BMCH2017-0111f
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78-495 CALLE TAMPICO D Q.�i
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0111.
Property Address: 48150 PASO TIEMPO LN LN
APN: 646360023
Application Description: WU / HVAC CHANGEOUT 14SEER/ 80AFUE CENTRAL PACKAGED HP
Property Zoning:
Application Valuation: $4,075.00
Applicant:
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189
PALM DESERT, CA 92211
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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. C36 License No.: 977333 A
Date: cj 11 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, 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.).
(1 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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
0
N Dat 3
. >7
Owner:
THOMAS WU
841 HARVEST CIFSE
v c7) n
TUMWATER, WA 92253C:)
2253O T o
Z N
_O
Contractor: v a
A#1 SERVICES DATING & A_WCONDITIONING
78206 VARNER RD #D-189
PALM DESERT, CA 92211 m
Z
(760)565-2691
LIc. No.: 977333
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ee 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 thSwork for which this permit is issued.
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 zarrier and policy number are:
Carrier: REPUBLIC UNDERWRITERS INSURANCE- COMPANY Polity Number: ATW
+010094
_ I certify that in the performance of -he work for which this permit is issued, I
shall not employ any person in any manner sous 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 _ 700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 14 4))–1 Applicant: Su�17_
WARNING: FAILURE TO SECURE WORKERS' CC IVIPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIUAL 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. : s
APPLICANT ACKNC WLEDGEMENT
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 :he 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 cancellatior.
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: 4141 7 Signature (Applicant cr Agent)S��
Date: 4/3/2017
Application Number: BMCH2O17-0111 Owner:
Property Address: 48150 PASO TIEMPO LN LN THOMAS WU
APN: 646360023 841 HARVEST CT SE .
Application Description: WU / HVAC CHANGEOUT 14SEER/ 80AFUE CENTRAL PACKAGED HP TUMWATER, WA 92253
Property Zoning:
Application Valuation: $4,075.00 J
Applicant' Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING _ A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189 78206 VARNER RD #D-189
PALM DESERT, CA 92211 PALM DESERT, CA 92211 �
(760)565-2691
Llc. No.: 97733:
ti
---------------=----------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - 14SEER/80AFUE CENTRAL PACKAGED HP SYSTEM. CARBON MONOXIDE ALARM(S) TO B= INSTALLED PRIOR TO FINAL
INSPECTION. 2016 CALIFORNIA BUILDING CODES. '
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.. �_ FINANCIAL INFORMATION
DESCRIPTION
• •
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- PACKAGED UNIT
101-0000-42402
0
$38.00
DESCRIPTION -
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
0
$25.33
Total Paid for CHAN3EOUT: $63.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
A
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
J
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CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: Jo Wu Date Prepared: 2017-03-23
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
CF1R-ALT-02 document for each dwelling unit.
01
Project Name
Jo Wu
02
Date Prepared
2017-03-23
03
Project Location
48150 Paso Tiempo Ln
04
Building Type
Single family
05
CA City
La Quinta �4_4
.06
Dwelling Unit Name
HOUSE
07
Zip Code
92253
081
Dwelling Unit Conditioned
3265
Installing new SC
Installing
Installing
Installing
Floor Area (ft)
Identification or
Location or Area
by this SC
.;
containing
system
more than 40
entirely new
entirely new
�
ffNumber
1, 7
of Space
System (W)
09
Climate Zone
15
?10
Conditioning (SC) Systems in
1
Alteration Type
SYSTEM 1
WHOLE HOUSE
3265
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information
lowi
_
Jr -W-0
01
02
03
04 '
- 05 .__. _:
_. 06 .:. ` ?
07
08
09
10
CFA
Is the SC
�.afit"t
Installing a,! s
,;��
„ , •,
[Cttc:r.��i��
SC System
SC System
served
systema
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 (W)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOUSE
3265
Yes
Yes
Yes
No
NorNo7
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: 417-A020086983A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-03-23 16:06:28
Report Version: 2016.1:005
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-03-23 16:06:31
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)lE and F)
•01
02
03
04
OS
06
07
08
09
30
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:
Central
All new
Central
All new
This field or
This field or
SYSTEM 1
packaged HP
heating
AFUE
0.8
packaged HP
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation: r� a �4
8
CF2R-MCH-01-E - Space Conditioning Systems ,; � `s r ' .
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6 (CZ�1 10)12'and�13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H -Duct Leakage Test required when heating or cooling components are Installed inducted systems, or when more than 40 ft of duct length is replaced
-Leakage rate compliance: <=15% or <= 10% leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing comp vents are nstalled or altered (applicable in CZ 2, 8-15).
i<
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required..
Exceptions:'
ng
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Tes requirements.
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH720 Duct Leakage Testing requirements.
''±fit-•-`� #� .-..
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changedi t (Sections 150.2(b)1Diia and 150.2(b)1E, F) .
This �seci on does nrot pply to % pr(o ect.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 417-A020086983A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-03-23 16:06:28
Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-03-23 16:06:31
CERTIFICATE OF COMPLIANCE CF1111-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:
Cara Goldberg
Ccwa.Go�dl�
Company: "
Signature Date:
A#1 Services Heating & Air Conditioning
2017-03-23
Address:
CEA/ HERS Certification Identification (if applicable):
78026 Varner Road #D-189
1.
City/State/Zip:Phone:
Palm Dessert CA 92211
X760) 342-3610
Responsible Person's Declaration statement
{
I certify the following under penalty of perjury, under the laws of the State of Californla:
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'theabu.ilding design or system design identified on this Certificate of Compliance (responsible designer). .
3. That the energy features and performance specifications, materials, components, and manufactu ed 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 identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency forapproval.with this building permit application. "
5. 1 will ensure that a registered copy of this Certificate of Compliance ha6be m�d vailabl�e 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`requi�ed`to be Included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:".1 rtial'c`5w �� �
R1,vatrk ib�e Designer Signature:
Cara Goldberg
Ccwct.Goid 1Wrg,
Company:
Date Signed:
A#1 Services Heating & Air Conditioning
2017-03-23
Address:
License:
78026 Varner Road #D-189
977333
City/State/Zip: ^
Phone:
Palm Dessert (-.A 47711.
(760) 342.3610
Digitally signed by CHEERS'". 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: 417-A020086983A-000-000-0000000-0000 Registration Date/Time: 2017-03-23 16:06:28 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-23 16:06:31
Schema Version: rev 10/16