11-1343 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00001343_-
Property Address:
79344 LIGA 7:7
APN:
772 -130 -052 -
Application description:
MECHANICAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
19000
Tu�1-44vQ"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
PIP,
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of hapter 9 (commencing with
Section 7000) of Division 3 of the Business and Profe i ode, and icense is in full force and effect.
License Class: C20 C36 i nse No. 06115
ate: ✓"Con or:
r
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 ($500).:
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The .
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law:).
(_ 1 I am exempt under Sec. , B.&P.C. for this.reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: -
Lender's Address:
LQPERMIT
Owner:
JOHN HELLAW
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/20/11
79344 LIGA
LA QUINTA, CA 92253
DEC 0 2011
Contractor:
HYDE$ FF Gi'PYPiF ? /1-
42949 MADIO STREET
INDIO, CA 92201---
(760)360-2202
Lic. No.: 906115
------------------
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 CEWC243358
_ 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' compensation laws of California,
and agree that, if I should become subje a worke compensation provisions of Section
'�3/70�0 of the •abor Code, I shall Orth h c mpl those provisions.
0oate: Z� ppIicant:
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 ($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 madeto 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 unty ordinances and state laws relating to building const coon er y authoriz epresentatives
of thi y to enter upon the above mentioned property for ins purp�
ate: CSign re (Applicant or Agent):
Application Number 11-00001343
Permit . .
. MECHANICAL
Additional desc .
Permit Fee
66.00 Plan Check Fee
16.50
Issue Date . . .
. Valuation . . . .
0
Expiration Date
6/17/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 9.0000 EA MECH FURNACE <=100K-
18.00
2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU
33.00
-----------------------------------------------------------------------
Special Notes and
Comments
HVAC CHANGE -OUT: 2
SYSTEMS, CONDENSERS, .
FURNACES & COILS.
SEE ATTACHED CF -1R
FORMS. 2010 CODES.
----------------------------------------------------------------------------
Other Fees .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee,summary
Charged Paid Credited
----------
Due
--------- - -------
Permit Fee Total
--------- ---------- ----------
66.'00 .00 .00.
66.00
Plan Check Total
16.50 .00 .00
16.50
Other Fee Total
1.00 .00 .00
1.00
Grand Total
83.50 .00 .00
83.50.
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 10 - 1S
Site Address:
Enforcement Agency:
Date:
7
Permit #:
79-344 Liga(2) La Quinta, CA 92253
City of La Quinta
Dec 19, 2011
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
Package Unit
V Furnace
V Indoor Coil
V AFUE 78%
V SEER 13.0
COP
HSPF
R 6 (CZ 10-13)
Served by system
V Setback
If not already present, must be
V Condensing Unit
EER
Resistance
R 8 (CZ 14-15)
:L600 sf
installed)
Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-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-411
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.
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
. Condenser Coil and /or
. Indoor Coil and /or
CF-611 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
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 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
4. The system will not be Ducted (ieDuctless•Mini-Split System) - (Also _ Exempt from; Refrigerant Charge)
2. New HVAC System
Required Forms: y ( v U
. Cut infor Changeout with',
new ducts: (all new
s ' r + / r
CF-6R forms: MECH-04, MECH-20=HERS, and (for split systems) MECH-22-HERS, and
ducting and all new
MECH-25sHERS 4 J N
CF-4R forms: MECH 20, 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-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 >_ 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: Dec 19, 2011
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202
Reg: 211-A0065939A-00000000-0000 Registration Date/Time: 2011/12/19 20:38:01 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
79-344 Liga La Quinta, CA 92253
City of La Quinta
Dec 19, 2011
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
Package Unit
V Furnace
V AFUE 78%
COP
R 6 (CZ 10-13)
Served by system
Y1 Setback
V Indoor Coil
V SEER 13.0
HSPF
R 8 (CZ 14-15)
1600 sf
If not already present, must be
V Condensing Unit
EER
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.
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 -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-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
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 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
4. The_system,will not be Ducted (ie. Ductless, Mini -Split System,) -(Also Exempt from, Refrigerant Charge)
f .
2. New HVAC System
Required For_ ms: V f
. Cut inlor Changeout with"
new ducts: (all new
" ' /
CF -6R forms: MECH-04, MECH-20� HERS; and (for split systems) MECH-22-HERS, and
ducting and all new
MECH-25=HERS f
+
CF -4R forms: MECH 20, 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 -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
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 i 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 19, 2011
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202
Reg: 211-A0065934A-00000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2011/12/19 20:35:13 HERS Provider: CalCERTS, Inc.
July 2010
Bin #
City of La Quinta
Permit #
Building & Safety Division
M�
P.O. Box 1504, 78-495 Calle Tampico
\V ✓
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application
Project Address: '� �
and Tracking Sheet
(_I
A. P. Number:
Owner's Name:
Legal Description:
Address: ( — 1
Contractor:
City, ST, Zip:
�Address: Telephone:
l `I 1
City, ST, Zip: C]
Project Description �) 6 1
�^�a
6
Telephone:'
State Lic. # : O6'
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy: .
Name of Contact Person:
Project type (circle one): New Add' n Alter Repair'
Demo
Telephone # of Contact Person:
Sq. Ft.: # tories: # Units:
•
Estimated Value of Project:1 �
#
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal Req'd
Recd
Plan Sets
TRACKING
PERMIT FEES
Plan Check submitted
Structural Calcs.
Item Amount
Reviewed, ready for corrections
Truss Calcs.
Plan Check Deposit
Called Contact Persou
Energy Calcs.
Plan Check Balance
Plans picked up
Flood plain plan
Construction
Plans resubmitted
Grading,plan
Mechanical
Subcontactor List
2nd Review, ready for correctionsrssue Electrical
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
S.M.I.
Plans resubmitted
IN HOUSE:-
Grading
Review,
Planning Approval
ready for correctionsfissue
Developer Impact Fee
•
Called Contact Person
Pub. Wks. Appr
A.I.P.P.
Date of permit issue
School Fees
Total Permit Fees