13-0753 (MECH)4%
P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000753
Property Address:
79045 LADERA DR
APN:
604-271-033-7 -29624 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
15000
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
LicenseClass: C20 License No.: 878533
Date: �fhbJ Convactor
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 1$500).:
(_ 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 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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, Civ. C.1.
Lender's Name:
Lender's Address:
LQPfiRD41T
Owner:
JACK MALLORY
79-045 LADERA DRIVE
LA QUINTA, CA 92253
(
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: 6/18/13
D M D
JU ' J 2093
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
issued.
Ijlave 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 workerscompensation
insurance carrier and policy number are:
Carrier INS CO OF WEST Policy Number WVE502266100
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
Dat�%,, �\ , 337700 of the Labor Code�I shall forthwith comply with those provisions.
i� r�i� 1 APpI� n�!5 /� i
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 riot 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 toentere �enter upon the above-mentioned property for ins urposes.
Dale. ,vv 7 Signature (Applicant or Agent)-
Application Number .
. _ . . 13-00000753
Permit . . . . .
MECHANICAL 2013
Additional desc .
Permit Fee . . . .
143.00 Plan Check Fee
.00
Issue Date
Valuation . . .
. 0
Expiration Date
12/15/13
Qty Unit Charge
Per
Extension
2.00 35.7500
EA MECH'FURNACE
71.50
-2.00 35.7500
EA MECH CONDENSER/COMP
71.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT (2)
16SEER/80AFUE
SPLIT SYSTEM [2008 ENERGY]
CARBON
MONOXIDE ALARM(S) TO
BE INSTALLED PRIOR
TO FINAL INSPECTION.
2010 CALIFORNIA
BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . ... BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
95.32
Fee summary Charged. Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total
143.00- .00 .00
143.00
Plan Check Total
.00 .00 .00
.00
Other Fee Total
186.89 .00 .00
186.89
Grand Total
329.8 .00 .00
9
329.89
I.op I:IL\11'1'
Bin.#
City of La Quinta
Building $L Safety Divfsion
P.O. Box 1504,18-495 Calle Tampico
ta.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name:.
A. P. Number. 19ZLk_ "1 1 _ 03
Address: ld�'�S c-
Legal Description:
City, ST, Zip: 1 u- � CLA, CD:'aS_
Contractor. 0LN L
Telephone: '
Address:
Pmject Description: — D
City, ST, Zip: ��C.Y e• l��
(tie S .
s.'>
Telephone:�j� 1 LD � `{i �l"Ci
` S
State Lie. #: $ �j Lia #;
Arch., Engr., Designer {J
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: , Occupancy:
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 Rcc'd TRACIMG PERWF FEES
Plan Sets
Pian Cheek submitted
Item Amount
Strgctural Cales
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cales. -
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted- .
Mechanical
Grading plan
2'` Review, ready for correctionslissue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IPI HOUSE:-
7n° Review', ready for correctionsfissae
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address: 79045 Ladera Dr
Enforcement Agency: City of LQ
Date' 6-18-2013
permit #:
Conditioned Floor
Equipment T e'
List Minimum Efficienc z
Duct insulation requirement
Area
Thermostat
J
X.
Packaged Unit
Furnace
CX! AFUE80°i
C cop
Over 40 fl of ducts added or
Setback
x'
Indoor Coil
C EER16
HSPF
R 6 (CZ 10-13)
fflaced in unconditioned space
Served by system
1400 sf
(Ifnot already
present, must be
lX
Condensing Unit
Q EER
Resistance
Other
R 8 (CZ 14-15)
installed)
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1 R -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor 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 CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
signed. Beginning October 1, 2010, a registered copy of the CF -1R and CF -6R shall also be on site for final inspection.
(x 1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R 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
CF -4R 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
C 2. Duct systems with less than 40 linear feet in unconditioned space, or
C 3. Existing ducts stems 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
CF -4R 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
C' 4. New Ducting over 40 feet Required Forms:
• Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For splits stem or packaged units:' Duct leakage < 15 percent
EXCEPTION: Existing ducts stems 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 documenA on other applicable compliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement agency for approval with the permit appficition.
Name:Jane Recktenwald
Signature:
Company:Venvest Ballard Inc. DBA One Hour
Date: 6-18-2013
Address: 3030 Myers St
License: 878533
City/State/Zip: Riverside, CA 92503
Phone: 951-276-9744
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