BMCH2016-030878-495 CALLE TAW. ICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
r -
Application Number: BMCH2O16-0308
Property Address: 60562 WHITE SAGE DR
APN: 764330060
Application Description: ROUS / CHANGE OUT (1) SPLIT SYSTEM
Property Zoning:
Application Valuation: $7,800.00
Applicant:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
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: CC20 C�6 License No.: 9061/15
Date: P NO/ I f, Contract /
OWNER -BUILDER C RAT ON
I hereby affirm under penalty of perjury tha exe pt fr the Contractor's State
License Law for the following reason (Sec. 1.5, B i s and Professions Code: Any
city or county that requires a permit to construct, a r, 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/2016
Owner:
RICF.ARD ROUS::
92253
};., '• f-,liU 16 2015
Con-.ractor:
CER—IFIED COMFORT SYSTEMS INC DBA HYDES
42-549 MADIO STREET
IN DID, CA 92201
(760)360-2202
LIc. qo.: 906115
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty o- perjury one of the following declarations:
I have and will main'ain a certificate of consent to self -insure for workers'
compensation, as provided for )y Section 3700 of the Labor Code, for the performance
of k for which this pernn-it is issued.
I have and will main-.ain workers' compensation insurance, as required by
Sect n 3700 of the Labor Code for the performance of the work for which this permit
is issued. My workers' compenoation insurance carrier and polity 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 those provisions.
Date. fifApplican -
WARNING: FAILURE TO SECURE WORKERS' COMP SATION RAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENAL AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FES.
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 Lehalf 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 hoi d 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 perm t.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 da-fs 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 th
above-mentioned property forinspection purposes.
Date: Signzture (Applicant or Agen
F
Application Number: BMCH2016-0308
Property Address: 60562 WHITE SAGE DR
APN: 764330060
Application Description: ROUS / CHANGE OUT (1) SPLIT SYSTEM
Property Zoning:
Application Valuation: $7,800.00
Applicant:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
Date: 8/15/2016
Own ar:
RICHARD ROUS
, 92153
Contactor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
(7601360-2202
Lic. No.: 906115
---------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - (1) 18SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARNXS) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES. '
9
DESCRIPTION
FINANCIAL .• !.
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for'BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600.
0
$36.26
Total Paid for CHANGEOUT:
$108.78
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
Total Paid for PERMIT ISSUANCE:
$91.85
Bin. #
City of La Quinta
Building at Safety Division
P.O. Box 1504,-78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
"10I
Project Address:
Owner's Name• .
L
A• P. Number.
Address: 60
Legal Description:
Contractor: �(' i ,p
Address: —
City, ST, Zip:
.N.
Telephone:
Project Description:
City, ST, Zip: Lkit) 9
Tele hone: �,.� �' �' •> -111
{.?
State Lic.
City Lic. #:
Arch; Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #: „ . ;y
Construction Type: Occupancy:
Project type (circle one): New Add'nter Repair Demo
Name of Contact Person:
Sq. Ft:42#Stories:
# Units :
Telephone # of Contact Person:
Estimated Value of Project: �.
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMiT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Cafes.
Called Contact Person
Plan Check Balance
Tide 24 Calci.
Plans picked up
Caustractlon
Flood plain plan
Plans resubmitted..
Mecharilcal
Grading plan
2id Review, ready for correctionslissue
Electrical
Subcontattor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.I.
ILOAL Approval
Plans resubmitted
Grading
l7V HOUSE: -
Review', ready for corrections/issue
Developer Impact Fee
Planning Approval
Callen Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
^a
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: 60-562 White Sage Drive I Date Prepared: 2016-06-22
A. General Information
CF1111-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
60-562 White Sage Drive
02
Date Prepared
2016-06-22
03
Project Location
60-562 White Sage Drive
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
60-562 White Sage Drive
07
Zip Code
92253
08
Dwelling Unit Conditioned
2424
Floor Area (ft2)
SC System
SC System
CFA served
'--,,systema"
refrige ar nt '
Number of space conditioning
'In stallinig 7I
09
Climate Zone
15
10
(SC) systems in this dwelling
1
~ducted
containing
J system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information
01
02
03
04,�
/ = 05 i 1
06 " �1,
{ ( 07
09
10
' FIs the SC
'Installing a'
SC System
SC System
CFA served
'--,,systema"
refrige ar nt '
" Installing new SC
'In stallinig 7I
sn talling
,Installing
Identification or
Location or Area
by this SC
~ducted
containing
J system
more than 40
entirelyen w
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0232503A-000000000-0000
Registration Date/Time: 2016-06-22 19:35:11
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-22 19:34:01
Schema Version: 0.555SDD
i
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Central split
All new
Central split
All new
This field or
This field or
5ysterrl 1
HP
heating
AFUE
78
Ar
cooling
SEER
18
Setback
section is not
section is not
components
Components
applicable
applicable
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: :5 15%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct LeakageTesting requirements.
f
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23; or Refrigerant Charge MECH-25.
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
• y ~
�.'
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(4)lDiia and 150.2(b)1E, F)
,� ',- '' 4'=t `..►tt• �+, fti.t' . � is �1 r� f1 ;1 `l Md'
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 216-A0232503A-000000000-0000 Registration Date/Time: 2016-06-22 19:35:11 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-22 19:34:01
Schema Version: 0.555SDD
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:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2016-06-22 19:35:11
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
1760-360-2202
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
requirements of Title 24, Part 1 and Part 6 of the California Code of Re ulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit applicatiori.
5. 1 will ensure that a registered copy of this Certific to of Compliance shall be made availablewith the building permit(s) issued for.the building, 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: ��; -� 1 . -
i �>G'�
Responsible Designer Signature: V i
Wa
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2016-06-22 19:35:11
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
Digitally signed by CaICERTS. 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-A0232503A-000000000-0000 Registration Date/Time: 2016-06-22 19:35:11 HERS Provider: CalCERTS
`a CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-22 19:34:01
Schema Version: 0.555SDD