BMCH2016-038651770 Avenida Madero
BMCH2016-0386
78-495 CALLE TAMPICO U 1tiNl Cl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0386
Property Address: 51770 AVENIDA MADERO
APN: 773154001
Application Description: HEI NY / CHANGE OUT (1) SPLIT SYSTEM
Property Zoning:
Application Valuation: $6,000.00
Applicant:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
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. C36 License No.: 77 94
__ 'o 00000000000000000A
t
Date: D
Contractor: _ -
OWNER -BUILDS D CLARATION
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).:
1, 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.).
(1 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ELWIN HEINY
619 STAN DREWS LOOP
CRESWELL, OR 0
Contractor:
J ANTHONY PLUMBING
72216 NORTH SHORE S'
THOUSAND PALMS, CA
(760)328-8096
LIC. No.: 777794
Date: 10/25/2016
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'
compensati , as provided for by Section 3700 of the Labor Code, for the performance
of the w 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 polity number are:
Carrier: MIDWEST EMPLOYERS CASUALTY COMPANY 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 be c me subject to the workers'
compensation laws of California, and agree that, if I s ould become subject to the
workers' compensation provisions of Section 37 the Labor Code, I shall forthwith
comply with those provisions.
Date: 5 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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and klawng to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of thison the
above -men 'one property for inspection purposes.
Lender's Name: n
Date: r/i✓ Signature (Applicant or Agent)
..
Lender's Address: -
Application Number: BMCH2016-0386
Property Address: 51770 AVENIDA MADERO
APN: 773154001
Application Description: HEINY / CHANGE OUT (1) SPLIT SYSTEM
Property Zoning:
Application Valuation: $6,000.00
Applicant:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
Date: 10/25/2016
Owner:
ELWIN HEINY
619 ST ANDREWS LOOP
CRESWELL, OR 0
Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
(760)328-8096
Llc. No.: 777794
Detail: HVAC CHANGE OUT - 14SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES.
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
Bin #
City of % 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: 511 -ID P V ew i, kAaAD
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip:
Tele hone: — 5-5
Address: ,J ANTHONY SERVICES
Project Description:
City, ST, Zip: 72216 NORTH SHORE ST STE 101
--I-
Telephone:
:•;:':..::.;;::::««::;:x:::-:•:;;::>:<: :;.:j:;
( ^,
State Lie. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
i:•ii}r >:i:?iiii:::.:...•f:;::•::•: ii:•:hiSi:
o stru fin TYaneY
e: Occupancy:
P •
State Lie. #:
Project a circle one): New Add'n Alter Repair Dem
J type ) P o
Name of Contact Person: \
Sq. Ft.:
# Sto 'e
# Units:
Telephone # of Contact Person:
Estimated Value of Project: —
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
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
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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
I Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
I Project Name: HEINY I Date Prepared: 2016-10-24 I
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
HEINY
02
Date Prepared
2016-10-24
03
Project Location
51770 AVENIDA MADERO
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
HEINY
SC System
SC System
CFA served
Dwelling Unit Conditioned
refrigerant "
07
Zip Code
92253
08
Floor Area (ft2)
2000
Location or Area
by this SC
ducted
containing y
Number of space conditioning
more than 40
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
,
01
02
03
0C'
t' 05 ; Y `,..
r 06
OT
I:: OS ,+
09
10
the SC
Installing a
`
SC System
SC System
CFA served
xls
< ystem a- -
refrigerant "
.Installing new -SC
# Irnstal ung ;
Install g
Installing
Identification or
Location or Area
by this SC
ducted
containing y
system
more than 40
entirely new
'entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Altered space
System 1
Location 1
2000
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 216-A0396562A-000000000-0000
Registration Date/Time: 2016-10-24 10:32:55
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-24 10:32:55
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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
Outdoor
This field or
This field or
System 1
Central gas
Gas furnace
AFUE
78
Central split
condensing
SEER
14
Setback
section is not
section is not
furnace
AHU
AC
unit
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 & CF311-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: <_ 15%, or <_ 10% 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 & CF311-MCH-23 Air Flow>_ 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct LeakageTestingrequirements. r. —
X23, Charge K1ECH 25}
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH or Refrigerant
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)1Dlia-and 150.2(b)lE, F)
i - li r w f. w i 4" t >i s -
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 216-A0396562A-000000000-0000 Registration Date/Time: 2016-10-24 10:32:55 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-24 10:32:55
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
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:
Robinson, Kevin
/C
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2016-10-24 10:32:55
Address:
CEA/ HERS Certification Identification (if applicable):
72216 NORTH SHORE ST #101
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
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 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 o ., ystem 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. ' lel
4. The building design features or system design features identified on this Certificate of Compliance are -consistent with the informationprovidedon other%applicable' compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval withbuilding permit application. .3 }
`this
S. I will ensure that a registered copy of this Certificate of.Compliance shall be'made available `with the building permit'. j issued for:the-b'uildirig, 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 documenta tion,the,builder provides to. the building owner at occupancy.
Responsible Designer Name: t -- 4 #
Responsible Designer Signature
Robinson, Kevin
/CP.!/G li%kLQBJfi
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2016-10-24 10:32:55
Address:
License:
72216 NORTH SHORE ST #101
777794
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
Digitally signed by CaICERTS. 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: 216-A0396562A-000000000-0000
Registration Date/Time: 2016-10-24 10:32:55
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-24 10:32:55
Schema Version: 0.555SDD