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13-1354 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 13-00001354 81338 BARREL CACTUS RD 764-270-999-20 -300233- MECHANICAL MEDIUM HIGH DENSITY RES 10180 Architect or Engineer: 1\W ------------------ 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 my License is in full force and effect. License Class: C20 C36 LicenseNo.: 906115 Date:' /itiJ� Contractor . NER-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).: (_) 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 ISec. 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, 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/23/13 Owner: COLLEEN REYNOLDS 81-338 CARREL CACT LA QUINTA, CA 922 D A ( Contractor: OCT 2 3 2013 HYDES CITY OF 6A QUINTA 42949 MAD IO STREE FINANCE DEPT.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. Fl 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 CEWC468841 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 workers' compensation provisions of Section 3700 of the Labor Code, I s 1 forth o ly with those provisions. Date_Z-3­1—Applicant: t . WARNING: FAILURE TO SECURE WORKERS' C MPENSATION 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 h y authorize r presentatives of this county to enter upon the above-mentioned property for inspe gion p /� f 3 Date �/✓ Sig?ature (Applicant or Agent): C/ Application Number . . . . . 13-00001354 Permit . . . MECHANICAL 2013 Additional desc . . Permit Fee . . . . 83.42 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 4/21/14 Qty Unit Charge Per Extension 1.00 35.7500 EA MECH FURNACE 35.75 1.00 11.9200 EA MECH APPL REP/ALT 11.92 1.00 35.7500 EA . MECH CONDENSER/COMP 35.75 --------------------------------------------------------------------------'-- Special Notes and Comments HVAC CHANGE OUT - 13SEER/78AFUE SYSTEM (2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 52.43 Fee summary Charged Paid Credited Due Permit Fee Total 83.42 .00 .00 83.42 Plan Check Total .00 .00 .00 .00 Other Fee Total 143.00 .00 .00 143.00 Grand Total 226.42 .00 .00 226.42 LQPERMIT Bin #City of LaQ uinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracidng Sheet, Permit # �. Project Address: "-' . 'J-i Owner's Name: A P. Number: Address: F/— -j 3 9 6 • C-41A 5 Legal Description: City, ST, Zip: G j ZZ Contractor. ! Telephone: Address: • `�[ Z `� K /" lCt Project Description: /`� �i I'►c (�o. City, ST, Zip: O C QCiZ Z d Telephone 6a --z Zei- State Lie. # : q (% t%. City Lic. #: Z_Z Arch., Engr., Designer Y Address: City, ST, Zip: Telephone: Contraction Type: Occupancy.. State Lir. #: Name of Contact Person: Project type (circle one): New AMn Alter Rapw' Demo Sq. Ft: # Stories: # Units: -.Telephone # of Contact Person: Estimated Value of Project 01 % (j APPUCANT: DO NOT WRITE BELOW THIS UNE # Submittal Acied . Rec'd TRACIMG . PER?An FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for eorreddons Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Energy Calces. Plans picked up Const metion Flood plain plan Plans resubmitted Mechanical Grading pan' 2" Review, ready for correctiionsrissue Electrical Sabconactor List Called Contact Person Plumbing Grant Deed Plans picked up ML H.OA Approval Plans resubmitted Grading IN HOUSE:- Review, ready for correctionsfissae Devdoper-Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wim Appr Date of permit issue School Fees Total Permit Fees Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 81-338 Barrel Cactus La Quinta, CA 92253 City of La Quinta Oct 21, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit ® Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ® Indoor Coil ® SEER 13.0 E3HSPF R gCZ 14-15)Resistance 1600 sf If not already present, must be ® Condensing Unit E3EER [3E3 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 -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. ® 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 -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage o<-.15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH For PaGI(age d Unit -se r1... -t le akiag4i`'i Exempted from duct leakage testing`:if: ❑ l. -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 ciir structed, insulated or sealed with asbestos [].4. The system will not be Ducted (ie.Ductless ;Mini Split•System) ;(Also Exempt from, Refrigerant Charge) .�,,.... ❑ 2. New HVAC System Required Forms: . Cut in`or-Changeout with; e � .� _ .�. CF 6R,forms 'MECH-04 MECH 20 HERS and (for split systems) MECH 22 HERS and ' new ducts:..all new ( K Y; MECH 25=HERS; ducting and all new.ifr ? r e z a } CF 4R forms.'MECH20, andm(for split systems) MECH 22 and MECH 25;, equipment), r;� Vt. 41 For Split Systems'D ict leakage <. 6 percent; RC, CCA > 350 CFM/ton,' FWD; TMAH; SIMS; and eitherHSPP orPSPP For Packa ed Units: Duct leaka e < 6, e�.,. 9 9 . P rcent ❑ 3. New,Ducts with/or without s'; 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 Califomia 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 Califomia 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: Oct 21, 2013 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 213-A0079597A-000000000-0000 Registration Date/Time: 2013/10/21 14:13:18 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010