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BMCH2014-1128y Zoning: Application Valuation: $18,000.00 Applicant: II OCT 2 2014 Contractor: LIBERTY PLUMBING HEATING & AIR 11 LIBERTY PLUMBING HEATING & AIR OUTSIDE CITY LIMITS CITy OF LA QUINTA OUTSIDE CITY LIMITS COMMUNITY DEVELOPMENT DEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.::LIC-762454 Date O'Z Contractor OWNER -RI ILDE 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 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 ) 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 Llc. No.: :LIC -762454 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: _ _ 1 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: Applicant: P"VV WARNING: FAILURE TO SECURE WORKERS' OMPENSATION COVERAGE IS UNLAWFUL, LOYER AND SHALL SUBJECT AN EMPTO CR. INAL 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 en upon a above mentioned pp?operty for inspection purposes. Date: JR) - C S` Signature (Applicant or Ade* 'VOICE � � �itiN1�ICl/ (760) 777-7125 78-495 CALLE TAMPICO D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/28/2014 Application Number: BMCH2O14-1128 Owner: Property Address: 78922 BRECKENRIDGE DR KELLY ROBINSON APN: 770320051 78922 BRECKENRIDGE DR Application Description: HVAC AND WATER HEATER CHANFOUT LA QUINTA, CA 92253 Propert Q 11 y Zoning: Application Valuation: $18,000.00 Applicant: II OCT 2 2014 Contractor: LIBERTY PLUMBING HEATING & AIR 11 LIBERTY PLUMBING HEATING & AIR OUTSIDE CITY LIMITS CITy OF LA QUINTA OUTSIDE CITY LIMITS COMMUNITY DEVELOPMENT DEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.::LIC-762454 Date O'Z Contractor OWNER -RI ILDE 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 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 ) 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 Llc. No.: :LIC -762454 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: _ _ 1 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: Applicant: P"VV WARNING: FAILURE TO SECURE WORKERS' OMPENSATION COVERAGE IS UNLAWFUL, LOYER AND SHALL SUBJECT AN EMPTO CR. INAL 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 en upon a above mentioned pp?operty for inspection purposes. Date: JR) - C S` Signature (Applicant or Ade* FINANCIAL INFORMATION DESCRIPTION. ACCOUNT QTY AMOUNT PAID' PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 10/28/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LIBERTY PLUMBING HEATING & AIR DEBIT R2480 MFA Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - OTHER EQUIPMENT 101-0000-42402 0 $36.26 $36.26 10/28/14 PAID BY METHOD RECEIPT # CHECK #. CLTD BY LIBERTY PLUMBING HEATING & AIR DEBIT R2480 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - OTHER EQUIPMENT PC 101-0000-42600 0 $36.26 $36.26 10/28/14 PAID BY METHOD RECEIPT # CHECK #. CLTD BY LIBERTY PLUMBING HEATING & AIR DEBIT R2480 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $72.52 10/28/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LIBERTY PLUMBING HEATING & AIR DEBIT R2480 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $36.26 10/28/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY LIBERTY PLUMBING HEATING & AIR DEBIT R2480 MFA Total Paid forCHANGEOUT: $181.30 $181.30 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 10/28/14 *PAID BY METHOD RECEIPT # CHECK # CLTD BY LIBERTY PLUMBING HEATING & AIR DEBIT R2480 MFA Total Paid forPERMIT ISSUANCE: $91.85 $91.85 TOTALS: $274.1S $274.15 Description: HVAC AND WATER HEATER CHANGE OUT Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 10/28/2014 MFA Parcel No: 770320051 Site Address: 78922 BRECKENRIDGE DR LA QUINTA,CA 92253 Approved: Subdivision: TR 25389-3 Block: Lot: 51 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $18,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC CHANGE OUT - 13 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.WATER HEATER CHANGE OUT CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT LIBERTY PLUMBING HEATING & AIR OUTSIDE CITY LIMITS (604)592-0204 CONTRACTOR LIBERTY PLUMBING HEATING & AIR OUTSIDE CITY LIMITS (604)592-0204 OWNER KELLY ROBINSON 78922 BRECKENRIDGE DR LA QUINTA CA 92253 (604)592-0204 Printed: Tuesday, October 28, 2014 10:34:52 AM 1 of 3 O ' SYS7Eh1S Printed: Tuesday, October 28, 2014 10:34:52 AM 2 of 3 V?sysrEMs INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL"* CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 10/28/14 R2480 DEBIT LIBERTY PLUMBING MFA HEATING & AIR Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $36.26 $36.26 10/28/14 R2480 DEBIT LIBERTY PLUMBING MFA OTHER EQUIPMENT HEATING & AIR HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $36.26 10/28/14 R2480 DEBIT LIBERTY PLUMBING MFA OTHER EQUIPMENT PC HEATING & AIR HVAC CHANGEOUT - 101-0000-42402 0 $72.52 $72.52 10/28/14 R2480 DEBIT LIBERTY PLUMBING MFA SPLIT -SYSTEM HEATING & AIR HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $36.26 10/28/14 R2480 DEBIT LIBERTY PLUMBING MFA SPLIT -SYSTEM PC HEATING & AIR Total Paid forCHANGEOUT: $181.30 $181.30 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 10/28/14 R2480 DEBIT LIBERTY PLUMBING MFA HE &AIR Total Paid for PERMIT ISSUANCE: $91.85 $91.85 Printed: Tuesday, October 28, 2014 10:34:52 AM 2 of 3 V?sysrEMs INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL"* Printed: Tuesday, October 28, 2014 10:34:52 AM 2 of 3 V?sysrEMs ATTACHMENTS Printed: Tuesday, October 28, 2014 10:34:52 AM 3 of 3 C SYSTf. tits CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 ) Project Name: Robinson I Date Prepared: 2014-10-27 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 CF111-ALT-02 document for each dwelling unit. 01 Project Name Robinson 02 Date Prepared 2014-10-27 03 Project Location 78922 Breckenridge Dr 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name Robinson 07 Zip Code 92253 08 Dwelling Unit Conditioned 2500 Installing Installing Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 15 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type S. Space Conditioning (SC) System'Information � f 01 02 01 04� 05 06 / 07 ,"08 09 10 Is the SC Installing a k�� SC System SC System CFA served system a refrigerant 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 (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 Location 1 2500 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib) This section does not apply to this project. Registration Number: 214-A0126597A-000000000-0000 Registration Date/Time 2014-10-27 12:36:34 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-10-27 12:37:23 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -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 it 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 Dud or Name Type Components Type Value System Type Components Type Value Type Dud Length R -Value Central gas All new Central split All new Less than or System 1 furnace heating AFUE 0.78 AC cooling SEER 13 Setback equal to 40 R-8 components components feet Rhe uired Documentation: CF2R-MCH-01-E - Space Conditioning Systems Duds and Fans -Duct Insulation requirement for new plenums: R6. CF2R-MCH-20-H & CF3R-MCH-20-H — Dud Leakage testing required when heating or cooling components are installed In ducted systems, or when more than 40 ft of dud length is replaced. -Leakage rate compliance: 515%x, ors 10% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & CF3R-MCH-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. As; ` ` `. Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Dud Leakage -Testing requirements. t -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,astiestos 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)lDiia and 150.2(b)IE, F) This section does not apply to this project. Registration Number: 214-A0126597A-000000000-0000 Registration Date/Time: 2014-10-27 12:36:34 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-10-27 12:37:23 Schema Version: 0.551SDD 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)1C) This section does not apply to this project. Registration Number: 214-A0126597A-000000000-0000 Registration Date/Time: 2014-10-27 12:36:34 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-10-27 12:37:23 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -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 Author Name: Documentation Author Signature: howes, Jerry ��� Company: Signature Date: LIBERTY PLUMBING HEATING & AIR CONDITIONING INC 2014-10-27 12:36:34 Address: CEA/ HERS Certification Identification (if applicable): 39252 WINCHESTER ROAD #107-371 City/State/Zip: Phone: MURRIETA CA 92563 (951) 326-4892 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.designiidentified 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. Compl ante /the on 4. The building design features or system design features identified on this Certificate o aconsi tent with information provided other applicable compliance documents, worksheets, calculations, plans and specifications submitted Rto the enforcement agency for approval with this building permit application: 5. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permits) 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 Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: /1� howes, Jerry Oma/ � Company: Date Signed: LIBERTY PLUMBING HEATING & AIR CONDITIONING INC 2014-10-27 12:36:34 Address: License: 39252 WINCHESTER ROAD #107-371 761640 City/State/Zip: Phone: MURRIETA CA 92563 1(951) 326-4892 Digitally signed by CaICERTS. 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: 214-AO126597A-000000000-0000 Registration Date/Time: 2014-10-27 12:36:34 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-10-27 12:37:23 Schema Version: O.SSSSDD Bin. # Qty of La Quinta Building 8r Safety Division P.O. Box 1504,78-49S Caife Tampico ia.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address.— 1 Al, Owner's Name: . A. P. Number. Address• Legal Description: City, ST, Zip: Contractor. tt' / Telephon / Address -, Vi V1,41 Lf IV# , ) Pmjer4 Description: City, ST, Zip: 1 Q gog Telephone 7LADLI�. "'' {r. 43 >. State Lic. # : City Li c #,� Arch., Eng., Designer Address: City., ST, Zip: Telephone: Y. � State Lic. #: `-. • 7�r Name of Contact Person: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE 9 Submittal Req'd Reed TRACKING PERMIT FEES - Plan Sets Pian Check submitted' Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit. . Truss C21cs. Called Contact Person Plan Check Balance - Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted' Mechanical Giading plan 2'a Review, ready for correctionsliissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up t S.M.L H.O.A. Approval Plans resubmitted Grading Ii\ ROUSE:- '^' Review; ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees