BMCH2016-021378-495 CALLE TAMP,ICO
LA QUINTA;'a"CALIFORNIA 92253
Application Number: BMCH2O16=0213
COMMUNITY DEVELOPMENT_DEPARTMENT
BUILDING PERMIT
Property Address:
53060 AVENIDA RUBIO
APN:
774043003,
Application Description:
EELKEMA RESIDENCE / HVAC CHANT,
Property Zoning:
Application Valuation:
$11,000.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/17/2016
Owner:
STEVEN EELKEMA:
53060 AVENIDA RUBIO
OUT A LA QUINTA;",CA 92253
JUN 17 2016
.CITY OF LA QUINTA " Contractor.
MldUt,8TYDEV ELOFMENTDEPR9TMENT ALL SEASONS AIR CONDITIONING PLUMBING &
— 73605 DINAH SHORE DR STE 1316M
PALM DESERT, CA 92211
(.760)568-2663
LIc., No.: 827420
LICENSED CONTRACTOR'S DECLARATION ' WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions'of Chapter. I hereby affirm under penalty of perjury one of the following declarations:
.9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,,, I have and'will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation, as provided for bySection 3700 of the Labor Code, for the performance
License Class: C20: C36 License No.; 827420 of -the work for which this permit is issued.
�` �� e 1 have and will maintain workers' compensation insurance, as required by
Date:: �7 Con tractor, ,�.� ,z� Section 3700 of the Labor Code; for the performance of the work for which this permit
iris, ued. My workers' compensation insurance carrier and.policy number are:
OWNER -BUILDER DECLARATION Carrier: Policy Number:
I hereby affirm under penalty of perjurythat 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,DivW6 ��
3 of the Business and Professions Code) or that he or she is exempt therefrom and the ' Date: - r ii ) Applicant:
basis for the alleged exemption. Any violation of Section 7.031.5 by any applicant for;a:..
permit subjects the applicant to a civil'penaltyof 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
�) I, as owner of the property, or my employees with wages as theirso'le . ` ONE HUNDRED THOUSAND DOLLARS.($100,000). IN ADDITION TO THE -COST OF
compensation, will do the.work, and the structure isnot 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 herebymade.to"the Building Official for a.permit subject to
within one year of completion, the owner -builder. will have the burden of proving the on 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
(_) I; as owner of the property, am exclusively contracting with licensed contractors" ,request and for whose benefit work is performed under orpursuanUto any. permit
to construct the. project: (Sec. 7044, Business and Professions'Code: The'Contractors' issued. as a result of'this;applcation , 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 toemployees 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:
I.certify that [.have' read this application and state that the above information is correct.
CONSTRUCTION LENDING AGENCY I agree to comply.with all city and county ordinances and state laws relating to building
I hereby affirm under penalty of perjury that., there is a construction lending agency for, construction, and hereby authorize representatives of this city to enter upon the
the performance of the work for which this permit is issued (Sec. 3097, Civ. C:). above-mentioned property for inspection purposes.
r—� cat
Lender's Name: Date: � l 7 I Signature (Applicant or Agent):
Lender's Add
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Description: EELKEMA RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED Applied: 6/17/2016 MFA
Parcel No: 774043003 Site Address: 53060 AVENIDA RUBIO LA QUINTA,CA 92253 Approved: 6/17/2016 MFA
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 176 Lot: 22 Issued:
UNIT 18
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $11,000.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0. No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT -14 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
Printed: Friday, June 17, 2016 2:32:52 PM 1 of 2
SYSTEMS
,.,.7777777
DESCRIPTION }
ACCOUNT
CITY
AMOUNT
PAID
PAID GATE
"RECEIPT;#
F "CHECK #
METHOD
PAID BY
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BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
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 $0.00
a
• i ��
INSPECTIONS
I
PARENT PROJECTS w
BOND INFORMATION
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ATTACHMENTS
Printed: Friday, June 17, 2016 2:32:52 PM 2 of 2
SY57fM5
Bin. #
City. of La Quinta
8ui1(r1ngw Safety Mkion
P.O. Box 1504;'78-495 Caffe.Tampfco
La.Qufnta, CA 92251-:(760).77-T7012
Buildin Permit Application, and Trackingg Sheet
Permit #. `
nM
ProjectAddcess::53060 Avenida.Rubio
Owner'sNamec` Steven Eelkema "
A P. Number
Address: 53060Aven,ida Rubio
LegalDescripgon:
City, ST, Zip:', La Quinta, CA 92253
Contractor."AII Seasons AIC, Plumbin & Heatin
'Tel hone: .9845Address:
73605 Dinah Shore Drive. #1310M
Pmject Description: Replace 3.5ton Heat. Pump &, Air Handler.
City, ST, Zip: Palm Desert, CA 92211
Telephone: 760-568-2663. "
MMIMMM
State Lie. #: 827420 City L i c.#;
Arch., E ngr., Designer:
Address: . .
City., ST, Zip:
Telephone:,V Y. '`�
State Lia 4:
Name of Contact Person: StevenSbhnierer ,.
Construction Type:.. Occupancy:
project type (circle one): New. - Add'n Alter Repair Demo
. Sq:Ft.: _#:$tories-.. .. #Units:
Telephone # of Contact Person:..818-735=7876
Estimated Value of project: $11,000.00.
APPLICANT:' DO NOT`WRITE'BELOW THIS UNE
0
Submittal
Req'd•Reed
TRACIdNG
PERMIT FEES
Plan Sets
'Plan Check submitted
Item Amount
Structural Calcs..
Reviewed, ready for corrections
Plan Check Deposit. .
Nass Cates.
Called Contact Person
Plan Check Balance •
Title 24 Calcs.
Plans picked up
Construction .:
Flood plain plan
Plans resubmitted
Mechariit l
Grading plan
2i6 Review, ready for corrections/Fssue
Electrical
Subeontactor List
Called Contact Person.
Plumbing
Grant Deed
`Plans picked up .
S M 1 ' ..
H.O.A. Approval
Plans resubmitted
Grading,
IN HOUSE:-
'"' Review; ready Mr corrections!issue
Developer Impact Fee
Planning Approval.
Called Contact Person
Pub. Wks. Appr '
Date of permit Issue
school Fees
Tota! Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 03115 : CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations - HVAC CZ 2, and 8-iS (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
Dage Prpared:
Permit#:
30(,00 Ave \i cic,vn
Ci DE' LG vi
Q t-) r,le
Equipment Type
Equipment Efficiency
New. ucting, Plenums, Vneset:
Required R -value
Conditioned
Floor Area (sq ft)
Thermostat
❑ Packaged
❑ Evaporator Coil
AFUE
COP❑'R-6
(CZ 2, 8-13) Ducting ''
Served by'system
Setback
System
[Condensing Unit
.
IN
13 R-8, ((,111, 14, 15) Ducting "
S( �i0 sgft
(If not olready.
❑ Split System
❑'Compressor
SEER
HSPFpresent
❑ R-6 (dll CZ's):Plenums
must
❑ Mini Split
❑ Lineset
EER
• O. R-5 or R7.5) Uneset`
be installed)
11 Furnace
❑ 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
Required Compliance 'Documents to be left on site for Final:
All Equipment,
CFIR-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 2O -HERS, MECH-(23 or 24) -HERS', MECW25-HERSZ
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Dud leakage L15%, or < 10%to outside; or seal all accessible leaks), Air Flow 2'3.00 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
01. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 4011near feet of ductin.unconditloned space, or
❑ 3. Existing duct systems are constructed; insulated or sealed.with asbestos (list manufacture of:building 1 .
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CFIR-ALT-62-E
including Mini Split
CF2R: MECH-01, MECH-20=HERS, MECH-22-HERS, MECH-(23 be 24) -HERS, MECH-25-HERS=
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS?, MECH-25-HERSZ
Mini Splits require`.CFIR-ALT=02-E, CF2R-MECH-01, and (CF2R-CF3R) MECW25-HERS
Installer Requirement: Dud leakage15 6%, Fan Efficacy (:58W/CFM), Air -Flow 2'350 CFM/ton (or alternative), Refrigerant Charge
113. AII New Ducts with Replacement
Required Compliance Documents to be left on site'forFnal:
All New Duds' and one or more of the following
CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset; FumaceZ
CF3R: MECH-20-HERS, MECH-(23 or24)=HERS, MECH-25-HERS
Installer Requirement: Dud leakage < 6%, Air Flow 2 350 CFM/ton (or alternative); Refrigerant Charge
Exempted from dud leakage testing if: ❑ 1. Existing,duct systems are c6nstructed,'insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet
Required Compliance Documents to be left on'sitefor. Final:
New ducting but less than All New Ducts,
I CFIR=ALT-02-E„CF21k: MECH-2044ERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (:S.15% or, < 10% to outside or, or seal all'accessible leaks)
❑ EXCEPTION: Existing dud 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.
Z Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or.24), or Refi-igerant Charge verification MECH-25
' All New Ducts is when ai 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 handler, coil, plenums, duct: material)
R-5 W' thick insulation) for linesets 1” and less. 11-7:5 (1.5" thick insulation) for.linesets over Iinch. Most mfg will require Suction line Diameter
with insulation as the following 1.5=2T-2%", 2:5-3T=2%", 3.5 to 4T-2W,.5T-4Y"
Contractor (Documentation Auttior's /Responsible Designer's Declaration Statement)
I certify the following under penalty ofperjury, 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 I and 6 of the California:Code of Regulations (CCR).'
4. That the energy features and performencespecificafions, 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 Desi ner Name:
erelr
Res onsible Desi ne Signature:
Da a Si ned:
(0 17 )b
Licenser
% 27-4zo
Company: -
Address: . -
Gty/State/Zp:
Phone:
Ail Sec>,sov>s Neck
'73(0o5 L� ly" 131W
'Maim 6 82211
?Iro -S(o8 - z (v(o
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at:1-800-772-3300