BMCH2015-044378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&�t 4 4 Q91K&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0443
Property Address:
79363 NUEVO DR
APN:
604392031
Application Description:
HIROHATA / CHANGE OUT (1)18SEER/78AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$8,000.00
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: I I A D /(� Contractori�
OWNER -BUILDER DECI,01ATION
I hereby affirm under penalty of perjury that I arr%'xempt 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).:
(1 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 ) 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 Na
Lender's Add
111111111111 11111111
69
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/2015
Owner:
HARUMI HIROHATA
79363 NUEVO
LA QUNTA, 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.
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 provisions.
Date: 0 At5 Applicant.
WARNING: FAILURE TO SECURE WORKERS' COMPEN ATION 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 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
%� rty for inspection purposes.
Date: �� Y/ Signature (Applicant or Age
FINANCIALINFORMATI
RW'mi
V
,�.�.DESCRIPTION,ACCOUNT QTYi�zAMOUNT PAID
BSAS S131,473. FEE. 10170000-20306 0 $1.00 .$0.00
'ggg aw --jg�u
ge,
PAID.,' g,
'H -6 1 �, Z,,
"fUtt m gi_ 'g '!CHECK;f;J,.`,,-
WCEIPM" TWBY
:.-_....xZ�,41 ww "Al"It EM, rO:.�"
Total Paid.for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DEkRIPTIONf, FV1
&
it.-�=,E�
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PAIDA-M
�PAID DATE
.
409"0101 ns
'. jy_!�
. . ....... . ....... . . . ...... ...
3MKE N-,
a a,
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
$72.52
$0.00
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CUT BY
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CCOUNTX1
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FAMOUNmi,
PAI D"
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HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
.$36.26•
$0.00
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Total Paid for CHANGEOUT: $108.18 $0.00
I T
"ACCOUNTI-i
v
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ug
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AW
WWI
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IT
PERMIT ISSUANCE
101-0.000-42404
0'
$91.85
$0.00
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41
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Total Paid for PERMIT ISSUANCE- $91.85 $0.00
T•TALS: ::$0
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:.$201 .63 -
Description: HIROHATA / CHANGE OUT (1)18SEER/78AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 11/30/2015 SKH
Approved:
Parcel No: 604392031 Site Address: 79363 NUEVO DR LA QUINTA,CA 92253
Subdivision: TR 25953 Block: Lot: 72
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $8,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT-18SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Monday, November 30, 2015 2:21:03 PM 1 of 2.
SYMMS
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
CERTIFIED COMFORT SYSTEMS INC
42-949 MADIO STREET
INDIO
CA
92201
DBA HYDES
CONTRACTOR
CERTIFIED COMFORT SYSTEMS INC
42-949 MADIO STREET
INDIO
CA
92201
DBA HYDES
OWNER
HARUMI HIROHATA
79363 NUEVO
LA QUNTA
CA
92253
Printed: Monday, November 30, 2015 2:21:03 PM 1 of 2.
SYMMS
REVIEWS
_T
REVIEW TYPE REVIEWER SENT DATE DUE GATE RETURNED STATUS REMARKS NOTES
DATE
ATTACHMENTS
Printed:. Monday, November 30, 2015 2:21:03 PM 2 of 2 r
' srs7eMs
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
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 for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:0•
REVIEWS
_T
REVIEW TYPE REVIEWER SENT DATE DUE GATE RETURNED STATUS REMARKS NOTES
DATE
ATTACHMENTS
Printed:. Monday, November 30, 2015 2:21:03 PM 2 of 2 r
' srs7eMs
I
CERTIFICATE OF COMPLIANCE CRR -ALT -024
Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) (Page 1 of 3 )
Project Name: 79-363 Nuevo Dr Date Prepared: 2015-11-28
A. General Information
CF111-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit: When multiple dwelling units must be documented,
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
79-363 Nuevo Dr
02
Date Prepared
2015=11-28
03
Project Location
79-363 Nuevo Dr
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
79-363 Nuevo Dr
07
Zip Code
92253
08
Dwelling Unit Conditioned
2480
�`
'
Floor Area (ft2)
SC System
CFA served
systema
refrige ant i
Z
neve SC
Number of space conditioning
<I staIIi' g
09
Climate Zone
15
10
(SC) systems in this dwelling
1
containing
ZI,nstalling
system
more than 40
entirely new
unit.
B. Space Conditioning (SC) System Information r
01
02
03
04
05
'Y 06t .
071
M
09
10.
.cam
^N
Is the SC
Installing a
�`
'
SC System
SC System
CFA served
systema
refrige ant i
Z
neve SC
CinstaillA I
<I staIIi' g
,Installing
Identification or
Location or Area
by this SC
ducted
containing
ZI,nstalling
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
Location 1
1200
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-A6408694A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
Report Version: 2013-1.006
Schema Version: 0.555SDD
2015-11-28 12:50:39 HERS Provider: CalCERTS
Report Generated: 2015-11-28 12:47:44
CERTIFICATE OF COMPLIANCE CF111-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
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
18
Setback
section is not
section is not
-components
"'
components
applicable
applicable
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF311-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.
CF211-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 2 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MC 20 Duct Leakage Testing requNOW i ements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23 or Refrigerant Charge M CH -25.
-Existing duct systems constructed, insulated or sealed with. asbestos are exemptfrom MC Du Le age Test gyrequi er
.
`•�Irn•- '.5pr�.e r .awn +ir -W'. w
E. Entirely New or Complete Replacement Duct System, with or without Eq ipment Chan eout S ctio.ris 150.2(b)1Diia and 150.2(b)1E F)
a Ir -r IFS' `,. r If �► . I '
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-A6408694A-000000000-0000 Registration Date/Time: 2015-11-28 12:50:39 HERS Provider: CaICERTS
1
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-28 12:47:44
c�tiom� W—f....• n ccccnn
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
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2015-11-28 12:50:39
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
1760-360-2202
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 forthe 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 ofd egolatlons""� �r
4. The building design features or system design features identified on this Certificate;of Compliance are consistent with the information provided o other=applicable compliance documents, worksheets,
calculations, and specifications submitted to the agency for:approval with this building
plans enforcement permit application.
of shall available5withahe pe�mit(s),issuecl
5• 1 will ensure that a registered copy of this Certificate ompliance be"made bu Iding for the,buildmg, and;made avllable:
srn.#
C( Of" QUlll�a
Building U Safety Division
P.O. Box 1504,78-495 Calle Tampico
Ia,Quinta, CA 92253 -:(760) 777-7012
+C5 Building Permit Application' and Tracking Sheet
Permit #
OkO6
Project Address: s >� 3
Owner's Name: .
A. P. Number. Address: Dr
Legal Description: City, ST, Zip:LA 5
Contractor: • ' 76 — 6)
Address: 2^ Project Description:
City, ST, Zip: ('
Telephone: 7-3661
s,. i tea'
City Lie. #;
State Lie. 4: 2a Or
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: :� � ' Construction Type: Occupancy:
State Lic, #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft -2 -ft #Stories: # unite:
Telephone # of Contact Person: Estimated Value of Proj
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG PERMIT FEES
Plan Sets
Pian Check submitted Item Amount
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit. .
Truss Calcs.
Called Contact Person Pian Check Balance"
Title 24 Caled.
Pians picked up Construction '
Flood plain plan
Plans resubmitted'. . Mechanical
Grading plan
V Review, ready for correctionslissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''d 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