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13-1427 (MECH)• 44 P.O. BOX 1504 ^��' VOICE (760) 777-7012 78-495 CALLE TAMPICO \'�- —%� FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT _+_.".� •---moi /13 Application Number: 13-0000 C2,7 Owner: Property Address: 81555 T-IBURON DR RITA BRADLEY D LI'U APN: 767-523-003- - - 81555 TIBURON Application description: MECHANICAL LA QUINTA, CA 92253 n 6 2013 Property Zoning: LOW DENSITY RESIDENTIAL, (760) 564-4401 NOVY Application valuation: 19930 CITY OF LA QUINTA Contractor: FINANCE DEPT. Applicant' y) � Architect or Enginee . HYDES '� / V MADIO STREET INDIO 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 Prof ssionaI Code, d my License is in full force and effect. Licens las C20 C36 =rcen No.: 906115. �.�.-j Dat �ili� Contractor OW VER -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.). (_ I 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.). (_) 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.1. ' Lender's Name: Lender's Address: LQPER.A1IT , 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. 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 he workers' compensationlaws of California, and agree that, if I should beco a su ct to work ' compensation provisions of. Section 3700 of the Labor Code, I fo it o ply those provisions. -Datl. /'E .-,. �o—Applicant:_- - 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. agree t or with all city and county ordinances and state laws relating to building construction, a here /author' representatives of this�t`9 my jo enter upon the above-mentioned property for inspec& pposes. / LQPERMIT Application Number . . . . 13-00001427 Permit . . . MECHANICAL 2013 Additional desc . " Permit.Fee . . . . 143.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 5/05/14 Qty Unit Charge Per Extension 2.00 35.7500 EA MECH FURNACE 71.50 .2.00 35.7500 EA MECH CONDENSER/COMP 71.50 ---------------------------------------------------------------------------- .. Special Notes and Comments (2)HVAC CHANGE OUT 16 SEER 78% AFUE REPLACE 5 TON (2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2010_CALIFORNIA BUILDING CODES. ------------------------------- - Other Fees . . . . .". BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E" 90.57• PLAN CHECK, MECHANICAL 95.32 Fee.summary Charged Paid Credited Due Permit. Fee Total 143.00 00 .00 143.00 P1an.Check Total .00 .00 .00 .00 Other Fee Total 186.89 .00 .00 186.89 Grand Total 329.89 .00 .00 329.89 LQPERMIT Bin # City of La Quinta Budding 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico La QlAnta, CA 92253 - (760) 777-7012 ilding Permit Application and Tracking Sheet Permit # .� Pro ect Address:' j 'S Owner's Name: Arc, A. P. Number. Address: Legal Description:( /'. Contractor. etr k fie J Wi'1 44 g A City, ST. Zip: Telephone: G j L1 0 Address: • `� Z t { f't1c� City, ST, zip: A ZZ d 1 Project Description: -Z Telephone . 6rj _-ZZd� State Lie. # qC76 j. City Lie. #• 2Z Arch., Engr., Designer. ' Address: City, ST, Zip: Telephone: State Lia #: Name of Contact Person: Construction Type: Project type (circle one): New Add'u Alter Repair' Demo Sq. Ft: # St6 ' # Units: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd - Ree'd TTtACE3NG PERNMT FEES I.Plan Sets Pian Check submitted Item Amount Straetaral Calcs. Reviewed, ready for corrections Phu Check Deposit TYoss Calcs, Called Contact Person Plan Check Balance Energy Cales. Plans bicked up Construction Flood plain plan Pians resubmitted Mechanical Grading, plan Z' Review, ready for correcdonstissae Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for cormetionslisme Devdoper-Impact Fee Planning Approval Called Contact Person AMP.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 #: 81=555 Tiburon La Quinta, CA 92253, City.of La Quinta Oct 30, 2013 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit 10 Furnace ® Indoor Coil ® AFUE 8% ® SEER 13.0 [3 COP [3HSPF ❑ R 6 CZ 10-13) Served by system ®Setback If not already present, must be ® Condensing Unit [3 EER [3 Resistance [3R 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. r 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 1,12010, a registered copy of the CF-111 and CF-611 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 r CF-4R forms::MECH-21 and (for split systems) MECH725 . 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 FGF Par pereeRt Exempted from duct leakage testing:-) ❑ 1:buct system was documented to.have been previously sealed and confirmed through HERS verification, or [32. Duct systems with less thar:40 linear feet in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed,with asbestos be Ducted 5pht, (Also4t empt,from„Refngerent Charge) ' ❑ 4. The system will not (ie ,Du.cttess,Mmi System) ❑ 2. New HVAC System Required Forms x^ i'h.`.. • 1�f`', ..> ;: "� 4w ,. . . Cut intor Changeout ry CF-6R forms MECH 04 MECH 20 HERS and (for split systems) MECH 22 HERS, and �', new ducts (all new ductirg and all new h MECHf{25t1ER5 s ra' z' r.`?s i MECH 22,�and 25 equipment) CF=4R fo jMECH 20 and�(for split sys terns) ,MECH A, For Split Systems Duct leakage , <a6 percent,<RC CCAL>;T350fCFM/to,nE FWD;TMAH:STMS; and`either'HSPP>"or'PSPP :_ For Packaged'Unrts: Duct leakage < 6:;percentoil 113. New,;Duith/or without+.';.: Required Forms::: q, , 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-411 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. Code to responsibility for the design identified on this Certificate of • I am eligible under. Division 3 of the California Business and Professions accept Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Tide 24, Parts 1and 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: Oct 30, 2013 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA / 92201 , • Phone: (760) 360-2202 Reg: 213-A0082505A-000000000-0000 Registration Date/Time: 20.13%10/30 18:13:23 HERS Provider:-Ca10ERTS, Inc. 2008 Residential'Compliance Forms.July 2010