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BMCH2017-0146LICENSED 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: ++�ntcaetor: 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).: (_) 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 Name: 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 work for which this permit is issued. 4;;� 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: SECURITY NATIONAL INSURANCE COMPANY Policy Number: SWC1104544 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. SDate:' a4 I1 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 upon the above-mentioned property for inspection purposes. 214 c •uG` -LG-f/ 4 4v a N� VOICE (760) 777-7125 78-495 CALLE TAMPICO �1 - FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT m D 242, Application Number: BMCH2O17-0146 Owner: 1 Property Address: 54360 AVENIDA RAMIREZ TRACEY NEWTON APN: 774244006 54360 AVENIDA RAMIREZ C:D C7 Application Description: NEWTON RESIDENCE / HVAC CHANGE OUT LA QUINTA, CA 92253 0 � Property Zoning:m O —­0Application Valuation: $11,771.00 ro n t -Z Applicant: Contractor: y Z O IE INC ALL SEASONS AIR COND�i �VG POVIBING 31225 LA BAYA 75-450 GERALD FORD D$BTE 303 WESTLAKE VILLAGE, CA 91362 PALM DESERT, CA 9221 Z (760)202-3067 y Llc. No.: 827420 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: ++�ntcaetor: 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).: (_) 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 Name: 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 work for which this permit is issued. 4;;� 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: SECURITY NATIONAL INSURANCE COMPANY Policy Number: SWC1104544 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. SDate:' a4 I1 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 upon the above-mentioned property for inspection purposes. 214 Application Number: BMCH2O17-0146 Property Address: 54360 AVENIDA RAMIREZ APN: 774244006 Application Description: NEWTON RESIDENCE / HVAC CHANGE OUT Property Zoning: Application Valuation: $11,771.00 Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 Date: 4/24/2017 Owner: TRACEY NEWTON 54360 AVENIDA RAMIREZ LA QUINTA, CA 92253 Contractor: ALL SEASONS AIR CONDITIONING PLUMBING & 75-450 GERALD FORD DR STE 303 PALM DESERT, CA 92211 (760)202-3067 Llc. No.: 827420 Detail: HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT. QTY AMOUNT BSAS SB1473 FEE 101-0000=20306 0 $1.00 Total.Paidjor BU ILDING•STAN.DARDS.ADM INISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $76:00 DESCRIPTION ACCOUNT `. j QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-426000 $38.00 Total Paid for CHANGEOUT: $114.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION 'ACCOUNT QTY AMOUNT .TECHNOLOGY ENHANCEMENT FEE .502-0000-43611 0 $5.00 Total', for TECHNOLOGY ENHANCEMENT FEE: $5.00 B`° # Crty of La Quinta Building 8t Safety Division P.O.'Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 54360 Avenida Ramirez Owner's Name: Tracey Newton A. P. Number. Address: 54360 Avenida Ramirez Legal Description: City; ST, Zip: La Quinta, CA., 92253 Contractor: All Seasons A/C, Plumbing, & Heating Telephone: 760-668-4662 Address: 75-450 Gerald Ford Drive Suite 303 Project Description: Replace 3 ton A/C, coil, & FAU City, ST, Zip: Palm Desert, CA 92211 Telephone: 760-202-3067 s`'N„ State Lic. 4: 827420 City Lia 9- Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lia #: „,,. ji y." Name of Contact Person: Steven SchniererSq. Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Ft.: # Stories: #Units: Telephone # of Contact Person: 8.18-73577876 Estimated Value of Project: $11,771.00 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted. Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit, . Truss Cales. Called Contact Person Pian Check Balance Title 24 Calc$. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'd Review, ready for correctiouslissue Electrical Subcoutaetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE-- ''" Review; ready for corrections issue 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 CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF4R-ALT-HVAC) (Page 1 of 3) Project Name: TRACEY NEWTON Date Prepared: 2017-04-21 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 TRACEY NEWTON 02 Date Prepared 2017-04-21 03 Project Location 54360 AVENIDA RAMIREZ 04 Building Type Single family 05 CA City LA QUINTA 06 Dwelling Unit Name WHOLE HOUSE Identification or Location or Area by this SC . containing system 07 Zip Code 4 ¢'4# 92253 4 : 08 Dwelling Unit Conditioned 1425 System (ft) system? s�"� Ti Floor Area (ftZ ) duct system? SC system? Alteration Type SYSTEM 1 WHOLE HOUSE Number of Space Yes 09 Climate Zone 15 ; ni yar% 10 Conditioning (SC) Systems in 1 w r this Dwelling Unit: B. Space Conditioning (SC) System Information 01 02 03 04 NOS 06 07 08 09 10 SC System SC System CFA served Is the SC,. rr x a t t systema . Installing a ,• Ot;J- 1p"U �:�Ah"i refrigerant , t,, j ;.int', fJN 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 (ft) system? component? components? feet of ducts? duct system? SC system? Alteration Type SYSTEM 1 WHOLE HOUSE 1425 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib) This section does not apply to this project. Registration Number: 417-A020090637A-000-000-0000000-0000 Registration Date/Time: 2017-04-21 09:37:21 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-21 09:37:23 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) O1 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 All new All new Thi' field or This field or SYSTEM 1 Central gas" heating AFUE 80 Central split cooling SEER 16 Setback section is not section is not furnace components AC components applicable applicable Required Documentation: ' CF2R-MCH-01-E - Space Conditioning Systems tj F. - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6{CZ 1 10 f2 and 13) and R8 (CZ 11 and 14-16) . �., CF2R and MR -MCH -20-11- Duct leakage Test required when heating or cooling components are installed,inrdutted sy3tems;or when more than 40 ft of duct length is replaced -Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks. c CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing compoPenmare installed or altered (applicable in CZ 21 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. x�M�. ' Exceptions: Duct systems registered with HERS provider as previously sealed are.exempt from MCH -20 Duct Leakage ?estin'g requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23,.or Refrigerant Charge MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt'from MCH -20 Duct Leakage Testing requirements. ` 's i ?. i R E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and.150.2(b)H, F) This section does not -apply to this,project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC) This section does not apply to this project. Registration Number: 417-A020090637A-000-000-0000000-0000 Registration Date/Time: 2017-04-21 09:37:21 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.00S Report Generated: 2017-04-21 09:37:23 Schema Version: rev 10/16 r CERTIFICATE OF COMPLIANCE CF1R-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: David Beale -E)cwC&13ea& Company: Signature Date: All Seasons Air Conditioning Plumbing & Heating, Inc. 2017-04-21 Address: CEA/ HERS Certification Identification (if applicable): 73605 Dinah Drive #1310M City/State/Zip: Phone. Palm Desert CA 92211 760 568-2663 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 responsibilityIfor;the building design or system design identified on this Certificate of Compliance (responsible designer). 3. 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 California Code of Regulations. 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 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 with the bwldih&permit(s)-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 C pliance is requi� d to be in I"uded with the docu entation the builder provides to the building owner at occupancy. Responsible Designer Name: a ,�uatt_iI.ysa:d^iAi, David Beale Responsible, De esponsible,DesiignerISignature: Dc�vLd�Tiealer Company: Date Signed: All Seasons Air Conditioning Plumbing & Heating, Inc. 2017-04-21 Address: License: 73605 Dinah Drive #1310M 827420 City/State/Zip: Phone: Palm Desert CA 92211 760-568-2663 Digitally signed by CHEERS'". 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: 417-A020090637A-000-000-0000000-0000 Registration Date/Time: 2017-04-21 09:37:21 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-21 09:37:23 Schema Version: rev 10/16