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11-1008 (MECH)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:��31=000.0.1.00 Property Address: 55880 PINEHURST APN: 775-241-016- - - Application description: MECHANICAL Property Zoning: LOW-DENSITY RESIDENTIAL Application valuation: 16000 Applicant: ,Architect or. Engineer:, - BUILDING & SAFETY DEPARTMENT BUILDING PEWIT' Owner: TIM ENGLISH 55880 PINEHURST LA QUINTA, CA 92253 Contractor: HYDES 42949 MADIO•STREET VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS .(760) 777-7153 O Date: 9/19/11 SEP 1 ° 2011 a1TY.PF LA OUINTA gni lr E :v -FT• o' • INDIO,, CA 92201 -- (76;0) 360 2202.= Lic. No . 906115 LQPERMIT 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 70001 of. Division 3 of the Business and Professionals Code, and. myWense is in full force and effect. I:have and -will maintain a certificate of consent.to self -insure for workers' compensation, as provided - license Class C20%.C36:.: "i License o • 06115 .. ;,for by Sect*6n 3700 -of the Labor Code, for•the performance of the work for.which this permit is ., .. ,y,•.. - ate ; - - ntraetor: - - - ssued - • . I have and will maintain workers. compensq!jgr •msurance,-as required by Section 3700 of the Labor Code rfor ;the, performance of tRe,work for which this permit is issued' My,workers' compensation - ' OWNER-BUILDER-0ECLARATION insuran'ceiarrier and policy number are .-. , hereby affirm under penalty of perjury. that, I am exempt from the Contractor's State License Law for the • Carrier •NORGUARD INS : Policy.Number ' -,CEWC243358 following reason'(Sec. 7031.5, Business and*Professions Code: Any city of county that requires a -permit to I certify -that, in the performance of -the work -for which this permit -is issued, I shall,n3i employ any . construct, alter; improve, demolish, or repair`any structure, prior to its issuance, also requires,ihe.applicant for the _ person'in any manner so as to become bject to the wor rs' compensation laws of California, . permit to`file a signed statement that he ors d is 104rised'pursuant to the provisions of the Contractor's State. -and agree that, if I•should become ct -tot wor s' compensation provisions -of Section' License Caw (Chapter 9 (commencing with Section 70001' of Divisiom3 of the Business and.Professions Code) or ,u- 3700i6f the Labor Code Iahal6fo it m ith those provisions. _ that he or she is exempt therefrom and the oasis for the alleged exemption. Any violation of,Section 7031.5, by / "1.� any applicant for a permit subjects the applicant to a civil'penal[y of not more than fivehundreddollars lS5001:. ate: -. % plicant: • I—) I, as owner of -.the property,, or my,employees with wages as their sole'compe_nsation,-will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The • , —WARNING: FAIL RE TO SECURE WORKERS'. COMPENSATION COVERAGE IS -UNLAWFUL, AND SHALL . Contractors' State.License Law does not.app10 to an ownerof 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: het elf through his,or her own employees _provided that the DOLLARS ($100,000L'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,INTERESTANDrATTORNEY'S FEESi ' one -:year of c6impletion,tfie.ov%6r:builder will have the burden of proving that,he or she did not build or- improve.for the purpose'of sale.). - - APPLICANT ACKNOWLEDGEMENT. - (_ 1 I, as owner'of theproperty,.am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the�Director of Building and Safety for a permit subject to the 7044, Business and Professions Code:. The Contractors' State License Law does not apply to an.owner of - ..conditions and restrictionsset -forth on this application. property who builds or improves thereon,,and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behaif.this application is made, each person at whose request and for pursuant to the Contractors' State.LicenseLaw.). whose benefit work is performed under or pursuant to any.permit issued as'a result ofthis application, 1 _ 1 I am exempt under Sec. B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City - of La Quinfa, its officers, agents and employees for any act or omission related to the work being performed.under or following issuance of this permit. Date: Owner: 2. Any permit issued, as a result of this application becomes null and void if work is not commenced within 180 daysfrom date of issuance of such permit, or cessation of work for 180 days will subject - ' CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the 1 certify that I have read this application and state that the above information is correct. I agree to nf�with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building constructio and by author' representatives oIis co my to ante) upo a above-mentioned property for inspecti purposes Lender's Name: _ Date: ignature (Applicant or Agent): Lender's Address: LQPERMIT Application Number . . . . . 11-00001008 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/17/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 00 16.5000 EA MECH B/C `>3-15HP/x100K-500KBTU 33.00 Special Notes and Comments INSTALL (2)• 16:rsSEER"SYSTEMS, 4 TON ..& 5 ' TON..2010 CODES. _._-- 7, - - '-------'-------------- - =' ----- - - - - -- -.=-=------ --------------- Other Fees BLDG, STDs. ADMIN1.(SB1473) .1.00 4 Fee summary Charged Paid. Credited' Due 'F --------- ---- - ---- ---- ----- ----- v Permit .RFee Total 66:`00 .00, 00 66:00 >' ;Plan Check' Total' '16. .-50' 00 .Ob 16.50 Other Fee -Total:. ,. 1.00 00 - 00 1-.00 Grand Total 83::50 :00 .00: 83.50 LQPERMIT - _ Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 1S Site Address: Enforcement Agency: Date: Permit #: 55-880 Pinehurst La Quinta, CA.92253 City of La Quinta Sep 19, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit WiFurnace [J Indoor Coil 0 AFUE 78% © SEER i3.0 ❑ COP❑ [1]HSPF R 6 (CZ 10-13) Served by system R Setback if not already present, must be 2 Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 1600 sf installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -ZR -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 fnal,._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 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-21-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 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 feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The systernXill not be Ducted (ie. Du¢tless�Mini Split System,)4(AIso Exempt from Ref rigerrant46harge) ❑ 2. New HVAC S stem Y Re uired Forms ' F '° f'.x x� * t,. q r �f� �. t c V., V . Cut intor`Changeout with' At VAJ , hew duct's: (all new ducting a'hd all new CF 6Rfor�ms MECH-04 MECH: 20=HERS, and4(for split systems) MECH 22 HERS, and. MECH-25-HERS . CF 4R forms; MECH 2.0 and�(for split syste. "j. CH -22; and=MECH 25"'-,;- " r equipmenE) �sd _ .,+.ef . hA w s &� t&fr c AW 5 k.ea:€.;. ....es+.: ir,�'4'. `K. k�' ... _ -fF' i8m k - .,..0 S _ -'. �._7., ' 1 ��. For SplitSystems: `Duct leakage" < 6 percent,,,RC;rCCA >350 CFM/ton F;F.WD ,T. AH, STMS, and either HSPP o�"PSPP. For Packaged Units: Duct leakage <•6 percent` ❑ 3. New•Ductswith/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some.equipment CF -4R forms: MECH-20 and (for split systems) MECH-25 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 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: Sep.19, 2011 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 211-A0048512A-00000000-0000 Registration Date/Time: 2011/09/19 13:52:29 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Simplified'Prescriptive Certificate of Compliance: 2008'Residential HVACAlterations' CF-lR-ALT=HVAC Climate Zones 10 = 15 Site Address: Enforcement Agency: Date: Permit #: 557880 Pinehurst La'Quinta, CA 92253. .City of La Quinta Sep 19, 2011 Equipment Typel . List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit WiFurnace W, Indoor Coil 2 AFUE 78% p SEER 13.0 ❑ COP ❑ HSPF ❑ R 6CZ 10-1) by Served. b system � Setback If not already present must be Fj Condensing Unit C1 EER ❑ Resistance []'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 -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 -IR and CF -6R shall also be on site for final inspection. C� 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 <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH 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 feet in unconditioned space; or ❑ 3. Existing duct systems are constructed, insulated or. sealed with asbestos ❑ 4. The system twill not be Duc;te�d (ie. Ductless Mini Split"!,'S• ) stern = •Also:,Exempt from�;Refrigerant Charge) M-- 'v�:4. ❑ 2. New4HV4CSystem Required,FormsY":" . Cut infaok0hangeout with ducts': ° % ,�± :' w r OTHERS s) Z�2 and new (all new ducting and all new CF 6R��forms yMECH-04 MECH{ andplit syste MECH HERS MECH-25-HERS -"$ F. } .J• ..g r. ,�.f' .. IF 3` r3J"e"4`W"' 'NY yCF 4Rfforms 'MECH 20 and (for split systems),MECH-22 and�MECH 25 3+ equipment) _ ? ..y� a� N t vc :...�.#+ 'Ys�fot��lt�.u.�s�Y-. `�.u.�1. �.. �..k�ax.%w.. For Split Systems: Duct leakage'z 6rpereent RC; CCA 5r350tCFM/ton;: FWDi--sTMAH E'STMS, and-either•HSPP`orPSPP. For Packaged' Units: Duct leakage`< 6 percent 113. New:Ducts7with/or without Required Forms: Replacement' . Includes replacing or installing all new ducting and/or outdoor condensing..unit.and/or indoor CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS coil and/or furnace. No or some equipment CF -4R forms: MECH-20 and (for split systems) MECH-25 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 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: Sep 19, 2011 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 Reg: 211-A0048513A-00000000-0000 2008 Residential Compliance Forms Registration Date/Time: 2011/09/19 13:54:27 HERS Provider: Ca10ERTS, Inc. July 2010 Bin # -- Gty`of La Qpin*ta- Bq!1diqe,.a'Saf6ty'DivisionPermit.# P.O.. Box 1504;° 78-495 Calle Tampico 0o y La Quinta, CA 92253_. ,(760) 777-7012 �' i Building, 'App Application and�Tracking Sheet r: Q� Project'Address:�,�.ga ►n� wry r Owner's Name:' A. P. Number: Address: r�� `' �D p I 11 Q lil Legal Description: City, ST, Zip: C Contractor: �/� C r S Telephone: i , I 'Z c�{ Address: ' ,""I off, " l>� - Project Description: City, ST, Zip: � :` r � �•�� Telephone: � �QW'' State Lie. # 0 4 I 115". City Lic: #:. ^7 �✓Z{ {. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Coiishuction Type: Occupancy: p cy: State Lic. #:` Pro ect ' (circleone): New Add'n` Alter Repair Demo Name,of Contact Person: S Ft: 9-'- # Stories # Units: Telephone # of Contact Person: Estimated"V du of Project: ; 4C) 00 APPLICANT: [)U NOT'WRITE BEWO ('THIS LINE ' # Submittal; Req'dTRACEING.'. PERMIT FEES Plan Sets Plan 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' Review, ready for corrections issue Electrical Subcontactor List Called Contact Person } i Plumbing Grant Deed Plans picked °p S`M I. H.O.A. Approval Plans resubmitted Grading IN MOUSE:- Review, ready for corrections issue Developer Impact Fee Planning Approval Called Contact Person ' h A.LP.P. Pub. Wks, Appr Date of permit issue + School Fees Total Permit Fees