BMCH2015-0127 (BMCH)79768 Arnold Palmer
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7495 CALLE TAMPICO 4 VOICE(760)777-7125
FAX(760)777-7011
LA QUINTA,CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS(760)777-7153
BUILDING PERMIT
Date: 4/14/2015
'Application Number: BMCH2O15-0127 Owner:.
Property Address: 79768 ARNOLD PALMER MERCHANT VICKI BETTI LYON
APN: 775241078 78768 ARNOLD PALMER
Application Description: MERCHANT/CHANGE OUT(1)78AFUE FURNACE LA QUINTA,CA 92253 if
Property Zoning: z T
Application Valuation: $6,800.00
Applicant: Contractor: e,t
A R S AMERICAN RESIDENTIAL SER A R S AMERICAN RESIDENTIAL SER r c -
965 RIDGE LAKE BLVD SUITE 201 965 RIDGE LAKE BLVD SUITE 201 R D
MEMPHIS,TN 38120 MEMPHIS,TN 38120 cr
(951)276-9744 - ---r
Llc.No.:765074
---------------------------------------------------------------------------------------------
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:C36,C10,C20 License No.:765074 of the wo for which this permit is issued.
ve and will maintain workers'compensation insurance,as required by
Date: yes Contractor: 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:
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 of the Labor 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 ,` C
of the Business and Professions Code)or that he or she is exempt therefrom and the Date: '1 7' s 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 11,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. BAP.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 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 enter upon 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: S'( Signature(Applicant or Agent)
Lender's Address:
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 1 of 3)
Project Name: MERCHANT Date Prepared: 2015-04-08
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 CF111-ALT 02 document for each dwelling unit. '
01 Project Name MERCHANT 02 Date Prepared 2015-04-08 )'
03 Project Location 79768 ARNOLD PALMER 04 Building Type Single family
05 CA City La Quinta 06 Dweiling.Unit Name HOME
07 Zip Code 92253 OS Dwelling Unit Conditioned 1600
Floor Area(ft2)
Number of space conditioning
09 Glmate Zone 15 10 (SC)systems in this dwelling 1 i-
unit. R
B.Space Conditioning(SC)System Information
01 02 03 04 05 06 07 D8 09 10
is*!►e sc Instal i a i •:
SC System SCSy. ;,Aswm;ved7 systema refrigerant InstallMg new SCInstalling Installing InstallingMOWN Identification o ation. ea. b # wntaM nl g system rrorc than 40 entirely new entirely newName Sery �m? compoitT oornponents? feeto duct system? SC system? Alteration Type .
Altered space
System 1 yes No yes, „No No No conditioning
system
t ;
R
•I
C.Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Dlib) {`
This section does not apply to this project.
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Registration Number.315-A3005824A•000000000-0000 Registration Date/Time:2015-04.08 16:37:21 HERS Provider:USERA t"w
CA Building Energy Efficiency Standards:2013 Residential Compliance Report Version:2014-03-31 Report Generated:2015.04-08 16:37:38
Schema Version:0.S55SDD
? CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E i
Alterations to Space Conditioning Systems(former4y,CF-1R-ALT HVAC) (Page 2 of 3}
.r. , Vq
r D.Altered Space Conditioning System(Sections 150.2(b)IF-and F)
01 02 03 04 05, 06 07 08 09 10 11 12 f
s Heating Cooling ,x
' System Heating Altered Heating Minimum Altered Cooling Minimum Required New or '
identification System Heating Efficiency Efficiency Cooling ; Cooling `Efficiency Efficiency Thermostat Replaced New Ouds+
)'
•
or Name a Type Components- r Type Value System Type Components Type Value Type Duct-Length, R-Value. t;
.i " No coLess than or
All new oling
s=
Central gas Central splitzr
System 1 heating AFUE .78 component SEER 13 Setback equal to 40 R-8
furnace components AC altered feet
,.
q3, Reouired O$6rrientation:
r_ CF2R-MCH-01-E--Space Conditioning Systems Ducts and Fans
-Duct Insulation requirement for new-plenums:R6. �
?' CF211-MCH-20.14&MR-MCH•20-H—Duct,Leakage testing required when healing or cooling components are installed in ducted systems,or when more than 40 It of duct length is replaced. rt
Leakage,rate compliance:515%,ors 10%leakage to outside,or seal all accessible teaks.
S'::'t • CF2R•MCH•25•1,1&CF3R•MCH•25•H Refrigerant Charge Verification required when refrigerant containing components are installed or altered lapplirable in Q 2,9-15i.
r.;
r... CF2RCF3R-MCH-23&CF311-MCH-23 Air Flow 2300 CFM/ton roquired when MCH•2515 required, i:��,•
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/Fumace changes do not require verification of Ali Flow MCH-23.or Refrigerant Charge MECH-25. _
Existing duct systems constructed,Insulated or seated with asbestos are exempt from MCH-20 Duct Leakage Testing requirements,
� j �.„' ,� •,�,. ��c,.tea .. � ..�;,1s�.. - - ��t
E.Entirely Ne `or Complet ,���ee I enLD S em,with• r withOUt EquipmeM`Changeout("Sections 150.2(b)iDifa and 150.2(b)1E,F)
Th s section does not applyi to this pardoiJect. :
u F.Entirely New or Complete Replacement Space Co I ni {
�. .: P er ,f�ociation
This section does not apply to this project.
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Registration Number:315•Ai005824A-000000000.0000 Registration Date/Time:2015-0408 16.37:21 HERS Provider:USERA ,.y
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report,Generated:2615-04.08 16:37:38
x
""' t Schema Version;0.S55SDD ^"A
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-,? CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVAC {Page 3 of 3} �
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Documentation Author's Declaration Statement
�*s 1.i ceitlo that this Certificate of Compliance documentation is accurate'and complete.
' Documeniation`AuthorName: DocumentationAuthor Signature:
"r Jim McEligot
z :.•� Company Signature Date:
RighTime Home Services 2015-04 08
Address: GFA/HERS Certification Identification(if applicable): jy!
3030 Myers St 765074
Phone: Y g
City/state/rip: 951-276-9744
a z Riverside CA 92503
f 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. x
f 2. 1 am eligible under plvision 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designerl.
3. That the ere features and rformance specifications,materials,components,and manufactured devices for the building design or system des) Identified on this Cenincate of Cam lance conform to the x4
rgY pe � Po 8 g Ys 8n PI �-t
- requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations. -
" '+ v 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.tho enforcement agency for approval with this building permit application. j
S. I will en that a reglst cagy of {�}t�r�_p of Compliance shall be mads available with the building pemdbs)6sued.for the building,and made available to the enforcement agency for all applicable
ro inspectto _ derstand reglsgq`'pyof ti15. ectifkaof tort `pliance fs reQuired to be Included=with th_a documentatbn the builder provides to the building owner at occupancy. i
x
Responsible Designer ' eSpOnii Igoegnal "Y'1
R bleDes tsl ure: 1 f
s Jim McEllgot
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g3 ;,
Company,"
rS sh Ri hTinie Home 5 2015
f g . . of
30300MyersSt U.-S. Energy, Ra e`��QAssociation
City/State/Zip: Phone: } .
Riverside CA 92503 951-276-9744
..
'` 4 •' 'fiis digital signature is provided in order to secure
the content of this registered document;and in no
s ' i
way mpbes Registration Provider responsibddy for .
Kthe accuiacy of the information.
.YWLL_4 U
U.S.Energy Ratrro AS octadon
Registration Number:31S-A1005824X-000000000-0000
Registration Date/Time:2015-04-08 16:37:21 HERS Provider:USfRA t.
Ak
33 CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2015-04.08. 16:37:38 ,
`-'i Schema Version:0.555S0D t
FINANCIAL INFORMATION
DESCRIPTION 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-FURNACE ONLY 101-0000-42402 0 1 $36.26 $0.00
PAID BY METHOD RECEIPT# CHECK# CLTD BY
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
HVAC CHANGEOUT-FURNACE ONLY PC 101-0000-42600 0 $24.17 $0.00
PAID BY METHOD RECEIPT# CHECK# CLTD BY
Total Paid forCHANGEOUT: $60.43 $0.00
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00
PAID BY METHOD RECEIPT# CHECK# CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: • •0
a T�•G
F 'G
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PERMIT NUMBER
Permit Details
• : 0
Description:MERCHANT/CHANGE OUT(1)78AFUE FURNACE -
Type:MECHANICAL Subtype: Status:UNDER REVIEW Applied:4/14/2015 SKH
Parcel No:775241078 Site Address:79768 ARNOLD PALMER LA QUINTA,CA 92253 Approved:
Subdivision:TR 21381-3 SEE ASSESSORS MB 769-41 . Block: Lot:2 Issued:
40 FOR CMS
b
Lot Sq Ft:0 Building Sq Ft:0 Zoning: Finaled:
Valuation:$6,800.00 Occupancy Type: Construction Type: Expired:
No. Buildings:0 No.Stories:0 No. Unites:0
s
Details: HVAC CHANGE OUT-(1)78AFUE FURNACE.[2013 ENERGY]CARBON MONOXIDE ALARMS)TO BE INSTALLED PRIOR TO FINAL
INSPECTION.2013 CALIFORNIA BUILDING CODES.
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE :,NAME` ' ADDRESS l CITY ""STATE ZIP PHONE FAX EMAIL
APPLICANT A R 5 AMERICAN RESIDENTIAL SER 965 RIDGE LAKE BLVD MEMPHIS TN 38120 (760)771-2029
SUITE 201
CONTRACTOR A R S AMERICAN RESIDENTIAL SER. 965 RIDGE LAKE BLVD MEMPHIS TN 38120 (760)771-2029
SUITE 201
OWNER MERCHANT VICKI BETTI LYON 78768 ARNOLDLA QUINTA CA 92253 (760)771-2029
PALMER
FINANCIAL INFORMATION
Printed:Tuesday,April 14,2015 2:00:29 PM 1 of 2
RWYSTfMS
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gl�
Permit • ils PERMIT NUMBER
-
. ' _ , :"Id
•
uinta
DESCRIPTION ACCOUNT ~� QTY AMOUNT PAID PAID DATE RECEIPT# CHECK# ^ METHOD PAID BY CLTD
BY
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT- 101-0000-42402 0 $36.26 $0.00
FURNACE ONLY
HVAC CHANGEOUT- 101-0000-42600 0 $24.17 $0.00
FURNACE ONLY PC
Total Paid forCHANGEOUT: $60.43 $0.00
PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: 00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
MECHANICAL FINAL" BLD
PROJECTSPARENT
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
BOND INFORMATION
ATTACHMENTS
Printed:Tuesday,April 14,2015 2:00:29 PM 2 of 2
CN?WY5TfM5
'f
Bin, .:
i City of La Qurnia
Building ar Safety Division I
i Petmft# P.O.Box 1504,'78.495 Calle Tampico I
La.Qutnta,CA 92253(760)777-7012
'&RW Z-t?6 V X 27 Building Permit Application and Tracking Sheet
Project:Add,=: 79768 Arnold Palmer Dr ' owner'sNamc: Stevq Merchant ..
.i a P.Ntunber. Address: -79768 Arnold Palmer Dr.
Legal Description: City,ST,.Zip: La Uinta C 2
Contractor. Ri htime`Home Services Telephone: 760-771-2029 �r
Addtws: 3030 Myers St ProJectDescrlption:
City,ST vp: Riverside"CA 92503 Re lace 80 000 btu furnace in the attic
Yi
I Telephone951-276-9744 1:
1 StatcLlc,d: 76507.4 .City Llc.9,
1 �
Ar_fL,Enrr•,Dom«- N/A
Address:
City,ST,Zip:
Telephonc: WHIMConstruction Type:, Occupancy:
I! StatcLic.#: Project type(circle one): New Add'n Alter Repair Demo
Ino
f i Name of6ntactPerson: Jane Recktenwald Sq.Ft.: it Stories 17m
Telephonc It ofContact Pelson: 7.14-336-6159 Estimated value of Project 6,800.00 1
! APPLICANT:DO NOT WRITE BELOW THIS LINE
b Submittal ReV4 'Rev'd TRACKING PERMIT FEES
Plan Sed Plan Cheek submitted Item Amount
' StructuralCslr;. Itevimcd,ready fortor'recttuns Plan CLcckDeposit, .
j. Truss Cata. ..Called contact Perm Plan Check Balance, ;
TlUc 14 Calci. Plane picked up Construction
Flood plain plan Pians resubmitted,. Mechadlcal
I i Gtading plan T!Review,ready'for eorrectionshsste. Electrical
i .
I Subcontaetor List Called Contact Person Plumbing
1
i
Grant Dced Piauepicked up S"%LL
ILOA_Approval Plans resubmitted Grading
IPI HOUSE- '''Review,ready for tomctlonsRssue Developer Impact Yrce
1 Planning Approval Called Contact Person A LP.P.
1 Pub.Wks.Appr• Date of permit issue
School Fees
Total Permit Fees,