13-1470 (MECH)C,
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-0`0001470
Property Address: 1(7-9015—V3Al CARMEL
APN: 646 -400 -021 -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
/Application valuation: 29000 -
Applicant: Architect or Engineer:
'1000000L*
^� VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760),777-7153
BUILDING PERMIT
Owner:
DON STENQUIST
79015 VIA CARMEL
LA QUINTA, CA 92253
Dd Contractor:
HYDES
42949 MADIO STREET
Na1/:o Zo�� INDIO, CA 92201
V (760)360-2202
CITY �F�' Lic. No.: 906115
F1 DF 7A
Date: 11/20/13
---------------------------------------------------------------------------------------------------
' LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: _
Section 7000) of Division 3 of the Business and,Professionals Code, and my License is in full force and effect:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 C36 icense No.: 906115
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ontrac�or:
_ 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier NORGUARD INS Policy Number CEWC468841
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued,,I, shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
- permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become }�1ect o the workers' compensation provisions of Section
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
0 of` he Labor Code, I shall A iI comp'yy those provisions.
7 o)
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001•:
Dale: i Applicant:.
(_ 1 I, as owner of the property, or my.employees with wages as their sole compensation, will do the work, and
� i�-a-�.�
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of'property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS 1$100,0001. IN ADDITION. TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
' improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
( 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
•
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ I I am exempt under Sec. , BAP.C. for this reason - -
- -
-
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta its officers a ents and emP to ees for an act or omission related to the work bein -
Date: Owner:
_N
CONSTRUCTION LENDING AGENCY
1 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
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.stateJaws relating to building construction, and hereby authorize rep entatives
of this county to ent&r.upon_ ;the'above-mentioned property for inspection urpos .
-+'3 �-
Date:— --��Signature-(Applicant or Agent):
7
Application. Number .. . . 13-00001470
m
Permit ,. MECHANICAL2013
Additional desc .
=- Permit Fee- 250.26 Plan Check Fee
.00
Issue Date valuation . . .
. 0
Expiration Date 5/19/14
�. Qty Unit Charge Per
Extension
3.00 35.7500 EA MECH FURNACE
107.25
3.00 11.9200 EA MECH APPL REP/ALT
35.76
3.00 35.7500 EA MECH CONDENSER/COMP
107.25
Special Notes and Comments
(3)HVAC CHANGE OUT 5TON,4TON,2TON
FURNACES & COILS - 13SEER/78% AFUE
SPLIT SYSTEM [2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2010 CBC.
------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT -ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
157.29.
Fee summary Charged Paid Credited
Due
Permit Fee Total 250.26 .00 .00
250.26 -_
Plan Check Total .00 .00 .00
.00
Other Fee Total 248.86 .00 .00
248.86
Grand Total 499.12 .00 .00
499.12
LQPERNI IT
Bin #
P �
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Project Address:' � G _ ('
A. 'P. Number.
Contractor.
Address:(� Z � !/1
City, ST, zip: �L/o
Telephone: 6Cj — LZb1
State Lic. # q (% l I
Arch-, Engr> Designer:
Address:
City, ST, Zip: -
Telephone:
State Lic. #:
Name of Contact person:
Telephone # of Contact Person: .
# Submittal Rea'd
Plan Sets
Structural Cates.
'Fuss Coles.
Energy Calcs.
Flood plain plan
Grading plan'
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks APpr
School Fees
City of L- a Quinta
Budding 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Qlmrta, CA 92253 - (760) 777-7012-
Building
77-7012Building Permit Application and Tracking Sheet -
t ✓ !"lam. Owne's Name: tv'� VI
Address:. Gl - 0i (% + G
City, ST, Zip. C, A c
�j� Descriptio, 3
C Q ZZd�
City Lic. #. Sl
C_
-11 V"Z
ZZS
Total Permit Eecs
Consbuc tion Type:
c5,.
777
Froject type (circle one):
New Add'n Alter Repair � Demo
Sq.. Ft::
# Stories:
# Units:
Estimated Value Of Project Z aC�
APPLICANT: DO NOT WRITE BELOW THIS
UNE
TRACKING
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Palance.
Plans ticked up
Construction
ns resubmitted
Mechanical
Review, ready for correcdooslrssme
Electrical
led Contact Person
Plumbing
ns picked up
S.IVLL
ns resubmitted
fDate
Grading
eview, ready foreorrections/issue
Developer,Impact Fee
edContactPerson
of permit issue
Total Permit Eecs
Y
• ,ft
7.
t
Simplified Prescriptive. Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC
Climate Zones 10 - 15 '
Site Address:
Enforcement Agency:
Date:
Permit #:
79-015 Via Carmel(3) La Quinta, CA 92253!
City of La Quinta
Nov 19, 2013 -
Duct insulation
Conditioned Floor
`.
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat _
❑ Package Unit
® Furnace
® AFUE 78%
❑ COP
'
❑ R 6 (CZ 10-13)
Served by system
® Setback v
be
® Indoor Coil
® SEER 13.0
[3HSPF ,
❑ R 8 (CZ 14-15)
800 sf
If not already present, must
® Condensing Unit
❑ EER
❑ Resistance
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.
® 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 -
CF -611 forms: MECH-04,.MECH-2I-HERS and (for split systems) MECH-25-HERS
.Indoor Coil and/or - t
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct leakagek. 15 percent; RC, CCA-<_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH;
For. PaGliaged 15 peFeent
Exempted from duct leakage testirg;if, r
01. 'buct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less thA.'40 linear feet in unconditioned space, or,. _
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
p:4. The�systemrw,ill not be Ducted (ie:Ductless,Mirn Split System) -,(Also Exempt from,Refrigerant Charge)
❑ 2. New HVAC S stem
Require Forms x.`' ' '
q lk
y
.^
. Cut in'6K.Ch6ngeout with'
6R forms MECH-04, MECH 20 HERS;.and (f a split systems) MECH 22 HERS, and
CF {
new ducts (all new
ducting and all new
MECH 25;HERS
25
equipment)::.
G4R forms rMECH 20, and (for split systems),MECH 22; and MECH
r.
z�r
>.F �...<� y.:..:;. •nt ::r ,:.. _ .;...;+.... ,�...
For Split Systems Duct leakage
< 6;perce6t,;RC, CCA > 350 CFM/ton, FWDWH STMS,-and either HSPP"or PSPP *;
For Packaged Units: Dud
leakage < 6. percent .,: r :.....
❑ 3. New Ducts with/or without ':: -
Required Forms:
Replacement....
. Includes replacing or installing al.l:new
ducting and/or outdoor condensing`unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MEC_ H -25 -HERS
and/or indoor coil and/or furnace Ao 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 t •"F
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more.than 40
CF -6R forms: MECH-04, MECH-2I-HERS •:
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing dud 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. r
• 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: Nov 19, 2013 °
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA / 92201 Phone: (760) 360-2202 -
I. x
Reg:•213-A0086934A-000000000-0000 Registration-Date/Time: 2013/11/19 11:04:49 HERS Provider:•Ca10ERTS, Inc. .
2008 Residential'Compliance Forms r.: { July, 2010 • '