14-0058 (MECH)4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT / INSPECTIONS (760) 777-7153.
BUILDING PERMIT
Dater 1/21/14
Application Number: �*
14-.00-000 8 . i Owner.
Property Address: �"`50455 VIA SERENIDAD BLANCHAT MIKE
APN: 772-390-023- - - -50455 VIA SERENIDAD
Application description: MECHANICAL LA..QUINTA, CA :92253 D
Property Zoning: LOW DENSITY RESIDENTIAL (972) 955,-1628
Application valuatiori: 10380
Contractor:
Appli Jnt: Architect or Engineer: HYDES c ` QUINTA
42949 MADIO STREET C� '406VEPT
INDIO, CA 92201
(760)360-2202
Lic. No. 906115
LICENSED CONTRACTOR'S DECLARATION'-'-"T _F`� WORKER'S COMPENSATION DECLARATION
I 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. _ 1 have and will maintain a certificate of consent to self-insure for workers' compensation, as provided
_ _ License Class: C20 C36 Li nse No.: 906115 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _
L7 �,, issued.
Date: " '—"';Contractor. . 7 _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
"-"�""'•`^'r �� - 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 Iany
. 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 tofile "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 syybjectto orker 'compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or +- 3700 of the Labor Code, I shall f hwi ly • those provisions.
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/.'.D^_ate: A_pplicam::
1 _ 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 Y 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, providedthat the DOLLARS ($100,000). 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 exclusivelycontracting 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 a9Dt[aote0st4i'censed • 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,
(_ 1 I am exempt under Sec. , B.&P.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, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
.Date: Owner: 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 -
CONSTRUCTION LENDING AGENCY.. permit to cancellation. -
hereby affirm under penalty of perjury that there is aconstruction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all -
work for which this permit is issued (Sec. 3097, Civ- C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this c un`y to enty n the above-mentioned property for inspectio rposes.
Lender's Name: Name: - - r k. - - .�L3�/_^_ : --- _.�
Dater Signature (Applicant-or Agent): !/ -
Lender's Address: -
LQPERMIT' • .. -
Application Number" _ . . . 14-00000058
Permit MECHANICAL 2013
Additional desc .
Permit Fee 83.42 Plan Check Fee
.00^
Issue Date Valuation
0
Expiration Date 7/20/14
Qty Unit Charge Per
Extension
1.00 35.7500 EA MECH FURNACE
35.75
1-00 11.9200 EA MECH APPL REP/ALT
11.92
1.00 35.7500 EA MECH CONDENSER/COMP
35.75
Special Notes and Comments
FURNACE,INDOOR, COIL CONDENSING•UNIT 780
AFUE 13 SEER CARBON MONOXIDE ALARM(S) TO
BE INSTALLED PRIOR TO FINAL INSPECTION.
2010.CBC.
----------------------------------------------------------
---- - -------------------------------
Other
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1".00.
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
52.43
Fee summary Charged Paid Credited
Due
Permit Fee Total 83.42 .00 .00
83.42
Plan Check Total .00 .00 .00
.00
Other Fee Total 144.00 .00 .00
144.00
Grand Total 227..42 .00 .00
227.:42
LQPERMIT -
..
Bun #
Pertntit #
Project Addtess:-
A. P. Number.
Contractor.
Address: % Z K
City, ST, Zip:
Telephone: GCj _-
State Lic. #
Arch., Engr, Design:
Address:
City, ST, Zip:
Telephone:
State Lic. #
Name of Contact person.
Telephone# of Contact i'erson:
# Submittal
Plan Sets
Structural Cafes.
Truss Cafes.
Energy Cafes.
Flood plain plan
Grading plan
Sabcontactor List
Grant Deed
H.O.A. Approval
INHOUSE:-
Plannink Approval
Pub. Wks. APpr
School Fees
&W,
City of La Quinta
Build'mg At Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quanta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
S• l� ere/�� Owna'sName: / ice c��G
Address. C) ! S�, . e.icj j
h3', ST, Zip: Q G Z Z
f
t � ^T �S R / Telephone:
1c,, Project Description S hS
C iQ 'ct ZZd� '
City Lic. #: ff
Total Permit Fees
JAIN 21-2014
CITY OF LA C►uli�t
COMMUNITY DEVELOPMENT
Construction Type:
Occupancy:
(circle one):
New Add'n Alter Rept Demo
Lftojjectpe
# Stories:
Value ol'Project: / o 8�
APPLICANT:
DO NOT WRITE BELOW THIS UNE
Rec'd
TRACIMG
PERMIT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Pian Chock Balance
Plans picked up
Construction
Plans resubmitted
Mechanical •
Z"' Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.L
Pians resubmitted
Grading
Ji° Review, ready for eorreetious/rssae
Developer -Impact Fee
Called Contact Person
A.LP.P.
Date of permit issae
.
Total Permit Fees
JAIN 21-2014
CITY OF LA C►uli�t
COMMUNITY DEVELOPMENT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations' CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address- •
Enforcement Agency:
Dater 1.
7
50-455 Via Sere nidad La Quinta, CA 92253 •
t
]an 21,'2014
�.
Duct insulation
Conditioned Floor
b ti.�
.� * a ; , �
� � • y
•, ray ^F g
a i'
i�
;
.,
}
ACOP
[3 HSPF
[3R 6 (CZ 10;13)
Served by system
7 •
.® Condensing• Unit
` i� '� ��
[3Resistance
❑ R $ (CZ 14-15)
-yd' #:••!'Y' •
i
S
_«
_ f>•,
�rf 7A
. �_
*y
✓` .
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'
y -
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations' CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address- •
Enforcement Agency:
Dater 1.
Permit #:
50-455 Via Sere nidad La Quinta, CA 92253 •
CityW La Quinta
]an 21,'2014
-
Duct insulation
Conditioned Floor
Equipment Type1'
List Minimum Efficiency2'
requirement
Area
Thermostat
❑ Package Unit,
® Furnace
®.Indoor Coil. �
®-AFUE 78%
®SEER -13.0 •
ACOP
[3 HSPF
[3R 6 (CZ 10;13)
Served by system
® Setback
If not already present, must be
.® Condensing• Unit
[3EER
[3Resistance
❑ R $ (CZ 14-15)
1600 sf
installed)
❑ Other r
_
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 -1R
and CF -611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
All HVAC Equipment ; , •
CF -611 forms: MECH-04, MECH-21-HERS and (for.split systems) MECH-257HERS.1- .
replaced
CF -411 forms: MECH-21 and (for split systems) MECH-25
..Condenser Coil and /or
flit ff
CF -6R forms: MECH-04, MECH-2I-HERS and ors split sems MECH-25-HERS
( P Y. )
Indoor Coil and,/or
CF -4R forms: MECH-21 (for split systems).MECH-25
•Furnace �
For Split Systems: Duct leakage._<,15 percent; RC, CCA 5 300 CFM/ton (Minimum Air Flow Requirement); TMAH
.., '. •.� '
c- l spit -. r leak- t c �,�toat
Packaged uc#
Exempted from duct leakage testing if:. ' "•:. `
❑ 1. -Duct system was documented to have been previously'sealed and confirmed through HERS verification, or '
[32. Duct systems with less than;40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed; insulated or sealed with asbestos
Q:4. Theasystem�will not be Ducted'(ieDuctlessMinsplit System;)�(Alsoxempt�frcomRefrgerantChdrge) r 4
132. N64HVA System' RequirtedForms /i
a:mkdS .F a+s.e..:a�:x,+.¢,.Trx.:.. .iRR•...
'. Cut inor Chan eout withP,W A�<:,: ..
9 CFu6R forms MECH-04, M "WIU. HERS,; andj(forasplit systems) MECH,22=HERS, and
new ducts :: all new x ar
( MEGW25 4ERS ' � r: r
ductingPan"d all new MECH
CF 4R forms MECH 20, and°(for split systems+) 22, and�MECH 25'-
. `4 ~.dnF�.ut..•
equipment) ���_ :.. ..,,.�x:.� �..� .•�� sa.
For Split Sy t ms Duct''leak'—'
.::.
'< 6�percent RC;ICCAl>Fi350,CFM/toh''�FWD?"�sTMAH, STMS; and ether HSPP or3PSPP.
.. :.:. �.ar.
For Packaged Units: Duct
leakage}< 6. percent
[3 3. New. Ducts with/or without
Required Forms: •' r 'a r,
Replacement:..:::::.::;,
.Includes replacing orinstalling all new
unit
CF forms: MECH=04„MECH-20-HERS, and (for split systems) MECH-25-HERS
' ducting and/or outdoor condensing:
-6R
and/or indoor coil 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 replacingmore than 40
CF -6R forms: MECH-04, MECH-21-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 duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement). ? c
. I certify that this Certificate of Compliance documentation is accurate and complete. +..• • ^' t ; 1
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate'of
_ t
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 consisfent'with the information documented on other applicable compliance J
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: Jan 21, 2014.
Address: 42-949 MADIO STREET License: 906115 '.
City/State/Zip: INDIO'/ CA / 92201 Phone: (760) 360-2202 7
Reg`. 214-A0004797A-000000000-0000
Registration Date/Time: 2014/01/21
13:47:071, HERS Provider: Ca10ERTS,
Inca {