12-0573 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-000.00573--. -•
Property Address:
48701 SAN LUCAS ST
APN:
658-310-004- -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4500
Applicant:
Tity/ . 4 4Q"
Architect or Engineer:
1 L ft
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisionsof'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
/Date:15-4A5ntractor:''�
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 _ 1 1, 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.).
I—) I am exempt under Sec. , BAP.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
Owner:
BRUCKMAN CHARLES J
48701 SAN LUCAS STREET /
LA QUINTA, CA 92253 /�J
Contractor: r
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: 5/23/12
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Z
YI)
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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.
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 EVEREST NATL Policy Number CA10001300121
1 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.
ate:' plicant: Gih-
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
oft county to enter up o the above-mentioned property for inspection purposes.
ate: O� nature (Applicant or Agent).n,
Application Number 12-00000573
Permit MECHANICAL
Additional desc .
Permit Fee 31.50
Plan Check Fee
7.88
Issue Date . . .
Valuation
0
Expiration Date 11/19/12
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 16.5000 EA . MECH
B/C >3-15HP/>100K-500KBTU
16.50
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Special Notes and Comments
HVAC CHANGE -OUT: INSTALL NEW 5 TON A/C
UNIT - CONDENSER. 2010 CODES.
--------- ---------------- --
Other Fees BLDG
-------------- ---
STDS ADMIN (SB1473)
1..00
Fee summary Charged
Paid Credited
Due
Permit Fee Total 31.50
.00 .00
31.50
Plan Check Total 7.88
.00 .00
7.88
Other Fee Total 1.00
.00 00
1.00
Grand Total 40.38
00 .00
40.38
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency: Date:Permit #:
48701 SAN LUCAS La Quinta, CA 92253 City of La Quinta May 22, 2012
Duct Insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑ Package Unit
❑ Furnace ❑ AFUE ❑ COP ®Setback
❑ Indoor Coil ® SEER 13.0 C)HSPF [3R 6 (CZ 10-13) Served by system If not abreact y present,
® Condensing Unit E3 EER ❑ Resistance ❑ R 8 (CZ 14-15) 1440 sf installed)must be
❑ Other
1. Equipment Type: Choose the equipment being Installed; if more than one system, use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment ENlclencles: 13 SEER, 78010 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-611 and registered CF-4R
forms (no hand filled CF-411s allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-IR
and CF-6R shall also be on site for final Inspection.
® 1. HVAC Changeout Required Forms:
. All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coll and /or CF-611 forms: MECH-04, MECH-2I-HERS and for split systems MECH-25-HERS
. Furnace CF-4R forms: MECH-21 and (for split systems) MECH-25 )
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing If:
p 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
17 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)
O 2. New HVAC System Required Forms: t /
. Cut inor Changeout with
new ducts: (all new CF-611 forms: MECH-04, MECH-20-HERS land (fbr split systems) MECH-22-HERS, and
=
ducting &nd all newMECH=25-HERS ," r
equipment) `CF-411 forms: MECH-20, and (for split systemi) MECH-22, and MECH-25
For Split Systems: Dud leakage < 6 percent; RC, CCA 2350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
0 3. 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 call and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systeme: Dud leakage < 6 percent; RC, CCA 2 300 CFM/ton, TMAH
For Packaged Units: Dud 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: Dud leakage < 15 percent
❑ EXCEPTION: Existing dud 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: May 22, 2012
Address: 2712 EAST LA CADENA DRIVE License: 878533
City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951) 276-9744
Reg: 212-A0025972A-00000000-0000 Registration Date/Time: 2012/05/22 12:12:53 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms
July 2010
Bin #
City. of La Quinta
BuIldIng 8t Safety DNWon
P.O. Box 1504,78-495 Cate Tampico
14.QLdnta, CA 92253 -:(760) 777,7012
Building Permit Applicationand Tracking Sheet
Permit #^
Project Address:
Luco;s,
Owner's Name:. Cvlaor I,PJV
A. P. Number.
Address: -4
Legal Description:
City, ST, Zip:
Contractor.
–Telephone.
Address:
L0. (Id
Project Description:
City, ST, Zip: f�W _V-Sk
Ap
CYN Ic- !Lna
Telephone
Lie. #..
State Lic.#: AtCi
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Construe ion Occupancy:
project type (circle one): New Add'n. Alter Repair Demo
Name of Contact Person:
Sq. Ft.;
9 Stories:.
#Unit;:
Telephone # of C . ontact Person:
Estimated Value of Project i'I c3coll
APPLICANT: DO NOT. WRITE BELOW THIS LINE
N
Submittal
Reqld
'Rccld
TRACKNG
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cities.
Reviewed, ready for corrections
Plan Check Deposit.
Truss C21cs.
Called Contact Person
Plan Check . . Balance
–
Mile 24 Cal& —
Plans picked up
Construction
–
Flood plain plan
Plans resubmi ft.ed
Mechanical
–
Grading plan
r' Review, ready for correctio'nsrissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading*
IN HOUSE-,
Review; ready for correctionsAssuc
Developer. Impact Fee
Planning Approval.
Called Contact Person
AJ.P.P.
Pub,. Wks. Appr
Date of permit Issue
School Fees
7—
Total Permit Fees