13-0399 (MECH)P.O. BOX 1.504
78-495 CALLE TAMPICO --
LA QUINTA; CALIFORNIA 92253"' BUILDING & SAFETY DEPARTMENT ,
BUILDING PERMIT
Application Number: 13-00000399 ' Owner:
Property Address: 79810 VIA SIN CUIDADO . WARREN ASHMANN
APN: 772-390-007'- - - 79810 VIA SIN QUIDADO D
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760)698-8666
Application valuation: 11628
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirm under penalty of perjury that I am licensed under*provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: 1C20 License No.: 878533
Dater\ Contractor. -
Li
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the -Co'ntractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
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):
C. 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 .
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
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 1, 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 witha contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.C. for this 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: 1I,�/
Lender's Address: _ `\ \ .. ,
g
LQPERDIIT
VOICE (760) 777-7012
FAX-(766),777-7011.,
INSPECTIONS (760) 777-7153 2
Date: 4/03/13
a
APR 0.3 2013
Contractor:.
ONE HOUR A/C & HTG CITYooIAQUINTA
3030 MYERS STREET•• FINANCE DEPT
RIVERSIDE, CA 92503
(951)276-9744 ,
LiC. No.: 878533
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ofthe following declarations: r
• I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided -
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
��7� issued.
*&ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
CarrierINS CO OF WEST Policy Number WVE502266100
1 certify that, in the,performance of the work for which this permit is issued; I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
' 2 .3700 of the Labor Code, I shall forthwith comply with those provisions.
Date. Applicant: -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -
DOLLARS ($100,000)- IN ADDITION TO THE COST.OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 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 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.
2. Any permit issued as a result of this application becomes null and void if work isnot commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
'I certify that I have read this application and state that the above information is correct. 1 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 upon the above-mentioned propriw uo purposes.,
Date +SA2? Signature (Applicant or. Agent):
Application Number 13-00000399
Permit ,MECHANICAL
,... Additional desc .
Permit. Fee. 40.50 Plan Check .,
10.13,
_Fee
Issue.Date Valuation
0
Expiration Date 9/30/13
Qty Unit Charge Per..
Extension
BASE' FEE
15•.00
.1'.00' ' 9 . 0000 ' EA MECH ,FURNACE <=100.K
9.,00
1.00 16:5000 EA MECH B/C >3-15HP/>10CK-50OKBTU
16.50
Special Notes and Comments
HVAC CHANGE OUT - 16SEER/AFUE80 SPLIT
SYSTEM [2008 ENERGY] CARBON MONOXIDE
ALARM (S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2010 CALIFORNIA BUILDING
CODES.
-----------------------------------------------------------------------------
Other.Fees BLDG STDS ADMIN (SE1473)
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 .. ". .. -
City of, La Qulht'a ,
Buftdtng of Safety Division
P.O. Box 1504,"78-495 Calle Tampico .
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
Project Address:.
Owner's Name:.
A - P. Number. -?, i0_ 0
Address: �(� 4a—.Stut QudwlO
Legal Description:
City, ST, Zip:
Contractor. 0o,Q N �- �
Telephoner) ( z
Address: ?0 WA US
Project Description: (49
City, $T, Zip: �� CJ's �t�
V" '
elephone
Telephone-
State Lia # . •
State
City Lie. #;
Arch., Eau., Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Construction Type: J Occupancy:
Project type (circle one): New Add'n Alter . Repair Demo
Name of Contact Person:
Sq. Ft.: l ieco I # Stories:,
# Unit
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES-
EESPlan
PlanSets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Calm
Plans picked up
Construction
Flood plain plan
Plans resubmitted.'.Mechanical
Grading plan
2'! Review, ready for correctionsfissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ILO.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
4 .
Site Address:
7981 0 Via Sin Quidado
EnforcetnentAgency:City of LQ
Date:
4-3-2013
Permit #:
Conditioned Floor
Equipment T et
List Minimum Efficiency,Duct
insulation requirement
Area
Thermostat
Packaged Unit
X FurnacIndoor
A
COP
Over 40 ft of ducts added or
re laced in unconditioned space
Served by system
®x Setback
(If not already
x Indoor Coil
x EERts
ER16
HSPF
®Resistance
R 6 (CZ 10-13)
tsoo sf
present, mtrrt be
x Condensing Unit
®EER
R8 (CZ 14-15)
installed)
Other
1. Equipment Type: Choose the equipment being installed, if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF 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 -6R and registered CF -4R 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 -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• All HVAC Equipment replaced
CF -4R forms: MECH- 21 and fors lits stems MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and /or
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems:. Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
1. Duct system 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
3. Existing ducts stems are constructed, insulated or sealed with asbestos
E32. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-11ERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton,.FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
[33. New Ducts with/or without Replacement
Required Forms:
• Includes. replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor coil
CF -4R forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA> 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 -6R forms: MECH-04, MECH-21-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For splits stem or packaged units: Duct leakage < 15 percent
EXCEPTION: Existing ducts stems 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 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: Jane Recktenwald
Signature:
Company:Venvest Ballard DBA One Hour
Date: 4-3-2013
Address: 3030 Myers Street
License: 878533
City/State/Zip: Riverside, CA 92503
Phone: 951-276-9744
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