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12-1042 (MECH)TA P.O. BOX 1504 4 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT 'Date: 9/12/12 Application Number: 12-00001042 ° Owner: _ Property Address: 49311 .AVENIDA VISTA BONITA ROSENBAUM E. APN: 773-350-033-33 -14496 - 49311 AVENIDA VISTA BONITA ' Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL (760) 485-553.0 Q Application valuation: 3950 Contractor: Applicant: Architect or Engineer: DIAL ONE'S ONE HOUR A/C 2712 E. LA CADENA DRIVE `;•r� ! RIVERSIDE, CA 92507 LP,QVtP1TA` (951)276-9744 1(�(OF Lic. No.. 878533 C FINPNC�^ _ + LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that 1 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 willmaintain 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 -r•� issued. ,. Dater '� 1 -"-Contractor�- 1-� _ I have 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 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 EVEREST NATL Policy Number CA10001300121 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 provlslons of the Cunuautui's State - and agrec that, if I should become subject to the workers' compensation prnvisions of Section -License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Cade, 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 r- any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: _ Dae c`— la i pplicant: �� ' (_) 1; as owner of the property, or my employees with wages as their sole compensation, will do the work, and —G� _ 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 ($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 a - _ 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 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, (_ 1 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 Quinta, its officers, agents and employees for any act or omission related to the work being • - - - r - -` - .performed under or following issuance of this permit. Date: Owner: 2. Any permit issued as result of this application becomes null andvoid if workris 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 upon the above-mentioned property for ' action purposes. _ Lender's Name: —�� j •L -� Date: Signature (Applicant or A ' Lender's Address: , t -•.. n. _ _. _ .. LQPERMIT - - - Application Number . . . 12-00001042' Permit MECHANICAL - Additional.desc. . Permit Fee . . . . y33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 3/11/13 Qty Unit Charge Per Extension BASE FEE 15.00 ` 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 ------------- ------------------------------------------------- Special Notes and Comments - --- REPLACE 80,000 BTU FURNACE AND 5 TON COIL 13 SEER 2010 CODES. ----------------------------------------- Other Fees -. . . . . BLDG STDS ADMIN (SB1473) 1.00 „ Fee summary' Charged Paid Credited Due , Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 ._ Grand Total ,42.25 .00 .00 42.25 t , . S LQPERMIT . .. .. .. - Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 1S Site Address: Enforcement Agency: Date: Permit #: 49311 VISTA BONITA La Quinta, CA 92253 City of La Qulnta Sep 6, 2012 Equipment Typel List Minimum Efficlency2 Duct insulation requirement Conditioned Floor Area Thermostat (3 Package Unit 19) Furnace Indoor Coil ❑AFUE ® SEER 13.0 ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) 13 R 8 (CZ 14-15) Served by system 1800 sf ® Setback If not already present, must be Condensing Unit [3 EER C3 Resistance installed) Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 1. Minimum Equipment Effldencles: 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 -611 and registered CF -411 forms (no hand filled CF -411s 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. 0 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 ffor split systems) MECH-25 . Condenser Coll and /or . Indoor Coll 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 .11111 Exempted from duct leakage testing If: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verliwtlon, or ❑ 2. Duct systems with less than 40 linear feet In unconditioned space, or ❑ 3. Existing duct systems are constructed, Insulated or sealed with asbestos ❑ 4. The,systemywlll not be Ducted (Ie..PucdesskMIn,1,Split,System)(Also�Exempt:from,RefrigeranbClarge) O 2. NewAHVAC System Requloe Florins: Ozt m t I . Cut IntbrjChangeout wi new ducts: (all new -1 ., :Y r . CF -6R forms._tMECH-04 MECH-20-HERS and (for,split systems) MECH-22-HERS, and � - � � �? ducting'Yall new o r= MECH-25�HER5 "CF -4R forms: MECH-20, andN(for split, systems) MECH-22, and MECH-25 v.0 equipment - ) v' d°" . �+cX' P<+ fid;. . ' r` .:'?7�' ,1:. :€i!-ip -4X"� r For Split Syofems: Duct leakage'<i6 percent; RC,'CCA"2-350 CFM/ton, FWD, TMAH, STIVIS, and"elther HSPP or'PSPP. " 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 -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or Indoor toll 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 2 300 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 CF411 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 ❑ EXCEPTION: Existing dud 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. • 1 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: Sep 6, 2012 Address: 2712 EAST LA'CADENA DRIVE License: 878533 City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951) 276-9744 Reg: 212-A0049402A-00000000-0000 Registration Date/Time: 2012/09/06 15:.56:45 HERS Prcwider: Ca10ERTS, I"nc. 2008 Residential Compliance Forms July 2010 en .# City. Of L Quints Building & Safety Division P.O. Box 1504,'78-495 Calle Tampico La.Qt inta, CA 92253- (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 3 ( Owner's Name:. A. P. Number. s. 3 �3 Address:. e.' Legal Description: f Contractor. LGL` City, ST, Zip: Telephone: Address: ( p,� Project Description: 0.� 60 60d TL City, ST, Zip: Kt50 Telephone: ( 6 'q a •r?\ . ?,i ;z. ✓i< ' . State Lic. 0: �� g , City Lic. #; �- Arch., Engr., Designer A Address: City, ST. Zip: .Telephone: State Lic. #:Project Name of Contact Person: onstruction Type:. Occupancy: type (circle one): New Add'n .Alter Repair Demo Sq. Ft.:#Stories: # Units: Telephone # of Contact Person: Estimated Value of Project �- 1 Q . O co APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd 'Rec'd TRACKING PERMIT FEES Plau sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance._ Title 24 Cates. Plans picked up .' Construction' Flood plain plan Plans resubmitted.. Mechanical Grading plan 2a6 Review, ready for correcfionsfissue Electrical Subeoatactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L- H.O.A. Approval i Plans resubmitted.Grading IN HOUSE:- '^' Reyiew, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees