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14-0092 (MECH)..a P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 14-00000092 79770 TANGELO 772 -230 -004 - MECHANICAL LOW DENSITY RESIDENTIAL 8118 Architect or Engineer: 010-1 ----------------- LICENSED CONTRACTOR'S DECLARATION 4�VOICE 760 777-7012 FAX ('160) 777-7011 BUILDING & SAFETY DEPARTMENT �� INSPECTIONS (760) 777-7153 BUILDING PERMIT 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 LicenseNo.: 878533 at P60AL Contracto`r Date: V 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 (950n),; (_ 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 arenotintended 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, 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 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: THOMAS HOLCOM 79770 TANGELO LA QUINTA, CA 92253 (760)564-5262 Contractor: ONE HOUR A/C & HTG 3030 MYERS STREET RIVERSIDE, CA 92503 (951)276-9744 Lic. No.: 878533 Date: 1/30/14 WORKER'S COMPENSATION DECLARATION��1. 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. wave 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 WVE502266101 _ 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 become subject to the workers' compensation provisions of Section ` 3700 of theLaborCode, I shall forthwith comply with those provisions. - 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 3706OFTHE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - APPLICANT ACKNOWLEDGEMENT IMPORTANT Applicatinn ig here.hy 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 property for inspection purposes. Dated \1Y Signature (Applicant or Ag V Application Number4 . . . . 14-00000092 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee 11.92 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date ,. 7/29/14 Qty Unit Charge Per Extension 1.00 11.9200 EA MECH APPL REP/ALT 11.92 ---------------------------------------------------------------------------- Special Notes and Comments HVAC DUCT WORK - REPLACE DUCT WORK. 2010 CALIFORNIA BUILDING CODES. ------------------------------------ Other Fees . . . . . . . . . ---------------------------------------- BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 4.77 Fee summary Charged Paid Credited Due Permit Fee Total 11.92 .00 .00 11.92 Plan Check Total .00 .00 .00 .00 Other Fee Total 96.34 .00 .00 96.34 Grand Total 108.26 .00 .00 108.26 LQPERMff r ' 1 , � • a a i Ret d PItACiU7�tC '' � Durld)n� at 5�lety.D,vtsrori P O ox 1504,7 4�5`Catfe Tamprco,. - Renntt La Qutnw, CA 9Z25� •{z60J 777 701:2 Buermtt'Appli�atton anci Trackrng'SheeC j rrojr�tnaare� . Owner'sNnmei. t t7. Addtcxs ..-1 i—�• �{� `,/ 1 ' l t gs l ntscrirGon: Ctty,;S1 tip: BUY\ . A ci- k Contractor t kt' +2 elbphonc =`j -. ' •`n 4: Plan ChecI ialanec• 1 Addrrss['ro}cc D¢scrip�ion: t iP:' • ..' � Q,J(�\ �- '�-i�'� ��J i� 1 V ` ' 1 , Tcic{Iftolte:o 5. �.. t,�CC t�ky (r y , lw.. - S Ptanrreiubraliteit ' S.tatz Llc ti13 C1ty.Lic + jt •Are(i., !?ngr.;T3estgaer t� L�. � � t ':Address: Subcontocior I+tst Celt d Contoct Person CotistiuelioW 'pe, Occupancy: . '. Stntt Lic l ,. N, ,T Project type (circle ono); '2Cecv Ad&s!.: - .Alter Repair . Derno` l lans:hlcked up Ni<mc:ot Gontact.i'erson: Sil. iit:: 13 btuties: f1: Units: Tetepho#tc t+ :ot Catitac[ 1't non:, Estirnutcd.Vdl�ic ofa'rojcct' i Ai?WIiCAhl1 t;DU N�T::YdFiITE iiELlaW;`I NIS LlN r � , i Ret d PItACiU7�tC a I't�u:Sets E i StruciutatChlt;. ivlesvcd-,*dyCorc6mction.3 a Y1:anChccS,'Deposit, . S tT t :� • f s ( Plan ChecI ialanec• 1 lfll@24 Culc3. t Co,utn�ellun i !•'lood'phin'ptan Ptanrreiubraliteit ' Altcllalilcai t Grading plan 2" ltcvi6" , ready fCr corrcctionsltssue„ Iestriial Subcontocior I+tst Celt d Contoct Person Plumbl �g t a . u ' ISuhmlltal � ' lten'd i Ret d PItACiU7�tC - .. '1 M MI�';MES° I't�u:Sets 1!t6u Cheilt5uhsn[llcd Ittnl Ammint StruciutatChlt;. ivlesvcd-,*dyCorc6mction.3 a Y1:anChccS,'Deposit, . Trust $I Ca11id. tintacCl'crson.. Plan ChecI ialanec• lfll@24 Culc3. ilans:piik l,up Co,utn�ellun !•'lood'phin'ptan Ptanrreiubraliteit ' Altcllalilcai Grading plan 2" ltcvi6" , ready fCr corrcctionsltssue„ Iestriial Subcontocior I+tst Celt d Contoct Person Plumbl �g GTaliti)ccil-, l lans:hlcked up S:M'.1• ILO A rAppro�al Mus resobmlitid Grading IiC 1i0t�SE;-' '"' ltevtely; reedy for.t,lrrecinnstssui J)cvdopei•Impact Fee Nlsnning Approval, Ca11td Contact I'crson I'ub. \Y1s Apg bate olptrulit lssue . $drool Fcei`'� • ` ::1'utal :t'.cYtflii Ries T t + Sim lined Prescriptive Certificate of Compliance: 2005 Residential HVA C Alterations CF -IR -ALT -HVAC' Climate Zones 10 to 15 Site Address., 79770 Tangelo. Enforcement Agency: City of LQ Date: 1-30-14 Permit#. Equipment T et i List Minimum Efficienc 2 Duct insulation requirement Conditioned Floor Area Thermostat Packaged Unit Furnace [AFUE T [3 cop Over 40 ft of ducts added or re laced in unconditioned space Served by system ❑ Setback (ljnot already Indoor Coil EER 8 HSPF Resistance R 6 (CZ 10-13) 338 sf present, must be Condensing Unit ❑EER R 8 (CZ 14-15) Installed), x Other .ouctWe* 1. Equipment Type: Choose the equipment being installed; ijmore than one system, use another CF-IR-ALT-HVACjor 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 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 signed. Beginning October 1 2010 a re istered copy of the CF -IR and CF -6R shall also be on site for final Inspection. E] 1. HVAC Changeout Required Forms: CF -6R forms: MECH-04, MECH-2I -HERS and (for split systems) MECH- 25 -HERS • All HVAC Equipment replaced 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 • Furnace For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH 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 ducts stems are constructed,' insulated or sealed with asbestos 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (alt new ducting nod all CF411 forms: MECH 20 -,and (for split systerns)MECH-22, and MECH 25 new equipment) For SpUt 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 x 3. New Ducts with/or 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 >_ 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 -611 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 duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 certify that this Certificate 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. • 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, calculationsplans andspecifications submitted to the enforcement agency for approval with the permitidaication. Name:,Jane Recktenwald I Signature: Company:Venvest Ballard, Inc. Dial One Date:.1-30-2014 Address: 3030 Myers St License: 878533 City/State/Zip:Riverside. CA 92503 Phone:951-276-9744 inn.9 Dnoidunafrl F'nrnrr * Wnrnh 7nin