12-0013 (MECH)P.O. BOX 1504. VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX, (760) 777-7011
LA'QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 771 -7153-
-BUILDING PERMIT
Date: 1/06/12
Application Number: 612 ,-00-OD 0013-} Owner:
Property Address: 50820 NECTAREO COGBILL CLINTONL
APN: 772-070-013- - - PO BOX 5742
Application description: MECHANICAL LA QUINTA, CA 92247
Property Zoning: LOW DENSITY RESIDENTIAL
Application .valuation: 5450
Contractor:
Applicant: Architect or Engineer: DIAL ONE'S ONE HOUR A/C &
2712 E. LA CADENA DRIVE
RIVERSIDE, CA 92507 JAN 0 2�IL
*� (951)27 i
. � Lic. No..:: 878 878533 � CITY nFtAqalfNTA
Pfs1►�t?�f�E :PT_
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 1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of theBusiness and ProfessionalsCode, 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: C20 LicenseNo.:' 878533 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Z ,Contractor: _ 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
` oW R -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I a m t from the Contractor's State License Law for the Carrier INS COOF 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 become 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 shall forthwith comply 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).: K Date: \ Z.. Applicant: JI.l
(_) 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 CO ENSATION 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 PENA IES ND 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 CO 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.). - - APPLICANT ACKNOWLEDGEMENT
( _.) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. _ IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
r 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for -
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, ;
I—) I am exempt under Sec.. B.&P.C. for this reason 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.
Date: Owner: 2. Any perrnifissued 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
CONSTRUCTION LENDING AGENCY _ permit to cancellation. -
I hereby affirm'under penalty of'perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct.- I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1• city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of "this county to enter upon the above-mentioned property for inspection purpos
Lender's Name: -
Date: V Signature (Applicant or Agent):
Lender's Address:
LQPERMIT . .
Application Number 12-00000013
Permit MECHANICAL
Additional desc .'.
Permit Fee 30.50 Plan Check Fee
7.63 .
Issue Date Valuation . . .
. 0
Expiration Date .1/04/12
Qty. Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH B/C .<=3HP/100K BTU.
9.00
1• n n 05.5000 EA, MECH OTHER tICCII EQUIPMENT
G.50
Special Notes and Comments.'.
HVAC CHANGE OUT - 13SEER/80AFUE PACKAGED,
SYSTEM (2008 ENERGY] 2010 CALIFORNIA'
BUILDING CODES.
. January 6, 2012 1:50:41 PM AORTEGA.
-------------------------- -----------------------------.-
. Other Fees BLDG STDS ADMIN (SB1473)
1.00
• Fee summary Charged. Paid Credited
Due
Permit Fee Total 30.50 .00 .00
30.50
Plan Check Total 7.63 .00 .00
7.63
Other Fee Total 1.00 .00 .00
1.00
Grand Total 39.13 .00 .00
39.13
LQPERMIT.
Simplified.Prescriptive Certificate of Compliance:. 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
50-820 NECTEREO La Quinta, CA 92253.
City of La Quinta
Dec 28, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
V Package Unit
Furnace
v AFUE 80%
COP
'
R 6 (CZ 10-13)
Served by system
V Setback
Indoor Coil
V SEER 13.0
HSPF
R 8 (CZ 14-15)
1600 sf
If not already present, must be
Condensing Unit
EER
Resistance
installed)
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 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 thatthe 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.
V 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS
replaced
CF-4R forms: MECH-21 11IYESand (f8- splik systems) MECH 2
. Condenser Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS @Rd (fee split systems) MEGGH _25-WCDC
. Indoor Coil and /or
CF-4R forms: MECH-21 and (F^- split 6M.... 2
. Furnace
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 duct systems are constructed, insulated or sealed with asbestos
4. They,ystemwill not be Ducted (ie.,Ductless Mini=Split System))(Afso Exempt fromrRefrigerarit'Charge)
2. NewHVAC System
Requited Forms:
...
. Cut m'or;.Changeout with:.
new duets: (all new ,r'
sr f ..
CF-6R-forms .MECH-04, MECH�2Q=HERS, and (for split systems) MECH=22 ;HERS, and
`
-�
ductin a d all new,.,"
MECH`25 HERS t k ` s r.
F
;CF 4R forms: MECH„20, and (for 'jaIECH.22,sa d MECH-25
e ui rilen�t ° /� ,r�`
q P ) a r
split syst6ms
�•'_V1.. �.
For Split Systems: Duct leakage;-c,6 percent; "RC', CCA'> 350 CFM/ton`; FWD,'TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
3. New Ductswith/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
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: Dec 28, 2011
Address: 2712 EAST LA CADENA DRIVE License: 878533
City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951) 276-9744
Reg: 211-A0067472A-00000000-0000 Registration Date/Time: 2011/12/28 17:58:04 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin # ' .
Cityof Ld . uin to
Building ez SafetyDivislon .+
P.O. Box -1504, 78-495 Calle Tamplco •-
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #'
i2 • Wim'
Project Address: , O
Owner's Name: C r
A. P. Number: -p --� o .- 1
Address:
_ _ �04�2
Legal Description:
s City, ST, Zip:
QvN -It-a 9'4463
v �,�nvisfi �►
Contractor.. •�
ti W
el'epone:
4
Address: 2-1 E.VJDL '� .
Project Description: y� TO
City, ST, Zip: �'fX'S�O�2 �. "t �J�`1l9
\-\V pr +—
Tele hone.
^> '
MOM
-e L
State Lic. # : %Ss'2j ' G2Q
City Lie. #; 5313
Arch., Engr., Designer.
Address:
City, ST, Zip: "
Telephone:
MM
� '• > �.'
' :�4 4 Y'�:n.:::ry
v
Construction T Occupancy:
typecircle one New Adder Alter Repair Demo
State Lic. #: r
Name of Contact Person: c`
J \ E , O�
Sq. Ft :
# Stories: # Units:
Telephone # of Contact Person: CJ , (P _G1 7LA14Estimated Value of Project: 0 Cc7
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item. Amount
Structural Cates.
Reviewed, ready for corrections IMao Cheek Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Tide 24 Calcs.
Plans picked up Constructs-sn
Flood plain plan
Plans resubmitted Meehan"
Grading plan
P! Review, ready for eorrectionsfissue Electrical
Subcontaetor 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 correcdons/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