BMCH2016-017278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4t!t 4 4 Qums
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0172
Property Address: 79957 RANCHO LA QUINTA DR
APN: 602370002
Application Description: DOUG LES ANRONE / HVAC CHANGE OUT
Property Zoning:
Application Valuation: $5,000.00
Applicant:
ALBERT OLALDE DBA A AND G AIR SERVICES
81891 SANDY COURT
INDIO, CA 92201
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.: 743185
Dates Contractor':}�1r]sC
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 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
1 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:
Owner:
DOUGLAS ANTONE
27076 HIDDENTRAIL
LAGUNA BEACH, CA 92253
Contractor:
ALBERT OLALDE DBA A AND G AIR SERVICES
81891 SANDY COURT
INDIO, CA 92201
(7.60)342-0100
Llc. No.: 743185
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
o he work r which this permit is issued.
s+< ave and will maintain workers' compensation insurance, as required by
ctio
Sen 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. _
7571e: �' 1 A.rApplic ,ant:
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'ACKNO WLEDG EMENT
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: '� ^Signature (A p icant orAgent
K
FINANCIAL •• •
*77777-777
DESCRIPTION ., : ACCOUNT ,:`: � - ;QTY: + AMOUNT j PAID , °' p
.PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00
5/23/16
'PAID BY"... t,METHOD ; '_. RECEIPT # CHECK #-.,
t ,, x�a �'
CLTD BY,E
ALBERT OLALDE DBA A AND G AIR DEBIT R15705
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
DESCRIP.TION .. "'
Yi ACCOUNTr ,QTY3,
€wAMOUNT; `°F
E` PAID 9:;
PAID`DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$72.52
5/23/16
t .z r'' `PAID'w, P '_ ' ger;
+ .. , f METHOD s`
" "`'RECEIP,T#N .,x
' 4 ""CHECK#
d
"j CLTD BY
ALBERT OLALDE DBA A AND G AIR
DEBIT'
R15705
RSE
xx
r S . -.r
ri DESCRIPTION
r ACCOUNT. n
QTY
, g AMOUNT'
.k -�
'PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
5/23/16
_"j PAID
s
MTH0r'
.'BY
CLTDBY.
ALBERT OLALDE DBA A AND G AIR
DEBIT
R15705
RSE
Total Paid for CHANGEOUT: $108.78 $108.78
f' DESCRIPTION a
� ,ACCOLIN
QTY
x... AMOUNT"
"� �, ';PAID _."c _•
r PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
5/23/16
PAID'BY
IMETHOD',".
RECEIPT # z
g at R CHECK # Y'
'CLTD BY "
ALBERT OLALDE DBA A AND G AIR
DEBIT
R15705
RSE
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS:
9
Description: DOUGLES ANRONE / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 5/23/2016 RSE
Approved: 5/23/2016 RSE
Parcel No: 602370002 Site Address: 79957 RANCHO LA QUINTA DR LA QUINTA,CA 92253
Subdivision: TR 29457-3 Block: Lot: 4
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 ` Zoning:
Finaled:
Valuation: $5,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 - No. Unites: 0
INDIO
Details: HVAC CHANGE OUT - 16.5SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ALBERT OLALDE DBA A AND G AIR
SERVICES
FINANCIAL INFORMATION
Printed: Monday, May 23, 2016 3:48:04 PM 1 of 2
SYSTEMS
CONDITIONS
.NAMETYPE
: ,'NAME�,R '
ADDRESSI
'STATE ZIP��: ` PHONES FAX'. EMAIL
CONTACTS
CITY:a
APPLICANT
'ALBERT OLALDE DBA A AND G AIR
SERVICES
81891 SANDY COURT
INDIO
CA 92201
CONTRACTOR
ALBERT OLALDE DBA A AND G AIR
SERVICES
81891 SANDY COURT
INDIO
CA 92201
OWNER
DOUGLAS ANTONE
27076 HIDDENTRAIL
LAGUNA BEACH
j CA j 92253
FINANCIAL INFORMATION
Printed: Monday, May 23, 2016 3:48:04 PM 1 of 2
SYSTEMS
DESCRIPTION
`ACCOUNT
QTY `
AMOUNT
PAID
PAID DATE
'RECEIPT#'
CHECK#
"METHOD
PAID BY. ,,'
'
r
E;
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
S/23/16
R1570S
DEBIT
ALBERT OLALDE DBA
RSE
A AND G AIR
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$72.52
5/23/16
R15705
DEBIT
ALBERT OLALDE DBA
RSE
SPLIT -SYSTEM
A AND G AIR
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$36.26
5/23/16
R15705
DEBIT
ALBERT OLALDE DBA
RSE
SPLIT -SYSTEM PC
A AND G AIR
Total Paid for CHANGEOUT: $108.78 $108.78
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
5/23/16
R15705
DEBIT
ALBERT OLALDE DBA
RSE
A AND G AIR
Total Paid for PERMIT ISSUANCE: $91.85 7 $91.85
TOTALS:i
INSPECTIONS,;.:.
BOND INFORMATION
ATTACHMENTS
Printed: Monday, May 23, 2016 3:48:04 PM 2 of 2
CIFW.IYSTEMS
Qin #
Qty of La Q.uinto
Building St Safety Division
78-495Calle'7ampico
La Quinta, CA 92253 - (760) 777-7012
—® r"1 Building Permit Application and Tracking Sheet -
Permit#
6\ b
Project Address: S
Owner's Name: V
A. P. Number:
Address: -7
Legal Description:
City, ST, Zip: La�f I
ontract r•
Contractor:'N
Q
Telephone:
e.
Address: , , n
Project Description:
City, ST, Zip: r- . o 0,
-,, ' � v�
Te �
Telephone hone: v �
�3 0
State Lic. # :
City Lie.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
one:
xx
Construction Type:Occupancy:cy
•
State Lie. #:
P'tyPa circle one): New Add'n Alter Repair r Dem
0 toJec
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: (�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check.Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cales.
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.
I- .O.A.'Approval
Plans resubmitted
Grading
IN ROUSE:-
'"! Review, ready for corrcctionstissue
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
CF1 R -ALT -02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 )
Project Name: antone res Date Prepared: 2016-05-23
A. General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CF111-ALT-02 document for each dwelling unit.
01
Project Name
antone res
02
Date Prepared
2016-05-23
03
Project Location
79957 rancho la quinta dr
04
Building Type
Single family
05
CA City .
La Quinta
06
Dwelling Unit Name
antone res
07
Zip Code
9225308
Dwelling Unit Conditioned
1600
w_.�. 44 �
44 �.I
r"`"
AFloor
Area (ft2)
SCS stem
System
SCS stem
y
CFA served
t-\
refrigerant
Number of space conditioning
fnst'III'
09
Climate Zone
15
10
(SC) systems in this dwelling
1
1
ducted
c Mainin'
g
system
more than 40 -'entirely
unit.
entirely new
� Arn
B. Space Conditioning (SC) System Information1 f7
01
0203
;mac
04
t US
f-66107"
6*
09
10
4
k�
til FIs the SC"Installing
e
T.a s ..
a
'�` 04` d
w_.�. 44 �
44 �.I
r"`"
�Instalhng
SCS stem
System
SCS stem
y
CFA served
system a' +
3
refrigerant
,Installing.new SC
fnst'III'
Installing
Identification or
location or Area
b this SC
y
ducted
c Mainin'
g
system
more than 40 -'entirely
new
entirely new
Name
Served
System (ft 2)
system
component
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
living room
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b) 1Diib)
This section does not apply to this project.
Registration Number: 216-A0190655A-000000000.-0000 Registration Date/Time: 2016-05-23 12:47:31 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-23 12:47:33
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFI11-ALT-024
Alterations to Space Conditioning Systems (formerly CF -1R -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
10
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 gas
Gas furnace
Central split
All new
Less than or
System 1
furnace
AHU
AFUE
0.78
AC
cooling
SEER
16
Setback
equal to 40
R-8
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. i
MR -MCH -20-11 & CF311-1VICH-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: 5 15%, or15 10% leakage to outside, or seal all accessible leaks.
CF211-MCH-25-1-1 & 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 MCH -20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23; or Refrigerant Charge MECH=25
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from M6=20 Duct Leakage Testing requirements,
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections,150.2(b)lDiia and-150.2(b)1E, 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: 216-A0190655A-000000000-0000
Registration Date/Time: 2016-05-23 12:47:31
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-23 12:47:33
Schema Version: 0.555SDD
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:
1 % Q,/
Documentation Author Signature: �/J� ��
Olalde, Albert
019v e4 CGL�K�
Company:
Signature Date:
Albert Olalde
2016-05-23 12:47:31
Address:
CEA/ HERS Certification Identification (if applicable):
81891 sandy Court
City/State/Zip:
Phone:
Indio CA 92201 A
760-342-0100
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 Cod o 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 identified on this Certificate of Compliance conform to the
requirements of Title 24, Part land Part 6 of the California Code of Regulat ones
4. The building design features or system design features identified on this Certificate of Compliance are consistentwith=the information provided on other. applicable compliance documents, worksheets,
calculations, plans and specifications submitted.to the enforcement agency for ,approval iWthathis building permit application,.
is . 4 � 4 k n
5. I will ensure that a registered copy of this Certificate of,Coihpllance shall be made available with�ttie builduig•pe�mit(s);issued for,thebuilding, and matte avkiable,fo fie, gnforcement agency for all applicable
inspections. I understand that a registered copy of thls:Certificate of Complliance,is,required to be.included with the,,documeq tion the builder provides to -the building owner at occupancy.
Responsible Designer Name: Y !1!,
ti,,,; h+
Responsible Designer Signature: rE�
Olalde, Albert
CjC�( �JLIi
Company:
Date Signed:
Albert Olalde
2016-05-23 12:47:31
Address:
License:
81891 sandy Court
743185
City/State/Zip:
Phone:
Indio CA 92201
760-342-0100
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: 216-A0190655A-000000000-0000 Registration Date/Time: 2016-05-23 12:47:31 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
Report Generated: 2016-05-23 12:47:33