BMCH2016-0144f
TwitQ�i 642, Quillam
o
�j
78-495 CALLE TAMPICO
V
7600
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
FNSgP CTIONS
BUILDING PERMIT
D
e:
Application Number:
BMCH2O16-0144
Owner:
Property Address:
78885 PINA ST
JOHN FARKAS
�5
o_
APN:
776070003
P 0 BOX 669
ro
D
rn
Application Description:
ESCAMILLA / HVAC CHANGE OUT
FULLERTON, CA
9225
Property Zoning:
I �i
Application Valuation: $15,000.00
Applicant:
SAN'S AIRCONDITIONING & HEATING
51-530 JACKSON STREET
COACHELLA, CA 92236-2737
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 f ce and effect.
License Clas : Li nse No.: 522775 �eD
ate: Contractor
i
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 projectsmith 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
Contractor:
SAN'S AIR CONDIITIONING & HEATING
51-530 JACKSON STREET
COACHELLA, CA 92236-2737
(760)398-4287
Llc. No.: 522775
• WORKER'S COMPENSA
I hij under penalty of perjury one
e and will maintain a certifica
co oin Pqfion,as provided for by Section 37(
"for which this permit is issued.
have and will maintain workers' i
ect h 3700 of the Labor Code, for the perfc
is issued. My workers' compensation insurar
Carrier: Policy Number:
I certify that in the performance o
shall not employ any person in any manner s
compensation laws of California, and agree tl
workers' compensation provisions of Section
comply with thcggeproyYslQns.
WARNING: FAILURE TO SECURE WORKERS' C(
AND SHALL SUBJECT AN EMPLOYER TO CRIMI
ONE HUNDRED THOUSAND DOLLARS ($100,0
COMPENSATION, DAMAGES AS PROVIDED FC
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOI
IMPORTANT: Application is hereby made to th
the conditions and restrictions set forth on thi:
1. Each person upon whose behalf this appli,
request and for whose benefit work is perforrr
issued as a result of this application ,.the ownE
shall defend, indemnify and hold harmless the
employees for any act or omission related to tl
following issuance of this permit.
2. Any permitissued as a result of this applic
not commenced within 180 days from date of
work for 180 days will subject permit to cancel
I certify that I have read this application and s
I agree to comply with all city and county ord
construction, andI�grebuftohroirnizegresent
above-mentio oon
Dial
777-7125
777-7011
,777-7153
ON DECLARATION
the following declarations:
of consent to self -insure for workers'
of the Labor Code, for the performance
npensation insurance, as required by
ance of the work for which this permit
carrier and policy number are:
e work for which this permit is issued, I
to become subject to the workers'
if I should become subject to the
0 of the Labor Code, I shall forthwith
1PENSATION COVERAGE IS UNLAWFUL,
%L PENALTIES AND CIVIL FINES UP_ TO
). IN ADDITION TO THE COST OF
IN SECTION 3706 OF THE LABOR CODE,
Building Official for a permit subject to
application.
ation is made, each person at whose
!d under or pursuant to any permit
, and the applicant, each agrees to, and
:ity of La Quinta, its officers, agents, and
e work being performed under or
becomes null and void if work is
ice of such permit, or cessation of
that the abov information is correct.
ces and stat aws relating to building
s of this toj�rtter uvorrMe
l i ® • i
,�_.bD'iESCrR,s?cI.P:, Txn5IO:..v.fi�Esr, zF
ADKN.'M aa�'� DrAyTa.E�'E
mw
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
..jS4i4.:::'.
v.R?NECK #'� 1;-
+T..n`ti°.'4W`,:�'o`S,r✓..2� `asg..a{? i,":.�'z."'"sa.,,n, .. is-'F2nv:aXa�,,`i'e'Y.„'$,'.S.r�S?'"".+3,.i.,i„''".w-'.:G',. .,X.°ai�l55ka,Y%S..vEtii::. �wcn.'�f..xaW"3
Total Paid for BUILDING' STANDARDS ADMINISTRATION,BSA: $1:00 $0.00(
';DESCRIP,TION�F.
ACCOUNT �QTYAMOUNT,
gi
�_.�,.�
,{....
- r ,.PAID
PAID DATE'
HVAC CHANGEOUT - SPLIT -SYSTEM:
101-0000-42402'!
0
$72.52
$0.00
eA TSS'G`.. b ....- S ''s,`. 6 f75 �` "$ °_4.. i f�: -`{i
?{� > f {'�"�kg`,
.-��� PAID,BY�
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METHOD��-Eg�RECHPpT�#�147
.'z .er..
{
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J� ....°'RC&„-+:,A.Will'
.d'sls_,...va�.�aLw,.�atL��-..,.. .Y. .:. ...�el
SK.i"1"1 %9,..'YN..
, 3
CHECK#;�CLTDB�gY�
,"macfiF'�=F4k'...x{`i•,.✓`.(„'�'.�x..i$Csk.
i -n_ i� "1 ..
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W.Y.,7S4'raF':
55'�.Wr-',.»aFt.
,: q �_. DESCRIPTIONS a.� ��
.,. '' ._ s'A' `,iE +,. #.�� ': ;� - ?
ACCOUNT � < <
:,`''�r,.,.�'. s S.3r.....'a.''"'°ti.:.$.�'=."�.F`5"r�'.4,'1
r -w {'o "w:
QTY
:c'3e,§"wmyut '.4.. :, P
AMOUNT `"
.5... Fc4s[K<::.'Y;'�;.tiEtiikxY.{a. .., ='.��
r ,.. +.t ..d qfP +' 2 ?
. AIDS.% ,
,....XaY4kY.-EE:..'S•r1v:
'N
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
: 0
$36.26
$0.00
B2S�Y'
mg
_.W"R. k"
_ k°P" .iVie,,����w� . a
'��
+pF3�:, �b"v?�{` v'��,"� a%�%SRCFi'E',[Ck,H. E«,..,.EI...+.tPtfrrwTin �y'`#�S�..'�,i::h-',�:,;;he,���{
Pg-��NiE`my4�ayfi�aa.� C?Y,� H@A✓',E. L-r(zl# �,:
s
�3PC.5SL"1,fT._Y,D?{�y_`W�
BskYz.�S 1.:
Total Paid for'CHANGEOUT.
.$108.78 ? $0.00
" E DESCRIPTIONS
t94§.� `{-{#u
ACCOUNTn
ea`#' ka,
QTY
'... �� �.e"*g'�'xt "�zsr�t. t.; ..Y kt
jAMOUNT.,
'^"` saR3:•�ie?' a`�x
PAID
.'���'�i,i �C".�*.,
PAS DATE
PERMIT ISSUANCE
101-0000=42404
'0
$,91:85
$0.00
*E�."'�
'a''b.S�;��"';�"�`a":�5�:d{.,Ys,,'{."8.v+.u:.xs'uvi'caraY�:(.s%afiatn. s`. .,.`S,F(.�G>���.-',S.�a
.4*. ea4sw {' �,slda'"• ��. 7,`?.�3p>£. a@S�,}M.Cm�°. SEi'-ruhT._�.L'a3�Y�f.(O. f.4a�cD«' ' s`l.. d�:<?:.A'`Y"'e��i?^!iR, yCW
�'�i . �v�,"cA'�w, {.r'�
fC-'�.R..'%{.�E"";:ECla�.�w`eTti4,�#. Y+.. �'`e<.,.w. .f.^,.:w.•�Y. „a�.f
EIP'b01
:XPYsMEMO
i�C�AU
Total Paid for PERMIT ISSUANCE $91 85 $0.00
ROOM
0
\Y 0
Z
cs'yoF::�a;F9
Description: ESCAMILLA / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 5/6/2016 SKH
Approved:
Parcel No: 776070003 Site Address: 78885 PINA ST LA QUINTA,CA 92253
Subdivision: TR 24890-4 Block: Lot: 55
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM (2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
FINANCIAL INFORMATION
Printed: Friday, May 06, 2016 11:04:24 AM 1 of 2
' S YSTf MS
DESCRIPTION
ACCOUNT
QTY
AMOUNT'
PAID
PAID DATE
RECEIPT :#:
CHECK #
METHOD
PAID BY 7
CLTD
.. ..,
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
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 for CHANGEOUT: $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
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Friday, May 06, 2016 11:04:24 AM 2 of 2
SYS7EIviS
Bin #
City of. La Quin, ia
Building.Bt,Safety Division .
Calle Tampico
La Quinta, CA 92253.- (760) 777-7012
- Building Permit Application and Tracking.Sheet
Ie n
Permit i#78=495
Project Address: ,•
7�}
Na
Ow ner's me y
A. P. Number:
Address' '
Legal Description: -4
C.ST ?Zip ` d�f�
Contract or: S
�
Te h ri "
Ie P o e:
Address,,, I sa&
Project Description:'
City, ST, Zip:
TeleP h0 ne-
State Lic. # :
City Lic. #:
6
Arch., Engr., Designer:
Address:
City., ST, Zip: .
Telephone:
one:
:Co-nstruction Type: Occupancy:
:
a..
S t to Lic. #
r't type (circle one • New Ad d'ri Alter Repair Demo
Name of Contact Person:#Stories:
#. Un'ts:
Telephone # of Contact Person:
Estimated Value of Project: '
APPLICANT: DONOTWRITE BELOW:THIS LINE
9
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 Calcs.
Plans picked. up
Construction
Flood plain plan
Plans resubmitted'
Mechanical
Grading plan
2"d Review, ready for correctionsrisiue.-Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up :i
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN If OUSE:-
'"! 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
STATE OF CALIFORNIA
ALTEkATIONS - HVAC
CEC-CF 1 R -ALT -04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Add re
Enforcement Agency:
Dae repa d:
Permit#:
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset.
C nditi ned
Thermostat
/y
Required R -value
Floor Area (sq ft)
❑ Pa d System
❑ Evaporator Coil
D
49
COP
❑ R-6 (CZ 2; 8-13) Ducting
Served by system
❑ Setback
plit System
13 Condensing Unit
❑ R-8' (CZ 11, 14, IS) Ducting
sgft
(If not already
❑ Mini Split
❑ Compressor
SEER
HSPFpresent
❑ R-6 (all CZ's) Plenums
must
❑ Furnace
❑ Li et
EER
❑ R-5 or R7.5) Lineset
be installed)
W'XV
_
,
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
❑ 1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CFIR-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or< 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos.(list manufacture date of building 1
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CF1R-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS,.MECH-(23 or 24) -HERS', MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS.
Installer Requirement: Dud leakage < 6%, Fan Efficacy
(.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CF111-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Dud leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from dud leakage testing if: 111. Existing dud systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage L15% or,: 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between Floors etc.
' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
Ducts ' All New is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5 -3T -2W, 3.5 to 4T -2Y.", 5T-4%"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code.to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. That the energy features and performance specifications, materials, components, 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 CCR.
S. 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 for approval with this building permit application.
Responsible Designer Name:
Responsible Designer Signature:
Date Signed:
License:
Company:
Address:
City/State/Zip:
Phone:
f
7
Forassistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
714.