BMCH2016-0432T' t
78-495 CALLE TAMPICO T 0 D �Cl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
Application Number: BMCH2O16-0432
Property Address:
78395 GOLDEN SANDS PL
APN:
6431930091
Application Description:
MILEY / HVAC CHANGE OUT
Property Zoning:
LA QUINTA, CA 92253 a
Application Valuation:
$11,950.00
Applicant:
A#1 SERVICES HEATING & AIR CONDITIONING
74-866 LENNON PL #C
PALM DESERT, CA 92211
I
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT
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. I
License Class: C20, C36 License No.: 977333 s
��0�A��LL
1 / 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).: 1
( 11, 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.).
( 11, 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. . BAP.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 permii is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address
VOICE 760) 777-725
77-7
INS 7-713
"Dated 12/
Owner: c
N =1 to
TIM AND DENISE MILEYr„4
S �
78395 GOLDEN SANDS PL
Q9.
LA QUINTA, CA 92253 a
C�
L&
L1J
R
U cm
zd
Contractor:
A#1 SERVICES HEATING & I
I
74-866 LENNON PL#C
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.
' 11 have and will maintain workers' compensation insurance, as required by
S i 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: REPUBLIC UNDERWRITERS INSURANCE COMPANY Policy Number: ATW
+010094
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.
oe
Dat : � � l Applicant:
WARNING: FAILURE TO SECURE WORKER ' OMPENSATION VERAGE 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.
Date< / Signature (Applicant orAtfi )�
i
-
Date: 12/1/2016
Application Number: BMCH2O16.0432
Owner:
Property Address: 78395 GOLDEN SANDS PL
TIM AND DENISE MILEY
APN: 643193009 '
78395 GOLDEN SANDS PL
Application Description: MILEY / HVAC CHANGE OUT
LA QUINTA, CA 92253
Property Zoning: -
Application Valuation: $11,950.00
Applicant:
Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING
A#1 SERVICES HEATING & AIR CONDITIONING
74-866 LENNON PL #C
74-866 LENNON PL #C
PALM DESERT, CA 92211
PALM DESERT, CA 92211
r
(760)342-3610
------------------------------------------ ----------------------------------------------------
Llc. No.: 977333
Detail: HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES.
i
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT. -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
Bin # City of La Quinta
Guifdinn u Safety Division
permit; . - 78-495 Calle Tampico
La Quinta,CA 92253 - (760) 777-701,2
-f l� Building Permit Application and Tracking Sheet
Project Address:
�. Owner
A. P. Number:
,Address:
Legal Description:
City, ST, Zip:
onrafrC
Address:!
�C
Project Description: >"
rCity,"ST, "Zip:
Tele 1on e: —
6
-State Lie: #�J`
City Lie. #.:
Arch., Gngr., Designer:
Address:
City, ST, Zip:
Telephone:
-
_-
PaneY
Occupancy:
•Constructi n Type:
State L tc. ,.
Add Alter Repair Demo
Project ect type (circlele one): • New
�ame of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Te phone # of Contact Person: 76 . j� = 9 C-
-Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl
Submittal
Req'd
Rcc'd
TRACK)NG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
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
SubcontactorLis(
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
IT.O.A. Approval
'
Plans resubmitted
Grading
IN IiOUSE:-
Jr0 Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. \Vks. Appr
Date of permit issue
School Fees,
.
I
Total Permit Fees
A
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 )
Project Name: Denise & Tim Miley Date Prepared: 2016-11-30
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
Denise & Tim Miley
02
Date Prepared
2016-11-30
03
Project Location
78395 Golden Sands PI
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Denise & Tim Miley
07
Zip Code
92253
08
Dwelling Unit Conditioned
1299
`i�n:HiK1.:� MAs
''
,
X
:µ
isop�/y "i�'ifi
Floor Area (ft2)
SCS stem
Y
SCS stem
Y
CFA served
k',^'..
s. stem a
y
V'�
refri a ant '
g,
Number of space conditioning
+""5�, T .:;
(-'r 30111 g
09
Climate Zone
15 r r' :'°
10
(SC) systems in this dwelling
1
ducted
w
containing
.gi
system
more than 40
unit.
entirely new
P'ei
B. Space Conditioning (SC) System Infprmatioyn'%£
Ol
0203
04t
051'
06 '
0
0
09
10
w4:fi-�:•
•;:;rs
+'
_ �, Is the SC
,
b 'PhAsMi a :in `aY
Installing a
`i�n:HiK1.:� MAs
''
,
++G1g8i
isop�/y "i�'ifi
SCS stem
Y
SCS stem
Y
CFA served
k',^'..
s. stem a
y
V'�
refri a ant '
g,
'"° tic vr--
-Installin ane 'C
g i .,
+""5�, T .:;
(-'r 30111 g
g^K^r�"
Installin
; g
Installin g
Identification or
Location or Area
by this SC
ducted
w
containing
.gi
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
1299
Yes
Yes
Yes
Yes
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: 216-A0442673A-000000000-0000 Registration Date/Time: 201.6-11-30 14:57:03 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-30 14:57:12
Schema Version: 0.555SDD
rk
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)1E and F)
01
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
System 1
Central gas
All new
heating
AFUE
80
Central split
All new
cooling
SEER
16
Setback
Greater than
R-8
furnace
components
AC
components
40 feet
Reouired Documentation:
CF211-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. t�r3
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testinirequired 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%, or 5 10% leakage to outside,'or seal all accessible leaks.
—
J_c
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 Flowz 300.Uly /ton required when MCH -25 is required.
Exceptions:
Duct systems registered with HERS provider as previously sealed are_exe�mpt from20 Duct Leakage,, gstjn;g rem uciremegts.
Air Handler/Furnace do of Air Flow. MCIjr23r Refrigerant Cha�ge M� H 25,
-Heating-only systems and changes not require venficatfilwon
Existing duct systems constructed, insulated or sealed with asbestos.are exempt from MCI 2Duct leakage Testing regwreme ts.
nAOVYW
E. Entirely New or Complete Replacement DueCSystem, with or without- Equipment Changeout (Sections fS' 0.2(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: 216-A0442673A-000000000-0000 Registration Date/Time: 2016-11-30 14:57:03 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013. Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-30 14:57:12
Schema Version: 0.555SDD .
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:
Castillo, Daniel
Company:
Signature Date:
A 1 SERVICES
2016-11-30 14:57:03
Address:
CEA/ HERS Certification Identification (if applicable):
74866 Lennon PI
City/State/Zip:
Phone:
Palm Desert CA 92260 t
760-565-2269 1
Responsible Person's Declaration statement;',
I certify the following under penalty of perjury, under the lews.of the State of California:
1. The information provided on this Certificate &f Com pliance.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 devices for the building design or -system design identified on this Certificate of Compliance conform to the
manufactured
requirements of Title 24, Part 1 and Pah of the Cfo�r'nis Code of Regulations.
this
4. The building design features or system design features identified on Certificcaatee of Corr)pliance are.consistent with,the information<provided on othe { pplicab`le compliance documents, worksheets,
calculations, plans and specifications submitted toy the enforcement'a�gency fof app�rbval with this building per t application.
5. I will ensure that a registered copy of this Certificate of Compliance shall„pe made available wi,,, build ltg permits) issued fortthe1111:g, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of thfs2erti icate of Co nphianceiswrequ ed to beJncluded ith thudocumaeptationthe uilder p vides to the bu��ng owner at occupancy.
-
Responsible Designer Name:
Respons le Dess g er Signature: V
/v�GGG'�i(il�dZ
Castillo, Daniel
Company:
Date Signed:
A 1 SERVICES
2016-11-30 14:57:03
Address:
License: --
74866 Lennon PI
977333-
77333City'/State/Zip:
C i t7/5 Fa —te/ Z i p—:
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 no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number: 216-A0442673A-000000000-0000 Registration Date/Time: 2016-11-30 14:57:03 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-30 14:57:12
Schema Version: 0.555SDD