BMCH2015-021978-495 CALL TAMPICO
LA QLIINTA•,' CALIFORNIA 92253
Application Number: BMCH2O15-0219
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address:
79340 PASEO DEL REY
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby, affirm under penalty of perjury one of the following declarations:
APN:
604440062
and my License is in full force and effect.
compensation, as.provided for by Section 3700 of the Labor Code, for the performance
Application Description:
WORKMAN RESIDENCE,HVAC CHANGE OUT
`
Property Zoning:
Application Valuation:
$7,000.00
Section 3.700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
OWNER -BUILDER D CLARATION
FF
I hereby affirm under penalty of perjury that l am exempt from the Contractor's State
Applicant:
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any •
shall not employ any.person in any manner so as to become subject to the workers'
1 2015
CERTIFIED COMFORT SYSTEMS'
INC
workers' compensation provisions of Section 3700 of the Labo ode, I shall hwith
signed statement that he or she is licensed pursuant to the provisions of the ,
42-949 MADIO STREET
INDIO, CA 92201
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/18/2015
Owner:
TRACY WORKMAN
79340 PASEO DEL REY
LA QUINTA, CA 92253
Contractor:
CERTIFIED COMFORT SYSTEMS INC
42-949 MADIO.STREET
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
LICENSED CONTRACTOR'S DECLARATION
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby, affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
- I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as.provided for by Section 3700 of the Labor Code, for the performance
License Class: 20 C36 license No.: 906115
of the work for which this permit is issued:
`
I have and will maintain workers: compensation insurance, as required by
+Dates Contract
Section 3.700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
OWNER -BUILDER D CLARATION
Carrier: Policy Number:
I hereby affirm under penalty of perjury that l am exempt from the Contractor's State
I certify that in the performance,of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any •
shall not employ any.person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree -that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a:
workers' compensation provisions of Section 3700 of the Labo ode, I shall hwith
signed statement that he or she is licensed pursuant to the provisions of the ,
comply with those provisions.
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
Data; (J Applicn .:
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
permit subjects the applicant to a civil penalty of not more than five hundred dollars:
WARNING:.FAICURE TO SECURE WORKERS" PE ON COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure.is nottintendecl or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is, hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that ,
the conditions and restrictions set forth on this application.
he or she did not build on(mprove for the purpose'of sale.)'.
1. Each person,upon whose behalf this application is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose`6enefit work is, performed. under or pursuant to any permit
to construct the project. (Sec. 7044, Business and ProfessionsCode:. The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend; indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractors) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit. .
(� I am exempt under Sec. B.&P.C. for this reason
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.
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. Q.
Lender's Name:
Lender's Address:
I certify that l 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 r inspection purposes.
.', q-/%
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BSASS61473FEE. 1010000;20306
0 $100 T $0.00
BY aw 1741,
METHOD
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Total Paid forBUILDIN'iS NDARDSADMINISTRATION
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�DESCRIPTION"�
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PAID DATE -
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HVAC CHANGEOUT SPLIT -SYSTEM
101 0000=42402
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$0.00
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PAID"DATE';
HVAC CHANGEOUT -'SPLIT-SYSTEM PC
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0
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$0.00
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Total`PaidforCHANGEOUT
.: $108 78 $0.00
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PERMIT ISSUANCE
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0 $91 85.: ;r;
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�"PAID?BYf,r�
METFIOD� ,
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Total�Paid forPERMIT ISSUANCE A,J $91 85 F $0.00
#
r .
Crof La Quinta
ay
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
02 Building Permit Application and Tracking Sheet
Permit #
v1-AGtL9-o t 5
Project Address:
Owner's Name:. .
A. P. Number.
Address:
Legal Description:
City, ST, Zip:
Contractor' f r
rpk,Telephone:
Address. / ,
Project Description:
City, ST, Zip:
is
Telephone:•
State Lie. #:
City Lie'.
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone' Y
State Lie. #:
Construction Type:. Occupancy:
Project circle one): ,New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft,: # Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Pioj
APPLICANT: DO NOT.WRITE BELOW THIS UNE
N
Submittal
Req'd
Reed
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready Ior corrections
Plan Check Deposit, .
'Fuss Calcs.
Called Cant&ct Person
Plan Check Balance
Tide 24 Calcs.
Pians picked up
Construction
Hood plain plan
Plans resubmitted
Mechanical
Grading plan
Z°° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S3LL
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'i6 Review; ready for cormcdons/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description -4b KiNI&AESIDENCE HVAC CHANGE OUT,
Type: MECHANICAL Subtype:
Status: APPROVED.
Applied: 6/18/2015 EVA
Approved: 6/18/2015 EVA
Parcel No: 604440062 Site.Address: 79340 PASEO DEL_REYL ,QUINTA,CA 92253. -
Subdivision.'TR'27519 ” . Block:
L6f:-62'
Issued' '
Lot Sq Ft:,O Building Sq Ft' . 0
Zoning:
Finaledi
Valuation: $7,006.00 Occupancy:Type:
Construction Type: .
Expired;:
No Buildings 0. No."Stones 0
No Unites 0
D,etails:.HVAC'CHANGE'OUT 16,SEER /,SPLIT SYSTEM (2008 ENERGY] CARBON MONOXIDE ALARIVf(5)'TO BE INSTALLED PRIOR TO FINAL'
';�:INSPECTION: 2013,CALIFORNIA�BUILDINGCODES
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B B p 6j1
i
BSAS SB1473 FEE 101 0000-20306• 0 ' $1:00 $0:00
Total Paid for BUILDING STANDARDSADMINISTRATION
BSA: $1.00 $0.00
Printed: Thursday, June 18, 2015 10:41:37 AM . 1 of 2
- - . ` SYSTEMS -
Permit Details PERMIT NUMBER
Y
City of La Quinta
BMCH2O1l5=`0219
s
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT. REMARKS NOTES
DATE DATE
MECHANICAL FINAL** BLD
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, June 18, 2015 10:41:37 AM 2 of 2
SYSTEMS
CLTD
DESCRIPTION
_ ACCOUNT
QTY
AMOUNT.
PAID
PAID DATE
. RECEIPT #
CHECK.#
_
METHOD
PAID 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 for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT. REMARKS NOTES
DATE DATE
MECHANICAL FINAL** BLD
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, June 18, 2015 10:41:37 AM 2 of 2
SYSTEMS
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: 79-340 Paseo Del Rey I Date Prepared: 2015-06-13 1
A. General Information
CHR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one MR -ALT 02 document for each dwelling unit.
01
Project Name
79-340 Paseo Del Rey
02
Date Prepared
2015-06-13
03
Project Location
79-340 Paseo Del Rey
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
79-340 Paseo Del Rey
07
Zip Code
92253
OS
Dwelling Unit Conditioned
2008
Floor Area (ft2)
SC System
CFA served
system ar—
rye rige nt �
Installing new SC
Number of space conditioning
ln` ssstalli g
09
Climate Zone
15
30
(SC) systems in this dwelling
1
containing
system
more than 40
entirely new
unit.
B. Space Conditioning (SC) System Information11 ire* I
01
02
03
04
05
06
07'
U8
09
10
�a
_
e Is the SC's'"'
' `Inst (ling a'
SC System
SC System
CFA served
system ar—
rye rige nt �
Installing new SC
Installing �
ln` ssstalli g
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 •
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0158468A-000000000-0000
Registration Date/Time: 2015-06-13 13:31:34
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-13 13:30:25
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-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)lE and F)
O1
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 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
System 1
HP
heating
AFUE
0.78
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
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 40 ft of duct length is replaced.
-Leakage rate compliance: 515%, or15 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 >_-300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCHH--20 Duct Leakage4estmg requirements.
-Heating -only systems Air Handler/Furnace do ifioAP
Air FliMCH'23 for Refrigerant Cha�ge•MECH-25.:
and changes not requiriNA,e vercation of
Existing duct systems constructed, insulated or sealed with asbestos are exempt:from MChH=20Du Leakage Testing requiaemen�ts.
ng
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and150.2(b)lE, F)
This section does not apply to this project:
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 215-A0158468A-000000000-0000 Registration Date/Time: 2015-06-13 13:31:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-13 13:30:25
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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: /�
Hyde, Mark
l
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2015-06-13 13:31:34
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
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 design identified 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 identifiedon this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. , t IM
tea " �s d�?afv cRri
A
t . .
4. The building design features or system design features identified on.this Certificate of Compliance are consisteI'with the information,provided ther,applicable'compliarice documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval wrth this building permit application.
5. 1 will ensure that a registered copy of this Certificate ofCo�mpliance shall�be,made available with the building permit(s),issued for>the-building, and;made avallable:tothe enforcement agency for all applicable
inspections. I understand that a registered copy of this C ertificate of Com pl4ance s required to be included with the�documentationthebu built pvrovides tonthe buvildig owner at occupancy.
Responsible Designer Name: a —A
Responsible Designer Signature: V I
Hyde; Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2015-06-13 13:31:34
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0158468A-000000000-0000 Registration Date/Time: 2015-06-13 13:31:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-13 13:30:25
Schema Version: 0.555SDD