14-0633 (MECH)VO. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
4P BUILDING PERMIT
Application Number: 14-00000633 _ Owner:
Property Address: 55150 SHOAL CREEK JOYCE DANIELS
APN:. 775-142-009- - - 55-150 SHOAL CREEK
Application description: MECHANICAL CATHEDRAL CITY, CA 92
Property Zoning: LOW DENSITY RESIDENTIAL (760) 774-4127
Application valuation: 8175
Contractor:
Applic nt: Architect or Engineer: HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Lic. No.: 906115
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 Li ense No.: 906115
Date: Contractor:
OWNER -BUILDER DECLARATION
I he
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 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, hnwever, the building or improvement is sold within
one year of completion, the owner -builder will have the burdenofproving that he or she did not build or
improve for the purpose of sale.).
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 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/15/14
5
MAY 15 201+
CITY OF LA QUINTA
FINANCE DEPT.
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 whichthis 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.
Data: Applicant: !!i3
WARNING: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
.SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001• 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 this county to enter upon the above-mentioned propert ori spectionor i pur�es. ..
Date: Signature (Applicant or Agent):
LQPERMIT
Application Number . . . . . 14-00000633
Permit . . . MECHANICAL 201.3
Additional desc .
Permit Fee . . . . 83.42. Plan Check Fee
.'00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 11/11/14
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 35.75.00 EA_ MECH CONDENSER/COMP
35.75
---------------------------------------------7------------------------------
Special Notes and Comments
HVAC CHANGEOUT FURNACE COIL & CONDENSING
UNIT AFUE 78% 13 SEER 4 TON. 2013
MECHANICAL CODE.
----------------------------------------------------------------------------
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
W
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
55-150 Shoal creek La Quinta, CA 92253
City of La Quinta
May 14, 2014
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
®Indoor Coil
® AFUE 78%
®SEER 13.0
❑ COP
❑HSPF
R 6 (CZ 10-13)
13®
Served system
Setback
If not already resent, must be
y P
® Condensing Unit
[3 EER
❑ Resistance
R g CZ 14 -IS
13( )
sf
1600 sf
installed)
[]Other-
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -ZR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78010 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 -1111
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-HER-
. 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 th:an'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
Required Forms:
. Cut in or Gtiangeout'.with ¢` -
CF 6R fo s MECH 04"MECH 20 HERS, and (for split systems) :MECH 22 HERS, and
new ducts (all new ;. C4H 25HRr``
f` 2a�' M25f=
ductignall new
nad CMFErES
R .
equipment).' 4
Duct leakage < &.percent; RC CCA'- -1350 CFM/ton, FW:TMAH,STM..,.andp either HSPF or PSPP_ f.
For Split Systems
h .,.,.. r�k, r n...
For Packa9ed Units; Putt leakage c6 percent/ , �x �, , g,� yr3" ., W: l x
[13. New ducts w�t1i or iaithout
Required'.Forms.' . x'
Replacement
. Includes;replacmg;qr installing all new
ductin * 4' 1oc.' door con densmg,:unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
an& r 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 leakagez'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 under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
. am eligible
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 pre 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: May 14, 2014.
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202
Reg: 214-A0034254A-000000000-0000 Registration Date/Time: 2014/05/14 14:28:58 HERS Provider: Ca1Cr:tc•rs, Inc.
2008 Residential Compliance Forms July 2010
Bin #
Permit # j
PrqjectA&lress:' r.
>
A- P. Number:.
Legal Description:
Contractor.
City of La Quints
Building & Safety Division
P.O. Box 1504, 78-405 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Applicationand Tracking ldng Sheet
Owner's Name: el �*/
J00 e15 04
5
C S -T, zip: CA
5�154?115 A Telephone: 7�6-?7
Address.
/IlclProject Description- A A::�
.city, ST, Zip:
Telephone: 6C,
State Lic. # q C7r,
City Lic. #:.
Arch., Engr., Designer.
Address:
City ST, Zip:
Telephone:
Construction Type: 0ocupaucr.
State Lic. #:
Project type (circle one): New Add'n Alter Repair' Demo
Name of Contact Person:
Sq. Ft:Stories. # Units.
Telephone # of Contact Person:.
41F1rojettt:'
Estimated Value of —7
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal Req'd Reed TRACKING
TRAOMc PEW%�n FEES
PE"W'
Plan Sets
Plan Check submitted
submitted Item
Structural Calcs.
I Amount
Reviewed, ready vc O's
forcort h
for corrections
PL_
Plan Check Deposit
Truis Cates,
tP_
Called contact Pirson a,
Plan Check Balance
Energy CalcL
Plans pickedP Co a.
up us .0
Construction
Flood'plain pl=
Plans resubmitted Mechanical
Grading. plan"
2o° Review, ready for corrections/issue Electrical'
Socontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SALL
H.O.A. Approval -
Flans resubmitted. Grading
IN HOUSE:-
Review, ready forcior"reefitionWsrissae Developer impact Fee
Planning Approval I
.g
Called Contact Person
P AXPX.
: I
Pub. Wks. Appr
Date of Permit issue
School Fees
=J==11total Permit Fees
f