BMCH2016-036878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
. c&iy,, 4.4v Q"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0368
Property Address:
79256 LIGA ST
APN:
776130008
Application Description:
SHER / CHANGE OUT (3) 16SEER/80AFUE SPLIT SYSTEMS
Property Zoning:
Application Valuation:
$25,000.00
Applicant:
FIRST CHOICE A / C & HEATING INC
79-747 CASSIA STREET
LA QUINTA, CA 92253
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 License No.: 96813�8y
Date: _16—
IR 12o l (a Contractor:
�v
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, 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, 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. . 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
Date: ' 10/12/2016
Owner:
JACK SHER
79256 LIGA DR
LA QUINTA, CA 92253
Contractor:
FIRST CHOICE A / C & HEATING INC
79-747 CASSIA STREET,
LA QUINTA, CA 92253
(760)989-2369
Llc. No.: 968138
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.
4M 1 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: MID-CENTURY INSURANCE COMPANY Policy Number: A09478960
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:' I
Applicant:/ YA 1
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 upon the
above-mentioned property for inspection purposes.
f
Date: 0 ��� Signature (Applicant or Agent): `"
Date: 10%12/2016
Application Number: BMCH2016-0368
Owner:
Property Address: 79256 LIGA ST
JACK SHER
APN: 776130008
79256 LIGA DR -
Application Description: SHER / CHANGE OUT (3) 16SEER/80AFUE SPLIT SYSTEMS.
LA QUINTA, CA 92253
Property Zoning:.
Application Valuation: $25,000.00
Applicant:.
Contractor:
FIRST CHOICE A / C & HEATING INC
FIRST CHOICE A / C & HEATING INC
79-747 CASSIA STREET
79-747 CASSIA STREET
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(760)989-2369
LIc. No.: 968138
Detail: HVAC CHANGE OUT - (3)16SEER/80AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES
FINANCIAL INFORMATION
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
$228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$114.00
4 Total Paid for CHANGEOUT: $342.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
CF1R-ALT 02-E
(Page 1 of 3 )
Project Name: SHER I Date Prepared: 2016-09-16 I
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 CF111-ALT-02 document for each dwelling unit.
01
Project Name
SHER
02
Date Prepared
2016-09-16
03
Project Location
79256 LIGA DR
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
SHER
07
Zip Code
92253
08
Dwelling Unit Conditioned
4150
Floor Area (ft2)
SCS stem
CFA served
s stem a J
Y I
refri a ant
g f.
- nstalli }ne 'tS
�g.
Number of space conditioning
slnstaIIin ,
InstaIIin g.
LCIimate Zone
15
10
(SC) systems in this dwelling
3
k— i. r
containing
..+(
system
more than 40
fig.
entirely new
unit.
B: Space Conditioning (SC) System Information
01
02
03
-. 04
rJ95.
^ 06
0T
0
09 .
10
..
Is the SC
1 stalling a
.•�
SCSystem.Y
SCS stem
CFA served
s stem a J
Y I
refri a ant
g f.
- nstalli }ne 'tS
�g.
Instal i g
slnstaIIin ,
InstaIIin g.
Identification or
Location or Area
by this SC
ducted
k— i. r
containing
..+(
system
more than 40
fig.
entirely new
.
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?'
duct system?
SC system?
Alteration Type
System 1
Location 1
1850
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
1750
Yes
_
Yes
Yes
No
No
No
Altered space
conditioning system
System 3
Location 3
550
Yes
Yes
Yes
No
No
No
Altered space
.
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0342487A-000000000-0000
Registration Date/Time: 2016-09-16 11:05:21
.A. HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-16 11:06:00
CERTIFICATE OF COMPLIANCE CFIR-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
Gas furnace
AFUE
80
Central split
All new
cooling
SEER
16
Setback
This field or
section is not
This field or
section is not
furnace
AHU
AC
components
applicable
applicable
Central gas
Gas furnace
Central split
All new
This field or
This field or
System 2
furnace
AHU
AFUE
80
AC
cooling
SEER
16
Setback
section is not
section is not
components
applicable
applicable
Central gas
Gas furnace
Central split
All new
This field or
This field or
System 3
furnace,
AHU
AFUE
80
HP
cooling
SEER
16
Setback
section'is not
section is not
components
applicable
applicable
Required Documentation:
.CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
& heatijg ror c inst Iled in d te`dste, than ftf du I is
I
CF2R-MCH=20-H CF3R-MCH-20-H —Duct Leakage testing require en coling pnep$s are or when
-Leakage rate compliance::5 15%, or:5 10% leakage to outside, o�a l accessiKii, ak .
rno 40 ngth replaced.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification_rfegq red when refrigerant containing components are installed or altered lapplicabl`e
in CZ 2, 8-15).
fie`
u
required CFM/ ton req`wyl7,en MCH -2' .is�eq�
CF2RCF3R-MCH-23 & MR -MCH -23 Air Flow z 300 red.
` n V ice.
,
Exceptions: ,
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
i
-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)1E, 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 N.**r: 216-A0342487A-000000000-0000
CA Building Energy Efficiency Standards - 2018 Residential Compliance
Registration Date/Time: 2016-09-16 11:05:21
Report Version: 2013 Rev 1.008
HERS Provider: CaICERTS
Report Generated: 2016-09-16 11:06:00
CERTIFICATE OF COMPLIANCE CF111-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: �
�ttla Sot
Both, Atila
Company:
Signature Date:
FIRST CHOICE A / C & HEATING INC
2016-09-16 11:05:21
Address:
CEA/ HERS Certification Identification (if applicable):
79-747 CASSIA STREET
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-989-2369
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).
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 Regalations.
3. That the energy features and performance specifications, materials, components and anufactured devices for the buildingXnafoormartrbpprovidecl le"compliance documents,
4.. The building design features or system design features i ntified on his Certificate f C nIpliance are nsi tent h the on.othenapplical worksheets,
calculations, laps and specifications submitted to the e�fprcemen . a, enc for air v wi this builtltlin erm[t ap licatip
p P y f 1 p ka g p W R R �, e.
5. I that this CertificafofyQ�gryipliance s wttltrthe building s);issued forth.._e buil jag, andmade available tg the�enforcement agency for all applicable
will ensure a registered copy of alli#a.made•available permit
III(
inspections. I understand that a registered copy of this Ge�tj�icate of Conplances_requled to brg included Wife the ploy; des tithe building owner at occupancy.
Responsible Designer -Name: —4
Responsible Designer Signature: � � . � ..
�tita Soth
Both, Atila
Company:
Date Signed:
FIRST CHOICE A / C &.HEATING INC
2016-09-16 11:05:21
Address:
License:
79-747 CASSIA STREET
968138 E,
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-989-2369
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: 216-A0342487A-000*0000-0000 Registration Date/Time: 2016-09-16 11:05:21 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-16 11:06:00
Iain #
'
Permit ;
Project Address: g.2S� /—I
City of La Q Calin to
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701.2
Building Permit A'pplicatidn'and Tracking Sheet
' Owner's Name: CK S'FlE
A. P. Number:
14
Address: _
Legal Description:
City, ST, Zip:
Contractor: Fl2s-1
CKO'l /► I
Tele hone:
P
Address: _
Sold
Project Description: es�k, • V . - c—
City_ ST, Zip:
/�'
Telephone: ne
2
State Lic: # : 9
8
City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
one:
an
Construction Type: Occupancy:
cY:
State L ic_ # •
ProjectDemo
P circle one • New Alter Repair a
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Proect:,J ^ p
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl
Submittal
Rcq'd
Rcc'd
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
Subconlactor LIS(
Called Contact Pcrson
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
r
Plans resubmitted
Grading
Ilk JIOUSE:-
'"' Review, ready for correctionsrssuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P. '
Pub. 11'ks. Appr
Date of permit issue
School Fees,
Total Permit Fees