BMCH2017-0117�
78-495 CALLE TAMPICO O�i U. VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/6/2017
Application Number:
BMCH2O17-0117
Owner:
Property Address:
80411 OAK TREE
ABE TANG
APN:
775081087
80411 OAK TREE"
Application Description:
TANG RESIDENCE / HVAC CHANGE OUT
LA QUINTA, CA 92253
E`
Property Zoning:
c
Application Valuation:
$7,965.00
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Applicant:
Contractor:
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CHAMPION HVAC
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CHAMPION HVAC
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77899 WOLF ROAD SUITE
103
77899 WOLF ROAD SUITE
U uJ
PALM DESERT, CA 92211
PALM DESERT, CA 92211
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(760)360-7500
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Llc. No.: 1013139
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-----------------------------------------------------------------------------------------Q
--
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 License No.: 1013139
Date: 0LI '6 /- Confar actor.
OWNER -BUILDER D LARATION
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, tl a 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: L -
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.
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: EXEMPT 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: _ OG Applicant:
r
WARNING: FAILURE TO SECURE WORKERS' CO� ENSATION 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 property for inspection purposes.
Date: Signature (Applicant or Agent):
Date: .4/6/2017
Application Number:. BMCH2O17-0117 Owner: '
Property Address: 80411 OAK TREE ABE TANG
APN: 775081087 80411 OAK TREE I
Application Description: TANG RESIDENCE / HVAC CHANGE OUT LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $7,965.00
Applicant: Contractor:
CHAMPION HVAC CHAMPION HVAC
77899 WOLF ROAD SUITE 103 77899 WOLF ROAD SUITE 103
PALM DESERT, CA 92211 PALM DESERT, CA 92211 .
I,
(760)360-7500
Llc. No.: 1013139
---------------- ----=-;------------------------------------------=-"----------------:
Detail:'HVAC CHANGE OUT - 15 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
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DESCRIPTION
ACCOUNT I QTY I 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
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
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:' $216.27
0
CFRTiFICATE OF COMPLIANCE CF1R=ALT-0Z4
Alterations to Space Conditioning Systems (formerly CF=1R=ALT=HVAC) b (Page 1 of 3)
Prefect Namdi Abe Tang Qat@ Prepared., 2017-W-05
A, General Information _
CFIR-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling Unit, When multiple dwelling units_ must be docum@nted, nye-one
CF1R=ALT=Q2 document for each dwelling unit. �-
01
Project Name
Abe Tang - - —
02
Date Prepared
2017=04=05
03
Pr-gj@ct Location - ---
80411 Oak Tree -
04
@wilding Type
`tingle family `
e5
CA City
La Quint@ _
05
Dwelling Unit Nam@
Abe Tang
Q7
Zip Cede -
92253
C$
Dwelling Unit Conditioned -
Floor Area (ftz)
-- - ---_ _-_._—__---_---____--
1_330
----
-- --- ---
- ----------
- --
Number of space —
---------- ----------
09
Climate Zone
1s_
10
Conditioning (sE) Systems- in
1
entirely new
- entirely new
Name
this Dwelling Uniti
system (ftz)
B. Space Conditioning (SE) System Infermat1en
R -'1t 9v art .`" " ani a+ - 4>•',
--
01 ----
--Q2 --
03
04
Is the SC>
if
s_C 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 (ftz)
system?
I component?,
components?
feet of ducts?
duct system?
SC system?
Alteration Type .
XR14 with XV804
Ton
Whole Mouse
1330
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C, Extension of Existing Duct System, Greater Thain 4Q Feet (SectlAn1S02(b)1D1lib)
- - - This section does not apply to this project.
Registration Number: 217-A020109371A-000-000-0000000-0000
_ CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-04.05 11:15:2.6
Report Version: 2016,1.005 -
Schema Version: rev 10/16
HERS Provider: CaICERTS
Report Generated: 2017-04-05 11:15:40
CERTIFICATE Of COMPLIANCE
- --- ------- - - - - - - - - - - -
--Alterations to Space Conditioning Systems (formerly CF--IR=ALT=HV.AC)
(Page 2 of 3)
D, Altered Space Conditioning System (Sections 150.2(b)IE and F)
of
02
03
04
05
06
07
08
09
io
ii
i2
Heating
Cooling
SY§t@M
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
i�h XV80
XRIL4 with XV80
Wal
U a�
C@
All new
heating
AFUE
8i
5plit-
All ntw
gogling
SEER
W446
Thl5 fWd or
sea -ion i5 W
TW5 field or-
5tctigp. is riot
4 TQn
f
furnat
CgmP.Qnqnt§
AC
@PPk-able
appkawp,
Required Documentation:
R6 (q. itio, 1z and 13) and Ra 9 n an I4 6
D -Yo inWatign r@qvirernpnt fQf ft n@w pqrOP)m of supply -air and:rPtqr!j--@jr dwq5 or plenums;n —.0- -.
QF2R and QF3RMOH ZQ=H =puce Wak@go T& rvQvir@d he n,,heating of cooling cQmpgnot§ are imt0ed in ducted sWems, or when more than 4o ft of duct length is replaced
-Lggk4gq rat@ 151Y. Qr es 191ye kakip t@ e-6 jid gr s@Al all @cE@50419
UP and QF39=MC-H145=H Refrigerant 0grg VOF16tipn rquifto Who refrigerant containing cQrnpgnqnts are installed or altered (applicable in. CZ 2-
Qf-RR and (;F3R-M H43 AirflQw Rate >-- 3-90-CF.M pg tpri. m9wip9d,wb9n Mr; 45 is r@9 irO:
Exceptionss .
HERS @(Qvid@r as pfpyigusly sgai@d are exxnpt frern MEN -2Q DiACt L
Qqqt systems re-@M-qrQd with -94g€ Toting
-i' W"
h -, -
F, MQWU;�69-` Rf, 4(p W-H-25-
ftating @nly �y4t@rn� and Air Hodigr Furnace- chops dQ not (tqiair -gugh i . -f R
U
Existing Mt §M@ffli CQWCUIA0, imylAtO Qr �@g!0 with 44146671VUm @Kgrnp, frim MCW 'ipuk-k
77�
itirely New or Complete Replaceiilent DuW&em, with or without.Aulipm@0 and -1502(b)111, F)
This section does not apply to this prefect,
R.'E.ntirely New or Complete Replacement Space Conditioning System (Section 1504(b)IQ
This section does not apply W this praje--ct,
Registration Number: 217-AO20109371A-000-000-0000000-000,0
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-04-05 11-15:26 S HERS Provider: CalCERTS
Report Version: 2.016.1.005 Report Generated: 2017-04-05 11:15:40
Schema Version: rev 10/16
:ERTIFICATE OF COMPLIANCE CF1R=ALT=02=E
'llEera> ion§ to Space CenriiEioning 5y5tenls (formerly CF=IR=ALT-HVAC) (Page 3 of 3;
Documentation Author's keleratien Statement
1. I certify that this Certificate of Compliance documentation 15 accurate and complete. �– — - ------------------------- ---- ------
----- --- —
Doeumentatien Anther Nam@ -- u--- --
Deeurrie_ntatien Author signature: � (� —`
Ley, Michael
--
CHAMPION HVAC
2-01IM4=05 111:1520
--
Address: —�i-----------
CEA/ HERS Eertifkation Identifieatien (if gppki bl@)[
77899 WOLF ROAD SUITE 103
City/Stat@/2ip; �
Pherae - -
PALM DESERT'CA 92211
760=360=7500 X123
Respomible Perwn's Oecliaretien 5tetement "
I wtify the fellewing under p@n@lty of Perjury, ande-r the laves of the state of Ealif@rn!a
1. The information provided on this Uf.tiftc�at@ of Oniplianw is tru@'@nd c@rr@ct.
Z. I am. eligible under Division 3 of th@ ausiness and PfOessierig Code to aeE@pt f€spens!b!l!ty fof the building k4n or system d@s!gn identified on this CgrUk,@t@ of comPli@nee (responsible designer):
3, That the @nerdy f@atdf@s ani p@fre�tt!an@@ SP@EifiEati@r15, mat�flals: €t?mpan@rats, ani Ittan@fat 4�yt@d d@v�E€S for the bui!din @sig @system d@sign !d@ratified on th,s C@rhficate of �onipl.4 conform to the
re,quOrnenls_ of Title 24, Part 1. and Part 6 of the 41ifornia Cede of Regulations: k_
4. The building design features or system design features ii ratified 9rl;th!s €e�if�at@?ef E@mR!Iane@ aro ronsist@nt��rit�f! th@ infermatlen.,.(?foV!d@� @ �@th@faApllEabl@ €omPhartF@ do@drnws, worksheets,
..x '
Ealeulatieras Plans_ ]rad SP@Eif+.Eation5 3l+bt?�itted i6 the @marc@rn@nt,Rg@nfy fgfpO 3lov wlih illls bd11�3ng P@rr11 [ apPli@atrQt�, .
5. 1 will ensure that a register@d espy of this ceftifr€at�?i@(�Csmphan€e shall-b@made available with.th@ budding p0m.it(i) is-su@d forth@.bu1!�rng, and:mad@ ovadableie:th@ anf@r�ement ag@nay for all applicable
ins_p@@tions: ! andeFstand that a f€g!st f$d copy of tftis C��tificat@ of Complianee.is, f gdimi to be in€luded wish th�.d.9,Eument tion,ttt@sb�ild@r p[evi�es t@ the bdilding own@r at oeeugan€y.
Responsible D@signer Name:
-
Re3Ponsipie Design@r Signatirf@; '' a " ,„p` -
�fc�rezr:(
Ley, Michael
c� r/
Company ;
Date_ Signed:
CHAMPION HVAC
201 = -Q 11,15;20
Address_;'
Lieens_@�:
77899 WOLF ROAD SUITE 103
1013139
City/State/tip;
Phones
PALM DESERT CA 97711.
760360=7500 X123
Digitally signed by CaICFRTS.. this digital signature is provided in order to smre.the content of this registered document and in noway. ay implies Registration. Provider-
rM.Q(niW(y for the accuracy of the Wofmation.
Registration Number: 217-A020109371A-000-000-0000000.0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
r
Registration Date/Time: 2017-04-05 11:152-6
Report Version: 2016.1.0.05
Schema Version-, rev 10/16
HERS Provider: eaICERTS
Report Generated: 2017-04-05 11:15;40
0
Bin ff
Permit;:
Project Address:
pity of 1a Quintd
Building 8i• Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
QAk e f owner's Name: , A13 C —rk
A. P. Number:
Address:Q''�4+ IF
Legal Description:
City, ST, Zip: LN Q U (N � CA2 2 5 3
ContraC ct r:
0 C
��11
Telephone: � V
y s a
Address:
IA)JV--
0
ProjectDescription:
��A �STF Sy
City, ST, Zip:. A L-*1 Ati V c, cr'1
t`�(J�,�
COM Ue� . Iv �'W " . � M
Telephone: hone: 6
State Lic. #10 Q
City Lic. #;
Arch.,`Engr., Designer:
Address:
City, ST, Zip:
Telephone:
ecu an cY••
n tructi n T e• OP
Cos o YP
State L#. ic"
Project type (circle ne • New Add'n Repair. Demo
Name of Contact Person:
�� L `,�l
Sq. Ft.: J
# Stories: / # Units:
Telephone # of Contact Person: Q K 3 5— 6 Z S
Estimated Value of Project: �r
APPLICANT: DO NOT WRITE BELOW THIS LINE
ti
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
.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
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
11.0 A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd 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