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BMCH2016-037078-495 CALLE TAMPICO t44 �NLIi��il/ LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O16-0370 Property Address: 77956 GREY WOLF TR APN: 623510004 Application Description: WRIGHT / CHANGE OUT (2)19SEER/78AFUE SYSTEMS Property Zoning: Application Valuation: $25,000.00 Applicant: DESERT AIR CONDITIONING INC 590 WILLIAMS ROAD PALM SPRINGS, CA 92264 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, C43 License No.: 276586 <r n.tewrl �'��Contracto � Q/ (760)323-3383 Llc. No.: 276586 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 Df fthwork for which this permit is issued. 1 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: OWNER -BUILDER DECLARATION VOICE (760) 777-7125 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State FAX (760) 777-7011 INSPECTIO 153 city or county that requires a permit to construct, alter, improve, demolish, or repair W any structure, prior to its issuance, also requires the applicant for the permit to file a 16 a Owner: co ¢ o STEPHEN WRIGHT c _Z = 77956 GREY WOLF N W LA QUINTA, CA 92253 � a permit subjects the applicant to a civil penalty of not more than five hundred dollars O ($500).: O W O � � (1 I, as owner of the property, or my employees with wages as their sole Z V Contractor: COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, DESERT AIR CONDITIONING 1 590 WILLIAMS ROAD y PALM SPRINGS, CA 92264 W 0 (760)323-3383 Llc. No.: 276586 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 Df fthwork for which this permit is issued. 1 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: OWNER -BUILDER DECLARATION Carrier: BENCHMARK INSURANCE COMPANY Policy Number: CST5008762 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 those provisions. Contractor's State License Law (Chapter 9 (commencing with Section 7000) of DivisionI - - / 3 of the Business and Professions Code) or that he or she is exempt therefrom and the Date: ' W Applicant G� 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 (1 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 (1 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 , the owner, 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 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. 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: b 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 t ente pon the above-mentioned property for inspection purposes. Date: - Signature (Applicant or Agent Date: 10/13/2016 Application Number: BMCH2016-0370 Owner: Property Address: 77956 GREY WOLF TR STEPHEN WRIGHT APN: 623510004 77956 GREY WOLF Application Description: WRIGHT / CHANGE OUT (2)19SEER/78AFUE SYSTEMS LA QUINTA, CA 92253 Property Zoning: Application Valuation: $25,000.00 Applicant: Contractor: DESERT AIR CONDITIONING INC DESERT AIR CONDITIONING INC S90 WILLIAMS ROAD - 590 WILLIAMS ROAD PALM SPRINGS, CA 92264 PALM SPRINGS, CA 92264 (760)323-3383 LIC. No.: 276586 Detail: HVAC CHANGE OUT- (2)19SEER/78AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.' 2013 CALIFORNIA BUILDING CODES. I? FINANCIAL •• f. '4 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 $152.00. DESCRIPTION ACCOUNT QTY AMOUNT • ' HVAC CHANGEOUT _ SPLIT -SYSTEM PC 101-0000-426000 $76.00 Total Paid for CHANGEOUT: $228.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000=42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 City of La Qui to BuNQfng 8L Safety Divirialn P.O. Box 1504,•76-495 Calle Tampico La.,Qulnta, CA 92253 -:(760) 777-7012 Building Permit ,Application"and Tracking Sheet : Permit # HrojnntAddtess:• 7.7 L& T45 0"a'sName-. � 'I' � W A P. Number. Address: Legs# Description: Cowmaor: Desert Air Conditioning-, Inc,' City, ST, Zip: 111 C � 9 asp 3 Address 590 Williams. Rd. ProjectD�arlltNon:S l C� (� hrvav— city, ST, 71p: Palm Springs, CA 92264, 6— To- Y1 5 6 k ry 5 TelePhane: 760-323-3383 ' 1 - State Lic. # : 276586City Llc #; 363 Arch., Engr., Designer: N/A Address: City, ST. zap: Telephone: State Lic. #: Constrocti=Type: ' QGG(IpalLLjr; Project type (ogclo ons): em)Add'n Alta Repair Dmo Name of Con= Pea= (!,Lx yvf; cP— Fo is i -V k e— -Sq., Ft.. # StotiBs: # UtdtB: Telephone # of Contact kerson; 760-323-3383 ' Estimatcd Valuc of Project: APPLICANT: DO NOT WRITE BELOW THls LINE N Sabmlttal 8cq'd 'Reed TRACMG PlE,RMU FEES Plan Sets PIa;a Cheek eutnultted Ilam Amuaat Structural CAICJ. Reviewed, ready for corrections Plan Ciuek Deposit. . 'Doss Calm Called Contact Person Plan Check Balance Title 24 CYIeS. Plans picked up Construction Flood plain plan Plans resnbmlw., . Meefi„iicat Gradlreg pia o 7Pi Review, ready for eorreetionsrLm.e Electrical Sokntactor List Cniled ContactPerson Plumbing Grant Deed Plans plekad up SIM HA -A. Approval Plana resubmitted Grading IiCI[)SL:- R4aiew; ready ibr cnrreetlonxAssae Developer Iuapact Fee Planning 4pTOVKI. Called Contad Person Pub. Wks. Appr • Date ofpermit.isne 56061 Fees Tout rcrerjt Fcce CERTIFICATE OF COMPLIANCE. Alterations to Space Conditioning Systems (formerly CF-LR-ALT=HVAC) Project Name: 77-956 Gray Wolf Trail I Date Prepared: CF1R-ALT-02-E (Page 1 of 3 ) 2016-10-32 A. General Information CF1R-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 77-956 Gray Wolf Trail 02 Date Prepared 2016-10-12 03 Project Location 77-956 Gray Wolf Trail D4 Building Type Single family 05 CA City La Qulnta '06 Dwelling Unit Name 77-956 Gray Wolf Trail 07 Zip Code 92253 08 Dwelling Unit Conditioned 3589 Installing Installing Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 1S 10 (SC) systems In this dwelling 2 component? components? feet of duds? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information 02 02 03 D4 05 D6• 07 08 09 LO Is the SC Installing SC System SC System CFAserved 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 duds? duct system? SC system? Alteration Type system 1 Location 1 2000 Yes Yes Yes No No No Altered space conditioning system System 2 Location 2 2000 Yes Yes Yes No No No Altered space conditioning .system I C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)IDI ib) Registrat)on Plumber, 216-A0382937A-000000000-0000 This section does not apply to this project. Registration Date/Time: 2016-10-12 14:40:53 HERS Provider: Ca ICE RTS CA Building Energy Efficiency Standards - 201.3 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 201E-10-12 -14:40:46. Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CFIRrAIT=02-E _Alterations to Space Conditioning Systems (formerly CF-iR-AL7 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 11 12 '. Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Effidency 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 furnace All new heating AFUE 79 CentACsplit All new cooling SEER 19 Setback Less than or equal to 40 R-8 components components feet System 2 Central gas furnace All new heating AFUE 78 Central spilt All new cooling SEER 19 Setback Less than or equal to 40 R-8 components AC components feet _Required Documentation: CFZR-MCH-01-E -Space Conditioning Systems Ducts and Fans -Ductinsulation Tequirementfor new plenums: R6. MR -MCH -20-H & CM -MCH -20-H — Duct Leakage testing required when heating or cooling components are installed Inducted systems, orwhen morethan 40 ft of duct length is replaced. -Leakage rate compliance: S 15%, or 510% leakage to outside, or seal all accessible leaks, MR -MCH -254-1 & MR -MCH -25-H Refrigerant Charge Verification required when refrigerant contalningeomponents are Installed or altered (appl(cable in CZ 2, 8=15). &MCM-MCN-23 & CBR -MCH -23 Air Flow 2300 CFM/ton required when MCH -25 is required. Exceptions: -Duct systems registered with HERS provider as previously sealed areexempt from MCH -20 Duct Leakage Testing requirements. -Heating-only systems and Air Handier/Furnace changes do not require verification of Air Flow ?ACH-23, or Refrigerant Charge MECH-25. Existingduct systems constructed, Insulated orsealed with asbestos are exempt ham 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 216-AO382937A-000000000.00OD Registration Date/Time. 2016-10-12 14:40:53 HERS Provider: CaICERTS CA Building Energy Effldency Standards - 2013 Residential Compliance Report Verslon: 2013 Rev 1.008 Report Generated: 2016-10-12 14:44:45 Schema Version: 0,555SDD CERTIFICATE OF COMPLIANCE Aftefattons to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Documentation Author's Decra ration Statement L I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Trefun, Michael Company: Desert Air Conditioning Inc. Address: 590 Williams Road city/state/zip: Palm Springs CA 92264 Responsible Person's Declaration statement 60cumentation Author Signature: Signature Date: 2016-10-12 14:40:53 CXic{ure(Ji-gux CEA/ HERS Certification. Identification (if applicable}: 8216567 Phone: 760-323-3383 CFIR-ALT-02-E (Page 3 of 3 ) I certify the folrowing under penalty of perlwy, under the laws of the State of California; 1. Tire Information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Susfnem and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compl lance (responsible designer). 3. That the energy features and performance specfflcations, materials, componerrts, and manufactured devices for the building design or system design idendned on this Certificate of Compliance conform to the requirements of Title 24, Part I and Parc 6 of the Ca0fomia Code of Regulatiwns. 4. The building design features or system design features ldemffled on this CertiRcate of Compliance are consistent with th a information provided on other applicable compliance documents, worksheets, caicutatlons, 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 urith the building permitis) 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 Mth the documentation the builder provides to the buf (ding ovrner at occupancy. Responsible Designer Name: Trefun, Michael Company: Desert Air Conditioning Inc. Address: 590 Williams Road City/State/Tp: Palm Springs CA 92264 Responsible Designer Signature: Date Signed: 2016-10-12 14:40:53 License: 276586 Phone: 760-323-3383 "ciutet��rz Digi(ai1ysigmdby.C8XERTS. This digi(alsignatrnefslorovidedinordertosecwethe confemofthis registered dacumenand Innowayimp&3ReaisiradanprulgderresFonsdbrkfyfor the secwacyofthe infarmafion. Registration Number: 216-A0382937A-000000(300-0000 Registration Date/Time: 2016-10-12 14:40:53 HERS Provider: CaiCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 20161012 14:40:46 Schema Version: 0.5S5SDD