BMCH2015-06878 495 ALLE TAMPICO VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 t COMMUNITY DEVELOPMENT DEPARTMENT.
� ; - INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/11/2015
• Application Number: BMCH2O�L068' t Owner: .
Property Address: 55197 RIVIERA THOMAS MATHEWS
APN: 775153027 55197 RIVIERA
Application Description: ARNOLD PALM ER/MATHEWS/REPLACE (1) 16SEER/78AFUE SPLIT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $5,800.00 D
Applicant: Contractor:
BEST IN THE WEST AIR CONDITION 4 �• BEST IN THE W T IRf'Cal,{bIiIc�N 2095 '
255 N ELCIELO ROAD #140-125 255 N ELCIELO O D #140-125
PALM SPRINGS, CA 92262 PALM SPRING CA 922tj{YOFLAQUINTA
COMMUNITY DEVELOPMENT DEPApTMENT
(760)343-1002
Llc. No.-967982
---------------------------
y
LICENSED CONTRACTOR'S DECLARATION; WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self-insure for workers'
and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C20, C38 License No.: 967982 of t rk for which this permit is issued.
ec
"I have and will maintain workers' compensation insurance, as required by
Date:' Contractor.�Jf- frN' S� S00 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:
OWNER-BUILDER DECLARATION Carrier: "Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 oASLabor Code,'I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 ��� r(
of the Business and Professions Code) or that he or she is exempt therefrom and the Date: Applicant Applicant—
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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. _
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 APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to.the Building Official for a permit subject to
within one year of completion, the owner-builder will have the burden of proving that the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves , shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or
the Contractors' State License Law_.). following issuance of this permit.
(_) I am exempt under Sec. B.&P.C. for this reason 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.
Date: Owner: i
I certify that I have read this application and state that the above information is correct.
CONSTRUCTION LENDING AGENCY I agree to comply with all city and county ordinances and state laws relating to building
I hereby affirm under penalty of perjury that there is a construction lending agency for construction, and hereby authorize representatives of this city to enytopoy the above-
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). mentioned property
for inspection purposes.
Lender's Name:< Date' / / Signature (Applicant or Agent):
Lender's Address: ,
°-CERTIFICATE OF COMPLIANCE CFIR-ALT 02•E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Mathews.55197.3 Date Prepared: 2015-03-09
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CFIR-ALT 02 document for each dwelling unit.
01
Project Name
Mathews.55197.3
02
Date Prepared
2015-03-09
03
Project Location
55197.3 Riviera _ _ _
04
Building Type
Single family.
05
CA City
La Quinta
06
Dwelling Unit Name
Mathews.55197.3
07
Zip Code ax •.
92253 ;
08
Dwelling Unit Conditioned
Floor Area (ft2)
800 +, -
t
Installing new SC
Installing
- - -
Installing
Number of space conditioning
. ,
' 09
Climate Zone`. ',
15 ��. •, `+.
10
(SC) systems in this dwelling
1 '
entirely new
entirely new
Name
unit.
System'(ft2)
system?
component?
t
feet of ducts?
duct system?
SC system?
B. Space Conditioning (SC) System Information
A
,,:7.
3 a.
01
02 • -
,f, 03,
.* 3
t 04y
, :
1. OS ^'
; �+
:. 06 1-,
07' } `a"08
09
10
. • ` `�
Is the SC .
`' Installing a
" y. _
a '"►n- _J
'� ` '
SC System
SC System
CIA served_
systema
"refrigerant "
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
--wby this SC
ducted
containing
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 3 -
Casita
800;
F .' Yes
Yes
Yes
,~
No
No ' "
No ' '
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)IDllb) -
This section does not apply to this project.
Registration Number: 215-AO0642SOA-000000000-0000 Registration Date/Time: 2015-03-09 16:24:30 HERS Provider: CaICERTS ,
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-09 16:24:30
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFiR-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
Central split
All new
Central split
All new
This field or
This field or
System 3
heating
AFUE
0.78
HP
cooling
SEER
13
Setback
section is not
section is not
HP
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H – Dud 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%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-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. -7-7--i
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirerments.
-Heating-only systems and Air Handler/Furnace•changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
-Existing dud systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
`
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)lC)
This section does not apply to this project.
`Registration Number: 215-AO06425OA-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time
Report Version: 2014-03-31
Schema Version: 0.555SDD
2015-03-09 16:24:30
HERS Provider: CaICERTS
Report Generated: 2015-03-09 16:24:30
M
t
-" CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-iR-ALTHVAC)
CF111-ALT-024
(Page 3 of 3)
c
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: r7
Hansen, Jamie
amie d'Eansen
Company:
Signature Date: '
Best in the West Air Conditioning &Heating Inc- =- - — -
2015-03-09 16:24:30 -
Address:
CEA/ HERS Certification Identification (if applicable):
31225'Plantation Dr
City/State/Zip:
Phone:'
Thousand Palms CA 92276`'..` w.,
(760) 343-1002
Responsible Person's Declaration statement n'
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.Profession.s Code 6o 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 Regulations. t . �w ar zr ,•� •
..
-4. The buildingdesign features or stem design features ides ifiedon hi �4Certificate of Compliance are consistent withithe information rovided on other a licable com liance documents worksheets
g Y g t 5 P p PP P ,_
�'
t �. - t r r
calculations, plans and specifications submitted,to the enforcement: agency for approval with this building permit application. -7,
yf
S. ' ,. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permif(s) issued for the building and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance.is required to be induded'withfthe documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature_rr���
amie c ansen
Hansen Jamie )_ -t:
Company:
Date Signeda
Best in the West Air Conditioning & Heating Inc{ .r.r:
2015-03-09 16:24:30 ,
Address:
License:
31225 Plantation Dr
967982
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760) 343-1002 -
Digitally signed by Ca/CERTS. 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-A0064250A-000000000-0000 Registration Date/Time: 2015-03-09 16:24:30 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance' Report Version: 2014-03-31 Report Generated: 2015-03-09 16:24:30
Schema Version: 0.555SDD
A WES
'$T�o T
Air Conditioning A ting,
S f- 255 N El Cielo Rd, PMB 125 -
Palm Springs, CA 92262 - "
760-343-1002 -
- www.gotcoolair.com
:° . ,�, ,:WrkOr.°Tech: . �.
Xfi
2576-107 3/11/2015 INSTALLATION RICK
�,;:
Vickie Mathews Vickie Mathews
55197 Riviera 55197 Riviera
PGA West- Palmer, Gate - PGA West- Palmer Gate
La Quinta, CA 92253 La Quinta, CA 92253
Assistant 1 a f
ANTHONY
949-315-5827- CELL 949-415-0291- HOME 949-315-5827- CELL 949-415-0291= HOME
Description.
Inv-33096 (wip2)le4—
installing 16seer 2ton Maytag HP for Casita
Includes-permit and HERS, tstat,disp., h/o would like to return to be wrapped in.
bubble wrap. $8500-aftdr IID rebate $600,with possible $300-700 Maytag rebate
Installed Equip Install Date Model# Serial Equip. Warr Labor Warra Service Exp
1- NEW '14 ADP Coil- 410a 6/5/2014 NE5066OC21 OB2701A 7114CO2342
P.
1- NEW '13 Maytag FAU-upfio 80% 6/5/2014 PGC2TA100CVC1 PGD130604784 -
1- NEW '14 Maytag Condenser- 16/13 6/5/2014 PSA4BF048KC PSD140300576
2- NEW '14 ADP Coil- 410a 6/5/2014 V60A210D176 .7114B32810
2- NEW '13 Maytag FAU- horii 80%' 6/5/2014 PGC2TA100CVC1 PGD131103968
2- NEW '14 Maytag Condenser- 16/13 6/5/2014 PSA4BF048KC PSD140300570
All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices.'Any alteration or
deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above
the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection; including attorney's fees.
t Signature Date
FINANCIAL INFORMATION
ACCOUNT " �,
sATY�.s
AMpUNT�
_
,� PAID j �.
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Y PAIU BYlMETHOD
max"
" s� y RECEIPT #
',. CHECK # "`'
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
r DESCRIPTION
ACCOUNTx
QTY
a AMOUNT
ti PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD;CHECK
#
CLTD BY
' 4 `y7� t` "DESCRIPTION-A000UNT}`='"
QTY
"-�'• ,'`AMOUNT '��
'f = .�."-PAID �• :��
,PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
_A' 1�pq PAID BY
s'METHODRECEIPT#
CHECK# '
l' CLTD BY.
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIPTION °�=f.'i
:rA000UNT' . ;°',
,QTY
r ;AMOUNT, L�
:. PAID Y '!
gPAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
s:, it t, °' METHOD;
'�`iRECEIPT # * rbaw
'- .'{ CHECK # �, ,
. CLT D.$Y �.
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• •0
Description: ARNOLD PALMER/MATHEWS/REPLACE (1) 16SEER/78AFUE SPLIT SYSTEM
Type: MECHANICAL - Subtype:' Status: UNDER REVIEW
Applied: 3/11/2015 SKH
Approved:
Parcel No: 775153027 Site Address: 55197 RIVIERA LA QUINTA,CA 92253
Subdivision: TR 21381-2 CM 064/031 CM 067/001 Block: Lot: 4
Issued:
Lot Sq Ft: 0 -- Building Sq Ft: 0 Zoning:
Finaled: -
Valuation: $5,800.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT-13sEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAI
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
Printed: Wednesday, March 11, 2015 10:11:40 AM 1 of 2 .R
SYSTEMS
CHRONOLOGY
CONDITIONS
CONTACTS
. - _ Y
NAME TYPE -NAME ADDRESSl w
� ITY n T ATE
�ZIP< PHONE �'v -=
FAX- EMAIL
.i V
�C
;'
APPLICANT
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD
PALM SPRINGS
CA
92262
(
-
FINANCIAL INFORMATION
Printed: Wednesday, March 11, 2015 10:11:40 AM 1 of 2 .R
SYSTEMS
DESCRIPTION x
ACCO.UN
CITY
AMOUNI
'�PAID",
PAID DATE
CHECK4
M&I-16D
:PAID BY
T
_:RECEIPTif-
BY,
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVACCHANGEOUT-
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 forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404 .1
0
$91.85
$0.00'
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63 $0.00
I PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, March 11, 2015 10:11:40 AM 2 of 2 CRWYSTEMS'
Bfn.#
City 0f Quinta
Building a Safety Division
P.O. Box 1504,-78-495 Caife Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit -Application, and Tracking Sheet
Permit #
i
Project Address:j i
Owner's Name:. 1 ��
A- P. Number.
Address: / IWe r
100S
Legal Description:
Contractor. Q S4 i", le- ►-i4.
City, ST, Zip: LaLM &K
Telephone
Address: 4,25'5, IV e f rield, 4 j3 1 g0_125
Project Description:�-
City, ST, Zip: A
Telephone: (,6 -3 t,/' - j Uo Z
m RYri I LJf
State Lie. 9: - City Lie, #;
Arch, Bngr., Designer.
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person: ? c W�t:t 4J
Construction Type:. Ocwpaney:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: Unit
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
RcVd
Rec'd
TRACIMG
PERMirFEES
Plan Sets
Plan Check submitted
Item Amount
Stmctutw Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Cheek Balance
Mile 24 Cal&
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Gi adiag plan
2'! Review, ready for correctionMmue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Gradiug
rN ROUSE:-
Revtew, ready for correctionsAssae
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees ,
REGIUVED
• .. Y I n 1
MAR -10 2015��' 1:�.aPMENt
COMMUNITY DV
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT