11-1176 (MECH)P.O. BOX 1504
78-495 CALL TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1-1�00001176
Property Address: '::�48129-VIA HERMOSA
APN: 646-100-007- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8939
Applicant: .) Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
' BUILDING PERMIT
Owner:
ROGER & PAT BAILES
48129 VIA HERMOSA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760)' 777-7011
INSPECTIONS (760) 777-7153
a _4ate. 0/26/11
e
D .
OCT 2 6 2011
Contractor:
DIAL ONEIS,ONE HOUR A�i=&
2712 E. LA CADENA DRIVE
RIVERSIDE, CA 92507
a (951)276-9744
Lic. No.: 878533
OF a-01iNTA t,
LQPERMIT
' - LICENSED CONTRACTOR'S DECLARATION
- WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
_
I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business 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 License No.: 878533
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/-/ _
• ate:w t6 // ontractor: 10.- �j ll eS �� -e jTf'
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
-
Code, for the performance of-thework for which this permit is issued: My workers' compensation
- OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the .
Carrier INS CO OF WEST Policy Number WSD500334901
following reason (Sec. 7031.5, Business andProfessionsCode: Any city or county that requires a permit to
_ I certify that, in the performance of the. work for which this permit is issued, 1 shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the '
,
person in any manner so as to
ct subjeto the workers' compensation laws of California,permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
beco
and agree tha , if I should becoject 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 oft Labor Code, shap hwith comp) i 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate:); 7.6 pplicant:
' (_) I, is 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: FALURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
' Contractors' State License Law 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 ($100,000)• 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 3706 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.).
-APPLICANT ACKNOWLEDGEMENT
- (_) 1, as owner of the property, am exclusively,contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
- 7044, Business and Professions Code: -The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this.application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
-
1. Each person upon whose behalf this application is made, each person at whose request and for'
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
-
- of La Quints, its officers, agents and employees for any act,or omission related to the work being
- - _
performed under or following issuance of this permit. -
' Date: Owner:
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
- CONSTRUCTION LENDING AGENCY. -
permit to cancellation. -
' I hereby affirm under penalty of perjury that there is a construction lending agency -for the performance of the
I certify that I have read this application and state that the above information is correct. I agree;o comply with all
- work for which this permit is issued (Sec. 3097, Civ. C.). - - -
city ar}d county ordinance and state laws relating to building constru n, and hereby a horize representatives ,
oft s count o4on the above-mentioned property for• sp npurposes.Lender's
Name:
ateature (Applicant or Agent):
Lender's Address: - -
-
LQPERMIT
Application Number . . . . . 11-00001176
Permit MECHANICAL
.Additional desc .
Permit Fee . . . . 40.50 Plan Check Fee
10.13 .
Issue Date• Valuation
0
Expiration Date 4%23/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
- 1.00" 9.0000 EA MECH FURNACE <=100K
9.00•
1.00 16.5000 EA MECH B/C'>3-15HP/>100K-S00KBTU
16.50
Special- Notes and Comments
REPLACE 80,000.BTU FURNACE, .5 TON, 13
SEER A/C WITH COIL & DISCONNECT BOX.
SPLIT SYSTEM. 2010 CODES.
---------------------------------------------------------------------
Other Fees . . BLDG.STDS ADMIN (SB1473)
1.00
" Fee summary Charged Paid Credited
Due
'Permit Fee Total 40.50 .00 .00
40.50
Plan Check Total 10.13 .00" .00
10.13
- Other Fee Total 1.00 .00 .00
1.00
Grand Total 51.63 .00 .00
51.63.
LQPERMIT
- .
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
48129 VIA HERMOSA La Quinta, CA 92253
City of La Quinta
Oct 25, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficience2
requirement
Area
Thermostat ^,
❑ Package Unit
* Furnace
* Indoor Coil
R AFUE 80%
R SEER 13.0
r-
f HSPF
❑ R 6 (CZ 10-13)
Served by system
R Setback -
If not already present, mus_ t be
p Condensing Unit
❑ EER
[ Resistance
n R 8 (CZ 14-15)
2000 sf
installed)
F1 l Other
)
- +
1*
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for ?ach system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.711SPF 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 .he 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 -411
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 -611 shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
'
. Furnace
CF -411 forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Per. Paskaged.—tsm Duet leakage i 16
peFrseAt .� .,
Exempted from duct leakage testing if:
' ❑ I-Ductsystem 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
[13. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The �s_, m will not be Ducted (ie. Ductless.Mini,S;p t,.System).(At_so,Exempt f om�Refngerant Charge)
u
❑ 2, Neuv HVAC System
Required Forms: ! / -f.. " r $ � .
.Cut in�br,Changeout with*
-
* -- '
CF 6R forms:, MECH-04, MECH-20-HERS,jand,(for split systems) MECH=22-H=RS, i§; -d -'-
new ducts: (all new
ductin'g � all new
MECH=25 HERS � ) .- I I. N t . P f : .�-
CF + �
forms: MECH 20, and (for split systems), MECH-22, and MECH-25 '�
equipment) . ,,
-4R'
-..
:*#+ s �. g . . , A` It L- ,J Vtl ,ir4_
For Split Systems: Duct leakage <,•6-percent;"RC`CCA•>_'350"CFM/ton; FWDTMAH;'STMS, and`either F.SPP`orPSPP
For Packaged Units: Duct 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 coil and/or furnace. No or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA Z 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
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
r 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.
• I 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 Tide 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, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: ]IM MCELIGOT Signature: JIM MCE'LI60T
Company: VENVEST BALLARD INC I Date: Oct 25, 2011 ,
Address: 2712 EAST LA CADENA DRIVE License: 878533
City/State/Zip: RIVERSIDE / CA / 92507 Phone= (951) 276-9744
Reg: 211-A0055353A-00000000-0000
2008 Residential Compliance Forms
stration Date/Time: 2011/10/25 12:59:40= HERS Provider: CalCERTS, Inc.
July'2010
A `
Bin # ...
0ty of. La Quin tQ
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 77777012
Building Permit Application and Trackin- Sheet
Permit #
Project Address: �(Vla—
Owner's Name: S
A. P. Number: �w—� —
Address:
Legal Description:
(
Contractor. ��c_I oyle STelephone:.��>>.`•%i:
Lo v
City, ST, Zip:
', �t+Y:i;:�:•+:•:�Y:i:l��:4:t::iY�:::j0:3tY.
>.: #.Yz:?:>:«'arr:a:;
<>>::.v.:;::fY.u:Y,.Y•..>..;;Y:•Y.:
Project Description:
Address: '712 , �`P 4
City,.ST, Zip:1
Telephone: 15;Jrf a7� ` '7�f :<:h•:«;<sz r. .v::::.Y::.:.;.....,.::.:
::;yi:rriR:<;::y:; i>:w::a•Y';^;:9.;v'r,.;%fcb.:%.
State Lic. 9: g 7g j 7f:>� City Lic. #.Z6 5—,373
Arch., Engr., Designer:
Address:
`
City, ST, Zip:
Telephone:
State-Lic. #:
Sf:f�`.�,v'i:%C: }ti>L`vY..S...A'•1v: jC{.}:l
�;��:>.":;;;:v;;�:� ...:.
x`:<�r:`:a"~w,�� >c�.~,.;may:;.;.';>.,xr-•���� :
. Construction Type: Occupancy:
project type (circle one):. New Add'n Alter Repair. Demo
Sq. Ft.: #Stories: # Units:
Name of Contact Person: ��. (�(
Telephone # of Contact Person:—ry ;cx
Estimated Value of Project:
� �3
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Recd
TRACKING
PERMIT FEES .
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Chtck Deposit
Truss Cales•
Called Contact Person
Plan Chtck Balance
Title 24 Cates.
Plans picked up
Constru.tion
Flood plain plan
Plans resubmitted
Mechan=cal
Grading plan
200 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Piumbirgg
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
''" Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees