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13-1565 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tit�v 4�� /-�� VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) .777-7153 BUILDING PERMIT Application Nurrtber 01'565` Property Address: 48070 PASO TIEMPO LN APN: 646-350-024- - - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL ^•pplic3ticn v31u3tion: 10 11. i s Applicant: Architect or Engineer: Date: • 12/04/13 Owner: WELLS BYRON L 48070 PASO TEMPO'LANE LA QUINTA, CA -92253 ( Contractor: FEttl HYDES 42949 MADIO STREET0 6X813 INDIO, CA 92201(760)360-2202LiC..No.: 906115FNCE DEPT:___ _ ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License lass: C20 C36 License No.: 906115 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is /T'��/G7'.'�� /y issued. Date:'-'."j�fontracto� 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby -affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC468841 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ .I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject.to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the w kers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or C that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by G 1 3700 of the Labor Code, I shall fogith com ith se provisions. —��- _ P�'�%i{ip any applicant for a permit subjects the applicant to a civil penalty. of not more than five hundred dollars ($500).: Dat_]�� cads (_ 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 WARNING: FAILURE TO SECURE WOR ERS' COMPENSATION COVERAGE'IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($700,000): IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 I, 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 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 ori 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, d hereby authod epresentatives of this county to tto enter upon the above-mentioned property for inspectio rposes:�' Datew�� —'Signature_IAppl�icani-`orAgent): Application Number 13-00001565 Permit . . . MECHANICAL 2013 Additional desc ` Permit Fee . . . . 83.42 Plan Check Fee .00 Issue Date . . . Valuation 0 Expiration Date 6/02/14 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 FA MECH CONDENSER/COMP 35.75 ---------------------------------------------------------------------------- Special Notes and Comments HVAC FURNACE & COIL CHANGE OUT 78% AFUE 13 SEER 5 TON 2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CBC. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 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 144.00 .00 .00 144.00 Grand Total 227.42 .00 .00 227.42 LQPERMIT - - Bin # LPerminitA Ject Address: 1�� �r-7)"7C 7 A. P. Number Legal Description: Contractor. Address:- City, ddress: City, ST, Zip: Telephone: State Lie. #.: q Arch., Engr., Designer_ Address: City, ST, Zip:. Telephone:.. State Lia #: Name of Contact Person: Telephone* of Contact person:. # Submittal Plan Sets Structural Calcs. Truss Cates. Energy Calcs. Flood plain plan Grading, plan" Sabcontactor List Grant Deed H.OA Approval INHOUSE:- Planning Approval Pub. Wks. pppr School Fees W01 �0 City of La Quints - Building a Safety Division P.O. Box 1504, 78-49S Calle Tampico La Quinta, CA 92253 - (760) 777-7012 " Building Permit Application and Trac kirg Sheet R5;q' ner's Name: adress: c /17��C2y, ST, zip:ephone: Anect Description .� f G /• C Q 'cl ZZd/ i Lic. #: 11 f -Z: FM -2-7-7 Consftuction Type: O�� Project type (circle one): New Add', Alter Repair Demo Sq. Ft: #Stories #Units: Estimated Value o1 Project c� APPLICANT: DO NOT WRITE BELOW THIS LINE I%.'d TRACE3NG . PERMIT FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2Re'vicw, ready for correctionsrusue Electrical ' Called Contact person Plumbing Plans picked up S hLL Plans resubmitted Grading 3'd Review, ready for eorrectionsrLwae DeveloperImpaa Fee Called Contad Person -------------------- A.LP.P. Date of permit issue Total Permit Sces 14 e-, f 1 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 48-070 Paso Tempo Lane La Quinta, CA 92253 City of La Quinta Dec 2, 213 Duct insulation • Conditioned Floor (Thermostat Equipment Typel List Minimum Efficiency2 requirement Area ❑ Package Unit ® Furnace ® Indoor Coil ® AFUE 78% ® SEER 13,0 ❑ COP ElHSPF ❑ R 6 (CZ 10-13) Served by system ® Setback If not already present, must be ® Condensing Unit El EER [3 Resistance E3 R 8 (CZ 14-15) 2000 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R -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 -6111 shall also be on site for final inspection. ® 1. HVAC Changeout Required:Forms: y . 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 FQF p., ..L•...e..i �1..:.�. rl..r1 I��L�i.e i' 1 C.r.n ont 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 than40 linear feet in unconditioned space, or [33. Existing dud systems are constructed, insulated or sealed with asbestos 0''4. The system will not be DuctNed (ie Ductless Mim Split System) (Also Exempt,from Refrigerant Charge) ❑ 2. New HVAC §j stem Required Forms _ ��z,,<; ' .Cut in or,Changeout withi h:+ ,, ���S " CF 6R forms }MECH 04, MECH 20 HERS;.and (for split systems) MECH 22HEFS, and new ducts (all new MECH"25HERS"� a xF Y �. ducting and all new : s' CF 4R forms MECH 20 and (for split systems) MECH 22, and MECppH 25 sf� s �frf- equipment):. x,:.-i.•T.'•� e Fe'`'r �'.:•4fi'%'�" _saff .. P'•. i -i`#: '.'a� •,.'.ik aY.'%!K.- •�". •..,. For Spht Sysfems Dud leakage < 6;"percent; tRC,CCAP> 350 CFM/ton, FWD',�TMAH STMSand eitfier HS?P'or PSPP. For Packaged Units: Duct leak- ek `6 er`cent 9 g p. ❑ 3. _New Ducts with/or without '< Required Forms: - Replacement'' . Includes replacing or installing ailFhew 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`s'. 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 0.4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 • CF -6R forms: MECH-04, MECH-21-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 California Business and Professions Code to accept responsibility for the design idertified 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 `COM FORT SYSTEMS INC Date: Dec 2, 2013 Address: 77-825 WILDCAT DRIVE License: 906115 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202 Reg: 213-A0089892A-000000000-0000 Registration Date/Time: 2013/12/02 17:26:25 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010