12-0574 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000574
Property Address: 81860 EAGLE CLAW DR
APN: 764-280-999-32 -3'00235-
Application description:- MECHANICAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 42.00
T4&t4'440&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:.
MARYANN VANREMMEN
81860 EAGLE CLAW DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5123/12
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 (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 Llcenselaw:).
(_) 1 am exempt. under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby.afflrm 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: CJ.
Lender's Name:
Lender's Address:
L 2PERMfT
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.ls made, each person at whose request:and for
whose benefit work is performad:under or pursuant to any permit Issued as a result of thWapplication,
es
the owner, and the applicant, each ogre"
greto, and shall defend; Indemnify and hold harmless the City
of La Odirttarlis 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 it:work is not commenced
within 180 days from.dsts of Issuance, of such permit, or cessation of work for 180 days will subject
permli 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 u the above-mentioned property for inspection purposes.
Date: (.%re (Applicant or Agent): 25;A= -
Contractor:
Applicant: Architect or Engineer:
DIAL ONE'S ONE HOUR A/C &'`
2712 :E. LA CADENA DRIVET=L3
RIVERSIDE, CA 92507(951)276-974.4Lic.
NO.: 87853`3 :
------------------------------ -------------- ------------------------------------
LICENSED CONTRACTORS DECLARATION
=-_----------_---_-=-----
WORKERS COMPENSATION DECLARATION
I hereby. affirm under penalty of perjury that I am licensed under provisions of Chapter B (commencing with
I; hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of theAus_iness and Professionals Code, 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 Ucense No.: 878533
for -by Section 9700 of the Labor Code,.for the performance of the work for which this permit is
A�
Date:Contractor: <==A
issued.
1 have and will maintain workers' compensation, Insure ce, as required by Section 3700 of the Labor
Code; for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
Insurance carrier and policy number are:
I hereby affirm under penaltyof perjury that I em exempt from the Contractor's State License:Law for the
Carrier EVEREST NATL Policy Number CA10001300121
following'reason (Sec. 7031.5, Businessand Professions,Code: Any city or county thatrequires a permit to
_ I certify that, In.the performance of the work for which this permit Wissued, [shall not employ any
construct, alter, Improve, demolish; or repair any struchue, 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,
nt
permit to file a signed statement that he.or she is licensed pursuato 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, l shall forthwith comply withthoseprovisions.
that he or she le,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 (9500).:
ate:: 'av' pplicent: d-
1 _ 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
WARNING: FAILURE TO SECURE WORKERS: COMPENSATION COVERAGE 1S UNLAWFUL, AND SHALL
Contractors' State License Lew does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 (6100,000). IN ADDITION TO THE COST 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 3708 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.).
(_1 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 Llcenselaw:).
(_) 1 am exempt. under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby.afflrm 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: CJ.
Lender's Name:
Lender's Address:
L 2PERMfT
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.ls made, each person at whose request:and for
whose benefit work is performad:under or pursuant to any permit Issued as a result of thWapplication,
es
the owner, and the applicant, each ogre"
greto, and shall defend; Indemnify and hold harmless the City
of La Odirttarlis 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 it:work is not commenced
within 180 days from.dsts of Issuance, of such permit, or cessation of work for 180 days will subject
permli 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 u the above-mentioned property for inspection purposes.
Date: (.%re (Applicant or Agent): 25;A= -
Application Number . . . . . 12-00000574
Permit. . .
. MECHANICAL_
Additional desc
.
Permit Fee . . .
. 31.50 Plan Check Fee
7.88
Issue Date
Valuation . . . .
0
Expiration Date
11/19/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 16.5000
EA MECH B/C >3--15HP/>100K-500KBTU
16.50
------------------- --------------------------
Special Notes and
---------------
Comments
HVAC CHANGE -OUT:
INSTALL NEW 4 TON A/C
UNIT - CONDENSER.
2010 CODES.
--------------------------------------------------------------------------
Other Fees
BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid Credited
Due
Permit Fee Total
31.50 .00 ..00
3.1.50
Plan Check Total
7.88 .00 .00
7.88
Other Fee Total
1.00 .00 .00
1.00
Grand Total
40.38 .00 .00
40.38
Simplified Prescriptive Certificate of Compliance: 2008 Rewdendal HVAC Alteradons CF-lR-ALT-HVAC
Climate Zones 10 - 1S
Slte Address: Enforcement Agency:
Data:
Permit af:
81860 EAGLE CLAW DR La Quinta, CA 92253 City of La Quinta
May 21, 2012
Dud insulation
'Conditioned Floor
Equipment Typel
List Minimum Effidentyy2
requirement _
Area
Thermostat
(3 Package Unit
E3 Furnace
O AFUE'
O COPp
R 6 (CZ 10-13)
Served by system
® Setback
13 Indoor Coil
121 SEER 13.0
13 HSPF
13 8 (a 14 -IS)
sf
If not already present, must be
® Condensing Unit
C)EER
13 Resistance
Installed)
Installed)
0 Other
1. Equipment Type: Choose the equipment aebig baW led; ffLWthan one, system, use, anomer CF-IR-AI.T-ibCYIu each system.
2 MMhnum Equfpment Eff/chrndelr: 13 SEER, M% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Usted':below,are FOUR HVAC'akieration Options. Theinstaller decides what work is -being done
and picks•oneof the appropriate Options: Each Option 16U the HERS measures that must be conducted. A copy of the forms shall
be left onsite forfinal 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 alo verifies that each appropriate CF -6R and registered CF -4R.
forms. (no hand ftlled CF-4Rs allowed) are filled:out and signed.Beginning October 1, 2010, a registered copy of the CF -1R
and CF -GR shall also be on site for final Inspection.
®1. HVAC Changeout
Required Forms:
• All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25=HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
• Condenser C/or /or
• Indoor Coil andud /or
CF=6R tocros:
MECH4K, MECH-2I-HERS and (for splltsystems) MECH-25-HERS
• Purace
CF -4R forne: ,MECH-21 and (for split systems) MECH-25
For Split Syseamw Ductakage < 15 • RC, CCAS 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted duct leakage testing If:
E3 1. Dud system was documented to have been previously sealed and eorlftl7rted through HERS verification, or
13 2. Dud systems with less than 40 linear feet in unconditioned space, or
p'3. Existing dud systems are constructed, Insulated orraealed with asbestos
04. The,system,wlll not be Ducted (ie, Oudless,M rn Ir -t ystem)A(Also;Ezempt.from.Refrlgererrt'Charge)
_. New;HVAC System
RequI04
• Cut irmit Changeout witfi
CF-bRifortns::MECH-04 MECH-20HER5 arid�.(t�O� split sysbmsrtrs) MECH�=22-HERS, and
new duds: (all new
ductlng�khd all new
MKH-25-Zt .
tomins•;MECH-20,
equipment)
nd (fors lit ) -22; and MKH-25
4. a�,
For Split Sy's6ams: Duct kage <t6 percent;"RC;'CCA 2`350;CFM/Eon FWD; TMAH,:S1 M5, and"tither HSPF or PSPP.
For Packaged Units: Duct leakage < & percent
E3 3. New Ducts with/or without
Required Forms:
Replacement
*.Includes repMcbrig 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/orhmdoor.coll and/or furnace. No or some
CF -4R fomims; MECH-20 and (for split systems) MECH-25
. equipment changed.
For Split Systems: Dud leakage < 6� percent; .RC, .CCA Z 300, CFMjton, TMAH
For Packaged Un1ts:.Duct leakage <6 percent
O 4. New Ducting over 40 feet Req reForms:
• Includes adding or replacing more, then 40 CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of dud in unconditioned space. CF -4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
O EXCEPTION: Existing dudsystems constructed, Insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
e 1 certify that this Certif eate:of Compliance documentation Is accurate and complete.
• I am eGglble under Dlvislon 3 of the Califorpaftsiness and Professions Code to accept responsibility for theAesign identified on this Certificate of
Compliance.
• 1 certlfy that the energy features and performance specifications for the design Identified on this Certificate of Compliance conform to the
requirements of Title 24, •Parts I and6 of the California Code of Regulations.
• The design features Identifledon this Certificate•of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and speeflcabons submitted to the enforcement agency for approval with the pernit application.
Name: Jim McEligot Signature: Jimr McEIIW
Company: VENVEST BALLARD INC I Date: May 21, 2012
Address: 2712 EAST LA CADENA DRIVE License: 87853
City/State/Zip:. RIVERSIDE / CA / 92507 Phone: (951) 276-9744
Reg. 212-A06257SIA-00000000-0000 Registration'Date/Time: 2012/05/21 16-.35;49 HWig Provider: Ca10ERT5, Inc.
2008 Residential Compliance Forms July 2010
13fn.i#
City, of- La Quanta
-Bultdltig Bt:Saky lmian
P.O. Box 1504,'79-49S Calle Tampion
4,Quh4 CA 92253 -:(760) M-7012
Building Permit Applicadon'and Tracking Sheet
#
1 '
1a
Projea.Aadtess:' _
owmes Ntow
A. P. Mmber. i (Q —
Addtesa: 0012Lab
Legal, Description:
C11Y. 9, ZIP: L- 4& CA 41
Coubutor. V .I Cd one—
Tdephotu:' 111111111
Ptoject Description:
Address: 9,1) a E •. LaZa& Vr. .
city, ST, zip: lV A q.5o7
T��l
State i.ia # : City Lie. C.
Arch.. Eng, Destpw.
Address:
Chy. ST. Zip: - -
Tdophone:-Consotttdioa Type. Ocagmnw:
State %ic #: Pmjed type (dile am): Now Add'n Alta R�epaic Demo
. 1-im
Name of Contact Person: Sq. Ft:#Stones: # un*
Telepbone # of Contact Perm: Estimated Value of Project: c
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Beed -
TEA(I NG PSBM[F FEES
Plea Seb
Pian Check Submitted
Item Amonat
Structural Chin.
Reviewed, ready for cwmdo,m
Pbm Chock Deposit. .
TMU Cater.
Called Cantaet Person
Plan Cheek Balance_
11de 24 Cala.
Plane picked up
Caash•aetion
Flood plate plae
Plan ''omitted.
Mechanical
Grading plan
2`! Review, ready for corradoWmue
Electrical
Subeoutector List
Caped Contact Person
plumbing
Grant Deed
Plans pl dcd up
S.11LL
H.OA. Approval
Plain rsssdtm1w
Grading
R4ylm ready for eorreetioosilum
Developer-Impaet Fee
Phaoiug Approval•
Called Contact Person
Pub: Win. Appr •
Date of permit blue
School Fea
Total Permit Few