BMCH2015-005778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
SIMMONS, ADAM
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
:OMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
79130 CALLE BRISA
602130022
HEWITT RES HVAC CHANGE OUT
$5,800.00
A 0
FEB 205-2015
CITY OF LA QUINTA
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 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
\J�
License Class: License No.: :LIC -0003427/1
/ �[Sate:,�Z Contractor:
Jre��r
CCC 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/25/2015
Owner:
ROBERT HEWLETT
79130 CALLE BRISA
LA QINTA, CA 92253
Contractor:
SIMMONS, ADAM
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)564-7530
LIc. No.: :LIC -0003427
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 f he Labor Code, I shall forthwith
comply with those provisions.
-Date: 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.
r'
bate: i Signature (Applicant or V",�Jpzl Yoe/
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: Calle Brisa I Date Prepared: 2015-01-22
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
Calle Brisa
02
Date Prepared
2015-01-22
03
Project Location
79130 Calle Brisa
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Calle Brisa
07
Zip Code
92253
08
Dwelling Unit Conditioned
1600
Is the SC
Installing a„
r
x
Floor Area (ft2)
SC System
SC System
CFA served
Number of space conditioning
refrigerant
09
Climate Zone
15
10
(SC) systems In this dwelling
1
Location or Areax_
A
-_-" ythirSC
Ur�:
containing
unit.
more than 40
B. Space Conditioning (SC) Systeminformation N U.
-
01
02
03'
ix ' 04Vx;..
OS{r,a
_J
06x07.0$
09
10
°
Is the SC
Installing a„
r
x
SC System
SC System
CFA served
systema`
refrigerant
Installing new SC.
Installing
Installing
Installing
Identification or
Location or Areax_
A
-_-" ythirSC
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
Whole house
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)lDiib)
This section does not apply to this project.
Registration Number: 215-A0024552A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-01-22 08:28:55
Report Version: 2014-03-31
Crhomo %/Pminn• n GS1Cnn
HERS Provider: CalCERTS
Report Generated: 2015-01-22 08:22:21
CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
E.
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
l
Centragas
All new
Central split
All new
Less than or
System 1
furnace
heating
AFUE
0.7.8
AC
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
�; s
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 40 ft of duct length is replaced.
-Leakage rate compliance: 515%, ors 10% leakage to outside; or seal all accessible leaks.
.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification requiredcwhen refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF211CF311-MCH-23 & CF3R-MCH-23 Air Flow Z 300 CFM/ton required when MCH 25 is required
Exceptions: x
��
HERS from MCH 20 Duct Leakage Testing�requlrements
-Duct systems registered with provider as previously sealed are exempt
Heating -only systems and Air Hand ler/Fu rnacelchanges do not requitevenfication;of Air Flow MCH 23iir Refngerant Charge MECH 25:
r
Existing duct systems constructed, Insulated or sealed with asbestos are exempt from MCH;20 Duct Leakage Testing reyulrement
.,,,va , ate. -.. , .. as, -A ;..
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.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
. Registration Number: 215-A0024552A-000000000-0000 Registration Date/Time: 2015-01-22 08:28:55 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-22 08:22:21
Crhomn Varcinn• n SS1Cnn
CERTIFICATE OF COMPLIANCE CFIR-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: ���
Bachus, Tom
Company:
Signature Date:
MLC Building Performance
2015-01-22 08:22:29
Address:
CEA/ HERS Certification Identification (if applicable):
77825 Delaware Place
City/State/Zip:
Phone:
Palm Desert CA 92211
760-836-0066
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
i.
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 fnrthe building design or,system.design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials componentsi 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 identdied on this Certificate of Compliance are consistent with,the information provided on other applicable compliance documents, worksheets,
? t 'n -g
calculations, plans and specifications submrtted, to�the enforcement agency for approval with this building permitapphcabon.
� � ^ T v. '
e 'Y ', '
S. I will ensure that a registered co of this yi h
g copy Certificate of Compliance shall�be;made;available with the bwlding permits) issued for therbuildmg and:made:ayailable to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliarice Is"required.to"be Included with the documentation thebullder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
D"/640— W.W~
Simmons, Donna ;,
Company:
Date Signed:
ADAM SIMMONS
2015-01-22 08:28:55
Address:
License:
54440 AVENIDA CARRANZA
780534
City/State/Zip:
Phone:
LA QUINTA CA 92253
(760) 5647525
Digitally signed by Ca10ERTS. 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: 215-A0024552A-000000000-0000 Registration Date/Time: 2015-01-22 08:28:55 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-22 08:22:21
Crhomn waminn• n rricnn
FINANCIALINFORMATION_�'
-iE -- MR a4�t -� t, - ? .'�'. ¢
QTfYx ` F E� PAID n; PAID DATE
„rWDESCRIPTION kin �A000UNTy, ,AMOUNT X,
BSAS SB1473 FEE
101-0000-20306
0
$1.00 $0.00
e
PAIDBYz .0=r'h
METF.0
2 li CLTD BY
...E
a iIOD` ;e§
~RECEIPT##� .....'. ;:CHECK,# :'.
Total. Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
4', 5 as "xi
DESCRIPTION
y y .t #+r' "`
MOUNT `..:-':
PAIDD#
PAID DATE`
' 3f R , :W f .
t '4A000,UNT f
_A
:.
HVAC CHANGEOUT - SPLIT-SYSTEM
101-0000-42402.
0'
$72.52
$0.00
.y �i'x-.F
s� M � ��
PAID BY rte'
RECEIPT# �;
v£ ' g
CHECKA,
CLTD BY
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a j,
'>DESCRIPTION��'
..
FPAID:DATE
.:'
;s •n . :
.4: p y .. ,.: : f
Q TYAMOUNT
;�� •; , .. ..
a`s PAID`
�.
z
,HVAC CHANGEOUT - SPLIT—SYSTEM PC
101=0000-42600
0 .
$36.26
$0.00
y,<;:..i
RECEIPT„#EE
1
., 1 CHECK # t
".:CLTD
.a
., ��iF.i�M r�i.�i�+''�i`si;:
.� :.
ww'5h' "',r.vs...' b�kiY_.0�!4� :T�w''tt'�AW
r6'55 .£YtkEti.�:.w f v,:1,�'Ge?Y;.
Total Paid for CHANG EOUT: $108.78 $0.00
J �+ .'?n:yn.,•.. , k''Yj,'�`r+'a+Y r .. v. A .,s,. .� Y—"a s'::.:r;
4E DESCRIPTION
w,t �zk v€.-.3: ESE:.
SAG@OUNT '
i411AO,lJNT
.}
��;
.
DATE
..
:
q.`PAAID' :
? PAID
PERMIT ISSUANCE
101-0000-424040
..
$91.85
$0.00
k s y`-
pp
PAI D BY' : 2
Y4',c:;
z� r a
METHODu
:>..4z.,i1,dcf €” h v rr
r
RECEIPT #
'4 .r✓ ..
r;
CHECK #
�.`
CLTD BY
x;,
i'�, ::A.� �¢k..:i"y:.�.:..�Y..: BiW a.,n..-tYZ'.2�i�3����3w.3`,s:.;r�i�`.atar4.�v�.`.zd.��..aaY.Ev'�tF:.'%'6E.k.a
a
K3k$F::,:.'r m�,{.v��Y':.
y .:ti
�'��''�,k"'c, ...w >L�'s"u."'d:�a%�. i�.:.f sus".. �»b:
fix. i.S`. :"Fk..li.
P1 .Y..
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
o rr
J
:
J
Description: HEWITT RES HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 2/25/2015 PJU
Approved:
Parcel No: 602130022 Site Address: 79130 CALLE BRISA LA QUINTA,CA 92253
Subdivision: TR 28640 Block: Lot: 20
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,800.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No: Unites: 0
STATE
Details: HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES
Printed: Wednesday, February 25, 2015 1:02:25 PM 1 of 2
LJ ? SYSTEMS
-CHRONOLOGY
NAME TYPE
NAME
ADDRESSI
CONDITIONS
CONTACTS
CITY
STATE
ZIP
..........
PHONE FAX EMAIL
APPLICANT
SIMMONS, ADAM
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(913)206-9012
CONTRACTOR
SIMMONS, ADAM
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(913)206-9012
OWNER
ROBERT HEWLETT
79130 CALLE BRISA
LA QINTA
CA
92253
(913)206-9012
Printed: Wednesday, February 25, 2015 1:02:25 PM 1 of 2
LJ ? SYSTEMS
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
—]
RECEIPT #
CHECK #
METHOD
PAID BY
C
-
BY
BY
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 forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid. forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
. BOND, INFORMATION
Printed: Wednesday, February 25, 2015 1:02:25 PM 2 of 2 (fg?
SYSTEMS
Bre #City
Of U Quinta.
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 7777012
Building Permit Application and Tracking Sheet
Permit #
Project Address: t
Owner's Name:
A. P. Number:
Address:— I'�A
Legal Description:
City, ST, Zip: Z 2 Y 3 '
Contractor;
TeleP hone:
Address: ,� x "/
Project De ff G
City, ST, Zip:
QZ�dI/L .
Telephone:
"''»;�:::.;.::,.:::.:,.,:::::::.::>::::::.:..
State Lie. # :
City Lie. #..
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
' -
,:.:;;s;;. ;:;,;<:.;:;::,:>;;;:>;.«::.:::<
Construction Type: Occupancy:
State Lie. #:
.Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# S v es:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project ��O:p-e_,:,�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Caics.
Reviewed, ready for corrections .
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance,
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
'`" Reyiew, 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
c��