BMCH2017-044278-495 CALUJAMPICO . T.
D �NM�iil/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
MECHANICAL/
Application Number:
BMCH2O17-0442
Property Address:
78410 VIA DIJON
APN:
604610002
Application Description:
MCCLURE / HVAC CHANGEOUT 17SEER/81AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$20,090.00
Applicant: i' /A f7
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET ,
INDIO, CA 92201 OCT 0 3 20
17
CITYOFLAQUINTA
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class- C20 C36 License No.: 906115
Date: Cont�o
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
($500).:
(_J 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 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/3/2017
Owner:
MICHAEL MCCLURE
78410 VIA DIJON
LA QUINTA, CA 92253
Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
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.
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: 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 ose provisions.
Date: App—lic'ant:
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 ($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 Building Official 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 comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
aboveiT;w
y for inspection purposes.
DaeSignature.(AppliEant o Agent):
Application.Number_ .:',;,#1M91,2017-0442
Property Address:
78410 VIA DIJON
APN:
604610002
Application Description:
MCCLURE / HVAC CHANGEOUT 17SEER/81AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$20,090.00
Applicant:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
Date: 10/3/2017
Owner:
MICHAEL MCCLURE
7841C VIA DIJON
LA QL INTA, CA 92253
Contr3ctor:
CERTI=IED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIC, CA 92201
(760)360-2202
Llc. N:).: 906115
--------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT- (2)17SEER/81AFUE SPLIT SYSTEWCARBON MONOXIDE ALARM(S) TO -BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL
} .'DESCRIPTION
ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$78.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$156.04
Total Paid lfor CHANGEOUT: $234.06
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$98.83
Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:4.
Bin #
Permit •#
M(tt s1
Project Address:'
A. P. Number:
Legal Description: rr j
Contractor: � 2v �! t'/ ri
Address:
City, ST, Zip:
CO.-,
Telephone: 7j G 0 —
State Lic. # : q (Jc,
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Gradingplan'
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. ScWks. APpr
hool Fees
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
0 Owner's Name: . J'�
Address: 9%,%
11 City' ST' Zip: Q�
1'. e�
$ M5 Y,1 Telephone: _ (�
Project Description:
Lic. #: `-f i -L
Construction Type:
Occupancy:
Project type (circle one):
New Add, Alter Repair' Demo
Sq. Ft:
# Stories:
# Units:
Estimated Value of Project -11 10 0- CI o
APPLICANT: DO NOT WRITE BELOW THIS UNE
Ree'd
TRACKING .
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2' Review, ready for correciions/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.ML
Plans resubmitted
Grading
Review, ready for corrections/issue
Developer -impact Fee
Called Contact Person
A LP.P.
Date of permit issue
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3)
Project Name: 78410 Via Dijon . Date Prepared: 2017-30-02
A. General Information
CF1R-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
78410 Via Dijon
02
Date Prepared
2017-10-02
03
Project Location
78410 Via Dijon
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
78410 Via Dijon
iL I_-
TA
SC System
Dwelling Unit Conditioned
CFA served
07
Zip Code
92253
08
Floor Area (ft2)
2763
Identification or
Location or Area
by this SC
Number of Space
containing
09
Climate Zone
15
10
Conditioning (SC) Systems in
2
Served
System (ft)
system?
component?
this Dwelling Unit:
feet of ducts?
B. Space Conditioning (SC) System Information ( { I� it r`�, ;„
o
l r j i
; i
t
Ol
02
03
04 ...
.05
X06 _.
07 ,
�V,
0
8
:'69
�-�
10
is the SCS—
I staIIi &a •
>
i
iL I_-
TA
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than.40
entirely new
entirely new
Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Living Area
1200
Yes
Yes
Yes
No
No
No
Altered spaceconditioning
system
System 2
Bedrooms
1200
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: 217-A020339885A-000-000-0000000-0000 Registration Date/Time:
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006
Schema Version: rev 10/16
2017-10-02 07:34:23 _ HERS Provider: CalCERTS
Report Generated: 2017-10-02 10:34:35
CERTIFICATE OF COMPLIANCE CF1R-ALT-02=E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)IE 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
System 1
HF
heating
AFUE
81
AC
cooling
SEER
17
Setback
section is not
section is not
components
components
applicable
applicable
Central split
All new
Central split
All new
This field or
This field or
System 2
HP
heating
AFUE
81
AC
cooling
SEER
17
Setback
section is not
section is not
components
components
applicable
applicable,
RequiredDocumentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test 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: <= 15% or <= 10% leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification, required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
+
- Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage.Testing requirements. ir 1
1
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F)
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: 217-A020339885A-000-000-0000000-0000 Registration Date/Time: 2017-10-02 07:34:23 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-10-02 10:34:35
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF4R-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: // J
Hyde, Mark
�pj�ILP/
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2017-10-02 07:34:23
Address:
CEA/ MER] Cei tlflLAGun IJenGfiLutiuri (if opplicoblo):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
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 Regulations F. ?'{
_
4. The building design features or system design features identified ort this Certificate of Compliance are consistent with the information provided on otherapplicable compliance documents, worksheets,
calculations, plans and specifications submittdd to the enfotcement agency for approval with this builds g permit applicatign•
5. 1 will ensure that a registered copy of this Certificate of.Compliance shalfbe.made.available with;the building permits) issued for the building, and made available to the'gnforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is,required to be included with the documentation, he builder prow des to the building owner at occupancy.
Responsible Designer Name: "A f ? f 3 1 _
Responsible Designer Signature: V
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2017-10-02 07:34:23
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
Easy to Verify NMI.
at.CaICERTS.com N, r
p);Fk' �
5
Digitally signed b CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies
9 Y 9 Y 9 9, P 9 Y P
w
Registration Provider responsibility for the accuracy of the information.
�
❑
Registration Number: 217-A020339885A-000-000-0000000-0000
Registration Date/Time
2017-10-02 07:34:23
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: ZQ16.1.006 Report'Generated: 2017-10-02 10:34:35
Schema Version: rev 10/16