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10-1347 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:2:Z0 00-01.3-4_7 _L Property Address: 55110`IZVALLEY APN: 775-340-008- - Application description: MECHANICAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6805 Applicant: Architect or Engineer: CJD LICENSED CONTRACTOR'S DECLARATION I BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: C20 C36 Licen. No. 906115 Dat /� _4C1Gontractor: a OWNER -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 05001.: 1 _ 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 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 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 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: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011. INSPECTIONS (760) 777-7153 Date: 12/09/10 Owner: BAKER KRIS 55510 LAUREL VALLEY LA.QUINTA, CA 92253 ( nnoContractor: I� HYDES i1r. 2010 77825 WILDCAT STR T _•.••� PALM DESERT, CA 9121 CITY OFLA�;:it'.1J7A (760)360-2202 Pr 1'^"` =�i� F'�d- ,Lic. No.:' 906115 . ---'—'� _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ WORKER'S COMPENSATION DECLARATION hereby affirm underpenalty 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 CEWC133676 _ I certify that, in the performance of the work for which this permi ,is issued, I shall not employ any person in any manner so as to become subject to the work compensation laws of California, and agree that, i�Ishouldbecome sub) ct to ork compensation provisions of Section 3700 01 the Labde, I shall fort ith com th those provisions. Dater_4��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 1$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. I agree to complywith all city and county ordinances and state laws relating to building construction, and hereby auth ize repres tatives of this co����uuyyynty to enter the above-mentioned property for' coon poses. Date: ighature (Applicant or Agent): Application Number . . . . . 10-00001347 Permit. . . . . . . MECHANICAL Additional desc '. Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Expiration Date 6/07/11 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 • -----------------------------------------------------------"----------------- Special Notes and Comments A/C CHANGE OUT 4 TON 16 SEER 2007 CODES. ----------------------------------------------------------- Other Fees . . . . . . . . . BLDG ---------------- STDS ADMIN (SB1473) 1.00 Fee summary Charged --------------------------- ---------- Paid Credited -------------------- Due Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total 1.00 .00 .00 1.00 Grand Total 42.25 .00 .00 42.25 LQPER IIT Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC Climate Zones 10 - 15 Site Address: Enforcement Agency: Date: Permit 7 55-510 Laurel Valley La Quinta, CA 92253 City of La Quinta Dec 9, 2010 Equipment Typel List Minimum Efficiency2 Duct insulation requirement Conditioned Floor Area Thermostat ❑ Package Unit ® Furnace p Indoor Coil 0 AFUE o% Q SEER 16.0 �� ❑ COP ❑ HSPF ❑ R 6 (CZ 10-13) Served by system p Setback not already present, p Condensing Unit ❑ EER El ❑ R 8 (CZ 14-15) 1600 sf m must be installed) ❑ Other 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 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 -611 shall also be on site for final inspection. E5 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 -411 forms: MECH-21 and (for split systems) MECH-25 • Condenser Coil and /or • Indoor Coil and /or CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF -411 forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH For Packaged Units: Duct leakage < 15 percent Exempted from duct leagage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or ❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or ❑ 3. Existing duct,systems are constructed'. insula ted,orsealed with asbestos Jtr= ❑ 2. New HVAC 1 System Required -Forms: f (` j • L . Cut in or. Change out ,�? with new ducts: (all'} ' { i CF-6R,forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22=HERS and,. new ducting ar fall ss .. MECH'25tHERS .'s .t 1 -' 1 _, tri 1 r CF=4R forms:•MECHr30, and {forrsplit systems) MECH;.2� and MECH.25.. new equipment)" T dt l For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP. For Packaged Units: Duct leakage < 6 percent ❑ 3. New Ducts with/or without Required Forms: Replacement . Includes replacing or installing all new ducting and/or outdoor condensing unit and/or indoor coil CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS 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 linear feet of duct in CF -6R forms: MECH-04, MECH-2I-HERS unconditioned space. CF -411 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: Dec 9, 2010 Address: 77-825 WILDCAT DRIVE License: 906115 City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202 Reg: 210-A0030268A-00000000-0000 Registration Date/Time: 2010/12/09 14:27:29 . HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Bin Submittal Plan Sets RWd • City of La Quinita TRACEING • Plan Check submitted PFdrBrIITFEES Item Amount Plan Chat Deposit BlnH&W St. Safety Division P.O. Box 1504, 78-495 Calle Tampico Permit # L Reviewed, ready for corrections U Qlmlm, CA 92253 - (760) 777-7012 l� Building Permit Application and Tracidng Sheet Project Address:• —�'l6 VG. Owner's Name: Energy Calcs. A. P. Number: Construction iaaial Address S " C /� 4 e on: Flood plain plan cam, ST, Zip: 6A Contractor. lr 1 /� /' �, W7?i j'! j 5 7 e Telephone: - Project b Address: • �Z S INl Grading Plan City, ST, Zip= `z -z- 2i1 Review, ready for correctionsf m F,[ Subeontactor List Stave Lia # : City Lic. #: �ZZ Arcb., Fkw. Dedgna: Grant Deed Address: --------------- Plans picked up city, ST, Zip: Telephone: Construction Type: State Lia #: Mug Gra, Project type (circle one) New AMU Alter Rqw Demo IN HOUSE- Name of Contact Person: r" Review, ready for corrections%sue Sq. Ft: # Stories: # Unkm Telephone # of Contact Person:Estnmated Value of Project r,/YC-)5 ALMICAUT. rN) NAT WQtTc nin d%v. r........... # Submittal Plan Sets RWd • Beed TRACEING • Plan Check submitted PFdrBrIITFEES Item Amount Plan Chat Deposit Structural Calcs. Reviewed, ready for corrections Trans Calcs. Called Contact Person Plan Check Balance Energy Calcs. Pians picked up Construction iaaial Flood plain plan Plans resubmitted Grading Plan 2i1 Review, ready for correctionsf m F,[ Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.hLL SOA Approval Plans resubmitted Mug Gra, IN HOUSE- r" Review, ready for corrections%sue Developer Impact Fee Plawiiqg Approval Called Contact Person AMP.P. I.Pub- Wits. APpr Date of permit issue School Fees Total Permit Fees