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BMCH2015-0135Applicant: BEST IN THE WESTAIR'CONDITION 255 N ELCIELO ROAD #140-125 PALM SPRINGS, CA 92262 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. C38 License No.: 967982 Date: 447- 1 Contractor: 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, after, 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.). (_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.). (_J 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 Address: Contractor: BEST IN THE WEST AIR CONDITION 255 N ELCIELO ROAD #140-125 PALM SPRINGS, CA 92262 (760)343-1002 Llc. No.: 967982 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 of the Labor Code, I shall forthwith comply with those provisions. /__1D Date: t " 17- 15 Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ 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: Lf -745 Date: (Applicant or Agent . VOICE (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: 4/17/2015 ',Application Number: BMCH2O15-0135 Owner: Property Address: 79450 CANTERBURY 1404IAX1510W APN: &"150M 79450 CANTERBURY Application Description: fA-HVAC CHANGEOUT LA QUINTA, CA 92253 Property Zoning: Application Valuation: $1,200,00 Applicant: BEST IN THE WESTAIR'CONDITION 255 N ELCIELO ROAD #140-125 PALM SPRINGS, CA 92262 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. C38 License No.: 967982 Date: 447- 1 Contractor: 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, after, 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.). (_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.). (_J 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 Address: Contractor: BEST IN THE WEST AIR CONDITION 255 N ELCIELO ROAD #140-125 PALM SPRINGS, CA 92262 (760)343-1002 Llc. No.: 967982 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 of the Labor Code, I shall forthwith comply with those provisions. /__1D Date: t " 17- 15 Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ 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: Lf -745 Date: (Applicant or Agent . F AMOUNT •y r t >'. PAID` ' PAID '� bTE r F "`•kms' 4 DESCRIPTION x FINANCIAL INFORMATION ra ;� ACCOUNT *x'3CITYi BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 j -�RECEIP- K" t�jCH K #,V, 7tc Lf D" Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 HVAC CHANGEOUT - REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 7�K• METHODECK % M�,-;�;t& CLTD BY tj -,,A C C 0 U N . ..... 7.j PAID' PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00 PAID tRECEIPT CHECK # LT Total Paid forCHANGEOUT: $16.92 $0.00 R�,NTi Ent D PAID'DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 k1b, BY METHOD, s.; RECEIPT �'CHf C1 CLTD BY•- , Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS: $109.77 $0.00 Description: HANSON HVAC CHANGEOUT CONDITIONS Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 4/17/2015 KHE Approved: 4/17/2015 KHE Parcel No: Site Address: 79450 CANTERBURY LA QUINTA,CA 92253 Subdivision: Block: Lot: Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,200.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 EMAIL Details: REPLACE 3.5 TON COMPRESSOR ONLY BEST IN THE WEST AIR CONDITION 255 N ELCIELO ROAD #140-125 CHRONOLOGY CONDITIONS CONTACTS NAME*TYPE NAME • ADDRESSI CITY STATE. ZIP : _ PHONE ; FAX EMAIL APPLICANT BEST IN THE WEST AIR CONDITION 255 N ELCIELO ROAD #140-125 PALM SPRINGS CA 92262 CONTRACTOR BEST IN THE WEST AIR CONDITION 255 N ELCIELO ROAD #140-125 PALM SPRINGS CA 92262 OWNER HANSON 79450 CANTERBURY I LA QUINTA I CA 1 92253 FINANCIAL INFORMATION Printed: Friday, April 17, 2015 3:02:31 PM 1 of 2 CRWYS TEMS DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0. $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION HVAC CHANGEOUT = 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PC Total Paid forCHANGEOUT: $16.92 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:•• 00 Printed: Friday, April 17, 2015 3:02:31 PM 2 of 2 OjP srsrennS CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 ) Project Name:. Harrison.79450.1 Date Prepared: 2015-04-17 A. General Information CFIR-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 Harrison.79450.1 02 Date Prepared 2015-04-17 03 Project Location 79450.1 Canterbury 04 Building Type Single family O5 CA City La Quinta 06 Dwelling Unit Name Harrison.79450.1 07 Zip Code 92253 08 Dwelling Unit Conditioned 1400 e Floor Area (ft2) SC System SC System CFA served kj)ls ystem ae- refrigerant Number of space conditioning Installing 09 Climate Zone 15 10 (SC) systems in this dwelling 1 ducted a containing systems . more than 40 unit entirelynew B. Space Conditioning (SC) System Information. r cow. O3 02 03 044 USS —06'�` 07 " OS 09 10 fi Nd the SC Installing a e SC System SC System CFA served kj)ls ystem ae- refrigerant Installing ri .."k Installing s Installing Identification or Location or Area by this SC ducted a containing systems . more than 40 ilnstalling• entirely new entirelynew Name Served System (ft2) system? component? components? feet of ducts? ductsystem? SC system? Alteration Type System 1 Living 1400 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)Milli) This section does not apply to this project. Registration Number: 215-A0100616A-000000000-0000 Registration Date/Time: 2015-04-17 11:54:32 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance J Report Version: 2014-03-31 Report Generated: 2015-04-17 11:54:48 . Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT42-E 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) 01 02 03 04 05 06 07 08 09 16 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 Dud or.Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value Central gas No heating This field or This field or Central split This field or This field or System 1 furnace component section is not section is not AC Compressor SEER 13 Setback section is not section is not I altered applicable applicable applicable applicable Required Documentation: CUR -MCH -01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF2R-MCH-20-1 & 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: <_ 15%, or s 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 & CF311-MCH-23 Air Flow 2 300 CFM/ton required when MCH 25 is required. Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt froin'MCH 20 Duct Leakage-rT requiiements. i�}`�F i+V -Heating-only systems and Air Handler/Fumace changes do not require verification of Air no ACH-123 or Refriger'gant�Cirar�ge,MECH-25�p1 { 11-20nuct Leakage Test g requi'reme�rl;s. rF -Existing duct systems constructed, insulated or sealed with asbest�are exemptt m MCnk E. Entirely New or Complete Replacement Dud System, with or wlthout,Equipment Changeouti(Sectlons 150.2(§) lDiiayandr150.2(b)lE,•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-A0100616A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2015.04-1711:54:32 Report Version: 2014-03-31 Schema Version:0.555SDD HERS Provider: CaICERTS Report Generated: 2015-04-17 11:54:48 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: r�� Hansen, Jamie Jamie O-tansen Company: Signature Date: ' Best in the West Air Conditioning & Heating Inc 2015-04-17 11:54:32 Address: CEA/ HERS Certification Identification (if applicable): - 31225 Plantation Dr City/State/Zip: Phone: Thousand Palms CA 92276 (760) 343-1002 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of Califomia: 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 design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices far the building design or system design identified on this Certificate of Compliance conform to the �`696ns. ccsi � ?�I requirements of Title 24, Part land Part 6 of the Californias Hon i+ pr F:?. "q' e- - Code on this -4. The building design features or system design features identfied on,this Certficate.bf Gump iance are consistem cart&the igformation,provided on:otherapplicable compliance documents, worksheets, identified C l...�ti3:' YS thin`• jitap n i I:Z� calculations, plans and specifications submitted to the enforoementagency for approval�,witfi,this building permit application � are ',V a�,i de ci ,fx. 5. I will ensure that a registered copy of this Certificate;of;Compliance shallibe;made(ayailable WiMtthe building'permk(s);issued forrthe building, anee made avallableSoSheenforcement agency for all applicable Inspections. I understand that a registered copy of this -Cert cate of Compljance is required to be Included with the documentationthe builder provides to the building owner at occupancy. ' Responsible Designer Name: `�5. i' '^it 9-N -D Respontri le Dessfgnen5lgnatvre: 'V` d K.✓�" �r� r��^ +` : cfamie O'tansen Hansen, Jamie Company: Date Signed: Best in the West Air Conditioning & Heating Inc 2015-04-17 11:54:32 Address: License: 31225 Plantation Dr 967982 City/State/Zip: Phone: - Thousand Palms CA 92276 (760) 343-1002 Digitallysigned by CeICERTS. 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-A0100516A-000000000-0000 Registration Date/Tme: 2015-04-17 11:54:32 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-17 11:54:48 Schema Version:0.555SDD f3fn.# U Qtr of- La Quints Itlikung 8r Safety Division P.O. Box 1504,78-495 Calle Tampico fa.Quinta, CA 92233 -:(760) 777-7012 Building Permit'Application' and Tracking Sheet Pennft Project Address: Owner's Name:. G ,. , 0 1-7 A. P. Number. -7 -75 -0-22 - Q ( z Address: 7 0/c4,5 Q rr r Legal Description: City, ST, Zip: C Contactor. '01S P' �� „ Telephone: Address: �J� j �l - �'� i1ele a I 'TGi'%Z�j Project Description: City, ST, Zip: G S r; ZpC' S SQ/� Telephone: 7(,o -3,q3 _ 100 Z. State Lia #: 9t`o % % City Lir #: Arch, Fngr., Designer: Address: City., ST, Zip: Telephone: Construction Type:. Occupancy: State Lie. #: Project type (circle one): New Add' Repair Demo Name of Contact Person: 2 (G (/,/�G {� Sq. Ft: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project (Zoo. APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal RtVd Recd TRACKING PERMITFEES- Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit. . Truss Cala. Called Contact Person Plan Check Balance 71tie 24 Calm Plans picked up Construction Flood plain plan Plans resubmitted. • Mechanical Grading plan 2' Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SAU H.O.A. Approval Phut resubmitted Grading IN ROUSE:- ''' 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