BMCH2016-0331i• 3
78-495 CALLE TAMPICO C a 44 a"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0331
Property Address: 78745 NAPLES DR
APN: 609511013
Application Description: PATRICK TOLMAN / HVAC CHANGE OUT
Property Zoning:
Application Valuation: $5,800.00
Applicant:
LA QUINTA ALR CONDITIONING & HEATING INC
P O OX 557
LA QUINTA, C -A 92247
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/31/2016
Owner:
PATRICKTOLM IN
92253 1lJJ
C'i('(OrLl�liilli
Contractor: CO2i,�SJfdi7f�c';�":;.-;ii���'�����T
LA QUINTA AIR CONDITIONING & HEATING INC
P0OX557
LA QUINTA, CA 92247
(760)837-9344
Llc. No.: 902029
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. �f �t
tlC y t 6•
compensation, as provided for b Section 3700 of the Labor Code, for the performance
P P Y
License Class: C20 License No.: 902029
ofd work for which this permit is issued.
� haveiand
114
I will maintain workers' compensation insurance, as required by
Dater
/Contra or;
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:
OWNER -BUILDER DECLARATION
Carrier: MID-CENTURY INSURANCE COMPANY Policy Number: A09477705
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that.requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with hose provisions.
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
Date -. G Applicant:
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
( ) I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , theowner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. B.&P.C. for this reason
2. Any permit issued as a result of this applicatio6 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.
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
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 ci to enter upon the
above-mentioned property for inspection purposes.
Date. ��rSignature (Applicant or'Age
L
Application Number:
BMCH2O16-0331
Property Address:
78745 NAPLES DR
APN:
609511013
Application Description:
PATRICK TOLMAN / HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$5,800.00.
Applicant:
LA QUINTA AIR CONDITIONING & HEATING INC
P O OX 557
LA QUINTA, CA 92247
Date: ' 8/31/2016
Owner:
PATRICK TOLMAN
92253
Contractor:
LA QUINTA AIR CONDITIONING & HEATING INC
P O OX 557
LA QUINTA, CA 92247
(760)837-9344
Llc. No.: 902029
-------------=-------------------------------------------------------------------------------
Detail: HVAC CHANGE OOT - 16.5SEER/8OAFUE SPLIT SYSTEM [2013 ENERGY) CARBON MONOXIDE'ALARK4(SJ 1`O BE INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES.
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $100
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
Total Paid for CHANGEOUT: $108.78
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
Total'Paid forPERMIT ISSUANCE- ' '' ". $91:85
Bin # Qty of La Qu«ita
Building 8t• Safety Division
Permit #1 . _ 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
39 i Building Permit Application and Tracking Sheet
Project Address: — 0 �S ��Q, Owner's Name: ���Gf + �/%�Ao� '
A. P. Number:
Address: 7,0,7,41—r
Legal Description:
City, ST, Zip: Ig;z u ew
Contractor:1
Telephone: 6d � � '% 2 j'
Address: J(740 e-/
Project Description: ��,��j� f, D el 7--
city, ST, Zip:
C ity,
_r .
ele h ne d
0P D
7S 9
State Lic. # C4 6Z a 1-7
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: h
one:
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trcti O
n u
Cos on Type: ecu ane
YP P Y:
,
State a L#.
t Lic. •
Add'nProJect tYPa (circle one • New Alter Repair Demo
Name of Contact Person: '4~ G �
Sq. Ft.Y /
# Stories:
=#Unts-.
Telephone # of Contact Person:'1i
; 7,S -3,f 6 ,-e—
Estimated Value of Project: Q6
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Se
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 resubmitt.ed,,
Mechanical
Grading plan
2" Review, ready for corrcc ' srssue .
Electrical '
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
G ing
IN IiOUSE:-
Jr. Review, ready for corrections/issue
Developer act Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees,,
Total Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF11R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -1R -ALT -HVAC) (Page 1 of 1)
Site Address: Pyzz� . /�L����/ ;
J /{/
Enforcement Agency:
Date Prepared:
Permit#:
Type
Efficiency
Equipment E(cciiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
p'Evaporator Coil
d FUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
Setback
f�otafreud
lit System
ondensing Unit
❑ R-8' (CZ 11, 14, 15) Ducting/
Xsgft
❑ Mini Split
❑ Compressor
fBEER
HSPF
❑ R-6 (all CZ's) Plenums
present must
❑ Furnace
13 set
T is EER
❑ R-5 or R7.5) Lineset°
be installed)
❑Tin
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form ' allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and'a copy left on site.
1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
t
All Equipment,
CF111-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (<.15%, or < 10% to outside, or seal all accessible leaks), Air Flow a 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building ....... I
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CFIR-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' -
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
113. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, M
Compressor, TXV, Lineset, FurnaceCF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25
LIJ
Installer Requirement: Duct leakage < 6%, Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge1
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbesto
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
ire
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS Q
Installer Required to: Duct leakage (:<_15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. G
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
` R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-25/8", 2.5-3T-2%", 3.5 to 4T-2%", 5T-4%"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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 applicati
Aesp le Designer N me:
Responsible Des' r
=
Date Si ne--T—License:
6
.��✓/� ��.
— —
Company: .
Address:.
City/State ip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1 -NP -772-3300
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