13-0632 (MECH)4,4
P.O. BOX 1504. s -
78-495 CALLE TAMPICO
LA'QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
13-00000632
Property Address:
77366 VISTA FLORA
APN:
658-390-035-36 -28545
Application description:
MECHANICAL
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
5300
Applicant: Architect or Engineer:
I 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 Professionals Code, and my License is in full force and effect.
License Class: C20 C36I Lice -tqo.: 906115
/fr AlDate* a � Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 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 r
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.).
( '1 I am exempt under Sec. , BAP.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: 1
l
I,QPERAIIT
Owner:
LAURIE LUNDIN
77-366 VISTA FLORA
LA QUINTA, CA 92253
(626)825-6173
Contractor:
HYDES
42949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Lic. No.: 906115
-` VOICE (760) 777-7012
"FAX (760) 7.77-7011
INSPECTIONS'(760) 777-7153
Date: 5/20/13
--------------------=-------- LINA-------------
WORKER'S COMPE DECLARATION
I fiereby 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.
�',Phave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
<7Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number CEWC356415
�J 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, 1 shall fo h c Iy with those provisions. '
�Ze 4 �r %/
`D�a[e: Apply¢
WARNING: FAILURE TO SECUREORKERS' 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 Director of Building and Safety 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 co pty with all
city and county ordinances and state laws relating to building construction,
yand
�hhereby authorize resentatives
of this county, to enter u on the above-mentioned property for inspection d / S.
Date, ,f Signature (Applicant or Agent
.Application Number . . . . . 13-00000632
Permit . . . MECHANICAL 2013
Additional desc .
Permit. Fee 71.50 Plan Check Fee
.00
Issue•Dat•e Valuation . . .
. A
• Expiration Date 11/16/13.
Qty Unit Charge Per
Extension
1:.00 35.7500 EA MECH FURNACE
35.75
1.:0.0 35.7500 EA MECH CONDENSER/COMP
35.75
Special Notes and Comments
-------•-
HVAC CHANGE OUT 13SEER/7.7HSPF FURNACE
AND CONDENSOR [2008. ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTON..2010 CALIFORNIA
BUILDING STANDARS.
Other Fees BLDG STDS ADMIN (SB1473)
•1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, MECHANICAL
47.66
Fee summary Charged Paid Credited
' -------------------------=-------------------------------
Due'.
Permit -Fee Total 71.50 .00 - 00
71.50
Plan'Check Total. .00 .00 .00
.00
Other Fee Total 139.23 .00 .00
139:23
Grand Total 210.73 .00 .00
210.73
I,QPMNI IT
Bin #
City of La Quinta
Building .& Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 6 17vr Owner's Name:
� R (A
A. P. Number: Address: 7 7L
Legal Description: S /
` City, ST' Zip: Q �ZZS
Contractor: e� tl1 C ��� fo �� h Y 2 Telephone:
S�,r•15 q. /c P ne:
Address. .Z f' y�
/ '1c,. Project Description:
City,
Telephone: 7� 610 _ -ZZ e; -
State
-State Lic. # : q 0c, /, 1..i
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 Calcs.
Flood plain plan
Grading. plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning
OUSE:Planning Approval
Pub. Wks. Appr
School Fees
Lic. #: t`i k -•
3
Total Permit Fees
Construction Type:
Occupancy:
Project type (circle one):
New Add'n Alter Repair Demo
Sq. Ft :
#Stories:
#Units:
—177Estimated
Value of Project: Oo
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd
TRACKING
.
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
god Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M I.
Plans resubmitted
Grading
Review, ready for corrections/issue
Developer impact Fee
Called Contact Person
ALP P
Date of permit issue
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-111-ALT-HVAC
Climate Zones 10 - 1S
Site Address:
Enforcement Agency:
Date:
Permit #:
77-366 Vista Flora La Quinta, CA 92253
City of La Quinta
May 20, 2013
Duct insulation
Conditioned Floor
Equipment Type1
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
® Furnace
❑ Indoor Coil
❑ AFUE
® SEER 13.0
❑ COP
® HSPF 7.7
� R 6 (CZ 10-13)
Served by system
® Setback
If not already present, must be
® CondensingUnit
❑EER
❑Resistance
❑ R 8 (CZ 14-15)
Boo sf
installed )
❑ Other
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-111
and CF-611 shall also be on site for final inspection.
® 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
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- Paeleaged URitsl Duet leakage
Exempted from duct leakage testing if: A
, ❑ 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 duct systems are constructed, insulated or sealed with asbestos _
❑ 4. The system will not be Ducted (ie. Ductless. Mini-Split System).(Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System
Required Forms:
. Cut in or Changeout with,
CF-6R forms: •MECH-04, MECH-2AERS!and (foi= split systems) MECH-22-HERS, and `
new ducts: (all new
ducting and all new x
MECH-25-HERS i
MECH-22, MECH-25
r
CF-4R forms: MECH-20 and (for split systems) and
equipment)
1_
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/or without
Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit
CF-611 forms: MECH-04,'MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some
CF-4R forms: MECH-20 and (for split systems) MECH-25 1
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
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)
• I certify that this Certificate of Compliance documentation is accurate and complete. -
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
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 consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Mark Hyde Signature: Mnrk Hyde
Company: CERTIFIED COMFORT SYSTEMS INC Date: May 20, 2013
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO./ CA / 92201 Phone: (760) 360-2202
Reg: 213-A0030288A-000000000-0000 Registration Date/Time`. 2013/05/20.11:13:01'. HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms - July 2010