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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