BMCH2014-101078-495 CALLE TAMPICO C& 0 4 4 Qu&rcu
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/9/2014
Application Number:
BMCH2O14-1010 Owner:
Property Address:
52661 AVENIDA BERMUDAS CAROLYN ZAMORA
APN:
773305019
Application Description:
92253
Property Zoning:
Application Valuation:
$12,690.00
Applicant
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, iB�J 3 3
Licensee ClasqC_-W License No.:'W
Date: ' 1 l Contractor: b
OWNER -BUILDER DE RA N
I hereby affirm under penalty of perjury that I am a rom 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).:
U 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.).
(J 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 Name:
Lender's Address:
Contractor:
VENVEST-BALLAD INC./RIGHTIME
3030 MYERS ST
RIVERSIDE, CA 92503
(951)276-9744
Llc. No.:
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
Sects 37 of the Labor Code, for the performance of the work for which this permit
is issued. orkers' 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 wit those provisions.
Date: I Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPtPLTI
COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINALAND 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: n 1 Signature (Applicant or Agent
FINANCIAL .1•
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$71.50
$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
$35.75
$0.00
PAID BY
METHOD
RECEIPT #
'CHECK #
CLTD BY
Total Paid forCHANGEOUT: $107.25 $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 forPERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
Bin #
Permit #
()
D'O City of La QUinta
Building 8i' Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
er'sName: C PQ_�r0
Address: Cj g (o(,Q k
A. P. Number: _ _
Legal Description: r
City, ST, Zip: �� q;a-�
Contractor: ,
Telephone. -
Address: O O m S C
Project Description: <
City, ST, Zip:
VA- S
Tele hone>c
Y: h:\. _,
State Lie. # : �'( rj�j
City Lic. kktCj
Arch., Engr., Designer:
Address:
City, ST, Zip: �-
Telephone:
State Lic. #:X.
•';•^ :hrc:>.asr:Rs;.R,Rcxyg:agz: ",•
...? �;},�:.�c:;��.<�?�.;/,,,,:...>�.
r:<h .3 u„: rz':�i, :>y :A: ': =<>h
.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: /��� c�
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: S) - a`7 (0 ' °I �7 '�
Estimated Value of Project: 2 l 'q0 t O
APPLICANT: DO NOT WRITE BELOW THIS LINE
4
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Colts.
Called Contact Person
Plan Check Balance
Titie 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd 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
Federal Tax ID # 27-2838034
Fax # .951-328-5988
George Donaldson - F1737740
12984 Riley Ct
Rancho Cucamonga, CA 91739
DOB 12-15-1979
Insurance Company of the West.
WVE502266101
Expires - 1-1-2015
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name: CAROLYN ZAMORA Date Prepared: 2014-07-08
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CFIR-ALT 02 document for each dwelling unit.:
01
Project Name:
CAROLYN ZAMORA
02
Date Prepared:
2014-07-08
03
Project location:
52561 AVENIDA BERMUDAS
04
Building Type:
Single family
OS
CA City:
La Quinta
06
Dwelling Unit Name:
CAROLYN ZAMORA
07
Zip Code:
92253
08
Dwelling Unit Conditioned
1200
components?
duct system
Floor Area (ft2):
Number of space conditioning
09
Climate Zone:
15
10
(SC) systems being altered In
1
condensing unit,
Installing
this dwelling unit.:
system's
B. Space Conditioning (SC) System .14i 'rmation `
01
02_;
03r
04`N
05
;06 Jkr,
07
08�. ,
09
10
-;: 'Installing newt:'
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
AMANA
1200
1200
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 214-A0052304A-000000000-0000 Registration Date/rime: 2014-07-08 13:58:42 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014 -07 -OB 13:58:47
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 split
All new
Central split
All new
This field or
This field or
AMANA
heating
AFUE
0.78
cooling
SEER
18
Setback
section is not
section is not
HP
components
HP
components
applicable
applicable
Reouired Documentatlon:
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 46ft of duct length is replaced.
-Leakage rate compliance: S 15%, or S 10% leakage to outside, or seal all accessible leaks.
CF2R.MCH-25-H & CF3R-MCN-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 2 300 CFM/ton required when MCH -25 is required >, .: w s� ». 71� V, •:- y + , r :r " ^- M
Exceptions: y, n^ 3 < :. �: Sar J x
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements 0`*,
-Heating-only systems and Air Handler/Furnace changes do not require verificatlon of Air Flow 106-23; or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated ore led with asbestos are a Tmp
et from MCN 20 Duct Leakage Tespng requirementsr,
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)IE, F)
This section does not apply to this project.
Registration Number: 214-A0052300-000000000.0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
Report Version: 2014.03-31
2014-07-08 13:58:42
HERS Provider: CaICERTS
Report Generated: 2014.07-08 13:58:47
CERTIFICATE OF COMPLIANCE CF1R•ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 4
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 214-A0052304A-000000000-0000
Registration Date/Time: 2014.OMB 13:58:42
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03>31 Report Generated: 2014.07-08 13:58:47
?i
A
Registration Number: 214-A0052304A-000000000-0000
Registration Date/Time: 2014.OMB 13:58:42
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03>31 Report Generated: 2014.07-08 13:58:47
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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 Authorkame:
Documentation Author Signature;
McEligot, Jim
Company:
Signature Date:
VENVEST BALLARD INC dba RIGHTIME AiR CONDITIONING AND HEATING
2014-07-08 13:58:42
Address:
CEA/ HERS Certification Identification (if applicable):
3030 MYERS ST
City/State/Zip:
]Phone:
RIVERSIDE CA 92503
(951) 276-9744
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of Calitornia:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Buslness and Professions Code to accept responsibility (or 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 buiifing ldesign or 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 ,
4. The building design features or system design features idendr"4i on this Certificate of Comptlance are consistent with the Information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications ubmitted to the enforcementagency for appro al wttfi this building permit appllcatlon.
S. I will ensure that a registered copy of this Certllicte cf Compliance shall be made avaliable ivhh file bugdln
g g permlt(s) Issued for the building, and made available to the enforcement agency for all applicable
Inspections. I understand that a registered copy of this cirtificate of Compllance R iequired to bi Included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
McEligot, Jim
Company:
Date Signed:
VENV£ST BALLARD INC dba RIGHTIME AIR CONDITIONING AND HEATING
2014-07-08 13:58:42
Address:
License:
3030 MYERS ST
878533
City/State/Zip:
Phone:
RIVERSIDE CA 92503
(951) 276-9744
Digitally signed by CaICERTS This digital signature is provided in order to secure the con rent of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the
information.
Registration Number: 214-A0052304A-000000000.0000 Registration Date/Time: 2014-07-08 13:58:42 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03.31 Report Generated: 2014-07-08 13:58:47