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12-1230 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12_0.00.01230P.r Property Address: 55341 SOUTHERN HILLS APN: .775 -181 -021 - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8845 Applicant: . Architect or Engineer: ,plv 4 4 I. P, W . BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: BARTHOLOMEW KENNETH K, 55341 SOUTHERN HILLS LA QUINTA, CA 92253 Contractor: HYDES 42949 MADIO STREET INDIO, CA 92201 (760)360-2202 LiC. No.: 906115 VOA -1606) 7 -7012 FriX ( 777-7011 INSPECTIONS (760) 777-7153 Date:. 10/15/12 PF- ocr 1;27012 - ------------------- -- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION . I hereby affirm under penalty of perjury that I 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 Professional ode, 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 a C{lass: C20 C36 ense No.: 906115 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - issued. _ �lU5 0 /Y Oate: ontractor: v�\I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor . I 1 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 CEWC356415 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 mannersoas 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 thew rs' comrns'ation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 7D0 of the Labor Code, I sha I forthwith comp ' h rhos rowsions. 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)•: at Appli t: (_ 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 SECURE WORKS 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 NLTIES 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 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 - - 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 contractor(s) 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, I—) 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 Quinta, 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 certifythat 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 (Sec. 3097, Civ. C.). and county ordinances and state laws relating to building construc ' n, and hereby authoriz epresentatives .hisZ��Si Lender's Name: pon a above-mentioned property for ins rposes. /Date:: G1 ature (Applicant or Agent): Lender's Address: 1 LQPERMIT Application Number . . . . 12-00001230 Permit . . . MECHANICAL Additional desc . Permit Fee 40.50 Plan Check Fee 10.13 Issue Date . . . Valuation 0 Expiration Date.. 4/13/13 Qty Unit Charge Per Extension BASE FEE 15.00: 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 ---------------------- ------------------------------------------------ Special Notes and Comments HVAC CHANGE -OUT: 5 TON 14 SEER PACKAGE UNIT.- 2010 CODES. ----------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) ----- 1.00• Fee summary Charged Paid Credited Due Permit Fee Total 40.50 .00 .00 40.50 Plan Check Total 10.13 .00 .00 10.13 Other Fee Total 1.00 .00 .00 1.00 Grand Total 51.63 .00 .001, 51.63 ' LQPERMIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit #: 55-341 Southern Hills La Quinta, CA 92253 City of La Quinta Oct 15, 2012 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ® Package Unit ❑ Furnace ® AFUE 78% ❑ COP ❑ R 6 (CZ 10-13) Served by system ® Setback ❑ Indoor Coil ® SEER 13.0 ❑ HSPF ❑ R 8 (CZ 14-15) 2000 sf If not already present, must be [I Condensing Unit [3 EER' [3 Resistance installed) ❑ Other I - , 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 onsite 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 -IR 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 (fee split ......t.,ms) P49GH-25 HERS replaced CF -4R forms: MECH-21'and (f..F Split systems) MECH 2 . Condenser Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS aF;d (f8F Split ...,,.«,.ms) MEG14 ,c HERS y . Indoor Coil and /or M�H ,5 CF'4R forms + MECH-21 �� (f Split ,- ,•. . Fumace For Packaged Units:'Duct leakage;., -,15 percent Exempted from duct,leakage testing if: ❑ 1:'Duct system was documented.to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systerns.with less'then'40 linear feet in unconditioned space, or p 3. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. The#systeriiIwill,not be Ducted (ie 4Ductlessj,,y it System)"'(Algd`*Exernpt from_lR_efngerant ChaNrge) ❑ 2. New HVAC System Required Formsy°y:°� ;���iF . Cut inlor Changeout with; ": .: ....�, . CF 6R forms MECH 04; MECH 20 HERS, and (for split systems) MECH=22i HERS, and ---Y new ducts. (all new'* MECHI251HER5;, fir, rt f ` a;; ducting and all new CF 4R forms 'MECH 20` and (for split systems) MECW and MECH 25 i '` equipment) ` t c-i� ?� .' fes, .. >:a .?_- <ts '- '. For.Split Systems:;Duct leakage <16'percent; RCnCCA°>_ 350,CFM/ton*FWD;;TMAH STMS, anc1either1HSPP or'.PSPP For Packaged.Units'Duct leakage !c 6' ercent , `"i' .:A ❑..3.-New?Ducts with/or without ":iv Required Forms: Replacement . Includes replacing or installing aWnew 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. - ,r 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. . 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: Oct 15, 2012 Address: 42-949 MADIO STREET License: 906115 City/State/Zip: INDIO / CA'/ 92201 Phone: (760) 360-2202 M Reg: 212-A0057379A-000000000-0000 Registration Date/Time: 2012/10/15 13:33:11 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin # Permit .# Project Address: A. P. Number: ci -3 '-f 1 - Contractor: Address: ` c City, HE Zip: Lc TI h e ep one. 7.� GG — ZZ e,Z i State Lic. # : q 06� Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: ------------- Telephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Calcs. Energy Calcs. Flood plain plan Grading, plan SubContactor List Grant Deed ILOA- Approval IN HOUSE: - Planning Approval Pub. Wks. APpr School Fees 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 -Tracking Sheet Q✓n 5 Owner's Name: en -7 Address: City, ST, Zip: r G d Project Description: A •cl Z -" d I Lic. #: �`i x Z Zz S3 Construction Type: Occupancy: P cY= Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACI�YG PERMIT FEES Plan Check submitted Item Amount . Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2°d Review, ready for correctio�ssue Electrical Called Contact Person Plumbing Plans picked up ]Called S M L Plans resubmitted Grading 3rd Review, ready for corrections/issue Developer Impact Fee Contact Person A.LP.P. Date of permit issue Total Permit Fees