BMCH2015-044578-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O15-0445
Tay .4 4 Q�&&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address:
48543 VIA ENCANTO
APN:
646091009
Application Description:
BRAY / CHANGE OUT (1)16SEER/78AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$15,000.00
Applicant:
7,
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
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 Professions Code,
and my License is in full force and effect.
License Class: C20 C36 license No.: 906115
Date:' 0 Contractor. — —
OWNER-BUILDSK DEC RATION
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, 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.).
( ) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.. (Sec. 7044, Business and Professions Code: TIhe.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. BAP.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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/2015
Owner:
RICHARD BRAY
3606 154TH ST
URBANDLE, IA 92253
Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 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
oftJy� I for which this permit is issued.
,V 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: _ Policy Number: _
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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Lt 0 0 Applicant: -
WARNING: FAILURE TO SECURE WORKERS' MP SATION 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 Building Official 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 city to enter upon the
above-mentioned y for inspection purposes.
Date: ►� ` %� Signature (Applicant or Agent):
7,
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/2015
Owner:
RICHARD BRAY
3606 154TH ST
URBANDLE, IA 92253
Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 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
oftJy� I for which this permit is issued.
,V 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: _ Policy Number: _
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 subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Lt 0 0 Applicant: -
WARNING: FAILURE TO SECURE WORKERS' MP SATION 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 Building Official 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 city to enter upon the
above-mentioned y for inspection purposes.
Date: ►� ` %� Signature (Applicant or Agent):
I
FINANCIAL INFORIVIATI 0
ACC
.,.,DESCRIPTION,'
�.,w,.
BSAS SB1473 FEE 101-0000;.20306 0 $1.00 $0.00
gq,
ME Rip- VINR�0;�Ixarff ,Qwl;avp m
al "r RECEIPT141"Rig,
Na 74�
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
�DES CRIPTIOW!-L:
30 NT g EQTYRum
'.1 -.1%
�R' "TA
MYAMOUN M
"N
M
PAID
R .2
.11.1
MEN ;.�!
M -N
HVAC CHANGEOUT - SPLIT -SYSTEM
0
$72.52
$0.00.
PAID
OD
In -
R E C E I PTi JK,
'CHECW'*,t��,
UTU"
DESCRIPTION ip .
DES
u
kPAID*'�!.-*X 4vu
IPAIWDATE��
V_ W OR"A
11
-M
,
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42.600
0
$36.26
$01.00
WPAI D:BY
O%WM
dXff'_
W
LTDrBYDW
m
Total Paid for CHANGEOUT:
$108.178 $0.00
i.',,iDESCRIPTION'--"'=
ACCOAr CINTJ�! gg
m AMOUNT
2
"PAID 'DATV,
�v
Oljmf���
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
MO.
"M
A——
"10'RECEIR
777775
PT
fF 'CHEC
-7 R"N' $1'4P�X
jL's
Total Paid for PERM IT.ISSUANCE: $91.85 $0.00
•
Permit Details PERMIT NUMBER
City of La Quinta BMCH2O150445
Description: BRAY / CHANGE OUT (1)16SEER/78AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 11/30/2015 SKH
Approved: 11/30/2015 SKH
Parcel No: 646091009 Site Address: 48543 VIA ENCANTO LA QUINTA,CA 92253
Subdivision: TR 20052-5 Block: Lot: 9
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: HVAC CHANGE OUT-16SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI' "
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
CERTIFIED COMFORT SYSTEMS INC
DBA HYDES
42-949 MAD 10 STREET
INDIO
CA
92201
CONTRACTOR
CERTIFIED COMFORT SYSTEMS INC
DBA HYDES
42-949 MADIO STREET
INDIO
CA
92201
OWNER
RICHARD BRAY
3606 154TH ST
URBANDLE
IA
92253
FINANCIAL INFORMATION
Printed: Monday, November 30, 2015 2:38:53 PM 1 of 2 Cr
EAJF
sysums
DESCRIPTION
ACCOUNT
CITY
AMOUNT.
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD,
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 00
INSPECTIONS
Printed: Monday, November 30, 2015 2:38:53 PM 2 of 2 C
SYSTEiNS
Bln.#
CI�}/ Of Quinta
Building SL Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
-b WA
Project Address: '�3 1
Owner's Name:. `G
A. P. Number.
Address: J
Legal Description:
City, ST, Zip: Uh4r�[ 9:2-2531
Contractor: C Q
Telephone: k� z.............:U : <
Address:
Project Description:
City, ST, Zip:
Ci
Telephone: �� = �jb(%�Z I � :`V'.11 ",i
State Lie. 4: C 5 City Lie'. #•:
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
Y ' v: _
�. � A ��`
;
Construction Type: Occupancy:
State Lie.. #: �
Project tye (circle one): New Add'n Alter RepaiJDemo
Name of Contact Person:
Sq. Ft.: #Stories:
F# -units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
!t
Submittal
ReVd
Reed
TRACMG PERMIT FEES
Pian Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Pian Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Rtvitw, ready for correcHons%ssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
A.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^` Review; ready for correetionsMsue
Developer Impact Fee
Planulag Approval
Called Contact Person
M.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name:
48-543 Via Encanto I Date Prepared:
2015-11-11
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CF1R-ALT-02 document for each dwelling unit.
01
Project Name
48-543 Via Encanto
02
Date Prepared
2015-11-11
03
Project Location
48-543 Via Encanto
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
48-543 Via Encanto
07
Zip Code
92253
08
Dwelling Unit Conditioned
1950
Floor Area (ft2)
SC System
SC System
CFA served
system a'
refrigerant
Number of space conditioning
Installing
09
Climate Zone
15
30
(SC) systems in this dwelling
1 .
ducted
containing
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information
Ol
02
03
04..
fr05a' 1.4
' - 06 -^�%
r `'
07
08
09
10
.E
Is the SC`"
"Installing a,
SC System
SC System
CFA served
system a'
refrigerant
Installing new SC
Installing
Installing`
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Whole House
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A6390449A-000000000-0000
Registration Date/Time: 2015-11-11 09:35:02
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-11 09:35:04
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency.
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Central split
All new
Central split
All new
This field or
This field or
System 1
HP
heating
AFUE
0.78
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts arid Fans
-Duct insulation requirement for new plenums: R6.
MR -MCH -20-H & CF311-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: <_ 15%, ors 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow z 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
-
-Existing duct systems constructed, insulated or sealed with asb'estos;are exempt from MCH --20 Duct Leakage Testing requirements.
p,
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections.150.2(b)1Diia and 150.2(b)lE, F) .
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project. J
Registration Number: 215-A6390449A-000000000-0000 Registration Date/Time: 2015-11-1109:35:02 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-11 '09:35:04
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2015-11-11 09:35:02
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified ori this Certificate of Compliance are consistent with'the informetion_provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for. "approval with this building permit application. f `.t
5. 1 will ensure that a registered copy of this Certificate of.ACompliance SKall, be made available with;the building permit(s) issued for the building, andfimade avail'able'to the'enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance,is required to be included with the documentation the builder provides to the building owner at occupancy. .
Responsible Designer Name:
Responsible Designer Signature: A� ;
w4
Hyde, Mark
Company: "'
Date Signed: -
CERTIFIED COMFORT SYSTEMS INC
2015-11-11 09:35:02
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
Digitally signed by COURTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A6390449A-000000000-0000 Registration Date/Time: 2015-11-11 09:35:02 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-11 09:35:04
Schema Version: 0.555SDD