BMCH2016-044578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BMCH2O16-0445
To. ur°FlwQ91f&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
55455 LAUREL VALLEY Q
775181090
YOUNG RESIDENCE /HVAC DE U
$7,000.00 DEC 14
Applicant:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153-
Date:
77-7153
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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 Professions Code,
and my License is in full force and effect.
License Class: C20, C36 License No.: 906115
Date:- —Contracto .
k_ /
I hereby affirm under penalty of perjury tF I am a mpt from the Contractor's State
License Law for the following reason (Se 031.5 usiness and Professions Code: Any
city or county that requires a permit to onstru 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, 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, 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.).
Lender's Name:.
Lender's Address:
Date: 12/13/2016
Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
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: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600015264
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 should become subject to. the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with th se provisions.
Date: Applic
WARNING: FAILURE TO SKI JR RK COMPE 10 COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER T RIMIN ENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLA ($100 ). 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 Building Official 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 city to enter upon the
above -mention d pro erty for inspection purposes.
Date: Signature (Applicant or Agen
Owner:
YOUNG
aGRAEME
55455 LAUREL VALLEY
LA QUINTA, CA 92253
2016.
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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 Professions Code,
and my License is in full force and effect.
License Class: C20, C36 License No.: 906115
Date:- —Contracto .
k_ /
I hereby affirm under penalty of perjury tF I am a mpt from the Contractor's State
License Law for the following reason (Se 031.5 usiness and Professions Code: Any
city or county that requires a permit to onstru 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, 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, 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.).
Lender's Name:.
Lender's Address:
Date: 12/13/2016
Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
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: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600015264
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 should become subject to. the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with th se provisions.
Date: Applic
WARNING: FAILURE TO SKI JR RK COMPE 10 COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER T RIMIN ENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLA ($100 ). 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 Building Official 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 city to enter upon the
above -mention d pro erty for inspection purposes.
Date: Signature (Applicant or Agen
Date: 12/13/2016
Application Number: BMCH2016-0445 Owner:
Property Address: 55455 LAUREL VALLEY GRAEME YOUNG
APN: 775181090 55455 LAUREL VALLEY
Application Description: YOUNG RESIDENCE / HVAC CHANGE OUT LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $7,000.00
Applicant: Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET 42-949 MADIO STREET'
INDIO, CA 92201 INDIO, CA 92201
(760)360-2202
Llc. -No.: 906115
---------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM [2013.ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
PER 2013 CALIFORNIA BUILDING CODES
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
Bin .#
City. of La Quihta
�. Building 8T Safety Division
Box 1504,78-495 Calle Tampico
�-/'"1 J La,Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
Project Address:
Va
Owner's Name: .
A. P. Number.
Address: . 5La A/d3w
Legal Description:
�
Contractor: M10i
City, ST, Zip:
,Fc~....
Telephone:
Address: —�
Project Description:
City, ST, Zip: TL D C 92W l
Telephone: _Z2 .112
10 0L 1 4w
State Lic. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:Construction
State Lic. #:`
Name of Contact Person:
Type:. Occupancy:
Project type (oircle one): New Add'n Alter Repair Demo
-Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:oco
APPLICANT: DO NOT WRITE BELOW THIS UNE
p
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical .
Grading plan
2id Review, ready -for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
3" Review, ready for correctionsfissue
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 CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1'of 3 )
Project Name: 55455 Laurel Valley Date Prepared: 2016-11-17
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CF1R-ALT-02 document for each dwelling unit.
01
Project Name
55455 Laurel Valley
02
Date Prepared
2016-11-17
03
Project Location
55455 Laurel Valley
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
55455 Laurel Valley
07
Zip Code
92253
08
Dwelling Unit Conditioned
2388
`"' '"``''�" '� `"
'� �`
.. lad i['k•.J.+
`
'�„'
Floor Area (ft2)
SC System
SC System
CFA served
*_system a
�ilucted
refrigerant
Number of space conditioning
( Installing D
*�.._,
09
Climate Zone
15
10
(SC) systems in this dwelling
1
�,. x �
containing
t
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information.' I'f�
Ol
02
03
j 04�
05j{
{^U6'`r
F
) 07
P
08r
�1
09
10
rA.S
.LwM.ra1',e'
�°.
���Is the SC'
• �Installing aT'
`"' '"``''�" '� `"
'� �`
.. lad i['k•.J.+
`
'�„'
SC System
SC System
CFA served
*_system a
�ilucted
refrigerant
.Installing new SC
( Installing D
*�.._,
n
Installing
=Installing
Identification or
Location or Area
by this SC
�,. x �
containing
t
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1200
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to.this project.
Registration Number: 216-A0427747A-000000000-0000 Registration Date/Time: 2016-11-17 15:39:35 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-17 15:39:10
Schema Version: 0.5555DD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.. "
Documentation Author Name:
Documentation Author Signature: // J
Hyde, Mark
�dj�6LP/
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2016-11-17 15:39:35
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
. -r Tom, .*k
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. .1 * ! _
4. The building design features or system design features identified onthis Certificate of Compliance are consistent with the information provided or other. pplicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement:agency for"approvkwith this building permit application. In ��
5. I will ensure that a registered copy of this Certificate of3Compliance shall. be made available with_the building permits) issued for the,6uildirig, and:made available to,the:enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is.required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: `4 s ••.. o _ a
Responsible Designer Signature: •
Hyde, Mark
/`( %� ,
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2016-11-17 15:39:35
Address:
license:
42949 Madio
906115
City/State/Zip:
Phone: -
Indio CA 92201
760-360-2202
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
"responsibility for the accuracy of the information.
Registration Number: 216-A0427747A-000000000-0000
Registration Date/Time: 2016-11-17 15:39:35
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008. Report Generated: 201641-17 15:39:10
Schema Version: 0.555SDD