10-0360 (MECH)•' _ rV.6
P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
Application Number: 10=00000360
Property Address: 48210 VISTA DE NOPAL
APN: 646-110-015- -
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4950
T-it!t 4 4 Q"
Applicant: Architect or Engineer:
P,
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MERRITT PATRICIA L
48210 VISTA DE NOPAL
LA QUINTA, CA 92253
Contractor:
HYDES
77825 WILDCAT STREE
PALM DESERT, CA 922
(760)360-2202
Lic. No.: 906115.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/26/10
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:
-- -_t.QPER-MIT -_--._—_
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.
certify that I have read this application and state that the above information is correct. J agree to comply with. all
city and county ordinances and state laws relating to building construction, an ereby thorize representatives
oft is couittyy to nter upon a above-mentioned property for inspection p ses
Date: �' r.�n nature (Applicant or Agent):
LICENSED CONTRACTOR'S DECLARATION
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, phd my License is in full force and effect. -
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Cl ss: 0 C3 Licenseo.: 906115
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
1'
te: v� Contractor.
issued.
Y, 1 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
OWNER -B DER DECLARATION
insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that l am exempt from the Contractor's State License Law for the
Carrier DELOS INS Policy Number 02DKRM12004084
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 any
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 to file 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 subject to the wor s' compensation provisions of Section -
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
-
- 3 00 of the L or Code, I shall forthwith c ply those provisions.
that heor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
/f
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date: / pplicant:
(_ 1 l; as owner of the property, or my employees with wages as their sole compensation, will do the work, and /1111
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: AILURE-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, provided that the
DOLLARS 1$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 exclusively contracting 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 contractor(s) licensed
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,
(_) 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
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:
-- -_t.QPER-MIT -_--._—_
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.
certify that I have read this application and state that the above information is correct. J agree to comply with. all
city and county ordinances and state laws relating to building construction, an ereby thorize representatives
oft is couittyy to nter upon a above-mentioned property for inspection p ses
Date: �' r.�n nature (Applicant or Agent):
Application Number . . . . . 10-00000360
Permit . . .. MECHANICAL
Additional desc .
Permit Fee 40.50
Plan Check Fee
10.13
Issue Date . . . .
Valuation
0
- Expiration Date 10/23/10
Qty Unit Charge Per
Extension '
BASE
FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00
1.00 16.5000 EA MECH
B/C >3-15HP/>100K-500KBTU
16.50,
----------------------------------------------------------------------------
Special Notes and Comments
INSTALL 4 TON SPLIT SYSTEM. 2007"CODES..
----------------------------------------------------------- --
Other Fees BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
Permit` -Fee Total 40.50
.00 .00.
40.`50
Plan Check Total 10.13
.00 .00
10.13 -
Other Fee Total 1.00
.00 .00
1.00
Grand Total -51.63
.00 .00
51.63
LQY6IUNIT
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC
Climate Zones 10 to 15
Site A dress q, / _
0
Enforcement Agency:
Date-
-����
Permit #:
- �/
6 .
Conditioned Floor
Equipment T et
List Minimum Efficiency Z
Duct insulation requirement
Area
Thermostat
❑ ackaged Unit
�umace
(d�AFUET/"
❑COP
Over 40 ft of ducts added or
Setback
Coil
EER
❑ HSPF _
replaced in unconditioned space
❑ R 6 10-13)
S/erved b system
4
ll ,rot already
mast be '
�ndoor
Condensing Unit
2
BEER
❑Resistance
(CZ
❑ R 8 (CZ 14-15)
6 sf
present.
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed. if more than one .system, use another CF -1 R -AL T -HVA Cfor 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
si ed. Beginning October 1, 2010, a registered copy of the CF -IR and CF -611 shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (fors lits stems) MECH-25
• Condenser Coil and /or
• Indoor Coil and /or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4R forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
ducts: (all new ducting and all
CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
new equipment)
CF4R forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all 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 replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• 1 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 I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other appli ble compliance forms, worksheets.
calculations, las ands cifi a ons bmitted to the enforcement agency for approval with the permit application.
Name: / C -V e
Signature:
Company:
Mz
Date.
Address: � � � GA�� j �
License:
City/State/Zip: Q(� v ?j�/l
Phone:
2008 Residential Compliance Forms March 2010
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
10'
Project Address: -Zj Z/ i,¢ e �O
Owner's Name:
A. P. Number:
Address: •1j� v/S��C/v
Legal Description:
Contractor:
City, ST, Zip:(%✓�
Telephonq� .
Address: =� ��.
Project Description:
City, ST, Zip:
Telephone• a 3•���
State Lie. #: City Lie, #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n ter Repair
`i
Name of Contact Person: �C C
Sq. Ft : J 4�2�
#Stories:
%Demo
# Units:
Telephone # of Contact Person: d
stimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
Z"" Review, ready for correctionsfissue
Electrical
Subcontactor List
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 ApprovalCalled
Contact Person
A.I.P.P. ;
Pub. Wks. Appr
Date of permit issue
School Fees
LL:::
Total Permit Fees