10-0652 (MECH)rI
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1Q-00000652
Property Address: 48720 AVENIDA FERNANDO
APN: 658-310-008- -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8963
Ta�/ 4 s(P Q"
Architect or E i eer:
------------------
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,Ad my License is in full force and effect.
License CI ss: 20 C36 Li o.: 906115
Date: S �f Contractor
OWNER- ITE.
I hereby affirm under penalty of perjury that I am exempt rom 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:).
(_) 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.).
( ) 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:
LQPERAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/15/10
Owner:
CLARK CHARLOTTE
48720 AVENIDA FERNANDO
LA QUINTA, CA 92253
Contractor: D
HYDES
77825 WILDCAT STRE JULPALM DESERT, CA 92 1 U 1 r 2010
(760)360-2202
Lic. No.: 906115 CITY OF LA QUINTA
-----------------------------------------------
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 DELOS INS Policy Number 02DKRM12004084
_ 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 worker 'compensation laws of California,
a agree that, if I should become subject to the wor ers' mpensat.on provisions of Section
00 of the Labor Code, I shall forthwith comply h 1 se provisions.
�- Date: / Applicant:
WARNING: FAILURE -TO SECURE WORKERS' COMPENSATION ERAGE 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 comply with all
city and county ordinances and state laws relating to building construction, and hereb aut ize representatives
of this ccou ty to 9fiter upon the above-mentioned property for inspe n purposes
_Date: / %'Y Signature (Applicant or Agent):
Application Number . . . . . 10-00000652
Permit . . . MECHANICAL
Additional desc . .
.Permit Fee . . 51.00
Plan Check Fee
12.75
Issue Date
Valuation . . .
. 0
Expiration Date 1/11/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 9.0000 EA MECH
FURNACE <=100K
18.00.
1.00 9.0000 EA MECH
APPL REP/ALT/ADD
9.00
1.00 9.0000 EA MECH
B/C <=3HP/100K BTU
9.00
-----------------------------------------------------------------------
------------------ - _ -----Special- Notes--and.-Comments --
- _- _ ----- - -
- ----
TWO UNITS:
1. PKG UNIT CHANGE OUT 2. FURNACE AND
u COIL CHANGE OUT SAME LOCATION 1.
14 SEER
'
2. 80%FURNACE 13 SEER COIL ONLY.
-
----------------------------------------------------------------------------
I Other Fees . . . . . . .• BLDG STDS ADMIN (SB1473)
1.00
iFee summary Charged
Paid Credited
Due
Permit Fee Total 51.00
00 .00
51.00
Plan Check Total 12.75
.00 .00
12.75 I
Other Fee Total 1.00
.00 .00
1.00
Grand Total 64.75
.00 .00
64.75
LQPERMIT
i
flow
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
. Climate Zones 10 to 15
r.o—nom, J.,
Site Address:Enforcement
f/� �-�ye�,G/
Agency:
Date:
7--1 3 id
Permit #:
Conditioned Floor
E ui ent T, `
List Minimum Efficiency'
Duct insulation regutrement
Area
Thermostat
ElPackaged Unit
AFUE g��
COP
Over 40 ft of ducts added or
Setback
®Furnace
LIndoor Coil
densing L'nit
SEER
EER
® RSPF _
®Resistance
replaced in unconditioned space
R 6 (CZ 10-13)
®R 8 jCZ 1,F 1j)
Served by sy stem
I / �U sf
(lfnor already
present. must be
insta/1ed)
er
1. Equoment Type_ Choose the equipment being installed: if more than one system, use another CF -I R ALT HYACfor each system.
2. Minimam Egzdpmenr 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 fad the work complexed 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
si ed. Beginning October 1, 2010, a registered coy of the CF -1R and CF -011 shall also be on site for final inspection.
1. HVAC Cbangeout
Required Forms:
9uipm rep
• All HVAC Equipment laced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms. MECH- 21 and (for split stems) MECH-25
• Condenser Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and/or
CFVR forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For SpUt Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct.leakage < 15 percent
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
® 2. New HVAC System
Required Forms:
• Cut in or Chang with new
ducts: (all new ducticacti ng azrd all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new aern)
s MCF-4R forms: 20-, and (for split systems)MECH H -22, and MEC25
For Split Systems. Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton; FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
® 3. New Ducts with Replacement
Required Forms:
• Includes replacing or installing all new ducting
CF -6R forms: MECH-04, MECH-20-HERS= (for split systems j MECH 25 -HERS
and/or outdoor condensing unit and/or indoor
CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or fiance_ Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/tott, 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 unconditioned space.
CF -6R forms: MECH-04, MECH-2I-HERS CFVR forms: MEC14-21
For split tem or packaged units: Duct leakage < 15 percent
Ej 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.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• 1 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 t and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the iirformaaon documented on other applicable compliance forms, worksheets,
calculations, plans and specifications submitted to the enforcement aggncy for approval with the permit application.
Name: Michael Hyde Signature:
Comp- Hyde's Air Conditioning
Dom:
Address: 77-899 Wildcat Drive
Licenw. 906115
City/state/Lip: palm Desert, CA 92211
Phone: (760) 360-2202
2008 Residential Compliance Forms
March 2010
r
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC'Alteratioas CF-IR-ALT-HVAC
ClimateZones 10 to 15
I
rS&e=Ad&esws: EnforcementAgency: Date:�-77_13_)o
Conditioned Floor
1 glint inculAtirm recruirernent Arm Thermostat.
F-1 Packaged Unit� I Over 40 ft of ducts added or Setback
MFtunace AFUEg^I COP replaced in unconditioned space I Served by system (fnotalready
§Indoo;rColl ® EER ® HSPF _ R b (CZ 10-13)7C�f present mnt be
Condng Unit EER ® Resistance R 8 ('CZ 14-15)
Other
1. Equipment Type: Choose the equipment being installed: if more than one system, use another CF -IR ALT H6ACfor each system_
2. M&amam Equipment Effidendes: !3 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
pick 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 fatal, 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
-;e„ A Reainnina October L 2010- a registered coov of the CF -IR and CF -6R shall also be on site for final insuection.
1. HVAC Chaugeout Required Forms:
• All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split stems) MECH-25
• Condenser Coil and/or
• Indoor Coil and/or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimuun Air Flow Requirement), T AAH
For Packaged Units: Duct.leakage < 15 percent
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
® 2. New HVAC System Required Forms:
• Cut in or Changeout with new CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-1-jERS, and MECH-25-HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, GCA >_ 350 CFM/ton; FWD, TMAH, SIMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
® 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing a!1 new ducting CF -6R forms: MECH-04; MECH-20-HERS-
and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Dud leakage < 6 nercent
4. New Ducting over 40 feet Required Forms:
• Includes adding or replacing more than 40 CF -6R forms: MECH-04, MECH 21 -HERS CF -4R forms: MEC14-21
linear feet of duct in unconditioned space.
For splits stem or packaged units: Duct leakage < 15 percent
EXCEPTION: Existmg 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.
• 1 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 natures identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets.
calculations. plans and specificatin submitted to the enforcement agency for approval with the permit applicatioDe
Name: Michael Hyde Signature:
Company: Hyde's Air Conditioning
Dam:
Address: 77-899 Wildcat Drive
License: 906115
City/Smdzip: palm Desert, CA 92211
Phone: (760) 360-2202
2008 Residential Compliance Forms March 2010
Bin #
City of La Quinta
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet .
Permit .#
Project Address:'44— .72-o X ve ��� r --.e ,,
Owner's Name: 4 111 / 0
A. P. Number:
Address: '(-!e-72
Legal Description:
Contractor: / /j,�
City, ST, Zip:G,"-;i Z
Telephone:
Address:G
Project Descriptio „ 4-11 1 G114 4�0__Ocj
City,ST, Zi /IX
Telephone:
�4�/C G�� ✓
L'1
State Lic. #: ��/ City Lic. #: J�
Arch., Engr., Designer:
S�
Address:
City, ST, Zip:
-
Telephone:
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo .
Name of Contact Person:
Sq. Ft.:
# Sto es:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: h
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMTT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
Zed Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
ILO.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ieady for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r='