06-1592 (MECH)4 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
Date: 5/09/06
Application Number: 06-00001592 Owner:
Property Address: 78055 COBALT CT MILLER JOHN
APN: 604-023-032- - - 78055 COBALT COURT D
Application description: MECHANICAL LA QUINTA, CA 92253 d
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4000 ���
Contractor: O 2006
Applicant: Architect or Engineer: HYDES APPLIANCE PLBG & A/C NC C17Y
77825 WILDCAT STREET OFifiA
PALM DESERT, CA 92211
(760)36072202
Lic. No.: 598768
------------------
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 Busine Professionals Code, and my License is in full force and effect.
License Class: C20 C36 kA Lic se o.: 5 8768
w
Aate:���ontractor:
OWNER-BUILDE DEC RATION
I hereby affirm under penalty of perjury that I am exempt from the actor'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).:
( I 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 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: 1 `1
Lender's Address:
LQPERMIT
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 CLARENDON INS Policy Number 04KR0026985
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 sh ecome subject to t workers' compensation provisions of Section
3700 of the L or de shall forthwith com ly with t se provisions.
�i�� w
Date: 06k licant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSAT N C ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI ES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001. 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 I& 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 an -state laws relating to bui i co _[ruction, and hereby author' a representatives
of this county to enter up he above-mentioned pr, rty for ' spection purRoses.
ate: ig.,ature (Applicant or Agent):
Application Number. . . . . . .06-00001592
Permit . .
. MECHANICAL
Additional desc .
Permit Fee . . .
. 24.00
Plan Check
Fee
6.00
Issue Date . .
Valuation
. . .
.
0
Expiration Date
11/05/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 9.0000 EA MECH
APPL REP/ALT/ADD
9.00
----------------------------------------------------------------------------
Special Notes and
Comments
REPLACE 3 TON A/C
SYSTEM
Fee summary
-----------------
Charged
----------
Paid Credited
Due
Permit Fee Total
----------
24.00
----------
.00
----------
.00
24.00
Plan Check Total
6.00
.00
.00
6.00
Grand Total
30.00
00
.00
30.00
LQPERMIT
Bi" #
City of La Quinta
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampito
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address; 78 _
Owner's Name: "�'( (, (2
A. P. Number:
Address:
Legal Description:
City, ST, Ziptpt ? ,�
Contractor: 14\/D6
i t� tl/OIn)
Telephone:
a
Address:
�(L/ �'�j�
Project Description:
City, ST, Zip: F
C�Q
�Al/2.�� .
�k77
Telephone: ��'3 �po, GSL
Z
! jcG l � %1rd L- psi
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
p
City, ST, Zip:
Telephone:
Constru.tion Type: Occupancy:
State Lic. #:
Project type (circle one): New Add -'n Alter Repair Demo
Name of Contact Person:
�, YE�
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: /. 600
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval '
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 4) CF -1R
Project Title
M r Ll_L�- 2
rr K -ress d 5 VICO Z A -t-
Author
Compliance Method (Prescriptive)
Telephone
Climate Zone
Date
Building Permit #
Plan Check / Date
Field Check / Date
Enforcement Agency Use Only
✓ ❑ Alternative Component Package Method: (check one) C D D (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -IR page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 7-14
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ft2 Average Ceiling Height: ft
Maximum Allowed West Facing Fenestration Products Per Table 151-B or 151-C ---- (5% X CFA) ft2
Maximum Allowed Total Fenestration Products Per Table 151-B or.151-C ---- (20% X CFA) ft
✓ ❑ Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill out WS -4R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations.)
Number of Stories: Number of Dwelling Units:
Floor Construction Type: Slab/Raised Floor (circle one or both)
Front Orientation: North / South / East / West / All Orientations (input front orientation in degrees from True
North and circle one).
✓ ❑ RADIANT BARRIER (required in climate zones 2, 4, 8=15)
OPAQUE SURFACES INCLUDING OPAOUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge,
Doors)
Frame
Type
(Wood
or Metal)
Assembly U -
factor (for
Cavity Continuous wood, metal
Insulation Insulation frame and mass
R -Value R -Value assemblies)'
Joint
Appendix.
IV
Reference
Roof Radiant
Barrier Location/Comments
Installed' (attic, garage,
Yes or No typical, etc.
1) See Joint Appendix IV in Section IV.2, IV.3 and IVA"which is the basis for the U -factor criterion. U -factors can not
exceed prescriptive value to show equivalence to R -values.
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Pag////e 2 of 4) CF -IR
-rD
Project Title n Date
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓Q FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS-4R—must be included for New Construction,
Additions and Alterations.
Fenestration
#/Type/Pos.
(Front, Left, Origin-
Rear, Right, tation, Area U -factor
Skylight) N, S, E, W'(ft') U-factor2 Source SHGC4
Exterior
Shading/Overhangs6,'
SHGC ✓ box if WS -3R is
Sources included
13
13
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction
when the pitch is less than 1:12. See § 151(f)3C and in Section 3.2.3 of the Residential Manual
2) Enter values in this column are either NFRC Rated value or from Standards default Table 116A.
3) Indicate source either from NFRC or Table 116A,
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -3R.
5) Indicate source either from NFRC or Table I I6B.
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices.
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
Heating. Equipment Minimum Distribution
Type and Capacity Efficiency Type and Location Duct or Piping Thermostat Configuration
fumace, heat pump, boiler, etc. AFUE or HSPF ducts, attic, etc. R -Value Type split or acka e
CW_ IRJMI
Cooling Equipment Minimum
Type and Capacity Efficiency Duct Location Duct Thermostat Configuration
A/C, heat pum , eva . cooling) SEER or EER attic, etc. R -Value Type (split or package)
CT
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 4) CF -IR
r
�Y1 i L. C E V— U
eet Title ' Date
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following. are
required.
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Distribution
Type
Number
in System
Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
❑
TXVs; readily accessible (climate zones 2 and 8-15 only)
Installer testing and certification and HERS Rater field verification required.)
Standby
Loss %
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification required.) .
OR
❑ Alternative to Sealed Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features for
Proiect Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
OR
For additions and alterations, duct systems that are not documented to have been previously
❑ sealed as confirmed through field verification and diagnostic testing in accordance with procedures in the
Residential ACM Manual and duct systems with more than 40 linear feet in unconditioned
spaces shall meet the requirements of Section 150(m) and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
.Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per .
❑
dwelling unit. If the water heater is a storage -type, 50 gallons is the maximum capacity and recirculation system is
Standby
Loss %
not allowed.
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the
submittal.
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple
units
.Systems serving single dwelling units
Water Heater
Type/Fuel Type
Distribution
Type
Number
in System
Rated
Input'
tkw or
Btu/hr(gallons)
Tank
Capacity
Energy
Factor' or
Thermal
Efficient
Standby
Loss %
Tank
External
Insulation
R -Value
System serving multiple dwelling units
Water Heater .
Type
Distribution
Type
Number
in System
Rated
Input'
(kw or
Btu/lu)
Tank .
Capacity
(galions)
Energy
Factor' or
Thermal
Efficient
Standby
Loss %
Tank
External
Insulation
R -Value
1. For small gas storage water heaters.(rated inputs of less than or equal to 75,000 Btu/hr), electric resistance, and heat
pump water heaters, list Energy Factor. For large gas storage water heaters (rated input of greater than 75,000
Btu/hr),.lisi Rated Input, Recovery Efficiency, Thermal Efficiency. and Standby Loss. For instantaneous gas water
heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines > 3/4 inches) All hot water pipes from the heating source to the kitchen fixtures that are 3/4
inches or greater in diameter shall be thermally insulated as specified by Section 150 Q) 2 A or 150 0) 2 B.
Residential Compliance Forms March 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 4) CF -IR
Project Title
Date
SPECIAL FEATURES NOT REQUIRING HERS VERIFICATION (add extra sheets if necessary)
Indicate which special features are part of this project. The list below only represents special features relevant to the
vrescriative method.
✓
Feature
Required Forms if applicable)
Description .
❑
Metal Framed Walls
CF -1R
Refrigerant Charge
❑
Radiant Barriers
CF -1R
CF -6R art 6 of 12
❑
Exterior Shades
WS -4R
❑
Cool Roof
N/A;.Attach CRRC Label to
Forms.
❑
Dedicated Hydronic Heating
Performance Calculation
System
Required; Attach Run to Forms.
❑
Combined Hydronic System
Performance Calculation.
Required; Attach Run to Forms.
❑
Gas Cooling
Performance Calculation
Required.
❑
Buried Ducts
N/A; Indicate on building plans.
❑
Kitchen Pipe Insulation
See Section 5.6.2 Distribution
Systems in Residential Manual.
Multiple Water Heaters Per
See Table 5-13 or use
❑
Dwelling Unit
Performance Calculation and
attach Run to Forms.
❑
Central Water Heating System
Performance Calculation and
Serving Multiple Dwellings
attach Run to Forms.
❑
Non-NAECA Large Water
CF -1R
Heater
See Table 5-13 or use
❑
Indirect Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Instantaneous Gas Water Heater
Performance Calculation and
attach Run to Forms
See Table 5-13 or use
❑
Solar Water Heating System
Performance Calculation and
attach Run to Forms
❑
Wood Stove Boiler.
Performance Calculation and
attach Run to Forms
SPECIAL FEATURES REQUIRING HERS RATER VERIFICATION
.(add extra sheets if necessary) Indicate to the HERS Rater which credits are part of this project and need
verification.
Vol
Feature .
Required Forms if applicable) Description
❑
Duct Sealin
CF -6R part 4 of 12
❑
Refrigerant Charge
CF -6R part 5 of 12
❑
Thermostatic Expansion -Valve
CF -6R art 6 of 12
Residential Compliance Forms March 2005
INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R
Permit Number
MAd �-Co' 1 AZ i a- 9
INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE
INSTALLER COMPLIANCE STATEMENT
The building was: ✓ ❑Tested at Final ✓ ❑ Tested at Rough -in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE:
❑ Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior
finishing wall are properly sealed.
❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used
❑ New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of
ducts).
✓ ❑ DUCT LEAKAGE REDUCTION
Procedures forfteld verll(icadon and dlagnosdc tesdng of air distribution systems are available In RACM, Appendix RC4.3
NEW CONSTRUCTION:
Duct Pressurization Test Results (CFM @ 25 Pa)
Measured
Values
1
Enter Tested Leakage Flow in CFM:
Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured
2
If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(ptuhv) x Heating
` 2,
i in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here:
V/ V/Ca
3
Pass if Leakage Percentages 6% for Final or S 4% at Rough -in:
❑ Pass ❑ Fail
100 x (Line # 1 / (Line # 2
ALTERATIONS:
Duct System and/or HVAC Equipment Change -Out
Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct
4
System Alteration and/or Equipment Change -Out.
Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct
I
5
S stem for Duct S stem Alteration and/or ui ment Change -Out.
—42
j
Enter Reduction in Leakage for Altered Duct System
6
ine # 4 Minus Line # 5 —(Only if Applicable)
7
Enter Tested Leakage Flow in CFM to Outside (Only if Applicable)
✓ ✓
Entire New Duct System - Pass if Leakage Percentage S 6%° for Final
❑Pass 11 Fail
8
100 x (Line # 5 / Line # 2
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- V/ ✓.
Out Use one of the following four Test or Verification Standards for compliance:
9
Pass if Leakage Percentage 5 15% [ 100 x [ _(Line # 5) /t (Line # 2)]]
❑ Pass ❑ Fail
10
Pass if Leakage to Outside Percentage S 10% [ 100 x _(Line # 7) / (Line # 2)]]
❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage z 60% [ 100 x [(Line # 6) / (Line # 4)]]
I 1
11 Pass ❑Fail
and Verification b .Smoke Test and Visual Inspection
12
Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Ins 'on
❑ Pass ❑ Fail
Pass If One of Lines # 9 through # 12 pass
RIJBIM ❑ Pass ❑ Fail
✓ ❑l, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for
compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and
Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature: Date:
Copia to: BUILDING DEPARTMENT, ITERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms September 2005