10-0699 (MECH)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 Q*&
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:C 10=00000699 -1.
Property Address. 7_4-_5210- BIRCHCREST CIR
APN: 604-412-015-24 -23995 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7100
Applicant: 0 Architect or Engineer:
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LICENSED CONTRACTOR'S DECLARATION \
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin2J with
Section 7000) of Division 3 of the Business and Professi als Code, and my License is in full force and '&fact.
License Class: C20 C36 License o.: 90 15
ntractor.
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).:
(_) 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, 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 contractors) 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
Owner:
CRAIG CHRISTENSEN
45-210 BIRCHCREST CIRCLE
LA QUINTA, CA 92253
Contractor:
HYDES
77825 WILDCAT STREET
PALM DESERT, CA 92211
(760)360-2202
Lic. No.: 906115
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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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 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 1 should becomes bject to the workers' com Ksation provisions of Section
3700 of the L bor Code, I hall f with cc i tho rovisions.
70
Defe: 7 �9//applicant:
/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 ($100,0001. 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 com with all
city and county ordinances and state laws relating to building construction, an ereby au orize rep entatives
of this coy my to enter up o •the above-mentioned property for' peci p ses.
Date:J gnature (Applicant or Agent):
Application Number . . 10-00000699
Permit' MECHANICAL
Additional desc
'
Permit Fee . . . . 33.00
Plan Check Fee
8.25
Issue Date
Valuation . . .
. 0
Expiration Date .1/25/11
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
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Special Notes and Comments
INSTALL NEW 4 TON 14 SEER SPLIT SYSTEM.
2007 CODES.
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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 HYACAlteradons CF -I R -ALT -HVAC
Climate Zones 10 to IS
Site Address:
Enforwnenl Agency:
Date:
Permit #:n Q
Conditioned Floor
ent T ' List Minimum Efiiciencv=
Duct insulation requirement
Area
Thermostat
d Unit p Over 40 ft of ducts added or Setback
AFUEC�ib COP replaced in unconditioned space Served by system {noralreadv
oil SEER ®HSPF R 6 {CZ 10-13) � oa sf present naw be
sing Unit EER ® Resistance 1 � R8 (CZ 14 5)
1j:1n:d0or
I.Equ"ment'rYM Choose the egzupment being installed: ifmore d— one system, use another CF -IR ALT HVACfor each system.
? Mbrcm Eq�ipnre►rt Ef idmdes_ i3 SEER, 78•� AFUE 7.7HSPFfor typical residential systems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picIo; 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 homeo-+aer. At final, the inspector verifies that the work listed on this form was in fad the work completed by the
installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand fined CF-4Rs allowed) are filled out and
si ed_ BevOnning October 1, 2010, a registered copy of the CFAR and CF -611 shall also be on site for final inspection.
1. HVAC 22MeouR Required Forms:
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 2.5 -HERS
• All HVAC Equipment replaced CF -4R forms: MECH-21 and (for split stems) MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
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 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 fat in unconditioned space, or
3. E dstin duct systems are constructed, insulated or sealed with asbestos
®2 New HVAC System
Required Fortes:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH 22 -HERS, and MECH-25-HERS
CF -4R forms: Mlit MECH 20-, and for ( split systeras)MECH-22, and MECH 25
new eat
For Split Systems: Dud leakage < 6 percent; RC, CCA a 350 CFMhon; FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
®3. New Ducts with Replacement Required Forms:
+ Includes replacing or installing all new ducting CF -6R forms: v1ECH-04, MECH-20-HERS-and (for split systems) MECH 2.5 HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace_ Not aII equipment changed.
For Split Systems: Duct leakage <6 percent, RC, CCA? 300 CFMhon, TMAH
For Packaged Units: Duct leakage < 6 percent
M. New Ducting over 40 feet Required Forms:
+ Includes adding or replacmg more than 40 CF -6R forms: MECH-04, MECH-21-HERS CF -4R forms: MECH-21
linear feet of duct in unconditional space.
For split system or packaged units: Duct leakage < 15 percent
[j EXCEPTION: Emstmg dud systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documemon 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 featurts and perfom=ce specifications for the design identified on this Certificate of Compliance conform to the requisements of Trtie 24,
Parts I and 6 of the California Code of Regulations.
• The design feanuts identified on this Certificate of Compliance are consistent with the itfon-ation documented on other applicable compliance forms, worksheets,
calculations. plans and sp=rficanons submitted to the enforcement agency for approval whir the permit amlivirion.
Name: Michael Hyde
Signahue:
Compare': Hyde's Air Conditioning
Date:
7 _-
Address: 77-899 Wildcat Drive
L mnse: 906115
Cir./Statezip: palm Desert, CA 92211
Phone: (760) 360-2202
2008 Residential Compliance Forms ;March 2010
i
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# G�
V`
C d '
Project Address:
Owner's Name: G Y4 f A/^/ 5 IrAg e -I?' ?
A. P. Number:
Address:
Legal Description:
City, ST, Zip: 6y"(1
Contractor: CLvY / 401 Gd�h Mf
Telephone:
Address: 7:;-7Z�
Project Descriptio n:
City, ST, Zip: �rt g3C / G Z f!
lhl 5 Cay— rA
Telephone: G 3CG Z�Z
PatyLic.#:
State Lic. # :
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: -7 f�U
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
god Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3'd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
rLI.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
.-t-
t -
Total Permit Fees