BMCH2016-020678-495 CALLE TAMPICO `
LA QUINTA, CALIFORNIA 92253
T,i&t 4 4P Qubtro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0206 6J
Property Address: 52862 EISENHOWER DR
APN: 1 773331006 LJ11 17 2016
Application Description: HOFFMAN / HVAC CHANGE OUT
Property Zoning: CITY OF LA QUINTA
Application Valuation: COMWNITf DEVELOPMENTDEPARTMENT
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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.: 827420
Date _Contractor: ' r.
OWNER -BUILDER DECLARATION '
1 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 they
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, 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
Owner:
SETH HOFFMAN
52862 EISENHOWER
LA QUINA, CA 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/16/2016
Contractor:
ALL SEASONS AIR CONDITIONING PLUMBING &
73605 DINAH SHORE DR STE 1310M
PALM DESERT, CA 92211
(760)568-2663
Llc. No.: 827420
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.
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: 11 10 Applicant: I� � a
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.
Date (01t11 1—,T—Signature (Applicant or Agent)
DESCRIPTION
FINANCIAL •
ACCOUNT
1
QTY AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0 $72.52
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $108.78 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
b
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00 • 0i
Per1111t �etaUS PERMIT NUMBER
City of La a Uinta BMCH01[6-0206
e
Description: HOFFMAN / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 6/16/2016 SKH
Approved: 6/16/2016 SKH
Parcel No: 773331006 Site Address: 52862 EISENHOWER DR LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 145 Lot: 21
Issued:
UNIT 15
NAME TYPE
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $0.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
FAX EMAIL
Details: HVAC CHANGE OUT- 16/80EER SPLIT SYSTEM AND NEW DUCTING [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
1 Applied to Approved
11
Printed: Thursday, June 16, 2016 9:55:33 AM 1 of 2
OL.1 V 4J SYSTEMS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP PHONE
FAX EMAIL
APPLICANT
IE INC
31225 LA BAYA
WESTLAKE
CA
91362
VILLAGE
CONTRACTOR
ALL SEASONS AIR CONDITIONING
73605 DINAH SHORE
PALM DESERT
CA
92211
PLUMBING &
DR STE 1310M
OWNER
SETH HOFFMAN
52862 EISENHOWER
LA QUINA
CA
92253
Printed: Thursday, June 16, 2016 9:55:33 AM 1 of 2
OL.1 V 4J SYSTEMS
Permit Detrails PERMIT NUMBER
-� City of La Quinta BMCH--2016-Q206
INSPECTIONS
Printed: Thursday, June 16, 2016 9:55:33 AM 2 of 2
!J L.1 V L! SYSTEMS
CLTD
-BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BY
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:0i 00
INSPECTIONS
Printed: Thursday, June 16, 2016 9:55:33 AM 2 of 2
!J L.1 V L! SYSTEMS
ALTERATIONS -HVAC
CEC-CFIR-ALT-04-E (Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address: 2
_nfcrcemen figency:
C -ate Fre)ared:
Permit.
q✓L r. r n- .V 1rl-
Equipment Type
Equipment Efficiency
"P�eW DudingPlenums rneset:
R "`z
Conditio ed
Floor Area (sq ft)
Thermostat .
qurted R -value :`"5
❑ Packaged System
g
�v orator Coil
P
AFUE
COP
` "
❑ R 6 (CZ 2, 8 13) Ducting
Served by system
❑ Setback
❑ Split System
❑ Mini Split
BTondensing Unit
11 Compressor
SEER
HSPF
❑ R-8' (CZ 11, 14, 15) Ducting
sgft
pr (Ifnot already
present, must
❑ R-6 (all CZ's) Plenums
IZI Furnace
11 •L ineset
BEER
❑ R-5 or R7.5) Lineset'
be installed)
11 TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is 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
1�R-�'egwred Compliance Documents lobe left onsite for}Pmol r
All Equipment,"
CF113-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) -HERS', MECH-25-HERS'
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage (<_15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 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 �,RequiredCompliance Docuinents'to-be left`onsite To' r;,FinaIJ: +
All new equipment and All New Ducts' 'eriR ALT -02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
',installer,RequiremeritJbuct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement
q6ired6'6i0IiAce Docuirjents to be teff on sit"_for`Final )
All New Ducts' and one or more of the following
CF111-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
6213: MECH-01, M ECH-20- HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace2
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage:S 651., Air Flow ;-> 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from dud leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet �Requlred_ Compliance Documents fo,be felt on site:for;Final
New ducting but less than All New Ducts' CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3RiMECH-20'HERS
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.
'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 handier, coil, plenums, dud 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-2%", 2.5-3T-2%", 3.5 to 4T -2%s", 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.application.
Responsible Designer Name:
Responsible Designer Signature:
Date Signed:
License:
v
Q
Company:
A s:
City/State/Zip:'
Phone:
1
7 .
y,
- k
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
1�m
Of i1 Quinta
8rmoftaSafety Dhidb t
P.O Box 1504,'78-49S Cage Tan**
La Qua, CA 92253 -{760) 777-7012
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