13-1561 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00001561
Property Address:
48265 PASO'TIEMPO LN
APN:
646 -360 -008 -
Application description:
MECHANICAL
Property Zoninq:
LOW DENSITY" RESIDENTIAL
Application valuation:
5950
Applicant: Architect or Engineer:
V
-
BUILDING & SAFETY DEPARTMENT }
BUILDING PERMIT
-------------------------------------------------
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 10 License No.: 878533
1 Datq.9' 1— Contractor. f✓
OWNER -BUILDER DECLARATION
t 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
r . 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.).
(_ I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. .
7044, Business and -Professions Coder 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:
I
LQPERMIT
VOICE (760) 777-7012
-�� FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
SALLY LOWRY
48265 PASO TIEMPO LANE
LA QUINTA, CA 92253
(760)564-6086 .
Contractor: .
ONE HOUR A/C & HTG
3036 MYERS STREET
RIVERSIDE, CA 92503
(951) 276-9.744
Lic. No.: 878533
Date: 12/04/13
pre o 4 2013
CITY OF ILA QUINTA
FINANCE DEPT.
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
G�„ issued.
{Mave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
V 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 Numbei WVE502266100
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
�e 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dl� A?r \,2*1 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 ($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 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 pro oses
Dat �� -f-12 Signature (Applicant or Agent)i
r
Application Number . . . . 13-00001561
Permit MECHANICAL 2013 -
Additional desc
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . Valuation
0
Expiration Date 6/02/14
Qty Unit Charge Per
Extension
1-.00 35.7500 EA- MECH FURNACE
35.75
1.00 35.7500 EA MECH OTHER EQUIP
35.75
-----------------------------------------------------------------------------
Special Notes and Comments .
HVAC CHANGE OUT - 80AFUE FURNACE AND
INDOOR COIL (2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR.
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING CODES.
-------------- -------------------------------------------------------------
Other Fees PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
59.58
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 150.15 .00 .00
150.15
Grand Total 221.65 .00 .00
221.65
_ t
Submittal Req"I
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Sim lifted Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
S1reAddress:48265 Paso Tiempo Ln
Enforcement Agency. Cityof LQ
Da"
12-4-13
Permit #:
Conditioned Floor
.Equipment Typet
List Minimum Efficiency2
Duct insulation requirement
Area
Thermostat
Packaged Unit
x Furnace ®x AFUEW,4 ❑ COP
Over 40 it of ducts added or
laced in unconditioned space
Served by system
El Setback
(if not already
x indoor Coil OSEER B HSPF ,
ffR 6 (CZ 10-13)
3120 sf
present, must be
tnsrolled)
Condensing Unit ❑EER Resistance
R g (CZ 14-15)
Other
1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -1 R-ALT-HVACforeach 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 wharf 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 forts 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 CF4R forms (no hand filled CF4Rs allowed) are filled out and
sinned. Beelnnine October 1. 2010, a registered copy of the CF -1R and CF -611 shall also be on site for final Inspection.
Q 1. HVAC Changeout Required Forms:
• All HVAC Equipment replaced CF-6Rrm
fos: MECH-04, MECH-2I-HERS and (for split systems) MECH- 2`• -HERS
CF4R forms: MECH- 21 and fors lit stems MECH-25
• Condenser Coil and /or CF-611forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or CF4R forms: MECH- 21 and (for split systems) MECH-25
• rurnace
For Split Systems: Duct leakage < 15 percent; RC, CCA >_.300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: DuO 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 duct systems are constructe insulated or sealed with asbestos
2. New HVAC System I Required Forms 1
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-2:-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -411 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, SIMS, and either HSPP or PSPP.
For Packa ed Units: Duct leakage < 6 percent
0 3. New Ducts withfor without Replacement Required Forms:
• includes replacing or installing all new ducting CF -611 forms: MECH-04, MECH-20-HERS,and (for 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 some equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA 2:300 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 CFAR forms: MECH-21
linear feet of duct in unconditioned space.
For splits stem or packaged units: Duct leakage < 15 percent
EXCEPTION: Existing ducts stems constructed. insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Ccrtifrcate 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.
• 1 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 I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documentn other liable compliance forms, worksheets,
entrnta�inns. mans and snecifications submitted to the enforcement agency for approval with the permit a r on.
NIIQ1e:Jane Reektenwald �tgnatuce: G.,.
Company: Date Ballard Inc., DBA One Hour . '12-4-2013
Address: 3030 Myers St License: 876533
City/State/Zip: Riverside, CA 92503 Phone:951-2.76-9744
7nn.9 rmmnui ",a rinrmo A—Is 71114