14-0399 (MECH)r'
i.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000399
Property Address: 52585 AVENIDA JUAREZ
APN: 773 -244 -017 -ST -000000-
Application description: MECHANICAL
Property Zoning: COVE RESIDENTIAL
Application valuation: - ' 10415
Applicant:
T4'!t 4 4 "
BUILDING & SAFETY DEPARTMENT
Architect or En ineer:
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
1 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: CC20 C 6 /t nseNo.: 906115
Ddt ` ontractor/.,(�%�_
t./ '
✓ 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 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 _ 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.).
I—) 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:
PATRICK MATHEW
52585 AVENIDA JUAREZ
LA QUINTA, CA 92253
(
Contractor:
HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Lic. No.: 906115
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
•r,
Date: 4/09/14
D1��1 1.11 1
Cly s
Oifr'Al�;�
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 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 the workers' compensation provisions of Section
3700 of the Labor Code[ sh�J{Jorth ith comp) ith those provisions.
Dat '�� � A licant: /;%% �
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 comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of thislco my to entJer yLp n the above-mentioned property for in/syye n p oses.
Date: Sig azure (Applicant or Agent):
LQPERMIT
Application Number . . . . 14-00000399
Permit . . . MECHANICAL 2013
Additional desc .
Permit Fee 71.50 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 10/06/14
Qty Unit -Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
i
---=------------------------------------------------------------------------
Special Notes and Comments
HVAC CHANGE OUT - 13SEER/78AFUE SYSTEM
12008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
7 ---------------------------------------------------------------
Other Fees . . . . . .'. . . PERMIT ISSUANCE M/P/E
90.57
' PLAN CHECK, MECHANICAL
47.66
Fee summary Charged -Paid Credited
Due
----------------------------------------------------------
Permit Fee Total 71.50 .00 .00
71.50
` Plan Check Total .00 .00 .00
.00
Other Fee Total 138.23 .00 .00
138.23
Grand Total 209.73 .00 ..00
209.73
LQPERMIT
Bin #
City of La Quinta
Building a Safety Division
Permit .#
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building
Permit Application and Tracking Sheet
Project Address:*
I
V 2� l rAq �a�e Owner's Name:
A. P. Number:
. Legal Description:
Address: Z _ S8
Contractor: �ev �/ �(-
/ // City, ST, Zip: C %
i Y e'
51 PrzS A,/c Telephone:
Address: i� ` c 1 C7
�1c� Project Description:
City, ST, Zip: DC7
—
Ci
Telephone:
State Lic. # : q ('�(�
�• City Lic. #:r�2
Asch., Engr., Designer:
Address:
------------
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Name o�Contact :Sq•Ft•:
Project type (circle one): New Add'n Alter Repair Demo
TelephPerson:
# Stories#Units:
_
Estimated Value of Project: � TS
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Recd
TRACI{ING
Plan Sets
PERMIT FEES
Plan Check submitted
Structural Calcs.
Item Amount
Reviewed, ready for corrections
Truss Calcs.
Plan Check Deposit
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Flood plain plan
Construction
Plaos resubmitted -
Grading, plan
Mechanical
2od Review, ready for correciionstissue Electrical
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
S.M.I.
Plans resubmitted
H SE
Grading
3'd Review, ready for corrections/issue Developer Impact Fee
1 n
Called Contact Person
Pub. Wks, Appr
A.LP.P.
Date of permit issue
School FW R 0 2014
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
52-585 Avenida Juarez La Quinta, CA 92253
City of La Quinta
Apr 8, 2014
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
®Indoor Coil
® AFUE 78%
10 SEER 13.0
13 COP
(3sf HSPF
❑ R 6 (CZ 10-13)
Served system
®Setback
If not already present, must be
® Condensing Unit
❑ EER
❑ Rnceesista
❑ R 8 (CZ 14-15)
2000
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVAC fur 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-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
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
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 thair ;40 linear feet in unconditioned space, or
❑ 3, -Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini-Split System) (Also Exempt from Refrigerant Charge)
❑ 2."'. New HVAC System
Require&.Forms:
. Cut.in or;Changeout„with
CF-6R°forms:aMECH 04,`MECH 2O=.;HERS;