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10-0553 (MECH)4'4 P.O. BOX 1504 " 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT 'BUILDING PERMIT Application Number: 10-00000553 Property Address: 54595 AVENIDA VELASCO APN: 774 -283 -015 -5 -000000 - Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 5752 Ap�j Ijcant: - — T Architect or Engineer: fi . 0` 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: C20icense No.• 878533 Date: A -2 2- tC% Contractor: ' `j 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 ($5001.: (_) 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.). (_ 11, 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: Lender's Address: LQPERMIT Owner: CLEVC TONY/ HEIDI 54595 AVENIDA VELASCO LA QUINTA, CA 92253 (760)702-4471 _Contractor: 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: 6/22/10 _JUN .2-2-2010 . CITY OF LA t�U1N8e I ----------------------------------------------- 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. _ 1 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 INS CO OF WEST Policy Number WSD500334900 _ 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 be subject to the workers' compensation provisions of Section 3700 of the Labor Code, II forth ; th c pl with those provisions. Date: 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 1$100,0001. 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 o struction, and hereby authorize representatives of this county to enter upon the above-mentioned prope y r ' -pec )n p po s. - Date: Signature (Applicant or Agent): '^ LQPERMIT Application Number . . 10-00000553 Permit . . . MECHANICAL. Additional desc Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 12/19/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00. 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 ------------------------------------------ Special Notes and Comments ---------------------------------- . _REPLACE /"-CHANGE OUT (4) TON":13 "SEER-- ----.. _ .. .._ ...._ .. .... ... ..............................----.__.._.._ PACKAGE UNIT AND DISCONNECT BOX COMBO UNIT. ---------------------------------------------------------------------------- Other Fees . . . . BLDG STDS'ADMIN (SB1473) 1.00 Fee summary Charged -------------------- Paid Credited -------------------- Due ----------------- Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total- 42.25 .00 .00 42.25 LQPERMIT Simplified Prescriptive C'ertiikate of Compliance: 2009 Residential HVA CAItemdons CF -IR -ALT HVAC Cfrmate Zona 10 to 15 She Address: Wria E Date Perrrdi P. Cand' Toned Floor fAiuipmcryt Type List Minimum Efficiency' Dud insulation requirement Area Thamostat IffPackaged Unq Q Furnace 13 FUE D COP Over 40 ft of ducts added or Cd'S�etbadc Q Indoor t ail lrfi z O HSPF replaced in unconditioned m (llaorotna+u(r Q Condensing Unit Q EER p R Q R 6 (CZ.la13) O R 8 (CZ 14 -JS) sr prarent mum be hw4rlav Q Otho 1. Equ4meent 7)pe- Choose the equipment being in nailed; i(mor+e than one system, use arother CF -1R ALT-HVACfor each s)wem. Z Mininmm Equipueenf Firockwm 13 sfi81t 78%Am 7.711SPFfor typical resldena d syvteasr. HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what wait is being done and piths oneof the appropriate Options. Each Option lists the HERS mcamm 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 farm was in fad the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF411 forms (no hand filled CR4Rs allowed) we filled out and simp& Beginning October 1, 2610 • red copy of the CF IR and CF -6R step also be be site for Gaal inspection. ]_ HVAC Changeout Required Forms: • All HVAC Equipment laced q+uPm P CF -6R nts: fouMECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF4R forms: MECH- 21 and for split MECH 25 • Condenser Coil and/or • Indoor Coil and/or CF -6R foes MECH-2I-HERS and (for split systems) MECH- 25 -HERS CF -4R forma: MECII- 21 and (for split systems) MECH-25 • Furnace • For Split Systems: Duct leakage < 15 percent; RC, CCA>_ 300 CFMhoo(Minimum Air Flow Rrquiranent), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leakage testing if: Q 1. Dud system was documented to have been previously sealed and conformed IMuugh HERS verificalIon, or Q 2. Dud system with less than 40 linear feat in unconditioned space, or 0 3. Existing dud systems are constructed. insulated or sealed with asbestos 132. New HVAC System Required Forms: • Cut in or Changeout with new duds: (al( new ducting Md all CF -6R forms: MECH-04. MECH-2WiERS,and (for it stoma 22 -HERS, and MECH-2T-HERS new equipmentj CF -4P. forms: MECH 20-, and (for split systerts)MECW22, and MECH For Spht Systems: Duret leakage < 6 pemwt; RC, CCA >_ 350 CFMhon, FWD, TMAH, SIMS, and either HSPP or PSPP. For Paclmged Units: Duct leakage < 6 percent ❑ 3. New Ducts with Re lacerneut Required Fortes: • 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 aad%ar`ydoor CF4R Corms: MECH 20 and (for split syskms) MECII-25 coil and/or furnace. Not all equipment changed. For Split Systems: Dud leakage < 6 percent, RC, CCA >_ 300 CFMha% TMAH For PadutgW Units: Duct leakage < 6 percent 0 4. New Ductina over 40 feet Raluired Forms: • Includes adding or replacing more than 40 CF -6R loons: MECH-04, MECH-21-HERS CF4R forms: MECH-21 linear feet of dud in unconditioned For split system or packaged units: Duct leakage < 15 percent Q EXCEPTION: Existing duct system consbuWA insulated or sealed with asbestos. Contractor (Roctorientation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documeo mica it asnaate and complete. • 1 i n eligible ander Division 3 of" CWA mia Busim= acid proromioos Cc& to a,"pe respwmbifity for the design identified an this Cenifiaatte of Compli = • I certify that the energy festwes and performancespecifica w s fbr the design identified on this Certifinte d'Cornylierre rmfmm to the mga4 menta of Tide X Parts 1 and 6 of the California Code ofRegdetiaas • Thu design lean ms identified on this Ccawkae of Canptimm am cons ung with the ®fo araion doctarontedon o applicable cumptiame roan, Waikowcm aakulaai a s and acid' submintd to the cnfbM=Wnt far with the iaa Name:fjj�Hj 5igtratttre: Company: Date Address a License: City/5tateop: k1jVzfC16kPhone: 2008 Residential Compliance Forms March 2010 Bin # City of La Quinta Btillding 8r Safety Dlvtslon P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: �L�jT �� l Owner's Name: A P. Number. Address: _Pliif/� e 1Cc Legal Description: Contracto lCc, D e `-5 e L%r- City, ST. Zip: It/ Telephone: - Project Description: Address: 7/ / ` /��/mac °ei?f' �f/ City, ST, Zip: Telephone:-�160 State Lic. # : "CityLic. #; Arch., Engr., DesignerZk !.!/ Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: LoC Oaxrpancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calls. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'' Review, ready for correctionstissue Electrical Subcontactor ListCalled Contact Person Plumbing Grant Deed Pians picked up SALL H.O.A. Approval Pians resubmitted Grading IN HOUSE:- Review, read for eorrecdonslissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees f CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test — Existing Duct System I (Page 1 of 2) Site Address:; enforcement Agency: Permit Number: 54595 Ave Velasco, La Quinta CA 92253 (Home) City of La Quinta 10-553 Enter the Duct System Name or Identification/Tag: Home , Enter the Duct System Location or Area Served: Home Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the dwelling. ' r This installation certificate is required for compliance for alterations and additions in existing dwellings to space conditioning systems and duct systems. Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling, use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System. " Duct Leakage Diagnostic Test - existing duct system Select one compliance method from the following four choices. d 1. Measured leakage less than 15% of fan flow Ei 2. Measured leakage to outside less than 10% of Fan Flow O 3. Reduce leakage by 60% and conduct smoke and fix all leaks 4."Fix all accessible leaks using smoke and HERS rater verify Note. (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.) Determine nominal, Fan, Flow using one of the following, three calculation methods. a Cooling system,?nkhod: Size of condenser in Tons J4' x 400 = 1600 CFM O Heat g system method 21:Z xf f_{ Output Capacity in ~Thousands of Btu/hr = _CFM ✓O `airFlow Measured system using RA3.3 airflowutest:procedures: •CFM Option 1 used then:._.'`. sn, �.,r-, y� �.., w:: F. `,Cry!' i 1 Allowed leakage = Fan Flow 1600 x 0.15 = 240 CFM. Actual Leakage'-- 122 CFM ' Pass if Leakage Actual is less than Allowed Pass Fail Option 2 used then:. ' 2 Allowed leakage = Fan Flow_.;__ x 0.10 = _ CFM . Actual Leakage to outside = CFM i Pass if Leakage Actual is less than Allowed ❑ Pass E] Fail Option 3 used then: + • Initial leakage prior to start of work = _ CFM Final leakage after sealing all accessible leaks using smoke test = CFM 3 Initial leakage _ - Final leakage _ = Leakage reduction _ CFM ((Leakage reduction _/ Initial leakage _) x 100% _ No Reduction Pass if a/o Reduction > 60% Pass Fail Option 4 used then: �4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke allowed to leak from system. Including ducts, plenums, air handler and door panel. • Pass if all accessible leaks have been repaired using smoke Pass Fail 1 - Reg: 210-A0010278A-000000000-M21A Registration Date/Time: 2010/07/13 19:13:55 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 f l r CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21 Duct Leakage Test - Existing Duct System (Page 2 of 2) Site Address: Enforcement Agency: Permit Number: 54595 Ave Velasco, La Quinta CA 92253 (Home) City of,La Quinta 10-553 .t - �F 0 Outside air. (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off -� r during duct leakage testing. CFI.OA ducts that utilize. controlled motorized dampers, that open only when OA ventilation is -required to meet ASHRAE Standard 62.2, and close when CIA ventilation is not required, may be configured;torthe,.closed position during: -duct lea kage,testing dw . s- _ _ r ), All supply and return register boots must be sealed to the drywall if smoke.test is utilized for compliance 77 - applies to'duct IeakageAcbhipliance option 3 (leakage;reductlon;by'60%) and option 4,(fix all accessible jr_r l. leaks) described above. 0 New:duct Installations. cannot' utilize`, building cavities as plenums or platform returns in;lieu of ducts � - ,a a 2 Mastic and!draw bands must:be*lused in combination with cloth backed rubber adhesive duct tape to seal leaks at'all°new duct.conriections '- DECLARATION STATEMENT r . I certify under penalty of perjury,,under the laws of the State of California, the information provided on this form is true and correct. . I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater). . The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency. . The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the persons) ' responsible for the Installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the enforcement agency. Builder or Installer information as shown on the Installation Certificate (CF -6R) Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) VENVEST BALLARD INC Responsible Person's Name: CSLB License: Jim Mc Eligot 1878533 HERS Provider Data Registry Information Sample Group # (if applicable): N/A ©tested/verified dwelling ❑ not-tested/verified dwelling in a HERS sample group HERS Rater Information Ca10ERTS Certificate # CC1-1798501189 HERS Rater Company Name: Athens Air , Responsible Rater's Name: Responsible Rater's Signature: Andrew Pulos Andrew Pulos Responsible Rater's Certification Number w/ this HERS Provider: Date Signed: 7/12/2010 CC2004503 - ' 0 Reg: 210-A0010278A-000000000-M21A _ Registration Date/Time: 2010/07/13 19:13:55 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms March 2010 INSTALLATION CERTIFICATE (rage 3 of 12) CF -6R Site AddressPermit Number 54595 Ave. Velasco, La Quinta, Ca 110-553 An installation ocrtiEic:ac is required to be posted tit the building silc or,made wMilablo for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (Upon rugtirzt) and the building Owner Id uceupancy, per Section 10-103(a), HVAC SYSTEMS: Heating Equipment Equil)'type ( k r. licat lent) C]?C Crrtiticd N91i. Nurnu Dud Mudd Numbef u of1 I&i3t4;;,J S mems ktlic(cncy (APUE, cls.) k(;P-!R Vance) Duct Lucr11411 (arlic, tit.1 Duct or Pi}rind 11value Hwting I,iyld MAO Healing Clracity :B1016 PKG Goodman/GPH1348M21 80 Attic Existing 56000 70000 I L I I Cooling Equijrrrrenl Equip Tvpc (PI -g., heat lunl l) {:GCCortifiedM¢.. Numeund Model 'Humber Ir. of Idortical Sy, t v i i im til3icicm y l51>I Il)r Eli It) I kCF-IRVahit i')uc1 Location (.fate ew:.' Duct It.vilue t;:nolim, Loud (I?Uu1,r Carlin;; CUFMity (flta-tlr) PKG Goodman/GPH1348M21 13 Attic Existing 48000 48000 I L I I 1. �_ symbuI reads greater Own sirerlual to lyhrit is incliew.16d rin fire Cr 1 R wrhlvt Tnchi do both SEER and 'CUR if c umplianoe cretl!i 1:.Rir hiLYt ERR stir conditioner is claiTnLA L ✓ E3.1 I., die undersigned, verify that equipment listed above is: 1) is die actual equipment installed, 2) equivalent to or more efficient than that spocified in die certificate of compliance (Form CF -1$) submitted For compliance with the Enerjp; E.ft-ienty Standarrly for residuntial buildings, and 3) tgttipment 11Mt. Tnucis or execLA the Hpproprirlle requirements for manufactured devices (from the Appliance Efficiency Regulations or Part fi), where applicable. Installing Subcontr iotur (Co. Namc) OR GcncniI Contractor (Co. Munc) OR 0,Amcr 518nah11'C: Dale: Cr ric5 to- :80C .'UINC. DEP:ttiFt'fdl9;lr?i'.1',1HN:M lid.'!'t'kK (IF APPt.. CA110E) :t1U01"DON .. OWNER A"1' OC CU!PAPtCY Rca'idenrial Compliance FOP MS April 2005