BMCH2015-013479655 Mandarina
BMCH2015-0134
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&,y/ 4lwQ, rw
DMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Ntimber: BMCH2O15=0134--, /?- //V
Property Address , 9 6J 5_ /f/1A D
APN:
Application Description: MOSER - REPLACE EVAP COIL
Property Zoning:
Application Valuation: $1,800.00
Applicant:
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20, C38 License No.: 9679
ate: (7-ntractor:
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 folie
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 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 Name: ` l
Lender's Address: N I
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/17/2015
Owner:
MOSER
79655 MANDARINA
LA QUINTA, CA 92253
Contractor:
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD #140-125
PALM SPRINGS, CA 92262
(760)343-1002
Llc. No.: 967982
WORKER'S COMPENSATION DECLARATION - t
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 work 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: _ 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 Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
pplicant:
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 upon the above.
me/nti/oiled property foXu rposes.
atPl e: —1 - Applicant or Agent): '
Gt ;
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: Moser.79655.1 Date Prepared: 2015-04-17
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.
O3
Project Name
Moser79655.1
02
Date Prepared
2015-04-17
03
Project Location
79655.1 Mandarina
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Moser79655.1
07
Zip Code
92253
08
Dwelling Unit Conditioned
2000
CInstalliri +
9nstallin
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
c ntaining "
system ' `
Number of space conditioning
entirely a
09
Climate Zone
15
10
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information i l j l f
■■67))
O3
02
03
04N
4:5O5 ( k
1 f-06:
11
08 11
09
30
Is the St—
' Initallirig a`
SC System
SC System
CFA served
s stem a
refri Brant <
-Installin newSC
CInstalliri +
9nstallin
Installing
Identification or
Location or Area
by this SC
ducted
c ntaining "
system ' `
more than`0
entirely a
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Living
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section15O.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0100683A-000000000-0000 Registration Date/Tme: 2015-04-17 12:39:22 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-17 12:37:45
Schema Version: O.SSSSDD
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)1E and F)
O1
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
I 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 it of duct length is replaced.
-Leakage rate compliance: 5 15%, or 5 30% 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 & CF3R-MCH-23 Air Flow;t 300 CFM/ton required when MCH -25 is required.
Exceptions: 10-711
-Duct systems registered with HERS provider as previously sealed are exempt froon of Ai 20 Duct Leakage Testing r;nt C arge.. y
-Heating -only systems and Air Handler/Furnace changes do not require verification of Air Flow.fvlCH-'23, or Refrigerant 6haige.MECH-25j.{,
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 f)uct Leakage Testing requirements.
9 fix r^^ o .... il ! 4
E. Entirely New or Complete Replacement Duct System, with -or JithouL Equipment C ah ng out•( actions150.2(b IDiia and 15O.2(b)lE, F)
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: 215-A0100683A-000000000-0000 Registration Date/Time: 2015-04-17 12:39:22 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-17 12:37:45
Schema Version: O.SSSSDD
0
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: 77
Hansen, Jamie
Jamie d ansen
Company:
Signature Date:
Best in the West Air Conditioning & Heating Inc
2015-04-17 12:39:22
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 Callfornia:
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 myanufactured 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 ofR egulations. 1I rIf 1 e* ( I i
Iotherappliicabl-
^-.
4. The building design features or system design features identified on this Certificate of Compliance are consistent -with -the information.provided on mpllance documents, worksheets,
f r r. K i f _a i F ,:
calculations, plans and specifications submitted to the enforcement agency for'approval with this building permit appaication.
+FF fill (``
'rr11
/ a t tL F( ft,cl 'a, h- e>r if 1 }
5. I will ensure that a registered copy of this Certificate of Compliance shall be:made.available withthe building permtt(s).issued forthebuild(ng, and.matl available,(o the`enforcement agency for all applicable
inspections. I understand that a registered copy of thisCertific a of Compliance, is, required to be included with the-documentationQheNbuilder provides toot_he building owner at occupancy.
Responsible Designer Name:) -Y l''1 .. s
Responsible Designer Signature: V i r . 0 "
Hansen, Jamie
r'T
Jamie O ansen
Company:
Date Signed:
Best in the West Air Conditioning & Heating Inc
2015-04-17 12:39:22
Address:
License:
31225 Plantation Dr
967982
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760)343-1002
Digitally signed by CoICERTS. 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-A0300683A-000000000-0000 Registration Date/Time: 2015-04-17 12:39:22 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-17 12:37:45
Schema Version: O.SSSSDD
INFORMATION
DESCRIPTIONS: ''7 :'¢ACCOUNT' L"# . Y
QTY
AMOUNT ;PAID+
¢ ' -
PAID DATE:
BSAS SB1473 FEE 101-0000-20306
0
$1.00
$0.00
,PAID BYy }¢ U^i ;^, *METHOD : ;
RECEIPT #' t
CHECK # :
' CLTD:BY r'
Total Paid for BUILDING'STANDARDS ADMINISTRATION 'BSA $1.00 $0.00
DESCRIPTION "a};Hz
oACCOUNT rn a,W
QTY
'AMOUNT
',PAID.'
PAID.DATE.
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
QPAIDY S a ;?+*>'`
B
,lYt i"•yi (t ..t
` `METHOD :'
J . I . 'r. .1'at 1
fw`RECEIPT#i i v
_f:; %,
'CHECK# `
rCITDBY
DESCRIPTION :
, `ACCOUNT,r 1at 2
CRTY .AMOUNT
, 4
: PAID. Y '
:PAID DATE.
HVAC CHANGEOUT - REPAIR/ALTERATION
PC
101-0000-42600
0
$4.83
$0.00
",:rw;PAID BYE n;' ,
4 fi Y,,.tMETHOO a ;.
7u, f ..
s RECEIPT #1«r .
aw:
Y ; CHECK # ZG„ Uy
wCLTD BY
Total Paid forCHANGEOUT: $16.92 $0.00
DESCRIPTION t r' c ' `_' "``
r" t' ACCOUNT ` ''
QTY
i` AMOUNTs
PAID 3 " '
aA.
x,PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
s'f t• 'a `PAID BY: .xt ''S
;;METHOD ; c
+ : - "RECEIPT # ' ,
e' -'CHECK # `
y CLTD BY'
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:0• 00
Description: MOSER - REPLACE EVAP COIL
Type: MECHANICAL Subtype:
Status: APPROVED
Applied: 4/17/2015 KHE
Approved: 4/17/2015 KHE
Parcel No: Site Address: ,
Subdivision: Block:
Lot:
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $1,800.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: REMOVE OLD COIL 7 REPLACE EVAPORATIVE COIL IN ATTIC 2013 CODES
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
[ FINANCIAL INFORMATION7
Printed: Friday, April 17, 2015 2:42:07 PM 1 of 2
RWSYSTEMS
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
$12.09
$0.00
REPAIR/ALTERATION
HVAC CHANGEOUT -
101-0000 42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid forCHANGEOUT: $16.92 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:409.77 $0.00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR 'SCHEDULED COMPLETED -RESULT REMARKS ~NOTES
..
DATE ,. DATE
MECHANICAL FINAL" BLD
f PARENT PROJECTS
BOND
INFORMATION
ATTACHMENTS
Printed: Friday, April 17, 2015 2:42:07 PM 2 of 2
RW YSTEMS