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12-0821 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12=00000821-_ 4_ Property Address: 54_73-3—INVERNESS APN: 775 -091 -063 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7200 T-it4t 4 4aalkrw BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: FERN JENNINGS 54733 INVERNESS LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/25/12 Contractor: � 4 �s Applicant: Architect or Engineer: DIAL ONE'S ONE HOUR A/C HTGCh� 2712 E. LA CADENA DRIVE RIVERSIDE, CA 9250 -A O1? rl (951)276-9744 Lic. No.: 878533 t ----=-------------------------------------------------------------------------------------------- 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 1 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. ate: a ontractor. t1' 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 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 basisfor the alleged exemption. Any violation of Section 7031.5 by �7 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: plicant: (_ 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 WARNING: FAILURE TO SECURE WOR RS' 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.). ' (_ I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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 with a contractor(s) licensed pursuant to the Contractors' -State License Law.). 1 _ 1 I am exempt under Sec. , B.&P.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: Lender's Address: LQPERMIT 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 is not 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. I 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 property for inspection purposes. ate:�O ��^ S' nature (Applicant or A Application Number . . . . . 12-00000821 Permit . . . MECHANICAL Additional desc . Permit Fee 48.00 Plan Check Fee 16.50 Issue Date . . . . Valuation 0 Expiration Date 1/21/13 Qty Unit Charge Per Extension BASE FEE 15.00 .00 9.0000 EA MECH FURNACE <=100K .00 2.00 16.5000 EA MECH B/P >3-15HP/>100K-500KBTU 33.00 ---------------------------------------------------------------------------- Special Notes and.Comments HVAC CHANGE -OUT: REPLACE (2) 3.5 TON A/C UNITS & DISCONNECT BOX. 2010 CODES. ------------------------- --------------------------------------------------- Other Fees . . . . ... . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged --------------------------- Paid " Credited Due ---------- Permit Fee Total 48.00 -------------------- .00 .00 48.00 Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 65.50 .00 .00 65.50 LQPERMIT t Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 10 - 1S Site Address: 54733 INVERNESS WAY La Quinta, CA 92253 Enforcement Agency: City of La Quints Date: Jul 23, 2012 Permit #: Equipment Type1 List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit ❑ Furnace ❑ Indoor Coil 0 Condensing Unit13-IS) O AFUE 0 SEER 13.0 ❑EER ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) ( R 8 CZ 14 Served by system 2600 sf ® Setback If not already present, must be [3 Other ❑Resistance Installed) L Equipment Type: Choose the equipment being Installed; if more than one system, use another CF-IR-ALT-HVAC for each system. 2. Minimum Equipment Effldendes: 13 SEER, 78% AFUE, Z7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are POUR 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-411 forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-IR and CF-6R 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-2 -HERS replaced CF-411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coll and /or Indoor oil and /or CF-6R forms: MECH-04, MECH-2I-HERS and fors lit MECH-25-HERS • Furnace CF-4R forts: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent;, RC, CCAs 300 CFM/ton (Minimum Air Flow Requirement), TMAH 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 duct systems are constructed, Insulated or sealed with asbestos p 4. Thesystemlwill not be Ducted (IeDuctlesMlni;SplR,System)(AlsolEExemptf%m#Refigerant�Ciarge) - ❑ 2. New HVAC Sys'fem Requi.%. " i#:c P ,,p con` y N :r / a 0u InSol9Ctiangeaut with! °"' new ducts: (all new G�F$P6R forms•�MECH-04, MEGH-20-HERS,Fandffflersp& t systems) MECH; 3-HERS and ductingi all new ;,5gliERS co MECH-20, and (for ` equlpme`n_t) � split syCH-22 and'MECH,-25 For Split Systems Duet leakages<16.percent, RC�CCA'�2m350`,C?aT FM(Wn-,vFWDMAH,ISTMS, and eltner'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 and/or Indoor coil and/or furnace. No or some CF-6R forms: MECH-04, MECH-20=HERS, and (for split systems) MECH-25-HERS 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 linear feet of duct in unconditioned space. CF-611 forms: MECH-04, MECH-2I-HERS CF-411 forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, Insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • 1 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: Jim McEligot Signature: Jim McEligot Company: VENVEST BALLARD INC Date: Jul 23, 2012 Address: 2712 EAST LA CADENA DRIVE License: 878533 City/State/Zip: RIVERSIDE / CA / 92507 Phone: (951) 276-9744 Reg: 212-A0039083A-000000oo-0000 Registration Date/Time: 2012/07/23 13:33:01 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 (-" Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones i0 - is Site Address: 54733 INVERNESS WAY La Quinta, CA 92253 Enforcement Agency: City of La Quin ta Date: Jul 23, 2012 Permit tae: Equipment Typel List Minimum Efficiency2 Duct Insulation Conditioned Floorrequirement Area Thermostat [I Package Unit ❑ Fumace i7 Indoor Coil ® Condensing Unit O AFUE 0 SEER 13.0 p EER ❑ COP ❑ HSPF O R 6 (CZ 10-13) 13 R 8 (CZ 14-I5) Served by system sf ® Setback If not already present, must be ❑ Other p Resistance installed) 1. Equipment Type: Choose the equipment being Installed; if more than one system, use another CF-I R-ALT-HVAC for each system. 2. Minimum Equipment EMclendes: 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-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 e Indoor Condenser Coll and /or oil and /or CF-6R mom: MECH-04, MECH-2I-HERS and (for split systems) MKH-25-HERS • Furnace CF-4R forms: MECH-21 and (for split systems) MECH-25 Por Splk Systems: Duct leakage < 15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH Exempted from duct leakage testing If: p 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Dud systems with less than 40 linear feet In unconditioned space, or O 3. Existing dud systems are constructed, insulated or sealed with asbestos E3 4. The system%will not be Dined (le. Ductless Mln1—Split�System)_j(Nso Exempt,f%Ref igerant Charge) 0 2. New&VAC System Raqulred arms �}�y�yy��/. 'ter ` � _. ` - • Cut InatiChangeout with 6R o ' "r new duds: (all new a) 1MECH-04, MKH 20-HERS and (fo split systems) MECH-22-HERS, and ductin'" all new �MECH,25`HERS ,>I JAM m r; equlpin'ent� C-'F�-4R fo MECH-20, an (for spylit}systems) MECH-22, and MECH-25 ;, yQ�y¢{ `yJ ... M.E. , _ M: A9 1 �e - .-.+-w��31.MSQ: :'. ' C�� a� e— '.- J For Split Sofern Duct leak6g`e-�<t6 pertent;iRC;7CCAr2,350;CFM/ton; FWD`!t*,�TMAH; SiMS, andel er HSPPbr PSPP. "" For Packaged Units: Duct leakage < 6 percent E3 3. New Ducts with/or without Required Forms: Replacement • Includes replacing or installing all new ducting and/or outdoor condensing unit and/or Indoor coil and/or furnace. No or some CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS CF-4R forms: MECH-20 and (for split systems) MECH-25 equipment changed, For Split Systems: Dud leakage < 6 percent; RC, CCA 2 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent O 4. New Ducting over 40.feet Required Forms: . Includes adding or replacing more than 40 linear feet of duct in unconditioned space. CF-6R forms: MECH-04, MECH-2I-HERS CF- CF-4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ 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 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: Jul 23, 2012 Address: 2712 EAST LA CADENA DRIVE License: 878533 City/State/Zip: RIVERSIDE / CA /.92507 Phone: (951) 276-9744 Reg: 212-A0039084A-00000000-0000 Registration Date/Time: 2012/07/23 13:35:01 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010 Bill # City of La Qli%r�tC� Bulmy a Safety Division P.O. Box 1504,78-495 Calle Tampico 1A.Quinta, CA 92233 -:(760) 777-7012 Building Permit Application* and Tracking Sheet Permit # wner's Name:. ' ProjectAddress: +-113 �SEA, A. P. Number. _ _ �� dress: 3� .� s Legal Description:1—.A.- " ty, ST, Zip: Lo A Contractor. t4 Telephone: � ,,:'�� . �`", sx• Address: a_7 1 GL&e_ -D�-. Project Description: L City, ST, Zip:V&wt(J�c C �� To ovi ` AnneA Telephone: 4G . State Lic. # : #; Arch., Engr., Designer Address: City., ST, Zip: �. 7 Telephone:; a State Lic. #: � `. .w Name of Contact Person: Construction type: Occupancy: • Project type (circle one): New Add'n Alter Repair Demo Sq. .Ft.:#Stories: # Unit;': Telephone # of Contact Person: Estimated Value of Project E'" 1 � oiCX9 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rec'd TRACKING PERMrr FEES Plan Sets Plan Cheek submitted Item Amount Strgetural Cales Reviewed, ready for corrections Plan Check Deposit. . Truss CAM Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitied .. Mechanical Grading plan 2•! Revlew, ready for correctionstissue Electrical Subcoatactor List Called Contact PersonPlumbing Great Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Gradiag IN HOUSE:- 1i6 Review; ready for eorreetionsAssne Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees