BMCH2015-0145Applicant: LPMENTDEPAR
Contractor:.
HYDES HYDES
OUTSIDE CITY LIMITS -OUTSIDE CITY LIMITS
5
(760)360-2200
TMENT Llc. No.: :LIC -0004822
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,,
and my License is in full force and effect.
License Class: Li nse No.: :LIC -0004822
Date: /� / Contract
OWNER-BUILD ECLARATION
I hereby affirm under penalty of perju at 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
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.).
( )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 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 Address:
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:_ Policy Number: _
_ 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 Labo II for
comply with those provisions.
I
Qate: A p p I I c
WARNING: FAILURE TO SECURE WO S' 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 above-
mentioned ppopefor inspection purposes.
Pate: Signature (Applicant or Ag
'T
VOICE (766) 777-7125
78-495 CALLE TAMPICO
v D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/28/2015
Application Number: BMCH2O15-0145
Owner:
Property Address: 53442 VIA DONA
DONALD SEABLE
APN: 777420005
56492 VIA DONA
Application Description: DON SEABLE CENTRAL SPLIT SYSTEM
LA QUI NTA, CA 92253
Property Zoning: `
Application Valuation: $8,910.00
Applicant: LPMENTDEPAR
Contractor:.
HYDES HYDES
OUTSIDE CITY LIMITS -OUTSIDE CITY LIMITS
5
(760)360-2200
TMENT Llc. No.: :LIC -0004822
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,,
and my License is in full force and effect.
License Class: Li nse No.: :LIC -0004822
Date: /� / Contract
OWNER-BUILD ECLARATION
I hereby affirm under penalty of perju at 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
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.).
( )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 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 Address:
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:_ Policy Number: _
_ 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 Labo II for
comply with those provisions.
I
Qate: A p p I I c
WARNING: FAILURE TO SECURE WO S' 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 above-
mentioned ppopefor inspection purposes.
Pate: Signature (Applicant or Ag
INFORMATION
DESCRIFTIONn 3.ry�i �F*yts
ACCOUNT `4TY <. AMOUNT s . PAID DATE
�.,.i ,.,`!a f ....�z .: ,PAID
r y'
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
L•
RECEIPT;# `r'"CHECK#. CLTD BYry
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
;.:'.-DESCRIPTION
= ..ACCOUNT.
QTY
OU NTF.' '
PAID' -
RAID DATE'
s
r-. y .A
, ,AM
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY,:'r' r `
�` METHODS 'u;:,
_;`,,RECEIPT# '`
CHECK# ''
CLTD.BY,"
DESCRIPTION u°r� x..
a.{ r, i ,ACCOUNT aw,.x•
QTYxc
AMOUNT.
PAID
PAID DATE,
y
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY `,
�s' n , =METHOD 4 th4,
4RECEIFTt# +
CHECK,#
CLTD:.BY?
�<
;.tr
;;
Total Paid forCHANGEOUT: $108:78 $0.00
DESCRIP:TIONc'A000UNTe
QTYt
µ AMOUNT;
PAID DATE
PERMIT ISSUANCE '
101-0000-42404
0
$91.85
$0.00
s ° w PAID BY
!4,_ '� METHOD:'.
�RECEIPTW# _
r; CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:i 00
ti
Description: DON SEABLE CENTRAL SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 4/28/2015 PJU
Approved:
Parcel No: 777420005 Site Address: 53442 VIA DONA LA QUINTA,CA 92253
Subdivision: TR 29894-4 - Block: Lot: 22
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:.
Finaled: x
Valuation: $8,910.00 w 'Occupancy Type:.' Construction Type: '
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0 .•
`
Details: HVAC CENTRAL SPLIT SYSTEM 78% AFUE,16 SEER STON PER 2013 MECHANICAL CODES 2013 ENERGY] CARBON MONOXIDE ALARM
f (S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
ADDITIONAL SITES
Printed: Tuesday, April 28, 2015 11:15:03 AM 1 of 2
WLV SYSTEMS ,
CHRONOLOGY
CONDITIONS
CONTACTS
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APPLICANT
HYDES
OUTSIDE CITY LIMITS
(760)574-4497,
CONTRACTOR
HYDES
OUTSIDE CITY LIMITS
(760)574-4497
OWNER
DONALD SEABLE
56492 VIA DONA _
LA QUINTA CA
92253
(760)574-4497
Printed: Tuesday, April 28, 2015 11:15:03 AM 1 of 2
WLV SYSTEMS ,
^ ` F T MECHANICAL FINAL" BLD
4
�
�PARENT PROJECTS'
BOND
INFORMATION
ACCOUNT
ttT Y",
A16 DATE
RECEIPT #'
--CHECK W
WETHOD
ATTACHMENTS
HVACCHANGEOUT-
101-0000-42402
0
$72.52
$0.00
HVACCHANGEOUT-
10 1-0000-42600
Or
$36.26
$0.00
SPLIT -SYSTEM PC.
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
Total Paid for PERMIT ISSUANCE: $91.8s $0.00
TOTALS: $201.63 $0.00
^ ` F T MECHANICAL FINAL" BLD
4
�
�PARENT PROJECTS'
Printed: Tuesday, April D8,2O1511:15:33AKA � . 2of2 CNFWIYSTEMS
~ '
' ,
^
BOND
INFORMATION
ATTACHMENTS
Printed: Tuesday, April D8,2O1511:15:33AKA � . 2of2 CNFWIYSTEMS
~ '
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^
CERTIFICATE OF COMPLIANCE '
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
(Page 1 of 3 )
Project Name:
53-442 Via DonaDate
Prepared:
2015-04-27
General Information
R-ALT02 is applicable to multiple spaceconditioning systems
use one CHR -ALT -02 document for each dwelling
F
contained within a single dwelling unit. When multiple dwelling units must beumented,
unit.
01
Project Name
53-442 Via' Dona
02
Date Prepared P
2015-04-27
03
Project Location
53-442 Via Dona
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
53-442 Via Dona
07
Zip Code92253
08
Dwelling Unit Conditioned
Floor Area (ft2) `
4201
09
Climate Zone
15
Number of space conditioning
10 .
(SCI systems in this dwelling
T
unit.
B. Space Conditioning (SC) System Information;e=�
01
02
03 .
All,
tit 04
f= 05?I
06�
07'
08
09
' Is the SCS`
Installing a
10
SC System
SC System
CFA served
"'" `system a v
refrigerant
Installing'new SC
rylnstallmg�
Instalh g
•n nstalling
Identification or
Location or Area
' by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2).
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Bedrooms
2000Yes
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: 215-A0109762A-000000000-0000
Registration Date/Time: 2015-04-27 11:49:03
.
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Report Version: 2014-03-31
Report Generated:
Schema Version: 0.555SDD
2015-04-27 11:48:59
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01 02 03 04 05 06 07
Cooling
Heating
Minimum
Efficiency
Efficiency
System Heating Altered
Heating
Minimum
16
Altered
Identification System Heating
Efficiency
Efficiency
Cooling
Cooling
or Name Type Components
Type
Value
System Type
Components
Central split All new
System 1 HP heating
AFUE
0.78
Central split
All new
components
�
cooling g
components
08
09
Cooling
Cooling
Minimum
Efficiency
Efficiency
Type
Value
SEER
16
CF1R-ALT 02-E
(Page 2 of 3 )
10 11 12
Required
Thermostat
Type
Setback
New or
Replaced
Duct Length
This field or
section is not
a I' bl
Required Documentation:
pp ica e
MR -MCH -03-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: 515%, or s 10% 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 2 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH520 Duct Leakage Testing requirements. .
-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 .,
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia 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)lC)
Registration Number: 215-A0109762A-000000000-0000
This section does not apply to this project.
Registration Date/Time:
2015-04-27 11:49:03
New. Duct
R -Value
This field or
section is not
applicable
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
Report Generated: 2015704-27 11:48:59
Schema Version: 0.555SDD
a
CERTIFICATE OF COMPLIANCE '
I Alterations to Space Conditioning Systems (formerly CF -IR -ALT lHVAC)
t
Documentation Author's Declaration Statement
CF1R-ALT 02-E
(Page 3 of 3 )
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Hyde, Mark Documentation Author Signature:
Company:
CERTIFIED COMFORT SYSTEMS INC Signature Date:
2015-04-27 11:49:03
Address:
42949 Madio
CEA/ HERS Certification Identification (if applicable):.
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.
4. The building design features or system design features identified on;this Certificate.of Compliance are consistent with he i ormation.provided om:other applicable compliance documents worksheets''
calculations, plans and specifications submitted to the enforcement agency for; pproval with this building permit application. ��
5. 1 will ensure that a registered copy of this Certificate of Compliance shall, be made.available With the b 'lding pe mit(s) issued for the building,. and'. made availab a to theenforcement agency for -all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is.required to be included with the,d.
ocumentation the builder proyi�des to the building owner at occupancy.
Y
r
Responsible Designer Name: Yt a _ #
Hyde, MarkA Responsible Designer Signature r .+ 1• ��..s
- �
..... d
Company: Date Signed:
CERTIFIED COMFORT SYSTEMS INC 2015-04-27 11:49:03
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: 215-A0109762A-000000000-0000 Registration Date/Time: 2015-04-27 11:49:03
_ HERS Provider: CaICERTS
CA Building Energy EfficiencyStandards - 2013 Residential Compliance Report Version: 2014-03-31
Report Generated: 2015-04-27 11:48:59
Schema Version: 0.555SDD
Bin # "
City of La Quinta
Permit #
Project Address: ')
A. P. Number:
Contractor:,
Address: • % ` `� K 1
C(
City, ST, Zip:
Telephone: 6c,
State Lic If
Bmldmg 8L Safety Division
P.O. BOX 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Wilding Permit Application and Tracking Sheet
r
Owner's Name:
Address: 5 3,
C 52,
ity, ST, Zip: �� .�d (� J �T
.
Project Description:
ZZdt /
aC7 % City Lic. #:
Arch., Engr., Designer.-
Address:
esignerAddress:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle d'n
Name of Contact Person: one): New AdAlter Repair' Demo
Sq. Ft.: - #Stories:
Telephone # of Contact Person: # Units:
.
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading, plan'
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:
Planning Approval
Pub. Wks. APpr
School Fees
Estimated
Va1ue_o�'ProjecK:
APPLICANT: DO NOT WRITE BELOW THIS UNE
Recd TRACIUNG
Plan Check submitted
PERhIIT FEES
Reviewed, ready for corrections
Item Amount
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
•
Construction
Plans resubmitted
Mechanical
2'" Review, ready for correctionslissue
Electrical
Called Contact person
Plumbing
Plans picked up
S-M.L
Plans resubmitted
Grading
'"' Review, ready for correctioos/issne
Developer'Lnpact Fee
Called Contact Person
A.LP.P.
Date of permit issue
7
Total Permit Fees