13-0825 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-0.0000825
Property Address: 44630 N HARLAND DR
APN: 604-231-0,15-17 -23268 -
Application description: MECHANICAL
,Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5950
Tay/ °F 4 Q"
Applicant: .Architect or Engineer:
/ v
--------------- __
LICENSED CONTRACTOR'S DECLARATION
BUILDING 8r: SAFETY DEPARTMENT
BUILDING PERMIT
I, hereby affirm under penalty ofperjury that I am licen under provisions of Chapter 9 (commencing with -
Section 7000) otDivision 3' of the Business,and'Profe ovale Code and m icense isin full force and effect.
License Class: C20 C36 License o.: 06115
Data: �51ontractor:
OWNER BUILDER DECLARATION
I: hereby affirm under penalty of perjury that Lam exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Anycity or county that;requires a permit to
constnrot, alter,: improve, demolish; or repair, any structure, prior to its issuance,. also requires the applicant for the
permh: 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 7060) of Division 3 of the Business and Professions,Code) or
that.he orshe is exempt -therefrom and the basis.forrthe alleged exemption. Any violation. of Section 7031.,5 by
any applicant fora Permit 'subjectsahe applicant to: a civil penalty of not more than five hundred dollars (55001::
(_) I, as ownerof the property, or myemployeas with wages as their sole compensation, will do the work, and
the structure isnot intended'or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Caw does not apply to an owner of property who builds or improves thereon;
".and who does the work himself or herself through his or herown 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 affirmvnder penalty of perjury that there is;a construction lending agency forthe performance of'1he
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's, Name: _
Lender's: Address:
LQIPBRMIT
VOICE (760) 777-7012
iii FAX (760) 777-7011
INSPECTIONS (760) 777-7153,
Owner:
JOANNA WILLEY
LA QUINTA, CA 92253
(
Contractor:
HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-22,02
Liq. No.: 906.115.
Date: 7/03/13
WORKER'SCOMPENSATION, DECLARATION
Thereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensetion,,as`provided
for by Section 3700 of,the Labor Code, for the performance of the work for,which this per is,
issued:
_ I have and will maintain workers"compensation: insurance, as required:by Section3700'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. CEWC356415
_ Pe
_ I certify that, in the rformance of ,the work for which this permit is issued, I shall not employ any ,
person irrany manner so as to.become subjectto,the workers' compensation laws of California,.
and agree.that, if 1 should become subject 10the workers' compensation provisions of Section
3700 of the' Labor Code; I shalltfo it omply t ose provisions..
Date:7-1;1_0 Applicant,
WARNING:. FAILURE TO.SECURE WORKERS' C MP.ENSATION COVERAGE IS UNLAWFUL, AND SHALL,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES�AND CIVIL FINES. UP TO ONE HUNDRED THOUSAND
DOLLARS" (0160,666i. 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.onthis application.
1. Each person'.upon whose behalf this application ismade, each person at whose request and for
whose benefit work,is performed under or pursuant to any permit issued swa result of this application,
the owner,•.end,the applicant, each'. agrees to; and shall defend; indemnify and hold harmless the City
of La Quints, its officers, agents and employees for any act or omission relatedito the work being
performed underor following issuance ofrthis 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 that0&above information incorrect. I agree 'comply,with all
city and county ordinances and steteasws relating to,building construction, and hereby authorA representatives
of:this court t�o%'e or upon the above-mentioned propertyforinspe purp s.
Date: I Signature (Applicant ovAgent):
LQPERMIT
Application Number
Permit . . .
Additional desc .
Permit Fee . . . .
Issue Date . .
Expiration Date .
. . . . . 13-0.0000825
MECHANICAL'2013
71.50
12/.30/13
Plan Check Fee . . .00
Valuation 0
Qty Unit Charge Per Extension.
1.00 35.7500 EA MECH FURNACE 35.75
.1.00 35.7500 EA MECH CONDENSER/COMP 35.75
-----------------------------------------------------------------------
Special Notes and Comments
HVAC .CHANGE=OUT - 16 SEER/80 AFUE',3.5
TON HVAC SPLIT SYSTEM. [2008 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSP,.ECTION." 2010
CALIFORNIA BUILDING CODES.
--------------------------------------------------------------------------"-
Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1:00
PERMIT ISSUANCE"M/P/E 90.57
PLAN CHECK, MECHANICAL 47.66
Fee summary Charged
Permit Fee Total 71.;50
Plan Check Total ..00
Other'Fee Total 139.23
Grand Total 210.73
Paid Credited Due
.00 .00 71.50
.00 .00 .00
.00 .00 139..23
.00 .00 2.10.73
Bin # -
City of La Quinta
Building x Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: '(.l ,_x''30 t/ �'Gn
Owner's Name:
A. P. Number:
Address: Gl L4
Legal Description:
City;, ST, zip:
/' F Y
Contractor—evfl�(C-� �'^ ` 5.-�5 q. le-
Telephone:
Address: P1c,
Project Description: N .CC/ ��✓1QC 2n P
City., $T, Zip: �Q Z Z,
Telephone: -� 6r -_ 7�Z�;�
State Lie. # : UV /. �' City Lic. #: �.
Arch., EW., Designer:
Address:
City, ST, Zip.-
ip:Telephone:
Telephone:Consttyction Type: Occupancy:
State, Lie. #: Project type (circle one): New Add'n Alter Repair' Demo
Name of Contact Person: Sq. Ft- # Stories: # Units:
Telephone # of Contact Person:
Estimated Value ofProject: S .�
APPLICANT: DO NOT WRITE BELOW- THIS LINE
#
Submittal
Req'd
Reed
TRACING , i
PERMIT FEES
Plan Sets
Plan.Check submitted
Item
Amount
Structural Calm.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cat..
Called'.Contact Person
Plan Check'Balance
Energy Calcs.
Plana picked up
Construction
Flood plain plan
Plan§ resubmitted
Mechagical
Grading plan,
2" Review, ready for corrections/issue
Electrical
Subcoatactor List
Calicd..Contact Person
Plumbing
'Grant Deed
Plans-picked up
S M.I.
H.O.A. Approval
Plans resubmitted
Grading
Review, ready for correctiogs/rasae
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
TotalTermit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alt+eraHons CF -IR -ALT -HVAC
Climate Zones, 10 - 15
Site•Address:
Enforcement Agency:
Date:
Permit #:
44-630 North harland. Dr. La Quinta, CA 92253
City of La Quinta
Jul '1, 2013
Duct insulation
Conditioned Floor
Equipment Typel
Ust Minimum Efficiency2
'requirement
Area
Thermostat
0 Package Unit
® Furnace
ZAFUE 78%,
E3 COP
p R 6 (CZ 10-13)
Served bysystem
® Setback
®,Indoor Coil
® SEER 13:0
0 HSPF
R 8 (� 14 -IS)
1400 sf
7fnot'already present, must be
® Condensing Unit
p EER
0 Resistance
installed)
0 Other
l. -.Equipment Type: Choosethe.equipmentbeing installed; if more than one system, use anotherCE-1R-ALT-HVACfor each system.
2.=Mfnlmum Equipment Elflclendew 13 SEER, 78% AFUE, 7.7HSPF for typical residentialsystems.
HERS"VERIFICATION SUMMARY Usted below are FOUR HVAC alteration. Options. The installer decides what work is being done,
and picksone of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copyof'the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the rinspector verifies that the work listed on, this
form was in fact the work completed by the installer. The inspetor also verifies that each appropriate CF -611 and registered CF -411
forms (no hand filled CF-4Rs allowed) are filled out and signed Beginning; October 1, 2010, a registered copy of the CF -1R
and CF -6R shall also be on site for final inspection.
® 1. HVAC Changeout
Required. Forms:
.All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25=HERS.
replaced
CF -411 forms: MECH-21 and (forsplitsystems) MECH-25
• Condenser Coil and /or
. indoor Coil and /or
CF -611 forms: MECH-04, MECH-21-HERS and (for split systems) MECH-25-HERS
. Furnace
CF -411 forms: MECH-21 and (for.splitsystems) MECH-25
For Split Systems: Duct leakage%,' 15 percent; RC, CCA _< 300 CFM/ton (Minimum:Air Flow Requirement),, TMAH
Exempted from duct leakage testingtJf:
O is Duct.system wasdocumented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct:systems with less than40 linear feet in unconditioned space, or
0;3. Existing duct systems are constructed, insulated or sealed with asbestos
0;4. Theaystem,will not be Ducted (ie:; DuctiesslMmi-Sph System) (Also Exempt fromrRefngecant Charge)
x ,_. r
0 2. New; jlo A :'System
Required Forms k: a�'
. Cut m^or Changeout With -'CF
611 forms ,MECH-04, MECH�20ZHERS, and '(for split`systems) ME04-22 HERS, and
new ducts (ail new
ducting and all new
;
"MECH
E p�
equipment) : i re
CF4R formsRMECH 20 and fors lits stems 22}rand MECH 25
�t f 1( p Y ),
,r �.
n
t
Wl'V rodtH A, i.,' S' fY 1« , ; ._] '"J 3 I.y 2.d•. 4 Y 1 it ,
For Split Systems .Duct leakage�<
6 peroerit,sRC,�'CCAy>�y350 CFM/ton, FWD, TMAH, STM$, and either HSPP'or"PSPP.
For Packaged Units: Duct
leakage <, &percent -• r .:.. : -... _
0 3., NewrDucts with/or without::
Required Forms:
Replacement-:';;
.;Includes'replacing or'installing allnew
ducting and/or outdoor condensingunit
CF -611 forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or f6inace 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 < 6percent
4. New Ducting over 40 feet
Required Forms:
..Includes adding or replacing more than 40
CF=6R forms: MECH-04, MECH-21-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH--21
For spil[Csystem or packaged units: Duct leakage < 15 percent
0 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.
a I am eligible under blvision.3 of the California Business;and Professions Code to accept responsibility for the: design Identified on this Certificate of
Compliance.
. I. certify that the energyfeatures and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts1 and'6 of•the'Califomia 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, pians and specifications submitted tothe enforcement agency for approval with the permit application.
Name: Mark Hyde Signature: #,ark Hyde
Company: CERTIFIED COMFORT SYSTEMS INC Date: Jul 1, 2013
Address: 42-949 MADIO. STREET License: 906115
city/State/Zip: INDIO / CA / 92201 Phone: (760) 360.2202
Reg:. 213-A0048633A-000000000-0000 Registration- Date/T,ime: 2013/07/01 1`8:,00.:28 HERS Provider: CalCERTS, Inc.
2008 Residential'Compliance Forms July 2010