10-1303 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10n 00001303
Property Address:
48050 *PASO' TIEMPO LN
APN:
646-350-021- -
Application description:
MECHANICAL
Property ZDnina:
LOW DRNRTTY RRRTnRNTTAT,
Application valuation:
7605
Applicant:
Com
Til4t 4 ' 4a Q"
Architect or Engineer:
41�4_
-----------------
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 Cla s: C20 C36 License No.: 906115
Date: - G"`ntractor:.t
'`� -_
.OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
following reason ISec. 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).: C
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.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project 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 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 ISec. 3097, Civ. C.I.
Lender's Name: _
Lender's Address:
LQPE%-%IIT
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 11/30/10
Owner:
ALESI LOUIS T
48050 PASO TIEMPO
LA QUINTA, CA 92253.
(760)771 -0600. --
Contractor: NOVi
HYDES N 3 0 2010
77825 WILDCAT STREET
PALM DESERT, CA 92211 Cfr'OF
(760)360-2202 FfIvA EpUINTA
Lic. No.: 906115 Pr
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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 b�e, he workers' compensation laws of California,
and agree that, if I should become su ct orke ' compensation provisions of Section
37 0 f the Labor Code, I s or ith those provisions.
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 ($100,000). 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construc ' n, and hereby author' representatives
of this county to enter upon the above-mentioned property f r insp n pur
Signatures e-(Applicant,or-Agent):
Application Number . . . . . 10700001303
Permit . . MECHANICAL
Additional desc .
Permit Fee . : . . 33.00
Plan Check Fee
8.25
Issue Date
Valuation .
. 0
Expiration Date 5/29/11
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
Special Notes and Comments
A/C CHANGE /•FURNACE CHANGE OUT 16
SEER
2007 CODES..
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
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC
Alterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
48-050 Paso Tiempo La Quinta, CA 92253
City of La Quinta
Nov 30, 2010
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
[3 Package Unit
p Furnace
p Indoor Coil
2 AFUEu
p SEER
ElCOP
E]HSPF
❑ R 6 (CZ 10-13)
Served by system
f Setback
already present,
p Condensing Unit
❑ EER
❑Resistance
❑ R 8 (CZ 14-15)
2000 sf
must
must be 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 -611 shall also be on site for final inspection.
2 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
• 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 5 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leagage 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. Existi�ngYductysystems are�construc4dVinsujated�or, sealed with -asbestos t► '
�_ ..
❑ 2. New"HVAC -f
Required'Forms:
S,w' A- ff
System
' j .:.
. Cut ift ,Changeout
with new:ducts (11
new ducting and
�ti.-^ rra r =eb�a .. tp-r �Y '
CF 6R forms 1,MECH-04, MECH;20-HERS, and (forisplit systems) .MECH-22 :HERS, ander
MECHxZStiHERS ,tf .'
4
CF 4R forms MECH�20 ;and (for,split systems) MECH 22 a ECW25
new equipment),,:
ifr� u�dY a7. el7l¢t. .y(�' 4
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 and indoor coil
CF -6R forms: MECH-04,- MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or furnace. No orr 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 linear feet of duct in
CF -6R forms: MECH-04, MECH-2I-HERS
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: Nov 30, 2010
Address: 77-825 WILDCAT DRIVE License: 906115
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202
�y
Reg: 210-A0027982A-00000000-0000 Registration Date/Time: 2010/11/30 15:02:52 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forma July 2010
Bin #
City of LaQ Uinta
BWMM &: Safety Dhidon
P.O. Box 1304, 78-495 Calle Tampico
La Quinn, CA 92253 - (760) 777-7012
Building Permit Application and Tracidng Sheet
Permit #
�� J 130
Pmjed Address:' "' l �% G v SO -i t v+l P o
Owner's Name: Ou t'5 751-
A. P. Number:
�
Addrass — G �O �R 5v l (e h9 pv
Legal Dcsctipti=
City. ST, Zip: Zzs 3
Contractor. li it J fl •P Irk
Addrtss: ��S lv
Telephow.--760— % % - 3 t/,Og.
Project -1 G �li eta
City, ST, z;ip: o► -i /(A
.Tekp
State Lia #: q04 City Lic. #:
Arch., Eagr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lia #:
Name of Contact Pelson:
Coon Type. O
Project type (cQ+cle one} New Add'n Alta giepmw Dano
4 Ft.:
#Stories
# IFnits:
Telephone # of Contact Person:
Est mated Value of hoject U r'
APPLICANT:
DO NOT wnrTE smow nits Lue
#
Submittal
R-Vd
Red
TRACE 3NG ,
PERbffr FEES
Plan sets
Plan Check submitted
Item
Amount
Structural Caks.
Reviewed, ready for corrections
Plea Chale Deposit
Truis Caks.
Called Contact Pawn
Plan Chale Balance
Energy Cales.
Puns picked up
Coaa,racteon
Flood plum plan
R= resubmitted
Mahauiml .
l
T' Review, ready for corratioesftsue
>ricol
Subcontactor Inst
Called Contact Person
P
Graet Deed
Pbms pig up
S.bLL
ELOA Approval
Plans resubmitted
Gmftg
IN HOUSE:
r"' Review, ready for conimAonslnsae
Developer Impact Fa
PhAniftApproval
Called Contact Person
Ad.PY.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fes