BMCH2015-0023•. t
Twit 4 4 a9ba
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0023
Property Address:
81345 AVENUE 54
APN:
767320013
Application Description:
REPLACE 2 TON SEER HEAT PUMP/COIL
Property Zoning:
compensation, as provided for by Section 3700 of the Labor Code, for the performance
Application Valuation:
$3,100.00
Applicant:
I have and will maintain workers' compensation insurance, as required by
Section 3700 Labor Code, for for
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
Carrier: Policy Number: _
IIIIIIIIVIIIIIIVIIIIIII 77
IE
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
GRIFFIN RANCH INV
23 CORPORATE PLZ STE 150
NEWPORT BEACH, CA 0
JAN 2, 1 ZO?5
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
Date: 1/21/2015
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
(760)343-1002
Llc. No.: 967982
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.: 9679
of the work for which this permit is issued.
7 '00'
t" �— G � — / 7 Contractor:
I have and will maintain workers' compensation insurance, as required by
Section 3700 Labor Code, for for
e:
D
of the the performance of the work 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
r
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 fora
57
Date: ` _2I- I Applicant:
4F
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:
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 Address:
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: /�z�—�^% Signature (Applicant or Agent):�,
i�
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: Sheehan.Mark.3 Date Prepared: 2015-01-20
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
Sheehan.Mark.3
02 .
Date Prepared
2015-01-20
03
Project Location
79180.3 Coyote Creek
04
Building Type
Single family
05
CA City
La Quinta
06•
Dwelling Unit Name
Sheehan.Mark.3
07
Zip Code
92253
08
Dwelling Unit Conditioned
800
Installing new SC
Installing
Installing
Installing
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted
containing
Number of space conditioning
-
09
Climate Zone
15
10
(SC). systems in this dwelling
1
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SC) System'Information,Yo
01
02
03, �� F
, : 04�
ot J05
06
- ' 07';
µ y08� -�'
09'
10
f '
;Is the SC
Installing a
SC 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 (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Master Bedroom
800
Yes
Yes
Yes
No
No '
No -
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A0022186A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
Report Version: 2014-03-31
Schema Version: 0.551SDD
2015-01-20 09:16:10
HERS Provider: CaICERTS
Report Generated: 2015-01-20 09:16:13
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)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
No heating
This field or
This field or
Central split
This field or
This field or
System 1 -
furnace
component
section is not
section is not
AC
Indoor coil
SEER
13
Setback
section is not
section is not
altered
applicable
applicable
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 — Duct 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 & CF311-MCH-25-11 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/tbtf required when MCH -25 is;required..-
Exceptions: // E
with HERS as previously sealed are exempt from MCH -20 Duct L/eakage / I\
k
-Duct systems registered provider Testing'requirements.
-Heating-only systems and Air Handler/Furnace'changes do not require, verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
( . .
-Existing duct 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)IE, 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-A0022186A-000000000-0000 Registration Date/Time: 2016-01-20 09:16:10 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-20 09:16:13
Schema Version: 0.551SDD
i
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E I
Alterations to Space Conditioning Systems (formerly CF-iR-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: ��
Hansen, Jamie
damle O-tansen
Company:
Signature Date:
Best in the West Air Conditioning & Heating Inc
2015-01-20 09:16:10
Address:
CEA/ HERS Certification Identification (if applicable):
31225 Plantation Dr
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760) 343-1002
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. 1 am eligible under Division 3 of the Business. and. Profess ions Code to accept -responsibility forthe building design or,system design identified on this Certificate of Compliance (responsible designer).
�,. . -mss , t r— i ---^� . >: , r
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. f1 f 1
4. The building design features or system design featu^es'identified on this Certificate of Compliance are consistent with -the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submittedrto the enforcement'agency fo*approval with this building permit application. ' " 4
,,.•
S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permits) 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 included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Hansen, Jamie
Jamie O-Eansen
Company:
Date Signed:
Best in the West Air Conditioning & Heating Inc
2015-01-20 09:16:10
Address:
License:
31225 Plantation Dr
967982
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760) 343-1002
Digitally signed by Ca10ERTS. 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-A0022186A-000000000-0000 Registration Date/Time: 2015-01-20 09:16:10 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-20 09:16:13
Schema Version: 0.551SDD
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT • QTY A 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 - OTHER EQUIPMENT
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
= AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - OTHER EQUIPMENT PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $72.52 $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:00
Description: REPLACE 2 TON SEER HEAT PUMP/COIL
Type:•MECHANICAL Subtype: Status: APPROVED
Applied: 1/21/2015 MFA
Approved: 1/21/2015 MFA
Parcel No: 767320013 Site Address: 81345 AVENUE 54 LA QUINTA,CA 92253
Subdivision: Block: Lot:
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,100.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: REPLACE 2 TON 13 SEER HEAT PUMP AND COIL] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
ADDITIONAL,SITES
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE `"
ZIP
;PHONE
FAX
EMAIL
APPLICANT
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD
PALM SPRINGS
CA
92262
#140-125
CONTRACTOR
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD
PALM SPRINGS
CA
92262
#140-125
OWNER
GRIFFIN RANCH INV
23 CORPORATE PLZ STE
NEWPORT
CA
0
150
BEACH
FINANCIAL
INFORMATION
Printed: Wednesday, January 21, 2015 2:37:52 PM
1 of 2
R? SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY.
BSAS SB1473 FEE
1 101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
OTHER EQUIPMENT
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
OTHER EQUIPMENT PC
Total Paid forCHANGEOUT: $72.52 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Printed: Wednesday, January 21, 2015 2:37:52 PM 2 of 2(77
SYSTEMS
Bin #
City Of La QUinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: '!a 1'-3q
4/4ve—
Owner's Name:
A. P. Number:
Address: 31- 3 4 5
Legal Description:
City, ST, Zip:
Contractor. h
Telephone:
Address: P/�
55 N. 10 Ceef 1� 84kNO--�25
Project tion:
j •P Rernat� �
(4cC,
�-•
City, ST, Zip: ' ' J ��t�
922 % Z-
2- 'lidjn 56' k Ar
-*1
Telephone: 7.,.a, --3q3 —BOG 2
1T0
O t' 0 0
State Lic. # :City
Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:<
> >`:..:.:.:..::.::.,:.:,;:•:;:..,...
Construction Type: � � Occupancy:
State Lie.. -4'-
Project ' air Demo a circle one): New Adder Re
type
J ) P
Name of Contact Person: �,' l� LVeO✓. p
Sq. Ft.:
#Stories:
#Units:
Telephone #:of Contact Person:
Estimated Value of ProjectFX
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
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.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees