Loading...
12-1204 (MECH)P.O. BOX 1504 ^' VOICE (760),r- 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 -• . BUILDING PERMIT Date: 10/10/12 Application Number: X12-000.01204 — �. Owner: Property Address: 50185 VIA SIMPATICO CHRIS ALEVIOS APN: 772-400-015- - - 50185 VIA SIMPATICO Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4300 Contractor: �l a Applicant: Architect or Engineer: DIAL ONE'S ONE HOUR A/ ... . 2712'E. LA CADENA DRIV RIVERSIDE, CA 92507 �^'p grys (951)276-9744 y ®e✓1 0201 Lic. No.. 878533 Cli'y q FIN,�NCEp UJ�P 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 issued. ' ZDte: tor:czz�_ )t_I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performanceofthe work for which this permit is issued. My workers' compensation " OWNER-BUILDERDECLARATIONinsurance 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 EVEREST - NATL Policy Number CA100013 00121 following reason (Sec. 7031.5, Business and Professions Code:: 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 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 become subject to 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 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, I shall 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 `^' `-t any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•: ate: lW lO� t'a. plicant:, (_) 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: FAILURE 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 (5100,000). -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 I, 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 contractorls) licensed _ 1. Each person upon whose behalf this applicationismade, 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. , BAP.C. for this reason 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. 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 to comply with all work for which this permit is issued (Sec. 3097, Civ: C.). city and county ordinances and state laws relating to building construction, and hereby authorize' representatives ' of this county to enter on the above-mentioned property for i ion purposes. Lender's Name: - ate:)—wi Signature (Applicant or Agent): ,Lender's Address: ' LQPERMIT Application Number" :. 12-00'001204 % Permit MECHANICAL Additional desc . Permit Fee 37.50 Plan Check Fee 7.88 Issue Date Valuation 0 `. Expiration Date 4/08/13 Qty Unit Charge Per Extension BASE FEE 15.00 .00 16.5000, EA MECH B/C.>3-15HP/>100K-500KBTU .00 1.00 22.5000 EA .• MC B/C >15 <=30HP/500K-1M BTU 22.50 b' ------------------------ ----------------------- Special Notes and Comments HVAC CHANGE -OUT: REPLACE -4 TON A/C'UNIT, LOCATED AT SIDE YARD. 2010 CODES. - --------------------------------------------------------------- -------------Other Fees . . . . . . . . . BLDG STDS ADMIN'(SB1473) 1.00 Fee summary. Charged Paid Credited Due Permit Fee Total 37.50 00 :00 37.50 Plan Check Total 7.88 .00 00 7.88 Other Fee Total „1.00 .00 .00 1.00 Grand Total46.38 .00 .00 46.38 • • LQPERMIT .. - i - - .. '• Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 50185 VIA SIMPATICO La Quinta, CA 92253 City of La Quinta Oct 9, 2012 Duct insulation Conditioned Floor Equipment Typei List Minimum Efficiency2 requirement Area Thermostat - 0 Package Unit O Furnace 0 Indoor Coil' 0 AFUE ® SEER 13,0 E3 COP 0 HSPF p R 6 (CZ 10-13) R 8 Served by system 1600 sP ® Setback If not already present, must be ® Condensing Unit pfER 0 Resistance 0 (CZ 14-15) Installed) E3 Other, 1. Equipment Type: Choose the equipment being Installed; If more than one system, use another CF -IR -ALT -HVAC for each system. 2.' Miti/mum. Equipment Efficlencles: 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 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 -411 forms,(no hand.filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -11% and;CF-612 shall also be on site for final inspection. ® 1: HVAC Changeout Required Forms: . All HVAC•Equipment " CF -6R forms: MECH-04, MECH-21-1­1ERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coll and /or ` CF -6R forms: MECH-04, MECH-2I-HERS and for split systems) MECH-25-HERS • Indoor Coll and /or CF. -4R forms: MECH-21 and (for split systems MECH-25 • Furnace .. , . 1 For Split Systems: Duct leakage,< 15 percent, RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH -- Exempted from duct leakage testing ii: 0 1, Duct system was documented to have been previously sealed and confirmed through HERS verification, or 0 2, Duct systems with less than 40 linear feet In unconditioned space, or 0 1 Existing duct systems are. -constructed, Insulated or sealed with "asbestos 0 4. The system wlll not be Ducted (le}Ductles�s�Min( Split,System)"(AlsoiExempt from RefrigerrapVCharge) 0 2. New;HVAGSyBtem Required Forme..; 9_•'.Xft, .. d • Cut In or Chan eout wlth� g - t'at ti ® fj�.,x ;•,. IYJ,SRSt'f!t �' i6 ;v.". ` CF 6R forms (MECH-04, MEC-204HERS,rendi(for split systems) MECH222-HERS, end new ducts (all new ducting, all new MECH-15"HERS•� �~- • r and,,MEC-H,2ANIft CF -4R forms and for split systems) 51 ' - � equh ent) cx t =MECH-20, '7,ECH-22, h$A?Zt* �arR.� }. ., For Split Systemsr Duct leakage`k36 percent, RC `CCA a 350';CFM/ton; FWD;,DTMAH, STMS;'andJelthee.HSPP-or PSPP —' "" Por.Packaged Units: Ductieakage <;6 percent O 3. New Ducts With/ or without-. Requlred Forms: Replacement • Includes" replacing or Installing all i new ducting and/orbutdoor condensing unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or Indoor.coil and/or furnace. No or some CF -4R forms: MECH-20 and (for split systems) MECH-25 equipment changed. , For.Spllt Systems: Duct leakage < 6 percent; RC, CCA a 300 CFM/ton, TMAH For. Packaged Units: Duct leakage .< 6 percent ' 0 4. New.Ducting over 40 feet Required Forms: •,Includes adding or replacing more than 40 CF -611 forms: MECH-04, MECH-2I-HERS , ICF linear feet of duct in unconditioned space. -411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent .Cl 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 elfglble urider 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 documented on other applicable compliance forms, worksheets, calculations,.plans and specifications submitted to the enforcement agency for approval with the permit application. Name: Jim McEligot Signature: Jim McEligot - Company: VENVEST BALLARD INC, Date: Oct 9, 2012 p Address: 2712 EAST LA CADENA DRIVE License: 878533 City/State/Zip:, RIVERSIDE / CA /. 92507 Phone: (951) 276-9744 - Reg:*212-A0056270A-000000000-0000 Registration Date/Time: 2012-/10/09 11:47:24 HERS Provider: Ca10ERTS,Inc. 2008 Residential Compliance Forms . July 2010• ' Y i Bin.# City'f La Quanta • Building 8i' Safety Division Perinit # P.O. Box 1504,78-495 Calle Tampico ,1 a 14.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet i Pro ect Address: �►`"1 p \ i J �) L D S V L,G.. S I - I C6' Owner's Name:. A P. Number. �.,(a- 3-,; � i' • ' Address: i Legal Description: i City, ST, Zip: Contractor:`.:.• acs 'ii"'ti..s" :.r Telephone-1 Q-1-7 no . > ?r� r� Address: a1 I , Project Description: Q. City, ST, Zip: \ d'a -i %% C e c i Telephone: Ci 11 State Lic. # : ,7�j City Lic. #; Arch., Engr., Designer. ri Address: City., ST, Zip: Telephone: Construction Type:. Occupancy: State Lic. #: F:w%y Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: I Telephone # of Contact Person:Estimated Value of Project: A 0 , 'QD APPLICANT: DO NOT WRITE BELOW THIS UNE # ` Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Ca[es Reviewed, ready for corrections Plan Check Deposit.Truss . Ca1es•Called Contact Person Pian Check Balance _ ' Tine 24 Calti. Pians picked up Construction _- Flood plain plan— _ _Pleas-resubmitted - --. -Mechanical --- Grading plan 2`` Review, ready for correctionstissue Electrical " Subcontaetor List Called Contact Person _— Plumbing y Grant Deed Plans picked up S.M.L 11.0-4. Approval Plans resubmitted Grading IN HOUSE:- 'j° Review; ready for correctioaeissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue ' School Fees Total Permit Fees