14-0870 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
ceit!t 4 4 Q"
s
Application Number: 14-00000870
Property Address: `48124 CALLE SERANAS
APN: 646-110-064- - -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8760
Applicant: Architect or Engineer:
V
------------------
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, and my License is in full force and effect.
License Class: C20 jC36((�1 License No.: 906115
Date: �. �LlToArc or:
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 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
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:
BRENDA VERNA
48124 CALLE SERANAS
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6./17/14
e
Contractor:
FMOAM
HYDES42949 MADIO STREET1f�1�INDIO, CA 92201 (760)360-2202IU
Lic. NO.: 906115 �Ty OF LA QuiNTA
FEDEPT �_
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WORKER'S COMPENSATION DECLARATION
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.
rede 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, I shall forthwith comply with those provisions.
< licLA
Date: Pficant: � 0 -
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, 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 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 this county to enter upon the above-mentioned propertyf r inspection purposes.
Dat�5atu a (Applicant or Agentl:� Y/ 7�
Application Number 14-00000870
Permit MECHANICAL 2013
Additional desc .
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 12/14/14
A
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1.00 35.7500.EA MECH CONDENSER/COMP
35.75
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Special Notes and Comments
HVAC CHANGE OUT - 13SEER/78AFUE SYSTEM
[2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING
CODES.
---------------------------------------------------------------
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
0
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1 -ALT-HVAC
Climate Zones 10 - 15
Site Address: -
Enforcement Agency:
Date:
Permit #:
48-124 Calle Seranas La Quinta, CA 92253
City of La,Quinta
Jun 16, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
® Indoor Coil
® AFUE 78%
® SEER 13.0
❑ COP
❑ HSPF
❑ R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® Condensing Unit
(3 EER
[3 Resistance
[3 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 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 -1R
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 -411 forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF -611 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 dud leakage testing :if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less tti6, 40 linear feet in unconditioned space, or
❑ 1—Existing duct systems are 6nstruded, insulated or sealed with asbestos
❑ 4. The system will not be Dueteil (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2:`New HVAC System
Required Forms:
.Cut rn or Changeout with
Y
CF-6Wforms-�MECH 04, MECHx20 HERS and for split systems. MECH 22 HERS, and
new ducks'(all new
MECH 25 HERS"= E '
ducting and'all new
t
equipment)` cR
CF 4R forms MECH-20,`and (for split systems) MECH 22, andMECH 25 "' .......
rd a .: # �, . , 1 T +� r
For S ht S stems .,Duct leaks
P y
e < 6 ercent• RC CCA > 350 GFM/ton,FWD, TMAH� STMS;:and either HSPPfor FSPP r
9 P s R
"
For Packaged Umts. Duct
leakage{< 6 percent r,, �� {wt ,. }}+;,, ..,
❑ 3. New Ducts with'/or without i �5 x
Requ�red, rms
Replacement
. Inclu'd.es,riep.loaciong or installing alEghew
ducirj�aid%eutdoor condensin;init
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and%o�: indoor coil andor furnace':;No or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage.:;<f.-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.
. 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 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: Jun 16, 2014
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202
Reg: 214-A0043744A-000000000-0000, Registration Date/Time: 2014/06/16 13:03:06 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Work Order I II II II IIIII��.
Certified Comfort Systems, Iric.
dba Hyde's Air Conditioning sob Nb: 266261
42-949 Madio St.
Indio CA 92201.
760-360-2202 FAX: 760-360-3350
Service At: Customer # 115737 Bill To: Customer # 115737 Rating:
Verna, Brenda 760-564-4866 Verna, Brenda 760=564-4866
48-124 Calle Seranas 48-124 Calle Seranas
La Quinta CA 92253 La Quinta CA 92253
Email: Email:
Type: Source: FRIEND Open Balance:
Zone: LQ Map: Payment Method:
Subdivision: Laguna De La Paz Credit Limit:
Skill: Tax: CA Service Customer
Directions
Instructions Install 5 ton 16 SEER A.S. split system Gold XI. Total due Hyde's $8,760, py by chk. <<CUST WANTS TO KNOW
IF. SHE WILL BE W/OUT AIR ALL DAY OR JUST HALF?>>
Work Sugg
Work Done 6/14/14 12:55 p.m. lft. mess. confirming install. 1Q
Call Info
Job Info
Scheduled Time
Call No.: 266261
Booked by: Christina
Job No.: 266261
Taken: 6/10/14 9:47 AM
Type: FULL
Booked Date: 6/13/14
Class: Installation
Taken by: Christina
Scheduled: 6/16/14 8:OOAM
Sched by: Lisa
Type: FULL
Cust PO:
Pri Level: 5
Ld Src: FRIEND
SalesPerson: STEVE
Eq Age:
LS Ref:
Contact:
Equipment:
Assignments
Employee Taskdode
Scheduled Time
FRANK
8:00:00 AM
JOEY,
8:60:00 AM
Service History
Call # Date Tech
Type Status Bal. Due Job # 266252
266252 06/10/2014 STEVE
EAC
Work Done:
Work Sugg: SOLD 5 TON 16 seer split system A.S. Gold X1. Total due Hyde's $8,760
Bin #
City of La Quinta
Building 8L 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` L� -. cJI C ct S e✓ 4 n�S Owner's Name: 77747 G
A. P. Number: Address: 12Qin
Legal Description: City, ST, Zip: C A
Contractor: / el,rl fi d L�4,,.� 54n5 aJ Telephone: J
Address: L- .Z -� K /qJC( Project Description:C
G
City, ST,ZipO - A ZZ d
Telephone: 6c, _ zZ dZ
State Lie. # : q C 7c, j. City Lic. #:
Arch., Engr., Designer:
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: F%
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec.'d
TRACING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Mechanical
Flood plain plan
Plans resubmitted
Grading, plan,
2' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3' Review, ready for eorrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
p Lp p
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees