10-1050 (MECH)P.O. BOX 1504 T-it!t 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 10-00001050 Owner:
Property Address: 78856 VIA CARMEL CORT JERELD
APN: 646-430-021- - - 78856 VIA CARMEL
Application description: MECHANICAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 777-8421
Application valuation: 19000
Contractor:
Applicant: Architect or Engineer: HYDES
77825 WILDCAT STREET
PALM DESERT, CA 92211
(760)360-2202
Lic. No..:: 906115
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed un er provisions of hapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professio s Code, and rp<License is in full force and effect.
LicenseClass: CQ20 C36 Lic . a No 906115
Date: / 5—/1 Contractor:
O NER-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 ($500).:
(_ 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.).
(_) 1, 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
pwperty wiiu uuiiva ul unpiuvub uieteun, dllU wuu uulltlacts lur the protects wltn a contractorls) IIeensea
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: _
Lender's Address:
LQPER111IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/08/10
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 NORGUARD INS Policy Number CEWC133676
I certify that, in the performance of the work for which this permit is issue , I shall not employ any
person in any manner so as to become subject to the workers' com sa.ton laws of California,
and agree that, if I should become sub' ct to thew rk s' com sa[ion provisions of Section
/I�,.�n3700 of the Labor Code, I all fo ith p y th provisions.
Datef� /)Vy —1tplicant:
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$100,0001. 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 . tach 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.
1 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, • d hereby auU�rize re resentatives
of thisZ5�z
poly/y/�t�fabove-mentioned propeaf;rrpose
Date: conatitr€ (Applicant or Agent):
Application Number . . . . . 10-00001050
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
69.00
Plan Check Fee
17.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
4/06/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00 9.0000
EA MECH
FURNACE <=100K
18.00
2.00 9.0000
EA MECH
APPL REP/ALT/ADD
18.00
2.00 9.0000
EA MECH
B/C <=3HP/100K BTU
18.00
----------------------------------------------------------------------------
Special Notes and Comments
A/C CHANGE OUT (2)UNITS
1 ONE 17.3
SEER
4 TON ; (1) 19 SEER 2
TON 2007 CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
--------------------
Due
---------------------------
Permit Fee Total
----------
69.00
.00 .00
69.00
Plan Check Total
17.25
.00 .00
17.25
Other Fee Total
1.00
.00 .00
1.00
Grand Total
87.25
.00 .00
87.25
LQPERMIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC
Alterations CF-iR-ALT-HVAC
Climate Zones 10 - 1S
Site Address:
Enforcement Agency:
Date:
Permit #:
78-856 Via Carmel La Quinta, CA 92253
City of La Quinta
Oct 8, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
❑ Furnace
❑ AFUE
❑ COP
Over 40 ft of ducts
added or replaced in
0 Setback
0 Indoor Coil
p SEER 17.3
❑ HSPF
unconditioned space
Served by system
If not already
® Condensing Unit
❑ EER
❑ Resistance
❑ R 6 (CZ 10-13)
1600 sf
present, must
be installed)
0 Other Furn Heat Exch
❑ R 8 (CZ 14-15)
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-411 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.
8 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6111 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-6111 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF-4R 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
[13. Exis i ' ystems are stru d',01 " ate sea «
❑ 2. Ne&VAC
Requir fM.FFo sc`V AMSystemCut
i Ghangeout
n w ducts: I
new d
Rmi
MECH-22-with
E -,H 5-H ,�%
6RLfor' ECH-04, M 0- ER#EC
4f fb ms:ECH ZO rosPfit a
new eqw n�
-.
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For PackagediUnits: 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-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or furnace. No or some
CF-4R 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-4R 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: Oct 8, 2010
Address: 77-825 WILDCAT DRIVE License: 906115
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202
1 'i
Reg:.210-A0019082A-00000000-0000 Registration Date/Time: 2010/10/08 13:16:51 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms March 2010
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -IR -ALT -HVAC
Alterations
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
78-856 Via Carmel La Quinta, CA 92253
City of La Quinta
Oct 8, 2010
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
Over 40 ft of ducts
0 Setback
❑ Furnace
0 Indoor Coil
❑ AFUE
0 SEER 19.0
❑ COP
❑ HSPF
added or replaced in
unconditioned space
Served by system
If not already
0 Condensing Unit
❑ EER'
❑ Resistance
❑ R 6 (CZ 10-13)
800 sf
present, must
be installed)
0 Other Furn Heat ExilL.
I
I ❑ R 8 (CZ 14-15)
1
1
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.
0 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 -4R 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 -4R forms: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage <115 percent; RC, CCA _< 300 CFM/ton (Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage ,< 15 percent
Exempted from duct leagage testingif:
❑ 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. Exist�n dtic -,systems are,popstruct� fftulat0i opsealed wit a�b!stos P--r57^�
❑ 2. Nev6 HVAC 4
Requir I �Fofm`s:I ► -� �, �
Systeme
. Cut i or. Changeout
with new ducts: (I
new ducting ai ra
C? >. n r
-22- 6S, tinct ,
CF-6R�forms MECH-04, MESH 2O -HERS, nd (for split sys ems) MZ's
MEC 25 -HERS. � f r
%!CF
-4 forms: MEGH'20,-a d (for split systems) MECHr22_and MEC
new equipment)_ . -
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 z 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 -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems; Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more
CF -611 forms: MECH-04, MECH-2I-HERS
than 40 linear feet of duct in
CF -4R forms: MECH-21
unconditioned space.
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: Oct 8, 2010
Address: 77-825 WILDCAT DRIVE License: 906115
City/State/Zip: PALM DESERT / CA / 92211 Phone: (760) 360-2202
;� 0
Reg: 210-A0019080A-00000000-0000 Registration Date/Time: 2010/10/08 13:11:42 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms March 2010
Bin
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application .and Tracidng Sheet
Permit *�
�b�
Project Address: "7,q7-5,6
i,:1 c4,rr
Ownees Name:
A. P. Number:
Address:
Legal Description:City,
ST, Zip= Oct / l awl 'ti /CA
Contractor. c -e, r�, cls
Cj1t7 51
Telephone: 7,450 —7 -7•—S'IZ
Address: ��
(/,��,1 �(,I1CL�
Project Description: �, C • n
City, ST, zip: ct �''!
K1�1 el'T
/ I
"lZZ `
i7bl
Telephone:
%c"— — vIL
"Lic-State
Lic. #: o6
#: Z`Z
Arch., Fag+., Designer.
Address:
City, ST, Zip:
Telephone.
Construction Type. icy:
State Lia #:
Project type (circle one): New Add'3 Alter Repan Demo
Sq. Ft: # es # Units:
Name of Contact Person:
Telephone # of Contact Person:
I stimatod Value of Project C) ('J
APPLICANT: DO NOT WR[TE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG ,
PERMTi FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Play CheckDeposit
Truss Cales.
Called Contact Person
Plan CheekBaiance
Energy Cales.
Plans picked up
Constractim
NOW Plam Phu
Plans resabmitted
Mechanical
Grading plan
2'' Review, ready for corrections/issue
Electrical'
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE.-
'"' Review, ready for correctionslissae
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees