12-0575 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000575
Property Address: 81906 EAGLE CLAW DR
APN: 764-280-999-28 -300235-
Application description: MECHANICAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 4200
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
NANCY EVANS
81900 EAGLE CLAW DRIVE
LA QUINTA, CA 92253
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/23/12
MAY 2 1 9n17
Applicant: Architect or Engineer:
DIAL ONE'S ONE HOU
2712 R. I;A CADENA DRI
RIVERSIDE, CA 92507R.
CI TY OF LAQUINTA'
FINANCEDEPT
ny
(951) 276-9744
LiC. No.: 878533
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of.perjury that l am licensed under provisions of Chapter (commencing with
1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of f Division 3 of the Business and Professionals Code, and my Llcenseds In full force and,effect.
_ I have and will maintain a certificate of consent to aelf4nsure for workers' compensation, as provided
LI a Class: C20 License No.: 878533
Date: - a omractor.'i�.
for by Section 3700 of the.Labor'Code, for the.performance of the'work for which this permit is
Issued.y
I'have and will; maintain workers' compensation insurence,,,as required b Section 3700 of the Lebon
Code,,for the performance of the work for which this permit is Issued. My workers' compensation
OWNER -BUILDER DECLARATION
Insurance carrier and policynumber are:
I hereby affirm under penalty of perjury that I am exempt from thwCarmactor's State License Law for, the
Carrier EVEREST NATL Policy Number CA10001300121
.following reason (Sec. 7031.5, Business and Professions Codes Any city or county that requires a permit to
_ I -certify that, in the-performance'of the work for which this permit is Issued, I -shall not,amptoy any
construct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicam;forthe
person in any manner so as to become subject to the workers' compensation laws of. California,
permft:to file a signed statement that he or she is licensed pursuant to 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 Division3 ofthe Business and;Professions Code) or
3700 of the Labor -Code, Lshall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500).:
(_) 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
WARNING: FAILU , , TO SECURE"WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State. License Law does notapply to an owner of property who builds or Improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES'UP70 ONE HUNDRED THOUSAND
and who does the work.himself or hwwtf through his or her own employees, provided that the
DOLLARS (8100,000►. fN`ADDITION TO THE COST OF COMPENSATION; DAMAG_ ES_ AS PROVIDED FOR IN
improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within,
SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of, completion, the owner-builderwill have the burden of proving that he or she did not build; or
Jmproye for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed r:ontractors,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. forthis 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:
LQP&RMIT
APPLICANT ACKNOW11: EMENT
IMPORTANT Application is hereby made to the Director of Building and Safety fora permit subject to the
conditions and restrictions set forth on this application.
i. Each penton 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 shell defend, indemnify'and,hold harmless the City
of La Quirna, 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 1 So 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
oft antyenter un the above -mention ed property for inspection purposes.
ate:3^ nature (Applicant or Agenff
Application Number . . . . . 12-00000575
Permit. . .
. MECHANICAL
Additional desc .
.
Permit Fee . . .
. 31.50
Plan Check Fee
7.88
Issue Date . .
.
Valuation
0
Expiration.Date-:
11/19/12
Qty IInit.Charge Per
Extension
BASE
FEE
15.00
1.00 16.5000
EA MECH
B/C >3-15HP/>10OK-50OKBTU
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
31..50
Plan Check Total
7.88.
.00 .00
7.88
Other Fee Total_
100
.00 .00
1.00
Grand Total
4'0..38
.00 .00
40.38
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site,Address:
Enforcement:Agency:
Date:
Permit at:
81900 EAGLE CLAW DRIVE La Quinta, CA 92253
City of La Qulnta
May 21, 2012
Duct Insulation
Conditioned Floor
Equipment Type1
List Minimum Efficlency2
requirement
Area
Thermostat
l3 Package. Unit
13 Furnace
❑ AFUE
❑ COP
O R° 6, (CZ 10-13)
Served by system
® Setback
[3 Indoor Coil
® SEER 13.0
O HSPF
13 R 8 (CZ 14-15),
sf
If not already present, must be
0 Condensing Unit
p EER.
p.Resistance
-Lom
Installed)
0 Other
1. Equipment TWe: Choose the equipment being installed; i more than one system, use another CF-IR-ALT-HVAC. fbr each system.
2. Minimum Equipment Ffitdendesr 13 SEER, 78% AFUE, Z7HSPF for typicalresidential 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-611 and registered CF-4R
forms (no hand Riled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-11t
and CF-6R shall, also be on site for final inspection.
®1. HVAC Changeout
Required Forms:
I HVAC Equipment
CF-611 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'Coil•and /or
• Indoor Cod and /,or
CF4R florms: MECH-04, MECH-21-HERS and (for-split systems) MECH-25-HERS
• Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
For Spo! SyotaMae Duct leakage < 15 percent; RC, CCAs 300 CFM/ton (Minimum Air Flow Requirement), TMAH
--
Exempted from duct leakage testing if:
E3 1. Duct system was documented to have been previously sealed and eonfirme&through HERS verification, or
(3 2. Dud systems with less than 40 linear feet In unconditioned space, or
[3 3. Existing duct systems-are constructed, Insulated or sealed with asbestos
p4. The system will not be Ducted (ie. Ductlass<Minl-Spot Systerrt).(AIso;Exempt.fivm ReMgeraftCharge)
1 NeWHVAC Soliem
Required Forms: 4
• Cut In orChangeout witlta
Imo- ik iclmB MECH-04, MECH-20`=HERS, and,(Ibt split sys '-ms) MECH-22 HERS,,and
new ducts: (all newMECH-25=HERS.
ducting cit new
la
* A
forms- MECH-20, (for s
CF-411 and ptit
- sy�s6emsi"A CH-22,:and MECH-25
equipment i
r.
For Spot Systems: Ductleakage' c 6 percent, RC, CCA�t 350 CFM/tbn, FWD, TMAH, STMS, and either HSPP or PSPP. "
For Packaged units: Dud leakage < 6 percent
3. New. Ducts with/or without
Required Forms:
Replacement
• Includes replacing 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/or Indoor coll and/or furnace. No or some
CF-4R forts: MEC111-20 and (for split systems) MECH-25
equipment changed.
For Spot Systems: Dud leakage < 6 percent; RC, CCA t 300 CFM/bon, TMAH
For Packaged units: Duct leakage < 6 percent
134. New Ducting over 40 feet Required Fors:
• Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. CF-4R forms: MECH-21
For split system or packaged units: Dud leakage < 15 percent
O EXCEPTION: Existing dud.systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify thatthis Certificate of Compliance documentation Is accurate and complete.
• I am eligible under Division 3 of the Callfomia Business and Professions Code to accept responsibility for the design Identified on this:Certlficate of
Compliance.
•.l certify that the energy features and performance specifications forthe design Identified on this Certificate of Compilance.rnnform to the
requirements of Tule 24, Parts I and 6, of the California Code of Regulations.
. The design features Identified on thisCertlficate of Compliance are consistent with'the information documented on other applicable compliance
tarns, worksheets, calculations,, plans and speclficatlons submitted to+the enforcement agency for approval with the permit application.
Name: Jim McE Igot Signature: Ilia Akeigot
Company: VENVEST BALLARD"INC Date: May 21, 2012
Address: 2712 EAST 1A CADENA DRIVE License: 878533
Clty/State/Zip: RIVERSIDE/ CA / 92507 1 Phone: (951) 276-9744
Reg: 2124002578BA-00000000-0000 Registration Date/Time: 2012/05/21 16:38:51 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms: July 2010
srn.
C[iy of bQL1111ta
Butfog 8t Safety MUM
P.O. Box 1504,•78-49S Cage Tampfco
1.a.Quhita, CA,92255 -:(760) 777-7012
Building Permit Application* and Tracking Sheet
pelt (�
"J
Ptojed-'�ddtrss: �SI e-L
OwnwsNama..
%R00 fEt:lle.. C.A0.w r .
A P. Nymber-71.4-5t, , O`rn'jAddress
Lq* Des icon: q.4 4,ne, A
Contractor.
'City. ST, Zip: Lp-Q q S�
Tdephone:"'�
Project Description: II
C. Lkntl-
Address: -
City. $T Zip: -
stame Iiia 8: 51 sr jCJtyUC1,#,
AtdL., EW., Dasipw K f b
Address
Ckty, ST. ZIP:
Tdophm:
State iia:
Co»hudlon T"w.. , 0=pancy:
ProjecttyPc (curie one):- New Add'a Alter Repair Deep
Sq. FL: 9 Stories: q Unit
Nam Naof CDatact Person:
Telephone of Contact Pelson
Eft bod Ytd+te of Project:
APPLICANT: DO NOT WRITE BELOW TMS LINE
# Bob m ttAl RWd Rw1d TtiACICiNG PERwr FM:
PIm Seb
Pian Ckeek sobWMd
Item Amount
Slruetond Gies
Rev[ewed, read? for eateetloos'
Plea Cheek Deposit, .
Tim Glcs.
Called Coataet Panna
Plan C11eck Salaaee
Mlle 24 thlti
Plans pieked sip
Coastraedes
,Flood P►R plea
Plass resabmiftd.-.
Meebsrikal
Gisdlne plan
Z'! Resler, ready toc corcec6owf%+at
Flsctrlal
SubeonWdor U t
Called t ootset Person
Piumblas
Grant Deed,
Pians picked up,
UL
B.O.A. Aiprevd
ftw vesobmitied .
Grading
#4 MUM-
''� lleview; rally ter oorseetlonsflssde
Develaper Impact Fee
PlaaainB Approval.
Cal [ed Coataet P.
AMP.P.
Pub: Wlrs. AFPr -
Date of permit issue
&11061 Fees
Total Permit Fees