BMCH2015-035676963 Calle Mazatlan
BMCH2015-0356
78-495 CALLS 'fAMPICO D a(*fv VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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 License No.: 780534
Dater 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 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:
Lender's Address:
. 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 th ' ork 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 he Labor Code, I shall forthwith
comply with hose provisions.
Date: 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.
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 er upon the above•
mentioned property for inspection purposes. 71
Date: fly Idl f Signature (Applicant or Agent): 4AIZ., ell
Date:
9/15/2015
Application Number:
BMCH2O15-0356
Owner:
C
Property Address:
76963 CALLE MAZATLAN
CAROL SPUEHLER
APN:
658230022
76963 CALLE MAZATLAN
j
j
Cr
Application Description:
SPUEHLER / 13SEER/78AFUE SPLIT SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$6,000.00
Applicant:
Contractor:
U-)
I
ADAM SIMMONS
ADAM SIMMONS
PO BOX 314
/
PO BOX 314
LA QUINTA, CA 92247
LA QUINTA, CA 92247
(760)564-7525
Llc. No.: 780534
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 License No.: 780534
Dater 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 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:
Lender's Address:
. 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 th ' ork 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 he Labor Code, I shall forthwith
comply with hose provisions.
Date: 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.
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 er upon the above•
mentioned property for inspection purposes. 71
Date: fly Idl f Signature (Applicant or Agent): 4AIZ., ell
FI ANCIAC • -
3 `DESCRIPTION ' < #r mt: .€"'
ACCOUNTS" PAID', PAID.DATE
M ..., .QTY Cay "AMOUNT r .,
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
:Ee ' PAID:BY, '`` _r`METHOD oj ,"g
rCLTUBYt.
*c Ir,RECEIFT#CHECK#
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: -$1.00 $0.00
a 4 DESCRIPTION +nr'a
ACCOUNT ";z`
#QTY
"PAID "Xr~yPAIDDATE3:
a
AMOUNTy-"Al
f
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
x T rx :a
' s
-- a -c :
a •
YRCEIP,T
, - .: .
CHECK #`,'4PAIDBY
-
CLTD BYE
,K ? %
t
x
r.'DESCRIPTION..`'
s"
s 6 ACCOUNT
` QTY
AMOUNTS*
. PAIDPAID DATE
a
tt
HVAC CHANGEOUT - SPLIT -SYSTEM PC"
101-0000-42600
0'
$36.26
$0.00
';. b.,ar
;Y METHODry yY
tee` aRECEIPT#
CHECK #
CLTD BYE
<PAIDBY
r
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIPTION x {
' ACCOUNT
QTY€
AMOUNTS
f-" PAID ''
PAID
t"=
x '
x .DATE
PERMIT ISSUANCE
101-0000-42404
0.
$91.85
$0.00
"PAID BY ' 444, '
't•' ' METHOD
',:RECEIPT #r
CHECK #
CLTD BY
1
{
f
r x. "
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
r
n
1
r
Description: SPUEHLER / 13SEER/78AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 9/15/2015 SKH
Approved:
Parcel No: 658230022 Site Address: 76963 CALLE MAZATLAN LA QUINTA,CA 92253
Subdivision: TR 14496-3 & INT IN COMMONBlock: Lot: 22
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $6,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 13SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed_: Tuesday, September 15, 2015 3:34:11 PM 1 of 2
. SYSTEMS
CAROr1OLOGT
y J
CONTACTS'-
• ^m_.r',., .- .cw-oiw .. u.. ,p`. `+y.;: e ."r. ..a... F" . pan .^ tt-..✓y -yo.' -:. :. <t. .. . y..e ....- _-.." ::-n,i. drt' S-.: .:-mprer< m*_ti e ♦ .. .:.. "'^9 ti.'B,'f h
;_NAME"° ; ADDRE5S1 ;': >. CITY = STATE _ ;ZIPS ;PHONE y' FAX;: EMAIL
APPLICANT ADAM SIMMONS P 0 BOX 314 LA QUINTA CA 92247
Simmonscda@yahoo.c
nm
Printed_: Tuesday, September 15, 2015 3:34:11 PM 1 of 2
. SYSTEMS
17
... .
........... . . . ......... . ..
.DESCRIPTION:`ACCOUNT
QTY".
A'm6UNT'4 A
PAID
PAID DATE
RECEIPT #
;'CHECKV.
'METHOD
al
.r'q, I I
7
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVACCHANGEOUT-
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT-
101-0000-42600
0
$36.26
$0.00
SPLIT-SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42464
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63 $0.00 ij
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 )
Project Name: Spuehler Date Prepared: 2015-07-24
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
Spuehler
02
Date Prepared
2015-07-24
03
Project Location
76936 Mazatalan
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Spuehler
07
Zip Code
92253
08
Dwelling Unit Conditioned
2000
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
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
01
02
03
04
05
06
07
08
09
10
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
whole house
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0204437A-000000000-0000 Registration Date/Time: 2015-07-24 08:21:52 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-24 08:21:07 k
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFiR-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
it
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 Dud
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Dud Length
R -Value
Central gas
All new
Central split
All new
Less than or
System 1
furnace
heating
AFUE
0.78
AC
cooling
SEER
13
Setback
equal to 40
R-8
components
components
feet
Required Documentation%
CF2R-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 — Dud 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 8, 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 2 300 CFM/ton required when MCH -25 is required.
Exceptions:,
-Dud systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage 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 dud systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Dud 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)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC)
This section does not apply to this project.
Registration Number: 215-A0204437A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-07-24 08:21:52
Report Version: 2014-03-31
Schema Version: 0.555SDD
-
HERS Provider: CaICERTS
Report Generated: 2015-07-24 08:21:07
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Bachus, Tom
Company:
Signature Date:
MLC Building Performance
2015-07-24 08:21:02
Address:
CEA/ HERS Certification Identification (if applicable):
77825 Delaware Place
City/State/Zip:
Phone:
Palm Desert CA 92211
1760-836-0066
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 or system design identified on this Certificate of Compliance conform to the
requirements of Tftle 24, Part 1 and Part 6 of the California Code of Regulations.
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 the enforcement agency for approval with this building permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) 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: G,
Il ssX Ifl Gsi4GG Gd'
Simmons, Donna
Company:
Date Signed:
ADAM SIMMONS
2015-07-24 08:21:52
Address:
License:
54440 AVENIDA CARRANZA
780534
City/State/Zip:
Phone:
LA QUINTA CA 92253
1(760) 564-7525
Digitally signed by COMM. This digital signature is provided in order to secure the content of this registered documen4 and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0204437A-000000000-0000 Registration Date/Time: 2015-07-24 08:21:52' HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-24 08:21:07
Schema Version: 0.555SDD
Bin #
City of La Quinia
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:wner's
Name: L E
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: GiZL r5/
Tele h 0 3,T-3-5—
REMIM
Address: cV721q
Project Description:--/ C
City, ST, Zip: -3
Tep
le h 0 7
State Lic. #: 3
City Lic. #c
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
le one:
P
Construction s uction TYP e• c
Occupancy:
P Y:
State Lic. #•
Project e i w (circle one): New Add'n Alter Repair air e
h'P c Demo
Name of.Contact Person: r ! S
Sq. Ft.:
A
# Stories:
# Units:
Telephone # of Contact Perso . 7%
Estimated Value of Project: -0. Cj-zD
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
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:-
3' 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