13-1642 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number: 13-00001642
Property Address: 79060 COYOTE CREEK
APN: 772-030-042-47 -25429
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 9485
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions oZU�e
r 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and myis in full force and effect.
LicenseClass: C20 C36Lice!
Date: . r Contractor:
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 _ I 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 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.).
1 _ 1 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:
BILL HEALY
79060 COYOTE CREEK
LA QUINTA, CA 92253
(
Contractor:
HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Lic. No.: 906115
Date: 12/18/13
-----------------------------------------------
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 s �Ect to the workers' compensation provisions of Section
3700 gf�he Labor Code, I all f (with oe y wit t�se provisions.
i
Date: Applicant:
WARNING: FAILURE TO SECUIIE 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 informationi orrect. I agree to comply with all
city and county ordinances and state laws relating to building construction, d hereby rize representatives
of this county to enter up o the above-mentioned property for inspection urposes
/ </
Date: j Signature (Applicant or Agent):
Application Number . . . . . 13-00001642
Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee . . . . 83.42 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 6/16/14
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
wl
35.75
---------------------------------------------------
Notes and Comments
A/C FURNACE INDOOR COIL CHANGE OUT
18SEER/80AFUE SPLIT SYSTEM [2008 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2010CBC
------=------------------------=--------------------------------------------
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 .00
83.42
Plan Check Total .00 .00 .00
.00
Other Fee Total 144.00 .00. .00
144.00
Grand Total 227.42 .00 .00
227.42
LQPERMIT
Bin
City of La QuInta
Buiid'mg 8[ Safety DWon
P.O. Box 1504, 78-495 Cai[e Tampito
La Quetta, CA 92253 - (760) 777-7012
Building Permit Application and Tracidng Sheet
perink #
Project Ad&=' � —060 c
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A P. Number.
Address: moi- O o c, ape
Desaiptiew
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Project Descriptiow A?
Telephone: Ga—ZZo`i,
Static Uc. #: q i7c, I.
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Address:
City, ST, zip -
Telephone:
Co�on Type: Occnpaacy-
State Lic. #:
$Died type (circle one)- New Add'n Alder Repair-
Demo
Name of Conrad Pelson:
Sq. Ft.:
# Stories:
# -w=
Telephone # of Contact Pets=.
F.stim ted Vatae o f ect
APPLICANT: DO NOT WRITE BELOW THM LINE
#
SobmiHal
Req'd
RWd
TRAC MG .
rEgb tP FEES
Pian Sets
Plan Check sabmiiitd
item
Amount
Straeheral CakL
-
Reviewed, ready for cocceddons
Plan CheckDeposit
Truss Cates.
Called Contact Person
Pian Chi &Balance
Eaergv Calce.
Plans picged up
Coastraetion
Flood plain plan
Plans resubmitted
Methanieal
Grading pian-
2'r Review, reedy for oorrectionsf me
FdxOricat
Sabcontaetor List
CaIIed Contact Fuson
Plumbing
Grant Deed
Plans pid-d up
S hLL
H.O.A. Approval
Plans resubmitted
Grading
IN HOIISB:-
r"' Review, ready for eorreclionsrkwne
DevdoperLnpset Fee
Pianniz?g APPS
called Contact Person
A.L.P.
Pub. Wks. Appr
Date of permit issue
School Fees
-
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
#:
79-060 Coyote creek La Quinta, CA 92253
City of La Quinta
I Dec 16, 2013
Duct insulation
Conditioned Floor
Equipment Typei
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 1 0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
❑ EER
❑ Resistance
❑ R g CZ 14-15 )
800 sf
installed)
❑ Other
1. Equipment Typq: 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-411
forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-1111
and CF-6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-611 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
FQF Packaged Unit-S, rl-.et Ie + 4 19 n
aka@ Rt
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
[13. 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
Required Forms:.
. Cut in or Changeout with,
..
CF-612 forms: MECH-04, MECH-20 e.
CF' e (for split systems) MECH-22-HERS, and
new ducts: (all new
new .i.
MECH-25-HERS } y
ducting and all new
CF 4R forms: MECH-20, and (for split Systems) MECH:_ .2; and MECH-25 ,
equipment) °'
f. , j
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton; FWD, TMAH, STMS, and either HSPP or PSPP. '
For Packaged Units: Duct leakage < 6 percent
113. New Ducts with/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R 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
❑ 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.
--L-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 I 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: Dec 16, 2013
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202
Reg: 213-A0093723A-000000000-0000
2008 Residential Compliance Forms
Registration Date/Time: 2013/12/16 14:30:59 HERS Provider: CalCERTS, Inc.
July 2010
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