BMCH2016-018378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
To. 4 4 09mro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0183
Property Address:
53760 AVENIDA MENDOZA
APN:
774173001
Application Description:
CHAPMAN / HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$9,500.00 '-----
D
Applicant:
IE INC
MAY 2 7 2016
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
CITY ()FLAQUINTA
COMMU
NITYDEVELOPMENT DEPARTMENT
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.: 977333
Date: -Tl I 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: Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/27/2016.
Owner:
PEARL CHAPMAN LEVIN
P 0 BOX 1973
LA QUINTA, CA 92253
Contractor:
A#1 SERVICES HEATING &-AIR CONDITIONING
78206 VARNER ROAD #D-189
PALM DESERT, CA 92211
(760)342-3610
Llc. No.: 977333
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 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. 4�O
Date: S 2Q 11 L 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 enter upon the
above-mentioned property for inspection purposes.
v
Date: S Z% 1 to Signature (Applicant or
FINANCIAL •R •
DESCRIPTION `ACCOUNT QTY.
AMOUNT
PAID' PAID DATE
BSAS S81473 FEE 101-0000-20306
0
$1.00
$0.00
PAID..BY METHOD.
RECEIPT #
CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 .$0.00 .
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE.
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT #
CHECK#
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID'
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #CHECK
#
CLTD BY
Total Paid for CHANGEOUT: $108.78 $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
Description: CHAPMAN / HVAC CHANGE OUT
Type: MECHANICAL Subtype:
Status: APPROVED
Applied: 5/27/2016 SKH
Approved: 5/27/2016 SKH
Parcel No: 774173001 Site Address: 53760 AVENIDA MENDOZA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 249
Lot: 24
Issued:
UNIT 23
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $9,500.00 Occupancy Type:
Construction.Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: HVAC CHANGE OUT-16SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
STEPHANIE
Printed: Friday, May 27, 2016 1:27:33 PM 1 of 2 '
SYSTEMS
CONDITIONS
CONDITION
DATE
DATE DATE
CONTACT
STATUS
REMARKS NOTES
TYPE
ADDED
REQUIRED SATISFIED
READY 70 ISSUE
STEPHANIE
5/27/2016
5/27/2016 5/27/2016
PENDING
FINISH NOTES AND ENERGY FORM REQUIRED.
CHECKLIST
KHATAMI
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
IE INC
31225 LA BAYA
WESTLAKE
CA
91362
VILLAGE
CONTRACTOR
A#1 SERVICES HEATING & AIR
78206 VARNER ROAD
PALM DESERT
CA
92211
CONDITIONING
#D-189
OWNER
PEARL CHAPMAN LEVIN
P O BOX 1973
LA QUINTA
CA
92253
Printed: Friday, May 27, 2016 1:27:33 PM 1 of 2 '
SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD.PAID
BY
CLTD
BY
BSAS S81473 FEE
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
$72.S2
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85.
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• ••
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Friday, May 27, 2016 1:27:33 PM 2 of 2 CR
SYS7Ei41S
Bfn.#
Qty Of LCI Quiflta
Building 8T Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
ProjeccAddress: 53760 Avenida Mendoza
Owner'sName:. Pearl Chapman
A. P. Number:
Address: 53760 Avenida Mendoza
Legal Description:
City, ST, Zip: La Quints, CA 92253
Contractor: A#1 Services Heating & Air Conditioning'
Telephone: 760-880-0480
Address: 78206 Varner Road #D-189
Project Description: Replace 3.5ton Heat Pump & Air Handler
City, ST, Zip: Palm Desert, CA 92211
Telehone:
P 760-342-3610
i �1.
State Lic. # : 977333
City Lie'. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephoner
•Y'
Construction Type:. Occupancy:
State Lic. #:
t3'P )' Add'n. a circle one): New Addn Alter Re
1 air Demo P
Sq. Ft.: # Stories: # Units:
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person: 818-735-7876
. Estimated Value of Project: $9,500.00 .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan SetsPlan
Req'd
Recd
TRACKING
Check submitted
PERMIT FEES
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit,
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.*.Mechanical
Grading plan
ri Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A- Approval
Plans resubmitted
Grading
IN ROUSE:-
3" Review; ready for correctionsrssue
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
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
PEARL CHAPMAN I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2016-05-26
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 CHR -ALT -02 document for each dwelling unit.
01
Project Name
PEARL CHAPMAN
02
Date Prepared
2016-05-26
03
Project Location
53760 Avenida Mendoza
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
PEARL CHAPMAN
07
Zip Code
92253
08
Dwelling Unit Conditioned
1492
J . .�.� V l.1
U 1-��' J i
i!!/
[ A 4-1 "v
'-t __J lk-"Is
Floor Area (ft2)
SC System
SC System
CFA served
'system A-
r f igen nt {Installing
Number of space conditioning
Xristall�ing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information '
--, . ►' 1� .-
I
01
02
03
!t 041
(f-- r 05 I _
t �� 06 ���
07))
08 i
09
10
.
tiF
the SC"
a ♦ . }
Installing a
J . .�.� V l.1
U 1-��' J i
i!!/
[ A 4-1 "v
'-t __J lk-"Is
SC System
SC System
CFA served
'system A-
r f igen nt {Installing
ew Sy
Xristall�ing
Lalli g
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
Location 1
1492
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: 216-A0196818A-000000000-0000
Registration Date/Time: 2016-05-26 17:25:55
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-26 17:25:50
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CERTIFICATE OF COMPLIANCE CF1R-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)IE 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 Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Central split
All new
Central split
All new
Less than or
System 1
heating
AFUE
0.8
HP
cooling
SEER
16
Setback
equal to 40
R-8
HP
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 & 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: 5 15°x6, or 5 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 & CF3R-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 Leakage Testing requirements..,,
-Charge
-Heating-only systems and Air Handler/Furnace changes do not require verification -6f Air Flow MCH -23; or Refrigerant MECH-25J
-Existing duct systems constructed, insulated or sealed with asbestos are exemptfrom MCH=20 DuctLeakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without,Equipment Changeout (Sections 150.2(b)1Diia,and 150.2(b)lE, F)
G--, P.- I�-T `ti. t)_, t4 4 %i/
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-A0196818A-000000000-0000
Registration Date/Time: 2016-05-26 17:25:55
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-26 17:25:50
Srhpma Vpminn• n SSScnn
CERTIFICATE OF COMPLIANCE CF1R-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: ��//
�aco
Jacoby, Ian
�Yan Jr
Company:
Signature Date:
i PERMIT E RATERS
2016-05-26 17:25:55
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
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 Title 24, Part 1 and Part 6 of the California Code of Regulations. 3
�ther,applicable
4. The building design features or system design features identified on this Certificate of Compliance are'co_ sent with the information provided ori compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcemeni agency for approval with this building permit application. X11i d } E f
5. 1 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, documentationµ the builder provides to The building owner at occupancy.
Responsible Designer Name: �$ ..a
Responsible Degigner Signature: V"kms t� � 'h
Jan
Jacoby, Ian
�acobJt.
Company:
Date Signed:
A 1 SERVICES
2016-05-26 17:25:55
Address:
License:
74866 Lennon PI
977333
City/State/Zip:
Phone:
Palm Desert CA 92260
760-565-2269 1
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: 216-A0196818A-000000000-0000 Registration Date/Time: 2016-05-26 17:25:55 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-26 17:25:50
Crhpma Vprcinn• n SSSCnfI