BMCH2017-013878-495 CALLE TAMPICO
TA0/ 0 u4j
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VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
(760) 777-7153
BUILDING PERMIT
Date: 4/18/2017
Application Number: BMCH2O17-0138
Owner:
Property Address: 44650 SEELEY DR
MARY DANIEL
APN: 604224002f
44650 SEELEY DR
Application Description: DANIEL / HVAC CHANGE OUT - 14SEER/83AFUE SPLIT SYSTEM
LA QUINTA; CA 92253
Property Zoning:
_z
c-) ! y
Application Valuation: $15,562.00i
.m o I D
Applicant:
1
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
A R S AMERICAN RESIDENTIAL S/� O
96S RIDGE LAKE BLVD SUITE 201
965 RIDGE LAKE BLVD SUITE 20 9
MEMPHIS, TN 38120
MEMPHIS, TN 38120
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: C36, C10, C20 License No.: 765074 /1 44,C -
Date. ^/ -f/ Contractor:
OWNER -BUILDER DECLARATION .
Ulf
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
Lender's
09
(951)276-9744
Llc. No.: 765014
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 thew k 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: LIBERTY INSURANCE CORPORATION I Policy Number: WC7631508631
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. e(a.A
D t :/�, 1 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 on the
above-mentioned property for inspection purposes.
,y�8.7
Date:/ Signature (Applicant or Agent):
1 x
Date: 4/18/2017
Application Number: BMCH2O17=0138 Owner:
Property Address: 44650 SEELEY DR MARY DANIEL
APN: 604224002 44650 SEELEY OR
Application Description: DANIEL/ HVAC CHANGE OUT - 14SEER/81AFUE SPLIT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $15,562.00
Applicant: Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C A R S AMERICAN RESIDENTIAL SERVICES OF:C
965 RIDGE LAKE BLVD SUITE 201 965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, TN 38120 MEMPHIS, TN 38120 _
(951)276-9744
Llc. No.: 765074
Detail: HVAC CHANGE OUT - 14SEER/83AFUE SPLIT SYSTEM. CARBON" MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
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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
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-426000
$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
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Bin # City of La QuInta
Building U Safety Division
Permit # 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701.2
Building Permit Application and Tracking Sheet
Project Address: Owner's Name: I fie,
A. P. Number:
Address: (�,:5Q c -56f --"`V yJ\P
Legal Description:
City, ST, Zip: % u f/V / / 1 C� 9(J� �
Contract0 r:
/ 1
-
T n
eleAh o e.
Address: . �
Project Description: `
<
City, Zip: V mf;& �� a�
T C
TeleP h0 n - /
(r2
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State Lic. # : G :50 /
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
cu an
Constructiontraction Type Occupancy:
cY:
Lic. #
ro'New Add'n AlterttYPe circle one : Repair r
Demo
Name of Contact Person: ��� /� -y
Sq. Ft.•,:?,j C_.t.CC
I # Stories:
##/Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
ff
Submittal
Req'd
Rcc'd
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
tad Reviciv, ready for corrections/issue
Electrical
SubcontactorList
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.T.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. lVks_ APpr
Date of permit issue
School Fees,
I
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: DANIEL Date Prepared: 2017-04-18
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 documented, use one
CF1R-ALT-02 document for each dwelling unit:
01
Project Name
DANIEL
02
Date Prepared
2017-04-18
03
Project Location
44650 SEELEY DR
04
Building Type
Single family
05
CA City
LA QUINTA06
Installing -
Dwelling Unit Name
HOME
07
Zip Code
92253
l
09
Dwelling Unit Conditioned
2032
system
more than 40
entirely new
entirely new
floor Area (ft2).
Name
Served
System (ft)
system?
(
'
Number of Space
feet of ducts?
09
Climate Zone
15 �
'
Conditioning (SC) Systems in
1
Yes
Yes
Yes
No
this Dwelling Unit:
No
B. Space Conditioning (SC) System Information
01
02
03
04 `'
X05
06k
'- 07
08
09
10
SC System
SC System
CFA served
Is the SC ,
system a
Installing.,a,�
r�t�. ice:. .:l•i _a!
refrigerant
t 4 t
. 0 ,�� L_1it,
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
HVAC1
2032
2032
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Dii1b)
This section does not apply to this project.
Registration Number: 417-A020090129A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
r
Registration Date/Time: 2017-04-18 09:47:55
Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-04-18 09:47:56
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)lE 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 gas
All new
Central split
All new
Less than or
HVAC1
furnace
heating
AFUE
0.81
AC
cooling
SEER
14
Setback
equal to 40
R-8
components
components
feet
Reouired 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.140,,12-an&13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installeduct
in ducted systems, or when more than 40 ft of duct length is replaced
,. I .c
-Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks. c— .tom I
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF311-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. r r
�
Exceptions:
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 Duct Leakage Testing requirements.
E. EntirelyNew or Complete Replacement Duct System, with or without'E` ui ent Chan eo ut Sections 150.2 b lDiia and 150.2 b lE F
p P Y q p g ( () () )
�2..=s x _�r,r ric p v:z'-:�
This section does not apply to this -project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 1501(b)X)
This section does not apply to this project.
Registration Number: 417-A020090129A-000-000-0000000-0000 Registration Date/Time: 2017-04-18 09:47:55 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-18 09:47:56
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Christina Calhoun
ChYi.�t'wLa.Ca�lwtuv
Company:
Signature Date:
Rightime Home Services
2017-04-18
Address:
CEA/ HERS Certification Identification (if applicable):
965 Ridge lake Blvd, Suite 201 ..
City/State/Zip:
Phone:
Memphis TN 38120
r.
9 X951 276-9744
1 .
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. I 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 Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for, -approval with this building permit application.
5. I will ensure that a registered copy of this Certificate of Compliance shall be mad vailable-With the-tiuilding:permitO 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 CC plianc'e is requirdfo be included with'the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: "=
Christina Calhoun
Responsible. Designer Signature:
Cl-w%�ttv�.a.Callhottvt�
Company:
Date Signed:
Rightime Home Services
2017-04-18 '
Address:
License:
965 Ridge lake Blvd, Suite 201
765074
City/State/Zip:
Phone:
Memphis TN 38120
951-276-9744
Digitally signed by CHEERS'"'. This digital signature is provided in order to secure the content of this registered
document and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 417-A020090129A-000-000-0000000-0000
Registration Date/Time: 2017-04-18 09:47:55
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-18 09:47:56
Schema Version: rev 10/16