BMCH2015-0383a78-495 CALLE TAM PICO 4
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DE
BUILDING PERMIT
Application Number: BMCH2O15-0383
Property Address: 45735 COLDBROOK LN
APN: 604423004
Application Description: ROTH RESIDENCE / HVAC CHANGE OUT
Property Zoning:
Application Valuation: $7,000.00
Applicant:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
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: C20 C36 License No.: 906115
Date: Contracto .
OWNER -BUILDER CLAR N
I hereby affirm under penalty of perjury that I am a empt 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
Lender's Address:
54
� n_VOICE (760) 777-7125
n FAX (760) 777-7011
0720 1 INSPECTIONS (760) 777-7153
5 I U/l
COAfAlUNf� In'OF� QU
I LJ
pFyFCOF Q 2��QrA Date: 10/7/2015
Owner: EPARTtiffNT
ROGER ROTH
45735 COLDBROOK
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.
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 Labor Code, I shall forthwith
comply with those pro isions.
Date: Lf) Applicant:
WARNING: FAILURE TO SECURE WORKE PENS ON COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO (MINA NALTIES 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( roperty for inspection -purposes.
Date. Plir Signature (Applicant or Age
DESCRIPTION
FINANCIAL INFORMATION 1.
ACCOUNT QTY :. „ : AMOUNT
PAID PAID DATE
BSAS SB1473 FEE
101-0000-20306 0 $1.00
$1.00 10/7/15
PAID BY
METHOD, RECEIPT #:.
CHECK # CLTD'BY
CERTIFIED COMFORT SYSTEMS INC
CHECK R9835
20273 MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
DESCRIPTION
_ ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$72.52
10/7/15
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
CERTIFIED COMFORT SYSTEMS INC
CHECK
R9835
20273
MFA
DESCRIPTION
= ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
10/7/15
PAID BY
_ METHOD
RECEIPT #
CHECK #
CLTD BY
CERTIFIED COMFORT SYSTEMS INC
CHECK
R9835.
20273 _t_MFA
Total Paid for CHANGEOUT: $108.78 $108.78
DESCRIPTION
= ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
10/7/15
PAID BY
= METHOD
RECEIPT #
CHECK #
CLTD BY
CERTIFIED COMFORT SYSTEMS INC
CHECK
R9835
20273
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
• 1$201.63
Description: ROTH RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: ISSUED
Applied: 10/7/2015 MFA
Approved: 10/7/2015 MFA
Parcel No: 604423004 Site Address: 45735 COLDBROOK LN LA QUINTA,CA 92253
Subdivision: TR 23995-8 Block: Lot: 53
Issued: 10/7/2015 MFA
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $7,000.00 Occupancy Type: Construction Type:
Expired: 4/4/2016 MFA
No. Buildings: 0 No. Stories: 0 No. Unites: 0
APPLICANT
Details: HVAC CHANGE OUT - 20 - SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
__j Applied to Approved
Approved to Issued
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
CERTIFIED COMFORT SYSTEMS INC
DBA HYDES
42-949 MADIO STREET
INDIO
CA
92201
(760)485-3160
CONTRACTOR
CERTIFIED COMFORT SYSTEMS INC
DBA HYDES
42-949 MADIO STREET
INDIO
CA
92201
(760)485-3160
OWNER
ROGER ROTH
45735 COLDBROOK
I LA QUINTA
I CA
92253
1 (760)485-3160
Printed: Wednesday, October 07, 2015 10:18:48 AM 1 of 2
SYSTEMS
�t. Permit Details PERMIT NUMBER
City of La Quinta BMCH201s=03 3
Printed: Wednesday, October 07, 2015 10:18:48 AM 2 of 2
SYSTElviS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS 561473 FEE
101-0000-20306
0
$1.00
$1.00
10/7/15
R9835
20273
CHECK
CERTIFIED COMFORT
MFA'
SYSTEMS INC
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
HVACCHANGEOUT-
101-0000-42402
0
$72.52
$72.52
10/7/15
R9835
20273
CHECK
CERTIFIED COMFORT
MFA
SPLIT -SYSTEM
SYSTEMS INC
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$36.26
10/7/15
R9835
20273
CHECK
CERTIFIED COMFORT
MFA
SPLIT -SYSTEM PC
SYSTEMS INC
Total Paid for CHANGEOUT: $108.78 $108.78
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
10/7/15
R9835
20273
CHECK
CERTIFIED COMFORT
MFA
SYSTEMS INC
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS:i
Printed: Wednesday, October 07, 2015 10:18:48 AM 2 of 2
SYSTElviS
Bln.#
Cjty, 0f Ld Quinta
Building er Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Owner's Name: .
EP.-Numbr,,
Address:
n:
Contractor: S
City, ST, Zip: °
Telephone:
Address:
Project Description:
City, ST, Zip:2a
Telephone:7 D— _
r.
5
State Lic. # :
City Lie'. #•:
Arch., Engr., Designer:
Address:
City,, ST, Zip:
Telephone: Y .�
State Lic. #:,? ~
Construction Type:. Occupancy:
Project type (circle one): New .Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units.
Telephone # of Contact Person:
Estimated Value of Proj
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Wd
Recd
TRACMG PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit. .
Truss Cates.
Called Contact Person Plan Check Balance-
alance_Title
Title24 Cates.
Plans picked up Construction
Flood plain plan
Plans resubmitted.. Mechanical
Grading plan
ZidReview, ready for correctionskssue Electrical
Subcontactor last
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'"' Review; ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr '
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
45-735 Coldbrook I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3 )
2015-09-02
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
45-735 Coldbrook
02
Date Prepared
2015-09-02
03
Project Location
45-735 Coldbrook
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
45-735 Coldbrook
07
Zip Code
92253
08
Dwelling Unit Conditioned
1800
,Installing new SC
i
"rinstallirig
i
`,
Installing
Installing
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted
r
containing
Number of space conditioning
or
more than 40
09
Climate Zone
15
10
(SC) systems in this dwelling
1
system?
component?-
components?feet
of ducts?
unit.
. SC system?
B. Space Conditioning (SC) System Information F i /�— 3 ? ��
Ol
02
03 ..
04a�
7 OS l�
~06 I `l�
f 07 `; _
i 08 t
09
10
'.Is the SC
.Installing a
SC System
SC System
CFA served
system a
refrige ar nt
,Installing new SC
i
"rinstallirig
i
`,
Installing
Installing
Identification or
Location or Area
by this SC
ducted
r
containing
r • ,
system
or
more than 40
s c..
entirely new
entirely new
Name
Served
System (ft2)
system?
component?-
components?feet
of ducts?
duct system?,
. SC system?
Alteration Type
System 1
Location 1
1600
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: 215-A6313788A-000000000-0000
Registration Date/Time: 2015-09-02 19:20:11
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-09-02 19:19:37
Schema Version: 0.5555DD
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)1E 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
HP
heating-'
AFUE
0.78.
AC
cooling
SEER
20
Setback
section is not
section is not
components
components
applicable
applicable
Required 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: 5 15%, or 510% 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 > 300 CFM/ton required when MCH -25 is required.
Exceptions:
—� f1 r rte.: r" ---�
HERS fromr MCH Duct Testing s� r
-Duct systems registered with provider as previously sealed are exempt -20 Leakage requireim
-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 requiremer. 1 1
� f
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia:and,150.2(b)1E, 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: 215-A6313788A-000000000-0000
1i.
Registration Date/Time: 2015-09-02 19:20:11
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-09-02 19:19:37
Schema Version: 0.555SDD
Ik
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: /� // J
Hyde, Mark
l
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2015-09-02 19:20:11
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 buildingdesign 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. C7 '} (- ,
I (
! //`, {-, i
{ [ l,_.J . ,
4. The building design features or system design features identified on this Certifcate 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 prov7des to the building owner at occupancy.
Responsible Designer Name: f 1 9G C A ._ :
Responsible Designer Signature:V I
Hyde, Mark
Company :
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2015-09-02 19:20:11
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
Digitally signed by Ca10ERTS. 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-A6313788A-000000000-0000 Registration Date/Time: 2015-09-02 19:20:11 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-09-02 19:19:37
Schema Version: 0.555SDD