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BMCH2014-1069-D Applicant: SEP O 9 2054 Contractor: CERTIFIED COMFORT SYSTEMS J19 CERTIFIED COMFORT SYSTEMS INC 42-949 MADIO STREET 42-949 MADIO STREET INDIO,CA92201 ( 1 CITYOFLI.OeJINTR COMMUNITyOEVEcON�dci�t+)E?KnI�AeNT INDIO,CA92201 (760)360-2202 ((( LIC. No.: 906115 --------------------------------------------------------------------------------------------- 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.: 906115 i D Y :'�/ 6:�01 — 7 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 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 ) 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 ) 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: 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 v�tork for which this permit is issued. 7� 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. Date: 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 upo th abov mentioned property for inspection purposes. , / /7 Date: / `7 —f- Yf Signature (Applicant or Agen Ce4ht "d" Q9&& VOICE (760) 777-7125 78-495 CALLE TAMPICO D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/9/2014 Application Number: BMCH2O14-1069 Owner: Property Address: 79115 ASHLEY PL MARY SHANE APN: 604375012 79115 ASHLEY PL Application Description: PACKAGED UNIT CHANGE OUT 18 SEER LA QUINTA, CA 92253 Property Zoning: Application Valuation: $12,350.00 Q -D Applicant: SEP O 9 2054 Contractor: CERTIFIED COMFORT SYSTEMS J19 CERTIFIED COMFORT SYSTEMS INC 42-949 MADIO STREET 42-949 MADIO STREET INDIO,CA92201 ( 1 CITYOFLI.OeJINTR COMMUNITyOEVEcON�dci�t+)E?KnI�AeNT INDIO,CA92201 (760)360-2202 ((( LIC. No.: 906115 --------------------------------------------------------------------------------------------- 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.: 906115 i D Y :'�/ 6:�01 — 7 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 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 ) 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 ) 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: 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 v�tork for which this permit is issued. 7� 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. Date: 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 upo th abov mentioned property for inspection purposes. , / /7 Date: / `7 —f- Yf Signature (Applicant or Agen QTY AMOUNT' PAID PAID DATE DESCRIPTION FINANCIAL INFORMATION ACCOUNT BSAS SB1473 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 - PACKAGED UNIT 101-0000-42402 0 $35.75 $0.00 PAID BY METHOD RECEIPT # CHECK # - CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - PACKAGED UNIT PC 101-0000-42600 0 $23.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forCHANGEOUT: $59.58 $0.00 DESCRIPTION . ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $90.57 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $90.57 $0.00 TOTALS:00 Description: PACKAGED UNIT CHANGE OUT 18 SEER Type: MECHANICAL Subtype: Status: APPROVED Applied: 9/9/2014 MFA Approved: 9/9/2014 MFA Parcel No: 604375012 Site Address: 79115 ASHLEY PL LA QUINTA,CA 92253 Subdivision: TR 27899 Block: Lot: 12 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $12,350.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC PACKAGEW UNIT CHANGE OUT - 18 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ,,_j Applied to Approved Printed: Tuesday, September 09, 20141:50:16 PM 1 of 2 L1 LJ SYS TCti1S ADDITIONAL CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT CERTIFIED COMFORT SYSTEMS INC 42-949 MADIO STREET INDIO CA 92201 (310)486-5577 CONTRACTOR CERTIFIED COMFORT SYSTEMS INC 42-949 MADIO STREET INDIO CA 92201 (310)486-5577 OWNER MARY SHANE 79115 ASHLEY PL LA QUINTA CA 92253 (310)486-5577 Printed: Tuesday, September 09, 20141:50:16 PM 1 of 2 L1 LJ SYS TCti1S INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE - - MECHANICAL FINAL" _... ..... ...... LTD CBy DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY HVAC CHANGEOUT - 101-0000-42402 0 $35.75 $0.00 PACKAGED UNIT HVAC CHANGEOUT - 101-0000-42600 0 $23.83 $0.00 PACKAGED UNIT PC Total Paid forCHANGEOUT: $59.58 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $90.57 $0.00 Total Paid for PERMIT ISSUANCE: $90.57 $0.00 TOTALS:00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL" Printed: Tuesday, September 09, 2014 1:50:16 PM 2 of 2 rp SYSTEMS Bin City of La Quinta Btu7ding.at Safety Division P.O. Box 1504, 78-495 Calle Tampico (9� La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet, Permit # ,1' 1 Project Address:' _ t ( 1 Ph-- cz. Ownces Name .e, A- P. Number: Address: a _ (15 A,A p4ic ee Legal Description: City, ST, Zip: �.c4. �i .�„h. t"*c(a� �+ + Contractor. eY t! �! l,Ga1 ro g jt� Telephone: '310- Address: • `"T 2 q el / ''la Project Description: Ac— (' J' . e_ cu:f ,/ City. ST, zip: o C /�+ ZZ d Telephone: 6C7 State Lie. # : q C7& j. City Lia Arch, FAw, Desigaw- Address: Cita', ST, Zip: Telephone:Construction State Lia #: oil Name of Contact Person- Type: Occupancy: Prajoct type (circle ono): New Add'n R cpaQ' Demo Sq. Ft.: I Goo # Stories: # Unit's: Telephone # of contact Person: Fstima ted Value of Froject APPLICANT: DO NOT WRITE BELOW THIS UNE l Req'd Reed TRACKING • PMtMTf FEES s Plan Check submitted Item Amount al Calcs. Reviewed, ready for corrections Plan Check Deposit ates. Caked Contact Person Plan Chock Balance Cales.. FIE. -v Plans Picked up Construction ain plan Plans resubmitted Mechanical plan' 2"Review, ready for correeoiousilssue Electrical actor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L SOA Approval Plans resubmitted Grading IN HOUSE:- '”' Review, ready for correetionstissae 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 CFiR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 ) Project Name: Shane, Mary Date Prepared: 2014-09-05 A. General Information CFIR-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit.: 01 Project Name: Shane, Mary 02 Date Prepared: 2014-09-05 03 Project Location: 79-115 Ashley Place 04 Building Type: Single family 05 CA City: La Quinta 06 Dwelling Unit Name: Shane, Mary 07 Zip Code: 92253 08 Dwelling Unit Conditioned 1650 new Is.. ntire=pinstalling the e Floor Area (ft2): Number of space conditioning 09 Climate Zone: 15 30 (SC) systems being altered in 1 ` components? this dwelling unit.: B. Space Conditioning (SC) Systemanformation . 01 02 03 /,0'4' 0` 0 ' 09 10r. i04' A66 new Is.. ntire=pinstalling the e ` components? duct system (packaged unit, or accessible Are all of the condensing unit, Installing for sealing, system's Is the altered Altering or or more than 40 and is more components or installed installing a cooling/heating linear feet of than 75% of and ducts new SC System SC System CFA served system a refrigerant coil, or new or the duct or replaced? Identification or Location or Area by this SC ducted containing air -handling unit, replacement system new (entirely new Name Served System (ft2) system? component? etc) ducts? or replaced? system) Alteration Type System 1 Whole House 1650 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib) This section does not apply to this project. Registration Number: 214-A0088941A-000000000-0000 Registration Date/Time: 2014-09-05 10:29:47 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-05 10:29:16 CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 4 ) 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 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 All new This field or This field or System 1 furnace heating AFUE 0.78 packaged AC cooling SEER 18 Setback section is not section is not components components applicable applicable 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%, or <_ 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: ,f /• • �i ; Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage�Testing'requYrements. -Heating-only systems and Air Handler/Furnace"changes do not require verification of Air Flow MCH -23; or Refrigerant Charge MECH-25. 4 Existing duct systems constructed, insulated or, sealed withh..asbestos are exempt from MCH 20 Duct Leakage Testirig requirements. �,.t"" �+11r+` � �:;: . �..' �-•sr -, -ae�.. � , ^w sea... � ..,�y�yy :r1 +t.F Y' b�' � a E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F) This section does not apply to this project. Registration Number: 214-A0088941A-000000000-0000 Registration Date/Time: 2014-09-05 10:29:47 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-05 10:29:16 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 4 ) F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 214-A0088941A-000000000-0000 Registration Date/Time: 2014-09-05 10:29:47 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-05 10:29:16 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 4 of 4 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Hyde, Mark Company: Signature Date: CERTIFIED COMFORT SYSTEMS INC 2014-09-05 10:29:47 Address: CEA/ HERS Certification Identification (if applicable): 42949 Madio City/State/Zip: Phone: Indio CA 92201 (760) 360-2202 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). i -. A, 1, -- ' may' :*"#.r .-- l a " / . - N- V' r , rr J 3. That the energy features and performance specifications, materials, components and manufactured devices for the building design o_ r system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Pari 6 of the California Code of Regulations. [ J %" �.. 4 P t I - - r f a - :.�2 ^ 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 specificatioA submitted tothe enforcemeni agency for approval'with this building permit application. i. Y r'... •t � w "s �' 4 Ir 5. I 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 cif 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: Hyde, Mark Company: Date Signed: CERTIFIED COMFORT SYSTEMS INC 2014-09-05 10:29:47 Address: license: 42949 Madio 906115 City/State/Zip: Phone: Indio CA 92201 (760) 360-2202 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: 214-A0088941A-000000000-0000 Registration Date/Time: 2014-09-05 10:29:47 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-05 10:29:16