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13-1201 (MECH)r. P 10. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 r BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 13-00001201 Property Address: .49275 VIA BOLERO APN: 646-290-033- - - -Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL ' Y Application valuation: 4500 Applicant: Architect or Engineer: 1 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 Professional , and my License is in full force and effect. . License Class: C220� ce a No.: 533 Date: --1" / Contractor: OWNER- ER DECLARATION 1 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, 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 yearofcompletion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) 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.). ( 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, v. C.). Lender's Name: Lender's Address: LQPERMIT Owner: . CARLOS MAGTIBAY 49275 VIA BOLERO LA QUINTA, CA 92253 (646)512-4703 Contractor: ONE HOUR A/C-& HTG 3030 MYERS STREET RIVERSIDE, CA 92503 (951)276-9744 Lic. No.: 878533 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/24/13 SEP 24 2013 CITY OF LA QUINTA FINANCE DEPT. ------------------ 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 ��_� ��JJJJ issued. yFfave 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 WVES02266100 _ 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 the Labor Code, I shall forth omply with those provisions. Date: 2 Applicant: WARNING: FAILURE TO SECURE WORKERS' C ENSATION 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 constru . 'hereby authorize representatives of this county to enter upon the above-mentioned property for in ction poses. Date: - 1.Signature (Applicant or Agent): Application Number . . . . . 13-00001201 Permit . . . MECHANICAL.2013 Additional desc .'. Permit Fee . . . . 35.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/23/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH CONDENSER/COMP ---------------------------------------------------------------------------- 35.75 Permit .. . . . . ELECTRICAL 2013 Additional desc . Permit Fee . . . . 23.83 Plan Check Fee ..00 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/23/14 Qty Unit Charge Per Extension 1.00 23.8300 EA ELEC APPLIANCES, NON -RES 23.83 Special Notes and Comments J J HVAC CHANGE OUT - 13SEER CONDENSOR [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. . ELECTRICAL -SWITCH AT ELECTRICAL PANEL. 2010 CALIFORNIA BUILDING CODES. -=-------------------------------------------------------------------------- Other Fees . . . . . . . PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 23.83 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 59.58 .00 .00 59.58 Plan Check Total .00 .00 .00 .00 Other Fee Total 114.40 00 .00 114.40 Grand Total 173.98 .00 .00 173.98 LQPERMIT i IProject/lddress: i . `I -� i . i ,i ' �. j 1 Ski. # City. of* La Quinta Building a Safety Dfvisfon Permit # P.O. Box 1504,'78.495 Calle Tampico 4.Quktt'a, CA 92253 -•(760) 777-7012 Building Permit Application and Tracking Sheet 'lG • Y_0 Owner's Name: r� AP.Nttmber.. — p� .'%� Address: �a'ls V Legal Deuxiption: City, ST, Zip: 110— 0� ft- Contractor. Q f Tolephono: 5 Q— Address: S Project Description: . Q ✓j GitY, sT.P% lCA ctx='x)- Telcphone.4!1t j` '� t� C.. State Lic # : 33 City Lie #; Arrb, Bog., Designer Pc 'Address. City' ST. Zip. Telephone: State Lie. #: Construction Type:. Oocupaner. project type (circle one): New Add'n Alter Repair Dano Name ofContact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: .Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE b Submittal Req'd Rev'd TRACKING PERMrrFEES• Plan Sell Plan Cheek sabmilted Item Amount Slruelaial Cabs. Reviewed, ready for tartectloaa Pian Cheek Deposit. . Truss Cala. Called Contact Person Plan Cluck Balance Title V Calci. Plana picked up Construction Flood plain plan Plans rembmlRed Meehariieal Giadlogplan 2'! Review, ready for correctionsliaane Electriai Sutxonmetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. B.O.A. Approval Plans resubmitted Grading IIQ HOUSE - ReAmr, ready for cormcdondissae Developer Impact Fee Planotng Approval Called Contact Person AXP.P'. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees Simplified -Prescritive Certificate of Compliance: 2008 Residential RVA C Alterations CF -IR -ALT -HVAC Climate Zones 10 to 15 Site Address: 49275 Via Bolero Enforcement Agency; City of LQ Date: 9-24-13 Permit M Conditioned Floor Equipment T et_ List Minimum Efiicienc 2 Duct insulation requirement Area Thermostat Packaged Unit Furnace FUE RCEER ❑COP CopHSP Over 40 ft of ducts added or re laced in unconditioned space Served by system Q Setback pjnot already Indoor Coil 13 e R 6 (CZ 10-13) term sf present. mutt be x Condensing Unit Q EER Resistance R 8 (CZ 14-I5) installed) Other 1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -I R-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 fortes 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 -4R forms (no hand filled CF-4Rs 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. El 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 lits stems MECH-25 • Condenser Coil and/or CF -6R forms: 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 duct systems are constructed, insulated or sealed with asbestos ❑ 2. New HVAC System Required Forms: • Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS ducts: (all new ducting and all CFAR forms: MECH 20-, and (for split systems)MECH-22, and MECH 25 new 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 3. New Ducts with/or without Replacement Required Forms: • 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 and/or indoor coil CF -4R 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 'ff4. New Ducting over 40 feet Required Forms: A Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF4R 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) • I 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, Paris 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 lens and specifications submitted to the enforcement agency for approval with thepermit application. Name:Jane Reektenwald Signature: Company`Venvest Ballard Inc., DBA One Hour Date: 9-24-2013 Address:3030 Myers Street License:878533 City/State/Zip:Riverside, CA 92503 Phone:951-276-9744 7nnR Roc:dowinl rm—t;nnoo FA— Awnrnh 7n in