12-0227 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA,QUINTA,.CALIFORNIA 92253
Application Number:
Property Address:
•APN:
Application description:
Property Zoning:
Application valuation:
00000227"
49540
49540 AVENIDA VISTA BONITA
773-350-008-8 -14496 -
MECHANICAL
LOW DENSITY RESIDENTIAL
5386
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DAVE MARTIN
49540 AVENIDA VISTA BONITA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/14/12
Contractor:
Applicant: Architect or Engineer: HYDES
42949 MADIO'STREET��
INDIO, CA 92201
(760)360.-2202
Lic. No.: 906115
l MAR 1
e�-yn
---=------------------=--------------=-------------------------------1---- f,,�:;-�.i. --------=
_ - LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSA-' N-11 CLAR71TION -
I hereby affirm under penalty of perjury that I am'ilicensed 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, a VLd 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
Lice a Class: C20 C36 Licens o.: 906115 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
3 issued.
Date: �"'�C ractor: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
• - 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 CEWC243358
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 workers' 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 thwit o ly with those'provisions-
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by/ Y , y
plica
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - ate: nt: - -
(_ 1 1, 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 WARNING: FA RE 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,owoer,,hpilrlPr. will -have the=burden of_prov-in that he or.she did not build or '
improve for the purpose of sale.). --�•� `_ `:"-”- "' -- -"`� -"` --'-" "'APPLICANT- ACKNOWLEDGEM ENT-
(_) 1, 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,
1 _ 1 I am exempt under Sec. , BAP.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 1 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I a ee to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city nd county ordinances and state laws relating to building construction, a hereby a orize representatives
his county'to,enter upon the above-mentioned property for ins ecti - pur ses. -
Lender's Name: -
Date:� 'nature (Applicant or_Agentl: 04
Lender's Address:
LQPERMIT
Application Number . . . . . 12-00000227
Permit . . MECHANICAL -
Additional desc .
Permit Fee 40.50 Plan Check Fee
10.13
Issue Date Valuation
0 -
Expiration Date .. 9/10/12
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
A/C CHANGE -OUT 1.5 TON SYSTEM, AIR
HANDLER & CONDENSING UNIT. 2010 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.
~ LQPERMIT _
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-iR-ALT-HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency:
Date:
Permit #:
49-540 Avenue Vista Bonita La Quinta, CA 92253
City of La Quinta
Mar 14, 2012
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat
❑ Package Unit
p Furnace
❑ AFUE
❑ COP
❑ R 6 (CZ 10-13)
Served by system
2 Setback
❑ Indoor Coil
p SEER 13.0
o HSPF 7.7
❑ R 8 CZ 14-15)
�
400 sf
If not already present, must be
p Condensing Unit
[I EER
❑Resistance
installed)
❑ Other
1. Equipment Type: Choose the equipment veing 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 =opy 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) a -e filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R
and CF -6R 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-21 111 NOand (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF -6R forns: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF-AR:forns: MECH-21 and (for split systems) MECH-25
For Split Systems: Duct leakage: -c 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage.testing.if: -
p 1. Duct-system'was .documented to have been previously sealed and confirmed through HERS verification, or
❑ 2..Ductsystems_with.less. thail n 40;,linear feet in unconditioned space, or
• 3..Existing. Y duct s stems are constructed, Insulated or sealed with asbestos
0A The system will not be,Du�ctexc (le Ductless Mirn Split System) (AIso�Exempt fr}om-Refr=igerant Charge)
"
❑ 2. New HIVAC System
Re. uired Fo'rm's
q r
. Cut injor Changeout-with
'
` if
CF 6R forms MECH 04,:M�ECH 20 HERS, and (for split ystems) MECH 22 HERS, and
new ducts all new
ductin and(all new
3g
MECH 25iER5 I
CF forms MECH,20; and (for split systems).MECH=22, and-MECH
e ui rnent
For Split Systems Duct leakage < 6'oereert, RC, CCA >_ 350 CFMyton,;FWD, TMAH, STMS, and either HSPP or`PSPP.`
For. Packaged Units:. Duet leakage, 5,percent
11 3. New-D.u'cts with_ /or without _
Required Forms:
Replacement
. Includes replacing -or installing, all new
ducting and/or outdoor condensing<:unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or:furnace Noor some
CF -411 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 replacing more than 40
CF -611 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 Cerlficate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans arrd specifications submitted to the enforcement agency for approval with the permit application.
Name: Mark Hyde Signature: Mark Hyde
Company: CERTIFIED COMFORT SYST—EMS INC Date: Mar 14, 2012
Address: 42-949 MADIO STREET License: 906115
City/State/Zip: INDIO / CA /'92201 Phone: (760) 360-2202
Reg: 212-AO01291OA-00000000-0000 Registration Date/Time: 2012/03/14 13:22:14 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forma July 2010
Bin #
L
t #
Project Address: ILI
A. P. Number: 1
LegtDescrHip%tiotn_:ConAddM
City, ST, Zip:
r�
Telephone: ZVZ
State Lic. #
115
Asch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# I Submittal
Plan Sets
Structural Calcs.
Truss Cates.
Energy Cates.
Flood plain plan
Grading. plan'
Subcontector List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. A )pr
School Fees
ity 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
t ' 1 Owner's Name:
Address:
City, ST, Zip: G
t
S Telephone: y 7--7 .
Project Description: 4
q-2 ZU� 0 o -
City Lic. #:
Constriction Type:
Occupancy:
Project type (circle one):
New Add", Alter Re air
P Demo
Sq. Ft.:
#Stories:
# Units:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
TRAPERMIT
n Check submitted
q
FEES
iewed, ready for corrections
Item
Amount
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2"' Review, ready for correciioasrissue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
3' Review, ready for correctionsrssue
Developer impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees
fi