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BMCH2015-018878-495 CALLE TAMPICO D VOICE (760) 777-7125 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/28/2015 Application Number: BMCH2O15-0188 Owner: Property Address: 48610 CAPISTRANO WAY STEPHEN MAITA APN: 646390034 _ Property Zoning: z Application Valuation: $4,000.00 0 { T A Applicant: Contractor: ADAM SIMMONS ADAM SIMMONS z g N Z C5 PO BOX 314 PO BOX 314 �D y LA QUINTA, CA 92247 LA QUINTA, CA 92247 z (760)564-7525 Llc. No.: 780534 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 License No.: 780534 �_I Date: r Contractor: �1�/y t Yl//�ifiLr�r 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).: (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 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 th w rk 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 37 of the 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 cityenter upon the above- mentioned property bove•mentionedproperty for inspection purposes. J& 14�w� Date:/� Signature (Applicant or Agent DESCRIPTION PAID PAID DATE FINANCIAL INFORMATION ACCOUNT CITY AMOUNT 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,,, CITY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK `# CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY i i i Total Paid forCHANGEOUT: $108.78 $0.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 • •• Description: MAITA / CHANGE OUT (1) 13SEER/80AFUE SPLIT SYSTEM Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 5/28/2015 SKH Approved: Parcel No: 646390034 Site Address: 48610 CAPISTRANO WAYLA QUINTA,CA 92253 Subdivision: TR 27840 Block: Lot: 119 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $4,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC CHANGE OUT - (1)13SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. Printed: Thursday, May 28, 2015 4:53:44 PM 1 of 2 CN?W SYSTEMS CHRONOLOGY CONDITIONS NAME TYPE NAME- ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT ADAM SIMMONS P O BOX 314 LA QUINTA CA 92247 CONTRACTOR ADAM SIMMONS P O BOX 314 LA QUINTA CA 92247 OWNER STEPHEN MAITA 210 MARKET ST NO 301 KIRKLAND WA 92253 Printed: Thursday, May 28, 2015 4:53:44 PM 1 of 2 CN?W SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD 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 for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:• 00 ATTACHMENTS Printed: Thursday, May 28, 2015 4:53:44 PM 2 of 2 CRWSYSTEMS Qin # .0ty, Of La Quinta Building 81: Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: (b Owner's Name: A. P. Number: Address: �' Legal Description: City, ST, Zip: Contractor: r• o . Telephone: Address:06)r- 31Project Description: Ct�r G City, ST, Zip: ]� z 3 L Tele o h n e P ZSY State Lic. # : City Lic. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: one: ....................................................... Occupancy: �ConstructionTYPe: cY State Lic. # P oJect type (circle one • New Add'n Alter Repair ait Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Perso 4p Estimated Value of Project: vZ3>�J •�� APPLICANT: DO NOT WRITE BELOW THIS LINE H Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates. 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 Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3 H 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 CF -IR -ALT -HVAC) (Page 1 of 3 ) Project Name: Steve Maita I Date Prepared: 2015-05-18 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 CF11R-ALT 02 document for each dwelling unit. 01 Project Name Steve Maita 02 Date Prepared 2015-05-18 03 Project Location 48610 Capistrano 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name Steve Maita 07 Zip Code 92253 2 08 Dwelling Unit Conditioned 1000 are Wa Floor Area (ft2) SC System CFA served ay stem a refri BrantInstallin g f g, new SC Number of space conditioning nstallin g 09 Climate Zone 15: ''. '4 10 (SC) systems in this dwelling 1 con system more than 40 entirely nen► unit. B. Space Conditioning (SC) System Information •' 01 02 03 04 - 05 `063 07 69' 09 10 Is the SC a Installing a are Wa SC System SC System CFA served ay stem a refri BrantInstallin g f g, new SC Installin g nstallin g Installing g Identification or Location or Area by this SC ducted con system more than 40 entirely nen► entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 whole house 1000 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: 215-A0131624A-000000000-0000 Registration Date/Time: 2015-05-18 10:10:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-05-18 10:08:06 Crhamn Vaminn• n Srrrrnn CERTIFICATE OF COMPLIANCE CF111-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) - - 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 Duct 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 Required Documentation:. CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fan�s"� -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 inducted systems, or when more than 40 ft of duct length is replaced. -Leakage rate compliance::5 1590, or <_ 10'0 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). 77— CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flo 300 CFM/ton required when MCH -25 is required. Exceptions: '" ... -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. . -Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23 or Refrig ant Charge Iv* -25 nr-. -Existing duct systems constructed, insulated or sealed with are exempt » _ from MCH -20 Leakage Test g requirements. I '.� y. fi_ _��•� •`ref: '�R'dw.a.+m'a�. .. wnr""'4'° :!m& na+.4s"`.. 2 .px,. :w..' xaw e..+uV^' •M• a ,aFpt eYo, 0"1.,. 06� t X 0"446 r1ft r1%2 E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(0)iDiia and 150.2(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-A0131624A-000000000-0000 Registration Date/Time: • 2015-05-18 10:10:33 CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Cchoma 1/orcinn•!1 CSCCfIr) HERS Provider: CalCERTS Report Generated: 2015-05-18 10:08:06 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: �,�� Bachus, Tom Company: Signature Date: MLC Building Performance 2015-05-18 10:08:07 Address: CEA/ HERS Certification Identification (if applicable): 77825 Delaware Place City/State/Zip: Phone: Palm Desert CA 92211 tri 760-836-0066 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the�laws of the State of California: 11 1. The information provided on this Certificate of Compliance is true and correct. :_._. the 2. 1 am eligible under Division 3 ofBusiness 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, com o�nents, and manufactured devices for the building design or system desn identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and paM6 6 of the California C de of Regulations.APMNNW Ar 1 4. The building design features or system design features identified w1his Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, iawc� on - .. —I wm� Ong calculations, plans and specifications submitted to theorcement agency for approval with this building permit ap lication. :. � as � . 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permits issued for Lhe building, and made available to the enforcement agency for all applicable ..... ........ .... ..�..aan ........ ... ....... N, 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 Desig er Signature: V 11 -- Simmons, Donna Company: Date Signed: ADAM SIMMONS 2015-05-18 10:10:33 Address: License: 54440 AVENIDA CARRANIA 780534 City/State/Zip: Phone: LA QUINTA CA 92253 (760) 564-7525 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-A0131624A-000000000-0000 Registration Date/Time: 2015-05-18 10:10:33 HERS Provider: CaICERTS. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-05-18 10:08:06 Crhomn \/aminn• n SSSCrIr)