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MECH (12-0857)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: C-12-0000085.7 Property Address: 53905 AVENIDA MENDOZA APN: 774-172-018-8 -000000- Application description: MECHANICAL Property Zoning: COVE RESIDENTIAL Application valuation: 8000 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CAR- BRITTIAN 53905 AVENIDA MEND( LA QUINTA, CA 9225: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/01/12 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 _ I I, 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 with a contractorls) licensed pursuant to the Contractors' State License Law.). (_ 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 ISec. 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, indemnity 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 reby a orize r presentatives of thiscougly to enter up n the above-mentioned property for inspec[io ur es. Date: ature (Applicant or Agent): Contractor: "` " 1 ?0l9 Applicant: Architect or Engineer: HYDES C/1 ` 42949 MADIO STREET R�obt. INDIO, CA 92201 apNTq IP(760)360-2202JLic. No.: 906115 ------------------------------------------------------------------------------------------------- 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 Pro essionals 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. C36 License .' 906115 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is / /ate: Cl� �COntractor: issued. 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 -B DER DECLARATION insurance carrier and policy number are: 1 hereby affirm under penalty'of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC356415 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 thew s' 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 forthwi con'Spl wi 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 1$5001.: Datpplicant: 1 _ 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 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.). 1 _ I I, 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 with a contractorls) licensed pursuant to the Contractors' State License Law.). (_ 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 ISec. 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, indemnity 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 reby a orize r presentatives of thiscougly to enter up n the above-mentioned property for inspec[io ur es. Date: ature (Applicant or Agent): Application Number . . . . . 12-00000857 Permit. . . MECHANICAL" Additional,desc . . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date . . . . Valuation 0 Expiration Date 1/2.8/13 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-500KBTU 16.50 ----------------=----------------------------------------------------------- .Special Notes and Comments HVAC CHANGE -OUT: INSTALL 4 TON 14 SEER PACKAGE SYSTEM ON ROOF AT SAME LOCATION. 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 #: 53-905 Avenida Mendoza La Quinta, CA 92253 City of La Quin ta Aug 1, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat p Package Unit ❑ Furnace 0 AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ©Setback ❑ Indoor Coil p SEER 13.0 [1HSPF ❑ R 8 (CZ 14-15) 1600 sf If not already present must be ❑ Condensing Unit ❑ EER ❑ Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -ZR -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 -611 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 -111 and CF -611 shall also be on site for final inspection. D 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -6R forms: MECH-04, MECH-2I-HERS aF;d (ter split systems) 049GH 25-494& replaced CF -4R forms: MECH-21 �a (f9F slit ......«,.ms) MC!`H 2 . Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (feF splik systems) MEGH 29 HERS . Indoor Coil and /or CF -4R forms: MECH-21 and (feF splik syst ws) 114EGH 25 . Furnace FeF Split Sys%em-si Duet leakage -; 15 peFeeRk; RG, GGA 15 999 GPM�teR (Minimum AiF Flaky RequipemeRk), T04AN 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 duct systems are constructed, insulated or sealed with asbestos ❑ 4. The system will not be Ducted (ie.•Ductless Mini -Split System) (Also -Exempt -from .Refrigera,ntCharge) ❑ 2. New HVAC System Required Forms: . Cut in or Changeout with- CF -6R forms: MECH-04, MECH-2Q-'HERS; and (for split systems) MECH-22-HERS, and new ducts: (all new ;r MECH-25-HERS J ducting and all new, CF -4R forms: MECH720, and (for split systems) MECH-22, and MECH-25 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 ❑ 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 -4R forms: MECH-20 and (for split systems) MECH-25 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-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 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: Mark Hyde Signature: Mark Hyde Company: CERTIFIED COMFORT SYSTEMS INC Date: Aug 1, 2012 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 212-AO04128OA-00000000-0000 Registration Date/Time: 2012/08/01 12:20:11 HERS Provider: CalC&RTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # Cit)( of La Quinta Building 8L Safety Division Permitiff oe-i P.O. Box 1504, 78-495 Calle Tampito La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:' AeJ1 0-1 '4 C"' Owner'sNam, Owner's Name: e -,n A. P. Number: Address. Address: ?OY' Description: RYJP City, S Zip. City, ST, Zip - T' 4_�f A ZZf TI h Telephone: -7 Aildiess.- L� LY 'I' A .I_ P ro J ct scp Project Description: 1�;'ST, Zip: SCJ ' 14 J Ci fief phone:3 60 �tate Lie. # : q C7C, City Lic. #: L !, -( Y z:z- Arch., Engr., Designer: eeeo Address: City, ST, Zip: Telephone: State Lie. #: ,ic E Construction Type: Occupancy: Name of Contact Person: Project Project type (circle one): New Add'n Alter Repair' Demo � Telephone # of Contact Person: Ft- # Stories: 9 Units: Estimated Value of Project: Gdo' C9 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec.1d TRACIMG Plan Sets • PERMIT FEES Plan Check submitted Structural Cafes. a - Item e dy TReviewed, ready for corrections Amount Truss Cafes. Plan Check Deposit C I Contact . ta Called Contact Person Energy Cafes. - -------------Plan Check Balance . plans picked Plans bicked up Construction Flood plain plan Plans resubmitted ------- es Grading. plan, Mechanical 2" Review, ready for correciionsrissue Subcontactor List Electrical 4R Called Contact Person Grant Deed . Plumbing Plans pi Plans picked up eked up S-1vLL R.O.A. Approval Approval ILO ppro' Plans resubmitted Plans resubmitted 01 HOUSE-- IN HOUSE:- fflanning Grading Review, Review, ready for corrections/issue ready for corrlltio-srl.,.e Developer Impact Fee Approval al C Called Contact Person .Pub. Wks. Appr A.LP.P. Date of permit issue School Fees Total Permit Fees I