11-0054 (MECH)P.O. BOX `1504 VOICE 760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT 1
Date:. 1/14/11
Application Number: y.1.1-�00000054� Owner:
Property Address: 55017 SOUTHERN HILLS 'PETHLEY LOWELL
APN: 775-181-006- - 55017 SOUTHERN HILLS
Application description: MECHANICAL , LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 771-5516
Application valuation: 1200 i r-
Contractor:
Applicant: Architect or,Engineer: 4 -,- HYDES
77825 WILDCAT STREET
' / Y PALM DESERT, ,CA 92211 ( 760) 360=2202 .
Lic. No.: 906115
--------------------------
LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:. _
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 C 6- License No.: 906115 for, by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.- '
e Date: 1 :— / 1 ontractor: - _ I.have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
1 • _--YY--"--�� Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number are: - - -
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number CEWC133676
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - - and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code; I shall fo with SDgtPly with those provisions.
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).: Date: 1 Applicant:
(_ 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 - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED_ FOR IN
r improvements are not intended or offered for sale. If, however, the building or improvement is sold within - SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year -of completion, the owner -builder will have the burden of proving that he or she did not build or i
improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
• - 7044, Business and Professions Code: The Contractors' State License Law -does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - _ whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec: , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Ouinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit. '
Date: Owner: 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
• CONSTRUCTION LENDING AGENCY permit to cancellation.-
• I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued ISec. 3097, Civ. C.). ' city and county ordinances and state laws relating to building construction, and hereby authorize representatives
+ - of this7cou7nty to ent r upon the above-mentioned property for inspection p rposes.
Lender's Name: y�yJ/5�
Date:� Signature (Applicant or Agent):
Lender's Address: J
o .
LQPERMIT -
Application Number . . . . 11-00000054
Permit MECHANICAL
Additional desc .
Permit Fee 33.00
Plan Check Fee
8.25
Issue Date
Valuation . . .
. 0
- -Expiration Date 7/13/11
Qty.' Unit Charge Per
Extension -
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 9.0000 EA MECH
--------------------------------------
B/C <=3HP/100K BTU
------------------------
9:00
--------------
Permit . . . . . MECHANICAL .
Additional desc
Permit Fee . . 33.00
Plan Check Fee
8.25
Issue -Date . . . .
Valuation
0
Expiration Date 7/13/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00
" 1.00 9.0000 EA MECH
FURNACE 5=100K
9.00
1.00 9.0000 .EA MECH
B/C'<=3HP/100K BTU
9`.00
Special Notes and Comments
(2) PACKAGED A/C UNIT CHANGE OUT.
13
SEER 2007 CODES.
-------------------_-----------
Other Fees . . . . BLDG STDS ADMIN (SB1473) '
1.00
Fee summary `Charged
Paid- Credited
Due
' Permit Fee Total 66.00
.00 .00
66.00
Plan Check -Total 16.50
..00 .00
16.50
Other Fee Total 1.00
.00 .00
1.00
Grand Total, 83.50
.00 .00
83.50
LQPERMIT
Reg: 211-A0002008A-00000000-0000 Registration Date/Time: 2011/01/13 15:49:47 HERS Provider: CalCERTS, Inc.
2008 Residential-Compliance•.Forms' -July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -IR -ALT -HVAC
Alterations ` 1
Climate Zones 30 - 1S -
Site Address: Enforcement Agency: Date: Permit #: '
55-017 Southern Hills La Quinta, CA 92253 City of La Quinta Jan 13, 2011
' Duct insulation Conditioned Floor
Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat'
p Package Unit '
❑ Furnace R AFUE • 78% ❑ COP - ❑ R 6 (CZ 10-13) Served by system 2 Setback
❑ Indoor Coil p SEER 13.0 ❑ HSPF If not already present,
❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 1500 sf must be 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, 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 %4R'f'&m's: MECH-21'and (for split systems) MECH-25
. Furnace wva ,
For Split Systems: Ductdeakage�< 15 percent; RC, CCA _< 300 CFM/ton (Minimum Air Flow Requirement),,TMAH
For -Packaged Units: Duct leakage<15 percent } '
Exempted"from-ductyleagage testing if:':. `
❑ 1. Duct system was documented,to have been previously sealed and confirmed through HERS verification, or -
❑,,2. Duct systems with less thd-h 40 linear feet in unconditioned space, or
❑°3. Exis�ting�'ductfsystems ar' '—tracte-dminsulatedsorxsealed51withTasbestos
;? spa wft'F �ti - :i'v ff]= �
❑ 2. New HVAC` — Required`]Form's:yp'. — yyy p f C�
y��• �'.,fC .�+ '.iC.. idC '�JC'38 du'n�. -.. `� YF� ^� "� �•'jv.y ,_L G- �••�''+!..`-. -ra�
S stem a zi [ b ! wY
.Cut in or Changeout -04'.
CF 6R forms MECH 04, MECH 2O -HERS, and (for, split systems)'MECH 22 HERS, and
with new ducts: (all o r z� •:
MECH 25"HERS, •� c'. J.»:("rxr'' rust '� I
new ducting and(all
yip , • CF 4R forms 3MECH-20 a-nd (forisplit systems) MECH-22,,and MECH.k25 �....
new;equipment)'� '
�i.� 4s•-Y.+,r K:G�`,�..'•i�v,...? ..�-ai,'.::�fYS.....Cra.:.e'+z �E*•,�-. �. Fyc- � .w'i.�R!i°r,;.: 'fw'•n'3fi' �r�S .�`i s"w-..-�.w ..
For split Systemsn'Duct leakage-<E6'percent;;RC CCA,2:�350'CFM/ton; FWD; TMAH; STMS, and either HSPP or PSPP.
For,Packaged{Units:, Duct leakage ;6'percent
❑ 3. New -,Ducts with%or without) f Required Forms:
Replacement ;? �t21 '
. Includes replacing or installing WWI, ,
new ductingand/or outdoors X''
-A ! y CF -6R forms: MECH-04, MECH720-HERS, and (for. split systems) MECH-25-HERS
condensing. unit and/or indoor:coil , ' CF -4R forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC„CCA >_ 300 CFM/ton, TMAH .
For Packaged Units: Duct leakage < 6 percent
0 4. New Ducting over 40 feet. Required Forms:
.Includes adding or replacing more CF -6R forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in CF -4R forms: MECH-21
unconditioned space. .
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: Jan 13, 2011
Address: 77-825 WILDCAT DRIVE License: 906115
City
a
/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202
Reg: 211-A0002008A-00000000-0000 Registration Date/Time: 2011/01/13 15:49:47 HERS Provider: CalCERTS, Inc.
2008 Residential-Compliance•.Forms' -July 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -IR -ALT -HVAC
Alterations ` 1
Climate Zones 30 - 1S -
Site Address: Enforcement Agency: Date: Permit #: '
55-017 Southern Hills La Quinta, CA 92253 City of La Quinta Jan 13, 2011
' Duct insulation Conditioned Floor
Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat'
p Package Unit '
❑ Furnace R AFUE • 78% ❑ COP - ❑ R 6 (CZ 10-13) Served by system 2 Setback
❑ Indoor Coil p SEER 13.0 ❑ HSPF If not already present,
❑ Condensing Unit ❑ EER ❑ Resistance ❑ R 8 (CZ 14-15) 1500 sf must be 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, 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 %4R'f'&m's: MECH-21'and (for split systems) MECH-25
. Furnace wva ,
For Split Systems: Ductdeakage�< 15 percent; RC, CCA _< 300 CFM/ton (Minimum Air Flow Requirement),,TMAH
For -Packaged Units: Duct leakage<15 percent } '
Exempted"from-ductyleagage testing if:':. `
❑ 1. Duct system was documented,to have been previously sealed and confirmed through HERS verification, or -
❑,,2. Duct systems with less thd-h 40 linear feet in unconditioned space, or
❑°3. Exis�ting�'ductfsystems ar' '—tracte-dminsulatedsorxsealed51withTasbestos
;? spa wft'F �ti - :i'v ff]= �
❑ 2. New HVAC` — Required`]Form's:yp'. — yyy p f C�
y��• �'.,fC .�+ '.iC.. idC '�JC'38 du'n�. -.. `� YF� ^� "� �•'jv.y ,_L G- �••�''+!..`-. -ra�
S stem a zi [ b ! wY
.Cut in or Changeout -04'.
CF 6R forms MECH 04, MECH 2O -HERS, and (for, split systems)'MECH 22 HERS, and
with new ducts: (all o r z� •:
MECH 25"HERS, •� c'. J.»:("rxr'' rust '� I
new ducting and(all
yip , • CF 4R forms 3MECH-20 a-nd (forisplit systems) MECH-22,,and MECH.k25 �....
new;equipment)'� '
�i.� 4s•-Y.+,r K:G�`,�..'•i�v,...? ..�-ai,'.::�fYS.....Cra.:.e'+z �E*•,�-. �. Fyc- � .w'i.�R!i°r,;.: 'fw'•n'3fi' �r�S .�`i s"w-..-�.w ..
For split Systemsn'Duct leakage-<E6'percent;;RC CCA,2:�350'CFM/ton; FWD; TMAH; STMS, and either HSPP or PSPP.
For,Packaged{Units:, Duct leakage ;6'percent
❑ 3. New -,Ducts with%or without) f Required Forms:
Replacement ;? �t21 '
. Includes replacing or installing WWI, ,
new ductingand/or outdoors X''
-A ! y CF -6R forms: MECH-04, MECH720-HERS, and (for. split systems) MECH-25-HERS
condensing. unit and/or indoor:coil , ' CF -4R forms: MECH-20 and (for split systems) MECH-25
and/or furnace. No or some
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC„CCA >_ 300 CFM/ton, TMAH .
For Packaged Units: Duct leakage < 6 percent
0 4. New Ducting over 40 feet. Required Forms:
.Includes adding or replacing more CF -6R forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in CF -4R forms: MECH-21
unconditioned space. .
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: Jan 13, 2011
Address: 77-825 WILDCAT DRIVE License: 906115
City
a
Bin #
City of La Quinta
Building.& Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracidng Sheet
Penna.#
Project Address:' �5`0 6&4 � e i A
Owner's Name: Ile, le -,v
A P. Number.
Address: .- D % SOLI �I erll (5
Legal Description:
Contractor.
City, ST, Zip: L G
Telephone: 0—
Address:. 7791<
City, ST, Zip: FD CjZZ
Project Description: Z yI !
vJQ au
Telephone: e
State Lie. # : q C,W f City Lc. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
Wil? c3':
State Lia #: .
PrIDject type (circle one): New Add'n Alter air' Demo
Name of Contact Person: Sq. Ft: #Stories #Units:
Telephone # of Contact Person: Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Recd TRACKING. PERMFr FEES
Plan Sets Plan Check submitted Item Amount
Structural Calcs.
Truss Calix.
Reviewed, ready for correcdons
Called Contact Person
Plan Check Deposit
Plan Check Balance
Energy Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan,2"
Review, ready for correctionsrccsue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.I1LL
H.O.A. Approval
Plans resubmitted
Grading
Developer Impact Fee
A.LP.P.
IN HOUSE:-
3n° Review, ready for correctionsrrssue
Planning Approval
Called Contact Person •
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees