BMCH2014-115778-495 CALLS TAMPICO �
LA QUINTA, CALIFORNIA 9225?'
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Numb r _•„� BMCH2'014"1157'
PropApplication
edress:
80520 VIA TERRA`
APN:
777260038
Application Description:
HVAC CHANGE -OUT 4 TON 16 SEER
Property Zoning:
Application Valuation:
$8,100.00
- A
Applicant:
2`4
C t✓ G ur LU: �F
HYDES
k
0 OUTSIDE CITY LIMITS
_
CITY OF LA QUINTA
LA QUINTA, CA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.: :LIC -000482
�te: � �a
OWNER -BUILD DECLA ION
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 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).:
(_) 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 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: I It
Lender's Address: A
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/2014
Owner:
LOGAN LATHEM
9075 INVERRARY )R SE
WARREN, OH 92233
Contractor:
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)360-2200 .
Llc. No.::LIC-0004.322
WORKER'S COMPENSATDN DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificateof 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 a to become subject to the workers'
compensation laws of California, and agree tha-, if I should beco subject to the
workers' compensation provisions of Section 3:00 or Code, I I forthwith
comply with,those provisions.
WARNING: FAILURE TO SECURE WOR CONIOENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER T CRIMIN^L PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000. IN ADDITION TO.THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR:N 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 cancellEtion.
I certify that I have read this application and stare 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 representat_?A:
ty to ente on the above-
mentioned property for
%inspection purposes.
Y I / ature (Applicant c
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
80-520 Via Terracina I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3 )
2014-12-19
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 CF111-ALT-02 document for each dwelling unit.
01
Project Name
80-520 Via Terracina
02
Date Prepared
2014-12-19
03
Project Location
80-520 Via Terracina
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
80-520 Via Terracina
07
Zip Code
92253
08
Dwelling Unit Conditioned
2535
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system'
Number of space conditioning
entirely new
09
Climate Zone
15
30
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
Is the SC
Installing a
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 (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Living Area
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 214-A0164525A-000000000-0000
Registration Date/Time: 2014-12-19 11:46:46
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-19 11:47:05
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE - CFlR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3-)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
it
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 gas
All new
Central
All new
Less than or
System 1
furnace
heating
AFUE
0.78
packaged AC
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Reauired Documentation:
CF2R-MCH-01-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%, ors 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H Be 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 >_ 300 CFM/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 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)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)lC)
This section does. not apply to this project.
Registration Number: 214-AO16452SA-000000000-0000
Registration Date/Time:
2014-12-19 11:46:46
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-19 11:47:05
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2014-12-19 11:46:46
Address:
CEA/ HERS Certification Identification (if applicable):
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.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2014-12-19 11:46:46
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:'
Indio CA 92.201.
(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: 214-A0164525A-000000000-0000 Registration Date/Time: 2014-12-19 11:46:46 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-19 11:47:05
Schema Version: 0.551SDD
Description: HVAC CHANGE -OUT 4 TON 16 SEER
ADDITIONAL
Type: MECHANICAL Subtype:
Status: APPROVED
Applied: 12/19/2014 KHE
Approved:
Parcel No: 777260038 Site Address: 80520 VIA TERRACINA LA QUINTA,CA 92253
Subdivision: TR 30357 Block:
Lot: 114
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0.
Zoning:
Finaled:
Valuation: $8,100.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
NAME TYPE
Details: HVAC CHANGE -OUT, 4 TON 16 SEER. CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
CONTACTS
CITY
STATE
Painted: Monday, December 22, 2014 9:04:17 AM 1 of 2 I SYSTEMS
ADDITIONAL
CHRONOLOGY
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT'
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
CONTRACTOR
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
OWNER
LOGAN LATHEM
9075 INVERRARY DR SE
WARREN
OH
92253
Painted: Monday, December 22, 2014 9:04:17 AM 1 of 2 I SYSTEMS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Monday, December 22, 2014 9:04:17 AM 2 of 2
. SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY -
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
.SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTAI,S: $201.63 00
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Monday, December 22, 2014 9:04:17 AM 2 of 2
. SYSTEMS
FINANCIAL .f•
DESCRIPTION ACCOUNT QTY AMOUNT
PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$0.00
PAID BY METHOD RECEIPT#
CHECK # CLTD BY.
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT,
QTY
AMOUNT
= PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT #
; ` CHECK #
CLTD BY
DESCRIPTION
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
' CHECK #
CLTD BY •
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
- PAID'
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
- METHOD
RECEIPT #
CHECK #,
CLTD 8Y
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:••
IBin #
Permit^ n14
Project Address-' A
A. P. Number:
Legal Description: /'
Contractor: ev>41 1 J L
141
Address: `—T .Z
City, ST, Zip: /O
Telephone: , 6 c, --zZ
State Lic. # : q (7c,
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 Cales.
Flood plain plan
Grading. plan
Subcontactor List
Grant Deed
H.o-A- Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
City Of La Quinita
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampito
La Quinta, CA 92253 - (760) 777-701
Building Permit Application and Tracking Sheet
' Owner's Name: ZIP
Address:
City, ST, Zip: %� ].. el '7n
Wen5. A
,Q 'ciZZdl
City Lie. #:
Project Description:
JOB
Construction Type:
Occupancy:
Project type (circle one):
New Add'n Alter Repair ep • Demo
Sq. Ft :
# Stories:
#Units:
Estimated Value of Prol a. 'r
APPLICANT: DO NOT WRITE BELOW
THIS UNE
Recd TRACIMG
.
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
2A Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
&IV L
Plans resubmitted
-------------------
Grading
'n° Review, ready for eorrections/issae
Developerlmpact Fee
Called Contact Person
A.LP.P.
Date of permit issue
Total Permit Few