BMCH2015-0055I I .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
DEVELOPMENT DEPARTMENT
UILDING PERMIT
Application Number:
BMCH2O15-0055
Property Address:
78875 MERIDIAN WAY
APN:
609480061
Application Description:
STARLIGHT DUNES/CUMMINS/(1)4TON SPLIT AND (1) 3TON SPLIT
Property Zoning:
78875 MERIDIAN WAY
Application Valuation:
$16,800.00
Applicant:
PACIFIC CONCRETE INC DBA
ANTHE
53800 POLK STREET
z;
COACHELLA, CA 92236
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: A. B. C20 License No.: 82291
Date: 2-2 4 Contractor:
OWNER -BUILDER DEC IA N
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
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 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.).
(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 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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
%3e
nd will maintain a certificate of consent to self -insure for workers'
cprovided for by Section 3700 of the Labor Code, for the performance
oich this permit is issued.
nd will maintain workers' compensation insurance, as required by
SLabor Code, for the performance of the work for which this permit
iers' 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, i I should becobject to the
workers' compensation provisions of Section 37 o the Labor C e I shall forthwith
comply with those provisions.
Date: 2-N - I
WARNING: FAILURE TO SECURE WORKERS PENS N COVERAGE V UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE INES 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 thea ove information is correct.
I agree to comply with all city and county ordinances ands to ws rel n to building
construction, and hereby authorize representatives of this c to me upon he above•
mentioned property for inspection purposes.
Date: '2--7-1 Signature (Applicant or ent)
Date:
2/24/2015
Owner:
MARY CUMMINS
78875 MERIDIAN WAY
LA QUINTA, CA 92253
y
z;
Contractor:-'
�•
PACIFIC CONCRETE INC DBA AN 1HE
�? 0
53800 POLK STREET
COACHELLA, CA 92236
u
c(760)469-2525
Llc. No.: 822918
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
%3e
nd will maintain a certificate of consent to self -insure for workers'
cprovided for by Section 3700 of the Labor Code, for the performance
oich this permit is issued.
nd will maintain workers' compensation insurance, as required by
SLabor Code, for the performance of the work for which this permit
iers' 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, i I should becobject to the
workers' compensation provisions of Section 37 o the Labor C e I shall forthwith
comply with those provisions.
Date: 2-N - I
WARNING: FAILURE TO SECURE WORKERS PENS N COVERAGE V UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE INES 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 thea ove information is correct.
I agree to comply with all city and county ordinances ands to ws rel n to building
construction, and hereby authorize representatives of this c to me upon he above•
mentioned property for inspection purposes.
Date: '2--7-1 Signature (Applicant or ent)
CERTIFICATE OF COMPLIANCE CKR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Cummins Date Prepared: 2015-02-23
A. General Information
CF111-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
Cummins
02
Date Prepared
2015-02-23
03
Project Location
78875 Meridian Way
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Cummins
SC System
SC System
CFA served
08
Dwelling Unit Conditioned
2800.
07
Zip Code
92253
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
2
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
O1
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
Y
Location 1
1600
Yes
Yes
No
No
No
No
Altered space
conditioning system
System 2
Location 2
1200
Yes
Yes
No
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
- Registration Number: 215-A0051281A-000000000-0000
Registration Date/Time:
2015-02-23 17:15:41
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-02-23 17:15:30
Crhama Varcinn• n 551Gnn
CERTIFICATE OF COMPLIANCE CF111-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)IE and F)
O1
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 gas
All new
Central split
All new
This field or
This field or
System 1
heating
AFUE
0.78
AC
cooling
SEER
14
Setback
section is not
section is not
furnace
components
components
applicable
applicable
Central gas
All new
Central split
All new
This field or
This field or
System 2
heating
AFUE
0.78
AC
cooling
SEER
14
Setback
section isnot
section is not
furnace
components
components
applicable
applicable
Reauired Documentation:
CF2R-MCH-03-E - Space Conditioning Systems Ducts and Fans
-Duct Insulation requirement for new plenums: R6.
CF211-MCH-20-1-1 & 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: 515%, or 510% leakage to outside, or seal all accessible leaks. I
CF2R-MCH-25-H & CF311-MCH-25-1-1 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/tan 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.
-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)1Diia 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)1C)
This section does not apply to this project.
Registration Number: 215-A0051281A-000000000-0000
Registration Date/Time:
2015-02-23 17:15:41
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-02-23 17:15:30
Crhoma Vorcinn• n mocmn
CERTIFICATE OF COMPLIANCE CF1R-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: 16WLdJ1t'/
Solomon, Michael
Company:
Signature Date:
Regency Energy Solutions
2015-02-23 17:15:41
Address:
CEA/ HERS Certification Identification (if applicable):
53800 Polk St
City/State/Zip:
Phone:
Coachella CA 92236
760 272 1421
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.
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.
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.bullding, and made available to the enforcement agency for all applicable
inspections. ]'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:
Solomon, Michael
Company:
Date Signed:
Regency Energy Solutions
2015-02-23 17:15:41
Address:
License:
53800 Polk St
822918
City/State/Zip:
Phone:
Coachella CA 92236
760 272 1421
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-A0051281A-000000000-0000 Registration Date/Time: 2015-02-23 17:15:41 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-02-23 17:15:30
Bin ffQty
Of La Quinta.
Building 81: Safety Division
P.O. Box 1504, 78 495 Calle Tampico .
La Quin ta, CA 92253 • (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 7g S7 S j'►'I ,.� �%/�
Owner's Name: -JOE C,,4M M 1^ 5
A. P. Number:
Address: 77;9 9-7 5 m e f i A,, wA
Legal Description:
City, ST, Zip:
Contractor: � �-�-� •eG� A,ti f C A,
Telephone:
Address:)4V4
S3 �lJo r01 —4:r,
Project Description: � � 'a�Mei1 – .
City, ST, Zip:' . 4a e J I A LEA
Lf) �G �i s j 4-c .&v
Telephone:
ahone: l
6 S s
v• r -i
3 t s
State Lic. # : gZ2C%
City Lie. #!
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
P
ii
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.......................................................
n n Type: ctrl ane
Co structio 4 4" 1
YP P Y•
AC.
State Lic. #:
Project a circle one): New Add' n Alter Repair Demo
J type )
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project:' 1b, goo.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
SubcontactorList
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading,
IN ROUSE:-
''a Reyiew, ready for corrcctionstssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
DESCRIPTION
FINANCIAL ! ,
ACCOUNT QTY. 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 - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$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
$72.52
$0.00
PAID BY
METHOD •
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $217.56 $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 forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Description: STARLIGHT DUNES/CUMMINS/(1)4TON SPLIT AND (1) 3TON SPLIT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 2/24/2015 SKH
Approved:
Parcel No: 609480061 Site Address: 78875 MERIDIAN WAYLA QUINTA,CA 92253
Subdivision: TR 23773-2 Block: Lot: 15
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $16,800.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No: Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - (2)14SEER/78AFUE SPLIT SYSTEMS [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
Printed: Tuesday, February 24, 2015 2:04:00 PM 1 of 2 C
SYS7Eti1S
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESS1
CONTACTS
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
PACIFIC CONCRETE INC DBA ANTHE
53800 POLK STREET •
COACHELLA
CA
92236
CONTRACTOR
'PACIFIC CONCRETE INC DBA ANTHE
53800 POLK STREET
COACHELLA
CA
92236
OWNER
MARY CUMMINS
78875 MERIDIAN WAY
LA QUINTA
CA
92253
Printed: Tuesday, February 24, 2015 2:04:00 PM 1 of 2 C
SYS7Eti1S
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
PAID
PAID DATE.
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
HVAC CHANGEOUT -
101-0000-42402
0
$145.04
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$72.52
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:•40.00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL"
Printed: Tuesday, February 24, 2015 2:04:00 PM 2 of 2 C
SVS7E/NS