BMCH2017-039378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4 4'P Qu!Ar(u
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O17-0393
Property Address:
55940 PINEHURST
APN:
775241019
Application Description:
WILLIAMS RESIDENCE/ HVAC
Property Zoning:
Application Valuation:
$17,840.00
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: Contractor
OWNER-BUI E EC ION
I hereby affirm under penalty of perjury at I 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 Name:
Lender's Add
VOICE (760) 777-7125
FAX (760).777-7011
INSPECTIONS (760) 777-7153
Date: 8/31/2017
Owner:
RON WILLIAMS
55940 PINEHURST
LA QU I NTA, CA S2253
Contractor:
CERTIFIED COMBORT 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 certifica:e 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: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600015264
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner sc 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 Labo Co , shall forthwith
comply wilh those provisions.
Date: (�J( Applicant:
WARNING: FAILURE TO SECURE WORKE OMPE A N COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER T IMQVA ALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS $100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to 0e Building Official for a permit subject to
the conditions and restrictions set forth on the 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 -he work being performed, under or
following issuance of this permit.
2. Any permit issued as a result of this applitation 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 canci llation. '
I certify that I'have read this application and sate that the above information is correct. .
I agree to comply with all city and county ord nances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentied p rty for inspection punoses.
Date: l Signature (Applicant or Agent):
Date:. 8/31/2017
Application Number:
BMCH2017-0393
Owner:
Property Address:
55940 PINEHURST
RON WILLIAMS
APN:
775241019.
55940 PINEHURST
Application Description:
WILLIAMS RESIDENCE / HVAC CHANGE OUT
LA QUINTA, CA E2253
Property Zoning:
Application Valuation:
$17,840.00
Applicant:
Contractor:
CERTIFIED COMFORT SYSTEMS INC.DBA HYDES
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
42-949 MADIO STREET
INDIO, CA 92201
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
Detail: (2) HVAC CHANGE OUTS -14 & 17 SEER/80 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER
2016 CALIFORNIA BUILDING
CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY_
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$76.00
Total Paid for CHANCEOUT: $228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0 .
$96.27 .
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $330.27
J
0
Bin #
Permit .#
Project Address:'
A. P. Number:
Contractor: 2y 11l e �1
Address: L -Z -� Cl
City, ST, Zip: 1/ �G
T
elephone. 6 C,
State Lie. #: q ('J6_1
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
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
W HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
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
-}- Owner's Name:
Address: O �� Y
City, ST, Zip:LCA k
rr jj e
t�^r �5 A, Telephone: ' - - 2
"tCt Project Description:
AL
Lie. #: -t k -L
Total Permit Fees
Construction Type:
Occupancy:
Project type (circle one):
New Add% Alter Repair' Demo
Sq. Ft:
#Stories:
# Units:
Estimated Value of project: G
APPLICANT:
DO NOT WRITE BELOW THIS LINE
Rec'd
TRACIUNG .
PERMIT FEES
Plan Check submitted
TItewAmount
Reviewed, ready for corrections
ck Deposit
Called Contact Person
Plan Check 3alance
Plans picked up
Constructio[E
Plans resubmitted
Mechanical
god Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
SALL
Plans resubmitted
Grading .
Review, ready for correctionstissue
Developer pe bui act Fee
Called Contact Person
A.LP.P.
Date of permit issue
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
55940 Pinehurst I Date Prepared:
CFiR-ALT-02-E
(Pagel of 3) 1
2017-08-22
A. General Information
CHR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF111-ALT-02 document for each dwelling unit.
01
Project Name
55940 Pinehurst
02
Date Prepared
2017-08-22
03
Project Location
55940 Pinehurst
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
55940 Pinehurst
ii N
SC System
SC System
Dwelling Unit Conditioned
system a
07
Zip Code
92253
08
Floor Area (ft2)
4276
Identification or
Location or Area
by this SC
ducted
Number of Space
system
09
Climate Zone
15
10
Conditioning (SC) Systems in
2
System (ft)
system?
component?
components?
this Dwelling Unit:
duct system?
zl I I ,rte"..,,, 1 r`— 1 r --V% `-1 r--' f/--,„, i f
B. Space Conditioning (SC) System Information t�
I I n101 (F -
01
02
03 '�
04
w. O5
06 ,�.
T07T' (f^
.V
X08
'`"� 09
10
'i's the SCS
I stalling a
n
%-.F i
L...O C
ii N
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Living Area
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Bedrooms
1200
Yes
Yes
Yes
No
No
No
Altered spaceconditioning
system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 217-A020288321A-000-000-0000000-0000
Registration Date/Time: 2017-08-22 16:25:12
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-22 16:25:13
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-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
81
AC
cooling
SEER
17
Setback
section is not
section is not
components
components
applicable
applicable
Central split
All new
Central split
All new
This field or
This field or
System 2
HP
heating
AFUE
81
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF311-MCH-20-H - Duct Leakage Test 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: <= 15% or <= 10% leakage to outside, or seal all accessible -leaks.
.••,:_� xi1 . r""""te
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containYing comtsponenare installed or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM perton required when MCH -25i is re uired.
p q
Exceptions: 706
i -
ie r from
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duc eakage TTesting regw ements. F n F
P
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, 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: 217-A020288321A-000-000-0000000-0000 Registration Date/Time: 2017-08-22 16:25:12 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-22 16:25:13
Schema Version: rev 10/16
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: �jJ
Hyde, Mork
►`ewmw�.
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2017-08-22 16:25:12
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 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 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 Regulat ons�� I �� r--- F—:1 L ` t ,�"j (
n
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information.provided on ther-applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for epprovalwith this building permit application.
11, %. Y If it i y< �� i ri -y
S. I will ensure that a registered copy of this Certificate of Compliance shall be:made'available with the building permit(.) issiiad fnr,the huilding, and.made available,to the`enforcement agency for all applicable
inspections. I understand that a registered copy of this{ertificate of Compliance ;is required to be -included with the documentation the builder provides to the building owner at occupancy.
+''�
Responsible Designer Name: : i L ! A ..
Responsible Designer Signature: V 1 -00
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2017-08-22 16:25:12
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
Easy to Verify O�
at CaICERTS.com
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies
120
Registration Provider responsibility for the accuracy of the information.
Registration Number: 217-A020288321A-000-000-0000000-0000
Registration Date/Time:
2017-08-22 16:25:12
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-22 16:25:13
Schema Version: rev 10/16