BMCH2015-018278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tw(t - 4 Zfv Qumroj
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number:
BMCH2O15-0182
Owner:
Property Address:
55068 OAK TREE
ST JEAN, MANUELA
z
APN:
775161021
2562 CLAYBOURNE CT
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D
Application. Description:.
ST JEAN/ CHANGE OUT (1)16SEER/80AFUE SPLIT SYSTEM,
NEWBERRY PARK, CA 91320
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Property Zoning:
0
Application Valuation:
$8,000.00rn
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N
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b
Applicant:
Contractor:
�D
c�I
A#1 SERVICES HEATING & AIR CON
A#1 SERVICES HEATING & AIRCON
78206 VARNER ROAD #D-189
78206 VARNER ROAD #D-189
PALM DESERT, CA 92211
PALM DESERT, CA 92211
(760)342-3610
Llc. No.: 977333
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.:
9773
Date: /MA''/Contractor:/y
i�/�Z
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 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 Na
Lender's
Address:
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.
Zk 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: _ 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 POO of the Labor Code, I shall forthwith
comply with those provisions.
Date: -2 Applicant:
WARNING: FAILURE TO.SECURE WORKERS' 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 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 upa the above•
mentioned property for inspection purposes.• /
Date: Signature (Applicant or Agen4��i-
vi T,115111R�Wl
�DESCRIPR WXAM PAIDPAID DATE
!,W*
BS,AS SB1473 FEE 101-0000-20306 0 $1.00. $0.00
iv gMETHOD* 1' 'Ik,.,'��,�'RECEIPT..# `Z;CLTDtf
Total Paid forB61LDING 'STANDARDS ADMINISTRATION BSA $1.00 $0.00
66 U
FINANCIAL
INFORMATION
PAID
AID DATE
f
vi T,115111R�Wl
�DESCRIPR WXAM PAIDPAID DATE
!,W*
BS,AS SB1473 FEE 101-0000-20306 0 $1.00. $0.00
iv gMETHOD* 1' 'Ik,.,'��,�'RECEIPT..# `Z;CLTDtf
Total Paid forB61LDING 'STANDARDS ADMINISTRATION BSA $1.00 $0.00
66 U
PAID
AID DATE
HVAC CHANGEOVT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
06E:
WTHo
_
RECEIPT,#�
CHECK
CLTD BY
-DESCRIPT ON A
1 CITY
Te
HVAC CHANGEOUT - SPLIT -SYSTEM PC
i 101-0000-42600
0
$36.26
$0.00
Rr_PAID ;By
Ail
,METHOD
R
I-V -11
Total Paid forCHANGEOUT: $108.78 $0.00
1 iv
RESCRIPTIONA.t ell',
04.5, i�!!*
ID�
��A
TA!,p D
PERMIT ISSUANCE
101-0600-42404
0
$91.85
$0.00
ME
,
t CHECK IV�CLTD
YcH
BY','-
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
NO 1 01
�or•;r�•n•
Description: ST JEAN / CHANGE OUT (1)16SEER/80AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 5/27/2015 SKH
Approved:
Parcel No: 775161021 Site Address: 55068 OAK TREE LA QUINTA,CA 92253
Subdivision: TR 20717-2 SEE ASSR MB 769 PGS 3134 Block: Lot: 6
Issued:
3536
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-16SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
` CHRONOLOGY:.. i.
FINANCIAL INFORMATION
Printed: Wednesday, May 27, 2015 11:13:25 AM 1 of 2 C W srsrEMS
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NAME:TYPE ti x C r 7r `;.NAME h
fADDRE$$1`. 3 °'
CITY " ?£
STATEt 21P�
PHONESt
j.- FAX
,p,'
APPLICANT
A#1 SERVICES HEATING & AIR CON
78206 VARNER ROAD
PALM DESERT
CA
92211
#D-189
CONTRACTOR
A#1 SERVICES HEATING & AIR CON
78206 VARNER ROAD
PALM DESERT
CA
92211
#D-189
OWNER
ST JEAN, MANUELA
2562 CLAYBOURNE CT
NEWBERRY
CA
91320
PARK
FINANCIAL INFORMATION
Printed: Wednesday, May 27, 2015 11:13:25 AM 1 of 2 C W srsrEMS
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7
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'i -AID,
!PT
ACCP�y NT
UN
�,p
�aRE RECEIPT
�-.';CHECK #
1. MET H
'AID' By
A;
BY'
BSAS SB1473 FEE
101-0000-20306
0
$1X0
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT_
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT-
101-0000-42600
01
$36.26
$0.00
SPLIT-SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
.101-0000-42404
0
$91.8.5
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63.., $0.00
INSPEC71ONS
n,�EQID i� 0 9 16 9 i r—TY- -P i, kgi;� 6*', SCHEDULED:, -CO P
RATE
MECHANICAL FINAL" BLD
REMARKS
SENT.DATE� ;.D UEDATE:.:
`1`�-REVIEWER .
-A
PE
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Printed: W . ednesday, May 27, 2015 11:13:25 AM 2of2 CB?WSYSTEMS
Bin #
City of La Quinta
Building SL Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: dAIC J/ee
Owner's Name: `yj Cly eAN
A. P. Number: '? /� (� (�
Address:
Legal Description:,
City, ST, Zip:
Contractor: A#
T �
P a e 3S C� —73/
`
Address: 7W(,ehy r !7 T/fie Jkl e c
Project Description:
City, ST, Zip: N ` C122
T _
ele h one•
P —2
Gb G 5I
S !o
State Lic. # : 3 City Lic. #:
Arch., Engr., Designer:
Address:
City,, ST, Zip:
Telephone: e one:
P
€.
.......
Con ' r
sttuctron Type: Occu anc Y:
tG � N P
r
State Lic.#:
PrJ ect hPa (circle cle one • New Add' n Alter Repairar
r Demo
�
Name of Contact Person: -D4 C ash 1io
Sq. Ft.: IS 17()
# Stories:
# Units:
Telephone # of Contact Person: qS'I 3 -?L/—'ZL4
Estimated Value of Project: g000
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactbr 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 Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
oo�
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: Manuela St lean Date Prepared: 2015-05-26
A. General Information
CF11R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CF1R-ALT-02 document for each dwelling unit.
01
Project Name
Manuela St lean
02
Date Prepared
2015-0S-26
03
Project Location
55-068 Oak Tree
04
Building Type
Single family
O5
CA City
La Quinta
06
Dwelling Unit Name
Manuela St Jean
SC System
SC System
'«CFA served
Dwelling Unit Conditioned
1500
07
Zip Code
92253OS
'Installing
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted
containing
Number of space conditioning
more than 40
09
Climate Zone
15
10
(SC) systems in this dwelling
1
system?
component?
components7
feet of ducts?
unit.
SC system?
Alteration Type
Goodman
Whole House
1500
Yes
Yes
B. Space Conditioning (SC) SystemInformation^y'fi! .
ion
a� �
O3
02
03 °
.. U4
1x05
6k
_
�7 _
p�
�8: Kf
�s
�A. 09
30
. 'Is the SC '
Installing a
�
SC System
SC System
'«CFA served
system a
re igera t
installing ew 5
Instal ung
IU. -I lli g
'Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components7
feet of ducts?
duct system?
SC system?
Alteration Type
Goodman
Whole House
1500
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0139051A-000000000-0000 Registration Date/Time: 2015-05-26 16:11:24 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03.31 Report Generated: 2015-05.26 16:09:00
Schema Version: 0.5555DD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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
No heating
This field or
This field or
Central split
No cooling
This field or
This field or
This field or �
This field or
Goodman
Central gas
component
section is not
section is not
AC
component
section is not
section isnot
Setback
section is not
section is not
furnace
altered
applicable
applicable
altered
applicable
applicable
applicable
applicable
Required Documentation:'
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
'
-Duct insulation requirement for new plenums: R6.�?it"" -
r�;
CF2R-MCH-20•H & Cf3R-MCH-20-H —Duct Leakage tertin-g'required when heating or cooling components are installed Inducted systems, or when more than 40 h of duct length is replaced.
-Leakage rate compliance: 515%, or s 101A leakage to outside, or sea] all accessible leaks.
CF2R-MCH-25•H & CF3R-MCH-25-H Refrigerant CFiarge.Verificai"' required when mfrigerantfcontaining components are installed or altered (applicable in CZ 2, 8.15).
,
/ton required when MCH-25:
CF2RCF3R•MCH-23 & CF3R-MCH-23 Air Flo w:23 6 CFM isrequired.
Exceptions:-,•r yp$>�' 't".
—
.
-Duct systems registered with HERS provider as previously sealed are exempt from20 Duct LeakagVTesting ksqulrem�eMnts
-Heatingonly systems and Air Handler/Furnace changes do, not.requlre vera iraiion of Air Flow MCHf23; or Refrigerant__:Charge-MECH-25.
duct systems constructed, insulated or sealed with asFbye0.stos.are exempfrom MCH 2OjDuct(Le 4kage Testing requi'41
rements. .2
-Existing ... w.v sa a -t. -
t• � 8""" ¢'°' -s"Ii + fes' ii. a" 0 ii4,*" ��vc .
E. Entirely New or Complete Replacement Duct System, with or withoU7Equtpment Changeout (S_ections 150.2(6)10ua andtl'30.2(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: 215-A0139051A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-05-26 16:11:24
Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2015-05-26. 16:09:00
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:
Castillo, Daniel
Company: -
Signature Date:
A 1 SERVICES
2015-05-26 16:11:24
Address:
CEA/ HERS Certification Identification (if applicable):
74818 Velie Way #11
City/State/Zip:
Phone:
Palm Desert CA 92260 t;
(760) 989-4468
Responsible Person's Declaration statement`;;
I certify the following under penalty of perjury, under the la'wi of the State of California: '
1. The information provided on this,Certificateof Compliance is.tiue and correct.
sis Code to acceprre3poriiibility for the building design or system design identified -on this Certificate of Compliance (responsible designer).
2. I am eligible under Division 3 of:.the Business and Profeson
omp3. That the energy features and perfo'imance specifications maYenals components, and manufactured devices for the building�design or„system design identified on this Certificate of Compliance conform to the
.rt -'moi pid..'�`
requirements of Title 24, Part 1 and Pa %:of the Caldornia.Code of Regulations. Rg, �• '
design featari identified this Certificcaat�e of Compliance are�consisterftWth,the information,provided on othe° applicable compliance documents, worksheets,
4. The building design features or system on
calculations, plans and specifications submitted to the enforcement•agency for approval'with.thisbuilding permit application.# '
1K 01,
M e i� *-A tea. .. ft .,Bir #� �. itis M ,.0 �""l �r rw
S. I will ensure that a registered copy of,.this Certificate of.Compliance shall,, inade:ayailable with;th'* ildIrttpermit(s)dssued forthe:_building; and made.avallablettorthe;enforcement agenryfor all applicable
Ku > a
inspections. I understand.that a registered copy oft his•CertiYfiicate of Compliance is requileed to be included with thra�do�cumentatronRthe#bi Ider provides tithe building owner at occupancy.
Responsible Designer Name: - If`"V -+
Responsi I Designer Signature: V ekp V V-V•
Z”, "Iivlk1Ge�d
Castillo, Daniel
Company:
Date Signed:
A 1 SERVICES
2015-05-26 16:11:24
Address:
License: '
74818 Velie Way #11
977333
City/State/Zip:
Phone:
Palm Desert CA 92260
(760)989 -4468
Digitally signed byCaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A01390SIA-000000000-0000 I Registration Date/Time: 2015-05-26 16:11:24 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015 -OS -26 16:09:00
Schema Version: 0.555SDD