14-0562 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
14-00000562
44850 CALLE PLACIDO
604-392-002-43 -25953
MECHANICAL
LOW DENSITY RESIDENTIAL
13460
c&ht 4 4v Q"
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 License No.: 906115
Date: Contractor: e
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 rp..gnirP_C 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, 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) 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:
BRIAN ROLF
44850 CALLE PLACIDO
LA QUINTA, CA 92253
(425)829-4827
Contractor:
HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Lic. No.: 906115
VOICE (760).777-70 - 12
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/.01/14
?r MAY 116 2094
CITY of LA QUINTA
FINANCE DEPT.
------------------
WORKER'S COMPENSATION DECLARATION
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 CEWC468841
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 cubject to the workers'-compen3otion low3 of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
,377 ¢0y0 of the Labor Code, I shall forthwith comply with those provisions.
Date:45 '!—tl applicant -. P,"
WARNING: FAILURE TO SECURERS' 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 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 employeesfor 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 counntty do eomer on the above-mentioned propert r in pectin pur oses.
Dat�i' 1 /• v, 1 Si nature (Applicant or Agent): -
Application Number . . . .. . 14-00000562
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee 143.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/28/14
Qty Unit Charge Per
Extension
2.00 35.7500 EA MECH FURNACE
71.50
2.00 35.7500 EA MECH CONDENSER/COMP
71.50
----------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - (1) 13SEER/78AFUE
SYSTEM AND (1)13SEER CONDENSOR/FURNACE
[2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES . -
----------------------------------------------------------------------------
Other Fees . . . . . . . . . PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
95.32
Fee summary Charged Paid Credited
Due
---------------------------------------------------------
Permit Fee Total 143.00 .00 .00
143.00
Plan Check Total 00 .00 .00
.00
Other Fee Total 185.89 .00 .00
185.89
Grand Total 328.89 .00 .00
328.89
0
LQPERMIT
r
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
44-850 Calle Placido La Quinta, CA 92253
City of La Quinta
Apr 30, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
,
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
[3 EER
E3 Resistance
[3 R 8 (CZ 14-15)
2000 sf
installed)
[3 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 fad 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-IR
and CF-6111 shall also be on site for final inspection.
® 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
CF-6R forms: MECH-04, 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'
Exempted from dud leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less tlan40 linear feet in unconditioned space, or
❑ 1 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)
❑ 2"New HVAC System Required, Forms:
. Cut in or Changeout with-:r;
CF-6R"forms iMECH 04, MECH 20 HERS; a and (for plitsysterms) MECH X22 HERS, and
new duds:`(all
ducting and'all new MEC HERS ;'x ° �,,; i :' ''
CF 4R forms , MECH 20, and (for split systems),,MECH 22, and MECH-25 .
equipment): _ ;,-�+, ,� s 7�.. �:.
For Split Systems: Duct .+ leakage < 6 percent, RC, CCA > 350 CFM/ton,!FWD, TMAH,'STMS� and either H SPP or PSPP
4 -
"
For Packaged Units: Duct leakage"< 6 percentr h �y ,s; .•;. u; .. .d° �.: , .,
_,. ,.. .
t a
❑ 3. New, Ducts with/or. without Required, Forms
. :,...
Replacement ....
k •:f:
. Includes replacing; or installing aIL new
ddcting:and/or outdoor condensing.-:unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/orindoorrcoil and/or furnace : No or some CF-4R forms: MECH-20 and,(for split systems) MECH-25
equipment than ed.
For Split Systems: Dud leakage 6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Dud 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: Dud leakage < 15 percent
❑ EXCEPTION: Existing dud 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: Apr 30, 2014
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202
Reg: 214-A0029966A-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2014/04/30 14:52:37 . HERS Provider: CalCERTS, Inc.
July 2010
l;
a — t
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
44-850 Calle Placido(2) La Quinta, CA 92253
City of La Quinta
Apr 30, 2014 .
'
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efriciency2
requirement . -
Area
Thermostat
❑ Package Unit
t•'
+
'
® Furnace
❑ Indoor Coil
❑ AFUE
® SEER- 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
®Setback
If not already present, must be
®Condensin Unit
9
❑ EER
❑ Resistance
❑ R $ (CZ 14-15)
600 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 -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R
and CF -6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms: `
.All HVAC Equipment r
CF -6R forms: MECH-04, ^^_�� �+ �_^� EXEMPTED and (for split systems) _G1
'EXEMPTED
replaced
CF -4R forms: PA_Tl9GGH 21 EXEMPTED and (for split systems) ^^,. , & EXEMPTED
• Condenser Coil and /or
CF -6R forms: MECH-04, M=cw „ �_^� EXEMPTED_ and (for split systems) ^4_GH 29 V_^-
• Indoor Coil and /or i
EXEMPTED
• Furnace
CF -4R forms: � ,�3 EXEMPTED and (for split systems) ^^_c.� EXEMPTED `
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing?if:
0.1. 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
03. Existing duct systems are'..". onstructed, insulated or sealed with asbestos
® 4. The system will not be Dued;.(ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System Required Forms �bQt<
. Cut m orrChandeout with
new ducts ;all new
:( J
ducting
CF 6R�forms MECH 04-M=ru,n u�o= EXEMPTED; and (forsplit systems) ^�_�� �� �_^_
....................
n EXEMPTED
n fi.EXEMPTED and
CF ^^=-�^ ^^,,,�� MGrnrtp:
and all new
ment
p4Rwforms EXEMPTED; and {for split systems)x
e ui
q Pp )% ,�
EXEMPTED
For Spht Systems tDuct leakage
< 6 percent SRC #CCAS>g 350 CFKM/tonrz FWD, TMAH SIMS, antl"e�therFjHSP3P�or`PSP,,P'
rhiey
oni'� ti Sd;i Ps�„'"L
..ta.�Y
For,,Packaged..Unit"s: Duct
21 f'j� .�K .
Ieakage,T�< 6 percent
❑ 3. New Ducts yr
Required:.Forms:
with/,or;,wittoui`.-
Replacement
i i>
. Includes replacing or.
installing all new
ducting and/or outdoor
CF=6R:forris: MECH-04, ^^_� ^ =D= EXEMPTED, and (for split systems) •p; -c„ m-,4_� EXEMPTED
condensing unit and/or
CF -4R forms: M,,�,� EXEMPTED and (for split systems) M_,m,g EXEMPTED .
indoor coil and/or
furnace. No or some
i
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
Required Forms:
over 40 feet i
. Includes adding or
replacing more than
CF -6R forms: MECH-04, ,�„;�; EXEMPTED +
¢
40 linear feet of duct in
CF -4R forms: m�;-23 EXEMPTED
unconditioned space.,
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: Apr 30,2014
Address: 42-949 MADIO STREET License: 906115
• 2008 Residential Compliance Forms
f ,
July 2010
M
Bin #
Permit #
City of La Quinta
Building .ar Safety Division.
P.O. Box 1504, 78-49S Calle Tampico
La Quinta, G 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet"
Project Address: °� gS�O C G
Owner's Name:
A P. Number.
C /�� /' CtC% C1
/ /; �-•�
City, ST, Zip- Z— lX Q Z Z.!
Legal Description:
i /
Contractor : %' /' �+ / e�
�e1-kfl e j L,0, •• 4. 5 AIr
'
Telephone: cl
Address: % .Z C� N,,
`tcr 105
City, ST, Zip: o Z Z d
Project Descriptio : e iqq
Telephone:
State Lie. # q (`J(� j. City L•ic. #:
Construction Type: „pas cy:
Project type (circle one): New Add'u Alter Rcpair - Demo
Arch., Engr., Designer. '
Address:
City, ST, ip: lr
Telephon "760 - j-oj-3
State Lic. #:
Name of Contact Person
Sq. Ft: #Stories: #Units:
Estimated Value of Project
BELOW THIS UNE
Telephone # of Contact Person:
APPLICANT: DO NOT WRITE
#
Submittal
Req'd
Recd
TRAaU NG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs
Reviewed, ready for correctionsPlan
Check Deposit
Trans Calcs.
Called Contact Person
plan Balance
Energy mac-
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan'
2" Review, ready for corrections/ucsue
Electrical
Sabcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
ELO.A_ Approval
Plans resubmitted
Grading
INHOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A i p.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
4-