13-0459 (MECH)Tihf 4 lv4
P.Q. BOX 1504 .
757495 CALLE'TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
GREG MOKLER
79580 MISSION DR E
LA QUINTA,,.'CA 92253
(970)215-7600
Application Number.
13-00000459
Property. Address:
79580' MISSION DR E
APN:
602-310-002- - -
Application description:
MECHANICAL
- Property Zoning:
LOW DENSITY RESIDENTIAL "
Application valuation:
9280
Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter (commencing with
- Section 700�qd
0) of Division 3 of the Business and Professionals e, and ytiicense is in full force and effect.
License Class: C20 C36 yiE 6se . 906115'
Date: /)contractor: ✓
OWNER -BUILDER DECLARATION
I hereby affirm under penalty,of perjury that I am exempt from the Contractor'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 15500).:
(_) 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 Lawdoesnot apply to an owner ofproperty 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.).
( •_) 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 contractor(s) licensed
pursuant to the Contractors' State License Law.). - -
(_ ) I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY '
1 hereby affirmunderpenalty 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: I�
Lender's Address:
LQP&Rn11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7.153
Date: 4/11/13 '
D U
Contractor:
HYDES
42949 MADIO STREET APR 112013
INDIO, CA 92201
(760) 360-2202 CITYOFLAQUINTA
Lic. No.: 906115 FINANCE DEPT.
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
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
issued.- '
-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
insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number CEWC356415
- _ I 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' mpensaticn laws of -California, -
and agree that, if I should become subject the rkers' mpensation provisions of Section
3700 of the Labor Code, I shat hw wit ose provisions.
Date:pplicant
-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 ($1 00,000). 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 LaQuinta, 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 comp) withall
city and county ordinances and state laws relating to building construction, and hereby authorize repres matives
of this county to entee u�jon the above-mentioned property for inspect . p.Lpfes.
Date:'Srgnature (Applicant or Agent):
1
Application, Number . . . . . 13-00000459
Permit MECHANICAL
_. Additional desc .
Permit Fee,., . . 40.50 Plan Check Fee
10.13
Issue Date •Valuation
0
Expiration Date 10/08/13
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
1.6.50
Special Notes and Comments
HVAC CHANGE OUT 4TON 16SEER/78% AFU
SPLIT SYSTEM (2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CALIFORNIA
BUILDING 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='
LQPERAIIT ..
-
Bin #
Permit #
Project Address
A. P. Number:
Legal Description:
Contractor: �,� 2v �/ / • lav
Address: K 7
City, ST, Zip:
v
Telephone: 6 a _
State Lie. # : q 0C /
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Cafes.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading plan'
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning
OUSE:Planning Approval
Pub. Wks. APPr
School Fees
City of La Quinta
Building .& Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: Gfe C� [�
Address: �✓7 Z J D r
City, ST, Zip: p G ham! C
Y 2y
A. /c, Telephone: 70 j'� 6 00
goS3 8-
0) Description: P tt v1 l C 1�
"1 rlc 11�_
14 Ci Z�✓ d' (�,
City Lic. #: '--I � Z
__ L I Total Permit Fees
Construction Type:
Occupancy:
P cy: .
Project hype (circle one):
New Add'n Alter Repair p � Demo
Sq. Ft:#Stories:
# Units:
Estimated Value of Project: Z CD
APPLICANT: DO NOT WRITE BELOW
THIS LINE
Recd TRACING
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
god Review, ready for correctionslissue
Electrical
Called Contact Person
Plumbing
Plans picked up
S M I
Plans resubmitted
Grading
''" Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A LP.P
Date of permit issue
__ L I Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
A
Site Address:
Enforcement Agency:
Date:
Permit #:
79-580 Mission Dr. East La Quinta, CA 92253
City of La Quinta
Apr 11, 2013
Duct insulation
Conditioned Floor
-
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
* Package Unit
* Furnace
[3 Indoor Coil-
0 AFUE 78%
0 SEER 13.0
13 COP_
E3 HSPF
[3 R 6 (CZ 10-13)
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones,10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79-580 Mission Dr. East La Quinta, CA 92253
City of La Quinta
Apr 11, 2013
Duct insulation
Conditioned Floor
-
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
* Package Unit
* Furnace
[3 Indoor Coil-
0 AFUE 78%
0 SEER 13.0
13 COP_
E3 HSPF
[3 R 6 (CZ 10-13)
Seed by system
®Setback
If not already present, must be
[3 Condensing Unit
[3 EER_
[3 Resistance
0 R 8 (CZ 14-15)
1600 sf
installed)
[3 Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 Sig ned.Beg inning October 1, 2010, a registered copy of the CF -111
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-21-HERS and (f@F split systems) 04EG14 2&4494&
replaced
CF -4R forms: MECH-21 and (fer split systems) P49GH 24
Condenser Coil and /or
CF -6R forms: MECH-04, MECH-21-HERS and (�BF split systems) MEGH 25b-WSA�
Indoor Coil and /or
CF -4R forms: MECH-21 and (�BF Split systems) MEGH 24
Furnace
FGF Spli% SVS%e-m-6- -QuiA leakage 4 15 pweeRti RG, GGA 15 3Q9 G.F-114�t@R (MiRiFRUm AiF: Flew ReqWiFeFAeRQ,.:FNAW
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
[3 1. Duct system was documented to have been previously sealed and.confirmed through HERS verification, or
[3 2. Duct systems with less than 40 linear feet in unconditioned space, or
[3 3. Existing duct systems are constructed, insulated or sealed with asbestos
0 4. The system will not be Ducted (ie., Ductless Mini -Split System) (Also Exempt from: Refrigerairit'Charge)
0 2. New HVAC System
Required Forms: I
Cut in'or Changeout with;
CF -6R forms: MECH-04, MECH-20-'HERS!and (for split systems) MECH-22-!HERS, Sind
new ducts: (all new ,
clucting and all newl
- I I .
ME�H-251 HERS I I I j I
CF -;4R forms: MECH-20 an d (for split systems) MECH-22, and MECH-25
equipment)._ ""./o � `' . I
I
11 1 . — 1 -1 1 ,/' .-/, 4",4,
For Split Systems: Duct leakage < 6 percent; RC, CCA �t 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or 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
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 Split Systems: Duct leakage < 6 percent; RC, CCA 'e 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
El 4. New Ducting over 40 feet
Required Forms:
Includes adding or replacing more than 40
CF -611 forms: MECH-04, MECH-21-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: Apr 11, 2013
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO/ CA/ 92201 Phone: (760) 360-2202
Reg: 213-A0021487A-000000000-0000 Registration Date/Time: 2013/_04/1112:17:01 HERS Provider: CaiCERTS,.Inc.
2008 Residential Compliance.Forms July '2010,,
IN,