11-0721 (MECH)P.O: BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application_Nun er: 11-00000721
Property Address: 78477 CALLE ORENSE
APN: 646-192-0,10- - -
Application description: MECHANICAL
Property Zoning: LOW: DENSITY_ RESIDENTIAL
Application valuation: 7800
Applicant:
4 #V1111-1 ,
Ta�. 4 4 Q"
BUILDING & SAFETY DEPARTMENT
•BUILDING PERMIT
Architect or Engineer:
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 Professionals Code, and my License is in full force and effect.
License Class: C20 C36 Licgwe No.: 9 Q.6115
Date:��Cont� }
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).:
(_) 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.).
(_ 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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
-1 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:
LORETTA DUFFY
78-477 CALLE ORENSE
LA QUINTA, CA 92253
(760) 7.71-0937
VOICE (760) 777-7012
FAX (760).777-7011
INSPECTIONS (760) 777-7.15.3J,
Date: 6/30/11
Contractor: U AL=Lj
HYDES
77825 WILDCAT ST (f 1e I
PALM DESERT; CA '92 11
(76'0)360-2202-- 20 1 �L
Lic. No.: 90611- cPr'Y(),
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 subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forc ,/nply wit) .those provisions.
0, 1 !Z
Date: 7® _Applicant: - ®' -y'
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. I agree to compj.y�With all
city and county ordinances and state laws relating to building construction, and h>DV- sentatives
of this c/o/pey totemupon the above-mentioned property for/inspection es.
Date: .y - signature (Applicant. or Agent)):
Application Number 11-000007.21
Permit'" MECHANICAL
Additional desc .
Permit Fee -33.00 Plan Check Fee
7.63 -
Issue Date . . . Valuation ,..
0
Expiration Date 12/27/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.009.0000 EA MECH FURNACE <=100K
9.00
'1.00 9.0000 EA- MECH B/.0 <=3HP/100K BTU
5.00
00. 6:5000 EA MECH AH <=10K CFM
00
Special Notes.and Comments
_
A/C CHANGE OUT 5 TON. SEER 13.0 AFUff 780
---------------------------------------------------------
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 7.63 .00 .00
7.63.
Other Fee Total 1.00 .00• .00
1.00
Grand Total 41.63 .00 .00
41.63_
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-1R-ALT-HVAC
Climate Zones 10 - 15 j
Site Address:
Enforcement Agency:
Date:
Permit #:.
78-477 Calle Orense La Quinta, CA 92253
City of La Quinta
Jun 30, 2011
`
Equipment Typel
List Minimum Efficiency2
Duct insulation
requirement
Conditioned Floor
Area
Thermostat
❑ Package Unit
R Furnace
R Indoor Coil
(® AFUE 78%
2 SEER 13.0
❑COP
E]HSPF
❑ R 6 (CZ 10-13).
Served by system
0 Setbe:ck
If not already present, must be,
R Condensing Unit
[I EER
❑ Resistance
O 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 etch system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, Z7HSPF 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-632 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.
0 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R forms: MECH-04, MECH-21-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-HER.*
. 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
t
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. i
3. Existing duct systems are constructed, insulated or sealed. with asbestos ' I
B
❑'4. The syshernjvwill not be Ducted (ie.:Ductless Mini SPlit System)f(Also,Exempt from�Ref�riger_.antdGharge)
❑ 2 New""'HVAC System
Requir"ed Forms a..�_, A,.'°
. Cut in(or,Changeout with—'*'
new ducts °{all new
'
CF 6R:forms IMECH 04, MECH-20 HERSiFantl (for split systems) MECH 22 HERS, and, MECH 25=HERS
ducting ip� all new
CF 4R`°forms MECH 20 andsplit sy`stems)'MECH 22, anc!WECH 25
,. I..
equipment)
����..g�
If
For Split Systems'Ducf leakageN<6}percent SRC 'CCA z 350 CFM/ton `4FW0„TMAH, SIMS, and erther,HPyor"PSPP.
>-
For Packaged Uriits: Duct leakaget<•6`percent'"`
❑ 3 New:Ducts°with/or without' ''
Required Forms:
Re lacement ¢
. Includes replacing or installing alf,new ducting
,
and/or outdoor condensing unit and/or indoor
CF-6R forms:'MECH-04, MECH-207HERS, 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 2:,300 CFM/ton, TMAHt r
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:. I
. 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 ider-tified on this Certificate•of
Compliance.
o 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 othe- app' ble com nce
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the a cati
Name: Mark Hyde Signature: Mark Hyde ,
Company: CERTIFIED COMFORT SYSTEMS INC Date: Ju-i 30, 2011
Address: 77-825' WILDCAT DRIVE - License: •906115
City/State/Zip: PALM DESERT / CA / 92211 Phone: 0760) 360-2202
L Reg: 211-A0032067A-00000000-0000 .Registration Date/Time: 2011/06/30 14:38:16• HERS Provider:-CalCERTS, Inc.
f 2008 Residential Compliance Forms July 2010
Bin #
City of La Quinta
Building at Safety Division
Permitfl ( P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Traclang Sheet
Project Address: �" � 7 7 Cel e /�hSPi Owner's Name: U y -
A. P. Number. 7
Address: —47
Legal Description: S // 4 G
CrtY, ST, Zip: L.- C. `�
Contractor. CIS .� r Telephone: 7 (O--1-7
Address: q
`1�9 01' 0. .lprjec, Description: C Ci Mr -le— .
City. ST, Zip: 1 v (� c! Z Q /
Telephone: U—36v—& -u
State Lie. # : (10(,t
City Lic. #: �Z
Arch-, Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy: .
State Lic. #:
P'oJer-t type (circle one): New Add'= Alter Repair' Demo
Name of Contact Person:
Sq. Ft : #Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project — p U
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Reed TRACE3NG
Plan Sets
PM. MLT FEES
Plan Check submitted
Structural Calcs,
Item Amount
Reviewed, ready for corrections
Plan Check Deposit
Trans acs'
Called Contact Person Plan Check Balance
End acs'
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading p II
2- Review, ready for correctionstissue Electrical
Snbcoutactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SALL
H.OA Approval
Plans resubmitted Grading
IN HOUSE:
'`" Review, ready for correctitions/issue Devdo PerInwact Fee
Planning Approval
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees