11-1246 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: _11-00001246
Property Address: 46450 CAMEO PALMS DR
APN: 643-182-005-10 -2043 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8100
Applicant:
T4ht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RECTOR DONALD R
46450 CAMEO PALMS DRIVE
LA QUINTA, CA 92253
Contractor: p
DIAL -ONE'S ONE HOUR A/C &
2712 E..LA CADENA DRIVE
RIVERSIDE, CA 92507
(951)276-9744
Lic. No.: 878533
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/17/11
I q '
14. py �•
I� 2011 !
CITYq ;�id4lyiA
------------------------------------------------------------=------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
P
Section 7000) of Division 3 of the Business and o essionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20Lic se No.: 878533
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Date: ontractor: _
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the .-
Carrier INS CO OF WEST Policy Number WSD500334901
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should beco a subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I s forth rith co ply with those provisions.
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).:
atent:
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 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 contiactor(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
. 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 andunty ordinances and state laws relating to building constr on, and hereby authorize representatives
of thi county to enter u n the above-mentioned property for ins on pur oses
ate: �I—/ %�Signature (Applicant or Agent):
Application Number . . . . . 11-00001246
Permit . . . MECHANICAL
Additional desc
_
Permit Fee . . . . 40..50
Plan Check Fee
10.13
Issue Date
Valuation . . . .
0
Expiration Date 5/15/12
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/>1bOK-500KBTU
16.50
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE 80,000 BTU CLOSET FURNACE
& 5
TON 13 SEER A/C WITH COIL. 2010 CODES.
-----=----------------------------------------------------------------------
Other Fees . . . . . . . ... BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
----------------- ---------- -=--------
Paid Credited
---------- -------
Due
--
Permit Fee Total 40:50
.00 .00
7
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
Cx�c o\•� n
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 1S
Site Address:
Enforcement Agency:
Date:
Permit #:
46450 CAMEO PALMS DR La Quinta, CA 92253
City of La Quinta I
Nov 8, 2011
Duct insulation
Conditioned Floor
Equipment Typei
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
R Furnace
W AFUE 80%
r-
R 6 (� 10-13)
Served by system
W Setback
FT, Indoor Coil
W SEER 13.0
r- HSPF
fl R 8 (CZ 14-15)
2000 sf
If not already present, must be
R Condensing Unit
p EER
[ Resistance
installed)
rl 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 Efflciencies: 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 -411
forms (no hand filled CF -411s 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.
0 1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
• Furnace
CF -411 forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
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
❑ 4. The_system_.will not be Ducted (ie. Ductless:Mini-Split,System)-(Also_ Exempt from;Refrigerant!Charge)
❑ 2. New HVAC System
Required Forms:-
. Cutin ,or Changeout with -
new ducts: (all new
' ' '�' It
CF -6R forms: MECH-04, MECH-20-HERS,Iand (for split systems) MECH-22-HERS, and
I F
ducting arch all new �'CF-4R
MECH-25=HERS v v �
{
forms: MECH 20 and (for split systems) MECH-22, and MECH-25
��
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
013. New Ducts with/or without
Required Forms:
Replacement
• 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 -411 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
❑ 4. 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
f 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 Tide 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: ]IM MCELIGOT Signature: JIM MCELI60T
Company: VENVEST BALLARD INC Date: Nov 8, 2011
Address: 2712 EAST LA CADENA DRIVE License: 878533
City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951) 276-9744
Reg: 211-A0057939A-00000000-0000 Registration Date/Time: 2011/11/08 11:56:03 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin # ..
City of La 'Quinta
Building &r Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
A�
ti
Project Address: /� �� y1e� , S
Owner's Name: <L —(/o Qr
A. P. Number: 3 _ 8.2' O0
Address:
Legal Description:
City, ST, Zip: /—A,
Contractor. plialt net c.1 K'
Telephone: —
Address: 71
Project Description:
City, ST, Zip: l v's irA&
la nE!, 721
Telephone:E81zy:. :s7F<
State Lic. # : City Lic. #...44_J3Z33
�► ��
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
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Construction Type- Occupancy:
State Lic. #:
Proect a circle one New Add'n Alter Repair Demo
Name of Contact Person: ��
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ,l • —
Estimated Value of Project I -C>
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.OA. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees