10-1375 (MECH)f . i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4tyl 4 4 a"
Application Number: v-10-00001375
Property Address: 79242 CETRINO
APN: 772-110-017- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL _
Application valuation: 8250
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 y License is in full force and effect.
LicenseClass: 20 C36 Lice N 906115
Date: f IN to Contractor:
OWN�DECLARATION
I hereby affirm under penalty of perjury that.] 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, after, 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).:
1 _ 1 1, 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 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.). -
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/16/10
Owner:
GENTNER ROCKY
79242 CETRINO
LA QUINTA, CA 92253
(
/-
Contractor:
HYDES _ t�
77825 WILDCAT STREE'Mn
PALM DESERT, CA 922 1 j
(760)_360-2202 G=iYr}�;� ;y •:r 1
�+ dict,+I rA
LIC. NO.: 906115 "�t.z:,t••._- ..,.__
WORKER'S COMPENSATION DECLARATION
I 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.
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
insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number CEWC133676
I certify that, in theperformanceof 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 wort rs' compensation provisions of Section
/ 3/700 of the Labor Code, I shall forthwith c ly h those provisions.
Date: ! / 'yr Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSAVEN 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 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 au rize representatives
of this cou ryy to/nter upon the above-mentioned property for inspe-rtion purpo
Date: —yL Signature (Applicant or Agent):
Application Number . . . . . 10-00.001375
Permit . .
. MECHANICAL
Additional desc .
Permit Fee . . .
. 33.00
Plan Check Fee
8.25
Issue Date . . .
.
Valuation
0
Expiration Date .
. 6/14/11
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
B/C <=3HP/100K BTU
9.00
----------------------------------------------------------------------------
Special Notes and
Comments
HVAC CHANGE OUT 16
SEER 4 TON UNIT 2007
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
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-lR-ALT-HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79-242 Cetrino La Quinta, CA 92253
City of La Quinta
Dec 16, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
Ri Furnace
0 Indoor Coil
® AFUE 78%
0 SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
0 Setback
If not already present,
® Condensing Unit
❑ EER
❑ Resistance
❑ R g( CZ 14-15)
0- sf
must be installed)
❑ 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 signed.Beginning
October 1, 2010, a registered copy of the CF-111 and CF-611 shall also be on site for final inspection.
8 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF-4R forms: MECH-21 and (for split systems) MECH-25
g,,
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,leagage 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. Existin ducts stems are constructedinsulated-or sealed with asbestos
❑ 2 Neuv.HVAC
Requiretl Form's:
System:.-
• Cut in orChangeout
with new ducts: (all
d`uctirig fall
CF 6R forms MECH 04 MECH 2O-HERS and (for. Split sstems MECH 22-HERS-and
n ' 41 )
MECH 25HERS ., a f.
new an .
,. ,�
GF 4R formsMECHr20 and (forsplit 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 leakage6 percent
❑ 3. New Ducts with7or without "
Required Forms:
Replacement
• Includes replacing or installing all
new ducting and/or outdoor'\ �."
condensing unit and/or indoor coil
CF-611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
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 >_ 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
CF-611 forms: MECH-04, MECH-2I-HERS
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: Dec 16, 2010
Address: 77-825 WILDCAT DRIVE License: 906115
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202
zo
Reg: 210-AO03214BA-00000000-0000 Registration Date/Time: 2010/12/16 17:34:59 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Bin #City
of La Quinta .
BaUding at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Qlmlta, CA 92253 - (760) 777-7012
Building Permit Application and Tracidng Sheet,
,
Pernlit
l
Project Address:' Ownees Name:
A- P. Number: Address: ' Z ?j �fi/f /,✓o
Legal Description: City, ST, Zip to�2G! i ;lm Cil
Contractor. CC G �,t�►O ,!i Telephone:
Address:.- �� ,/ '(/ Project Description: (_
City, ST, Zip:
TelephobQ
State Lic. # : City Lie. #:
ArcI ., EW, Designer•.
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
State Lic. #: Project type (circle one): New Add'n Repair' Demo
Name of Contact Person: L Sq. Ft:
# Stories:
# Units:
Telephone # of Contact Person b9 Q• �'� Y. Estimated Value of Project-
rojectAPPLICANT:
APPLICANT:DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACIMG .
PEST FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans bicked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan'
2' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.L
H.O.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