors lits stems 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 CFM/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/or without 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 coil
CF -4R forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA > 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
-ff4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
em or packaged units: Duct leakage < 15 percent
For spliEXCEPTION:
Existing ducts stems 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 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 documeptc4n other applicable compliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement a enc f approval with the permitafplicion.
Name:Jane Recktenwald
01
Signature:
Company:Venvest Ballard Inc. DBA One Hour
Date: 6-18-2013
Address: 3030 Myers St
License:878533
City/State/Zip: Riverside, CA 92503
Phone: 951-276-9744
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