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13-1658 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING. PERMIT Application Number: 13-00001658 Property Address: 78047 SAN TIMOTEO ST APN: 646 -160 -004 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 7513 Applicant- Architect or Engineer: &(-/ N116-- I LICENSED CONTRACTOR'S DECLARATION 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 ProfessV_nals Code, and my License is in full force and effect. LicenseClass: C20 C36 ;rricenseNo.: 906115 Datej��—��CSontractor: 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).: 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, 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: BROCK PHYLLIS 78077 SAN TIMOTEO LA QUINTA, CA 9225 ( 1p� Contractor: HYDES 42949 MADIO STREET INDIO, CA 92201 (760) 360 -22 02 Lic. No.: 906115 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/24/13 Opp 94 2013 leb�� 4 2013 ITY0'a Qu �- N �'1-4 1A1 QU/Afr,4 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 . PolicyNumber -CEWC468841 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 I should become subject to workers' compensation provisions of Section 4�00 of the Labor Code, I shall forthwith i en ith �;p�p�w,se provisions, Dat 12-2 e� ��_/Applicant: '011, 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. I . 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, indemnity 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 r ead 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 county to enter upon the above-mentioned pr party f� �'pec PU;pdCes. 0 Date: 12—Z lf_/�ignature (Applicant or Agent): Application Number . . . . . 13-00001658 Permit MECHANICAL 2013 Additional desc Permit Fee 83.42 Plan Check Fee,. .00 Issue Date . . . . valuation 0 Expiration Date 6/22/14 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 EA MECH CONDENSER/COMP 35.75 - - - - - - - - - - - - - - - - - 7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Special Notes and'Comments - - - - - - - - - - - - - - HVAC CHANGE OUT 3 TON AFUE 78%-13 SEER -2008 ENERGY] CARBON MONOXIDE ALARM(S). TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010 CALIFORNIA BUILDING CODES. ------------------------ 7-7-7 ---------------------------------------------- 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' 83.42 Plan Check Total .00 .00 .00 Other Fee Total 144.00 .00 .00 144.00 Grand Totai 227.42 .00 .00 227.42 LQPERMIT Bin # City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Caffe Tampito La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and T-racidng Sheet, Pennjt # PrqjectAddress:'.-7V-0'j-7 'F1,,4 -,--e 0,,.,e,Name: RA --C-A/ A. P. Number Address- -7 Legal Description: Contiramr. 5; City, ST, Zip: - C Telephone-- Address:- /Ilctl Project Description: - City� ST, 4 Zip Ci Telephone: 6o State Lie. # q C7c_ City Lic. #: Arch., Engr, Designer Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancr. Project type (circle one): New Add'n Alter Repair' Demo Name of Cont;act Person: Sq. Ft: # ftries: # Units: Telephone of Contact Pawn: Estimated Value ofProject --7 APPLICANT: DO NOT WRrrE BELOW THIS LINE # Submittal Reqld RWd IRACE3NG. PERhM FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truis CaIcs. CaRed'Contact P&son P" Check Balance Energy Cales. Plans bicked up Construction Flood plain plan Plans resubmitted Mechanical' Gradingplarf 2" Review, ready for corrections/issue Electrical Sabcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL ELOA- Approval, Plans resubmitted Grading IN HOUSE.- Riview, ready forciorrections/issat Developer -Impact Fee Planning Approval Called Contact Person AJ.P.P. -Pub. Wks. Appr Date of permit issue school Fees -0-0,.Fe Total Permit Fee, Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC Climate Zones 10 - 15 Site Address: 7En ement lAgency: force D te: Permit, 7 78-047 San Timoteci Li Quinita, CA 92253 C ty of La Quinta Ci7of I Dec 23, 2013 - Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat [3 Package Unit 0 Furnace Indoor Coil 0 AFUE 78% [3 COP [3 R 6 (cz 10-13) Served by system 0 Setback • 0 SEER 13.0 [3 HSPF 0 R 8 (CZ 14-15) 1200 sf If not already present, must be • Condensing Unit [3 EER [3 Resistance 1 installed) [3 Other_ I I I 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 fin�al, 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 -611 shall also be on site for final inspection. 1. HVAC Changeout Required Forms: • All HVAC Equipment CF -611 forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS - replaced CF -411 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 spli t systems) MECH-25 For Split Systems: Duct le '15 percent; RC, CCA :5 300 CFM/ton (Minimum Air Flow Requirement), TMAH FGF Pa 0..c �ge 15 perGeRt Exempted from duct lea age testing,�if: .[3 1:'Duct system was documented to have been previously sealed and confirmed through HERS verification, or 0 2. Duct systems with less than74.0 linear feet in unconditioned space, or 3. Existing duct systems are t on structed, insulated or sealed with asbestos 04. The s e ys�e,"i.11 not be Duc6 d -(ie. Ductless, Mini 7SDlit--Svstem) -,(Also�. Exempt�i [3 2. New -,HV -AC system Requiiied*,Forriii�:.�i�-*".-:r,.,,"�,�'i�.--If ;N W Cut iWor,Changeout with-�'�"-- new clkt�--".(all new CFL6R fo s:,,,MECH-04, MECW�O-HERS systems) MEC4'-'1'ii-'*HEkS 6'�cl' rrn ductirig--'6`hd all new,f1r.... MkW�51HER-S* VV R t0`4R146 `rn"-�:�' M -V R. djf':`:":l`t '25r:�z equipm�—nt—j ri an ;, or sp i sy ancl�MECH-Ai" ECH-.20, ': 3 K For Split Sy�;t'�-ni�.-.I.Dijct'.16�k'zigie;'<:46p.e�c6ht-'-RC,�,CCAI.�:�35o�.CFM/ton'I.,�FWD-,'t,,T an&'..eithet..-HSPP7ciFPSPP. For P ckage�d units: uct a eak6ds�" peincent::::e . 0 3. New,-Ducts�With/or withciuV.`.,..:::, Required Forms: Re 0 1 a! c e Includes replacing or installing iill:.niaw clucting and/or outdoor condensing, unit CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS and/or indoor coil and./or f6�nade.--:-No or some CF -411 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 13 4. New Ducting over 40 feet Required Forms: Includes adding or replacing more than 40 CF -611 forms: MECH-04, MECH-21-HERS 1CF-4R linear feet of duct in unconditioned space. 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 .- . I • 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 clocurnented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application� Name:. Mark Hyde . ------Fslgnature: Mark Hyde Company: CERTIFIEDCOM FORT SYSTEMS INC Date: Dec 23, 2013 Address: 42-949 MADIGSTREET License: 906115 ,City/State/Zip: INDIO 7 CA / 92201 Phone: (760) 360-2202 Reg: 213-AO095717A-000000000-0000 Registration Date/Time; 2013/12/23 14:03:20 HERS Provider: CalCERTS, Inc. .12008 Residential Compliance Forms July 2010