BMCH2014-1026 (BMCH)IIIIIIIVIIIIIIVIIIIIII 57
IE
ced�p a �v auba
78-495 CALLE TAMPICO
VOICE (760) 777-7125FAX
LA QUINTA, CALIFORNIA 92253
(760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/21/2014
Application Number:
BMCH2O14-1026
Owner:
Property Address:
43585 ALBA CT
GERALD ELLERBUSCH
APN:
609542021
43585 ALBA CT
Application Description:
HVAC CHANGE OUT - 13SEER/78AFUE SPLIT SYSTEM
LA QUINTA, CA 0
Property Zoning:
Application Valuation:
$8,455.00
Applicant:
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
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, C43 License No.: 276586
j
Date: / a lfi Contractor:
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 I am exempt under Sec. . BAP.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 Add
Contractor:
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
(760)323-3383
Llc. No.: 276586
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 w r for which this permit is issued.
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 Section3700 of a La or Code, I shall forthwith
comply with those provisions.
i b
Date: ' L I Aoolicant:
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 lawsrelatingto building
construction, and hereby authorize representatives of this city toe1
upon the above-
mentioned property for inspection purposes. /
Date: �z f Signature (Applicant or Agent)
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
PAID BY
METHOD RECEIPT #
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$71.50
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$35.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $107.25 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name: JERRY ELLERBUSCH Date Prepared: 2014-07-17
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 CF1R-ALT 02 document for each dwelling unit.:
01
Project Name:
JERRY ELLERBUSCH
02
Date Prepared:
201407-17
03
Project Location:
43-585 ALBA CT.
04
Building Type:
Singlefamily
05
CA City:
La Quinta
06
Dwelling Unit (Name:
JERRY ELLERBUSCH
07
Zip Code:
92253
OB
Dwelling Unit Conditioned
2400
duct system
Floor Area (ft2):
(packaged unit, or
Number of space conditioning
accessible
09
Climate Zone:
15
10
(SCI systems being altered in
1
condensing unit,
Installing
for sealing,
this dwelling unit.:
B. Space Conditioning (SC) SVstem. information
01
OZ
03
.04
05 :
06
07 -.
OS..
09
10
Installing new_ .
.Is the entire
components?
duct system
(packaged unit, or
accessible
Are all of the
condensing unit,
Installing
for sealing,
system's
Is the altered
Altering or
or
more than 40
and is more
components
or installed
installing a
cooling/heating
linear feet of
than 75% of
and ducts new
SC System
SC System
CFA served
system a
refrigerant
coil, or
new or
the duct
or replaced?
Identification or
Location or Area
by this SC
ducted
eonmIning
air -handling unit,
replacement
system new
(entireiy new
Name
Served
System (ft2)
system?
component?
etc)
ducts?
or replaced?
system)
Alteration Type
1 OF 1
HOUSE
2000
Yes
Yes
Yes
No
No
No
Altered space
cond(tioning system
G Extension of Existing Duct System, Greater Than 40 beet (Section 150.21b)2Diib)
This section does not apply to this project. -
Registration Number: 214-AA058078A-000000000-0000 Registration Date/Time: .2014-07-17 17:25:04 HERS Provider: Ca10ERTS
CA Building Energy E ficiency5tandards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-07-17 17:25:17
CERTIFICATE OF COMPLIANCE CFIR ALT -02 E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page Z of 4 )
D. Altered Space Conditioning'System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
1 10
11
12
Heating
Cooling
Swum
Identification
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
system
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duca
rName
Type
Components
TypeAll
OF 1
::I
Centra! gas
ne%v
heating
AFt1E
0.78
Centra! split
_
Tris field or
furnace
AC
cooling
SEER
13
Setback
section is not
R S
components
components
applicable
Reaulred Documentation:
MR -MCH -01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20•H & CBR -MCH -20-1-1 — Duct leakage testing required when heating or cooling components are installed in ducted systems, or when mote than 40 ft of duct length is replaced.
-leakage rate compliance; 515% 01:r 10leakage to
outside, or seal all accessible leaf.
CF211-MCH-25-0 & MR -MCH -25-1-1 Refrigerant Charge Verification required when refrigerant containing components are installed oraltered (applicable
in C22, 8 -IS).
CF2RCHRWCH-23 & CF311SMCH-23 Air Flow Z 300 CFM/ton required when MCH -25 is;regvired.. -
Exceptions: -
-Duct systems registered with H ERS provider as previously seared are e: em pt.froni'MCH-20 Duct Leakage Senting requirements.
-Heating-only systems and Air Handler/Furnace changes do not Air Flow Mc or Refrigerant Charge MECFi-25.
-Existing duct systems constructed, insulated or sealed tivith.asbestos are exempt from MCH.20 Ducf teakage Testing r `u irements,`
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)10iia ant! 150.2(b)1E, F}
This section does not apply to this project.
Registration Number: 214AO058078A-OOOOOD000-0000
Registration Date/Time,
2014-07-17 17:25:04
HERS Provider Cal CERTS
CA Buifdfng Energy Efficiency Standards- 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-07-17 17:25:17
CERTIFICATE OF COMPLIAPICE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 4 j
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
• Registration Number-`214-A0058078A-000000000-0000 Registration Date/Fime; 209407-17 9725:04
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2D14-03-31
HERS Provider: CaICERTS
Report Generated: 201407-17 17:25:17
CERTIFICATE OF COMPLIANCE
CFiR-ALT-02-£
Alterations to Space Conditioning Systems Jfomterly CF -IR -ALT -HVAC) (Page 4 -0 4 )
Documentation Author's Dedaration Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Narne:
Skov, Keri
Documentation Author Sig -nature:
�J�vs
Company:
Desert Al Conditioning Inc.
Signature Date:
2014-07-17 17:25:04
Address;
590 Williams Road
CEA/ HERS Certification Identification (if applicable):
city/State/zip;
Palm Springs CA 92264 1760-323-3383
Phone:
Responsible Person's Dedaration statement
I certify, the following under penalty of perjury, under the lava 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' Professi ons Code to accept responsibility for the building design or system deslgn identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance speciflcaEions, materia.fs,
components; and manufactured devfces:for the.building design or system design identified on this Certificate of Complfance rnnfnrm to the
requirements of Title 24, Part 1 and Par.6 of the California Code of Regalailons.7.
4. The building design features or system design ft azures identlfled M this Certiflcate ofComplfanoe are canslstent with4fie information prcMded'on other applicable compliance documents, viorksheets,
catcu lations, plans and specifitations.submitted to ifte enfo�cemen.
agency for approval with tfiis bbilditig permit app)li anon.
5. 1 %viil ensure that a registered Dopy of oris Certificate of C0610liafte shall be made avaifabie Faith the'build irig for the building,;
permit(i)-issued ancl:made available to the enforcement agency for a(I applicable
frnspectf ons. I understand that a registered copy of this Certificate of Corrrplfanee is required to be included with the documentation the builder provides to the building owner at occupancy,
Responsible Designer Name;
Responsible Designer Signature:
Skov, Keri
Company ;
Date Signed:
Desert Air Conditioning Inc.
2014-07-17 17:25:04
Address:
590 Williams Road t1Ense:
276586
city/State/2ip:
Phone:
Palm Springs CA 92264 1760-323-3383
DigiWty signed by CaMERTS. This digitaf signaWre is provided in order to secure the content of this registered dxamen4 and in noway implies Registra� on Providerresponsibility for the accuracy of the
information.
Registration Number. 214-A4058G78A-000000000-0000 Registration Date/Time: 2014-07-17 17:25:04 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-07-17 17:25:17
i
Flood f1slu plan
of La Quinta
Plaits rMbniif d '.
Bulkf ng ar Safeiy Division
Methatiical
i PeIiTa#
P.O. Box 1504,78-49S Calle T•amplco
zN Review, ready Lor torrectionvibsue
14-Quinta, CA 92253 -(760) 777,7012
13Aectrical
Building Permit
Application- and Tracking Sheet
1'r0jectA.4dtess: 43-586 ALBA. COURTOwna'sNeote:,JERRY
ELLERBUSCH .
A-P.Nttmber:
Grant Deed
Address; .43-585 ALBA COURT
%gal Description:
City, ST, zip: LA QUI NTA,. CA 92253
Contractor. Desert Air Conditioning; Inc.'
Tcicphona 760-345-4560 INIM =I
Address: 590 Williams Rd.
pmjegDescription: replace'5 ton split system on ground
City, ST, Zip: Palm Springs, CA. 92264.
ROMT.-
like for liks
j Telephone: 760-323-3383
''" l3eview, ready for earrectionw1uno
Developer IotpnCt i?ea
State Zia # ; 276586
-city Tic. H; 363
Arch, EW., D&'per: N/A
j Address:
Cities Contatt Person
A.TX.p,
City., ST, zip:
iters of perm k t98ice .
Tesltiphone
a
Constcucdon TY pe: Oerupaitcy:
i Stato f 1a #:
?
Pmjeet type (circle enc): Now Add'n Alta Repair Demo
Name of Conao Pawn.- Keri Skov
I
Sq. IR: # Starilx H Yyr►itS
Telephonc 9 of Contact Pamn: 760-323=3383 '
E
Estimated valise of Pmjeot: $8,465.00.
APPLICANT;
DO NOT WMM BELOW THIS LINE
• �
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.
er d news t C,ASRVC FR MIF):►E);9
PlRustts Pian Cheek "birthed Item Amoaat
Straetaeitt Caies. Revieveed, Mears for twrrteeOns Plan ClteskDeposit. .
T � �l�• Called Contact Pe nalt Pian Chetk Balance
Ti@e24 Cil piao8 nicked an Cenatrncdna
z6 �zoILI
Flood f1slu plan
Plaits rMbniif d '.
Methatiical
Otading plan
zN Review, ready Lor torrectionvibsue
13Aectrical
Sobewiffictor list
Called CCatactper80n
Plumbing
Grant Deed
Pians picictd up
9.M.I.
H.O.A. Approval
Plans ressabwMed
Grading:
ROMT.-
''" l3eview, ready for earrectionw1uno
Developer IotpnCt i?ea
Plaoelug Approval
Cities Contatt Person
A.TX.p,
Pub. R'ke. Appr '
iters of perm k t98ice .
&11061 Fees
Total Permit Pees
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