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BMCH2015-034878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4.4 Qumr(u COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O15-0348 Property Address: 79160 BIG HORN TRAIL APN: 776030016 Application Description: BIERSACK / CHANGE OUT (1) 14SEER CONDENSOR AND COIL Property Zoning: x Application Valuation: $3,000.00 Applicant: NJO DOVE AIR INC C.7'I 68-749 RISUENO ROAD CATHEDRAL CITY, CA 92234 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C20 License No.: 794315 Dat ` f 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).: (_) 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 ) 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: KEVIN BIERSACK 1290 CAMPEON CIR PALM SPRINGS, CA 92253 Contractor: DOVE AIR INC 68-749 RISUENO ROAD CATHEDRAL CITY, CA 92234 (760)327-1890 Llc. No.: 794315 Date: 9/3/2015 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 the work 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:. , �� Applicant: WARNING: FAILURE TO SECURE WCRKERS' 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 city to enter upon the above- mentioned property for inspection purposes. j,f�' Date: .3Signature (Applicant or Agent): z Uj o� x M rJ o2 rn y NJO n C.7'I M M 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 the work 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:. , �� Applicant: WARNING: FAILURE TO SECURE WCRKERS' 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 city to enter upon the above- mentioned property for inspection purposes. j,f�' Date: .3Signature (Applicant or Agent): FINANCIAL . DESCRIPTION ACCOUNT / QTY ` AMOUNT PAID PAID DATE 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 QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - CONDENSER ONLY 101-0000-42402 0 $36.26 $0.00 PAID BY METHOD. RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - CONDENSER ONLY PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forCHANGEOUT: $77.35 $0.00 DESCRIPTION ACCOUNT QTY 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 • 1 • $0.00 Description: BIERSACK / CHANGE OUT (1) 14SEER CONDENSOR AND COIL Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 9/3/2015 SKH Approved: Parcel No: 776030016 Site Address: 79160 BIG HORN TRAIL LA QUINTA,CA 92253 Subdivision: TR 25429 Block: Lot: 24 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $3,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: HVAC CHANGE OUT - (1) 14SEER CONDENSOR AND COIL [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT DOVE AIR INC 68-749 RISUENO ROAD CATHEDRAL CITY CA 92234 CONTRACTOR DOVE AIR INC 68-749 RISUENO ROAD CATHEDRAL CITY CA 92234 OWNER KEVIN BIERSACK 1290 CAMPEON CIR PALM SPRINGS I CA I 92253 Printed: Thursday, September 03, 2015 2:54:19 PM 1 of 2 SYSTEMS ATTACHMENTS Printed: Thursday, September 03, 2015 2:54:19 PM 2 of 2 R�SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $36.26 $0.00 CONDENSER ONLY HVAC CHANGEOUT - 101-0000-42600 0 $24.17 $0.00 CONDENSER ONLY PC HVAC CHANGEOUT - 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION HVAC CHANGEOUT - 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PC Total Paid forCHANGEOUT: $77.35 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 ATTACHMENTS Printed: Thursday, September 03, 2015 2:54:19 PM 2 of 2 R�SYSTEMS IT #14-r AIPA t 40�---S Bin # City of La Quinta Building SZ Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: -3 �362— Owner's Name: A. P. Number: Address: 5'U 2 PCtl E/ r. Legal Description: City, ST, Zip: 0 " C_ -5'b Contractor: / v Telephone: hone: Address: t YA l) Project Description: ULl A, V I City, ST, Zip: c� Telephone: / 'SS State Lic. # : City Lie. #. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: - . Construction n TY Pe: aneY Occupancy: : ic. #• Project hPa (circle le one • New Add'n Alter Repair Demo Name of Contact Person: p Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: L/!3 —113 " Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for-corrections/issue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"! Review, ready for corrcctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.1.P.P. Pub. Wks. Appr Date of permit issue scho6l Fees, Total Permit Fees WX CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: Kevin Biersack I Date Prepared: CF1R-ALT 02-E (Page i of 3 ) 2015-09-01 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 Kevin Biersack 02 Date Prepared 2015-09-01 03 Project Location 79160 Big Horn TH. 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name Kevin Biersack SC System SC System CFA served 08 Dwelling Unit Conditioned 1200 07 Zip Code 92253 Floor Area (ft2) Location or Area by this SC ducted , a . containing system Number of space conditioning entirely new 09 Climate Zone 15 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information Ito. M ir 01 02 03 c 04 kv 05. 06 07 "� _f 08 - 09 10 .. ��Is the SC i 9i ..4 "'n �wtl < Installing a Y bL IFM K "MA�.IY W SC System SC System CFA served `'tis�ystem a refrigerant 4.. ,Installing,new SC { + a . Installing I w Installing= 1 ..+ *.- Installing Identification or Location or Area by this SC ducted , a . containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? I SC system? Alteration Type Altered space System 1 Office &Bedroom 1200 Yes Yes Yes No No No 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-A6309967A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: Report Version: 2014-03-31 Schema Version: 0.555SDD 2015-09-01 08:13:24 HERS Provider: CaICERTS Report Generated: 2015-09-01 08:13:23 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) CF1R-ALT-02-E (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) rN 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 No heating This field or This field or Central split All new This field or This field or System 1 Central gas component section is not section is not AC cooling SEER 14 Setback section is not section is not furnace altered applicable applicable components applicable applicable Reauired 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%, or 510% 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 2 300 CFM/ton required when MCH -25 is required. Exceptions:' -Duct systems registered with HERS provider as previously sealed are exempt from 'MCH-20,DDuucct Leakage,Testing ke{gwrements. -Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow+MCH-23, or Refrigerant Charge MECH-2 nr- insulated or sealed with asbestos are exemptf�rom MCH 20 Duct Leakage Testing requirements. -Existing duct systems constructed, �., E. Entirely New or Complete Replacement Duct System, with or w thout Equipment Changeout (Sections 150.2(b)1Diia an J150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC) This section does not apply to this project. i Registration Number: 215-A6309967A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2015-09-01 08:13:24 Report Version: 2014-03-31 Schema Version: 0.555SDD HERS Provider: CalCERTS Report Generated: 2015-09-01 08:13:23 CERTIFICATE OF COMPLIANCE CFiR-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: Laster, Gary Company: Signature Date: DOVE AIR INC 2015-09-01 08:13:24 Address: CEA/ HERS Certification Identification (if applicable): 68-749 RISUENO ROAD City/State/Zip: • Phone: 1(760) CATHEDRAL CITY CA 92234 327-1890 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 identified on this Certificate of Compliance conform to the `_=� requirements of Title 24, Part 1 and Part 6 of the California Code of R egula ons. �� � � � �� Certificate of Compliance are the information -provided on other applicable ompliance documents, worksheets, 4. The building design features or system design features identified on this �connistent.with and specifications submitted to the enforcement agency for approval with this building permit application. calculations, plans P P 't1 4.4 �i.y� � vk �. k6! , % 5. I will ensure that a registered copy of this Certificate of,Compliance shall,be'made:available witl] the buIIdingtpermit(s),issued for,the building,and,made available,to,the4enforcement agency for all applicable �,ia. inspections. I understand that a registered copy of this Certificate of Compliance is_requiired to be included with the.,documeentationApwl�thepuilder provides to the buvilding owner at occupancy. ,ice, v v ie— Responsible Designer Name: i� .- Responsible Designer Signature:` G(lbiXJ(i Laster, Gary Company: Date Signed: DOVE AIR INC 2015-09-01 08:13:24 Address: License: 68-749 RISUENO ROAD 794315 City/State/Zip: Phone: CATHEDRAL CITY CA 92234 (760) 327-1890 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-A6309967A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: Report Version: 2014-03-31 Schema Version: 0.555SDD 2015-09-01 08:13:24 HERS Provider: CaICERTS Report Generated: 2015-09-01 08:13:23 Bin # City of La Quinta Building a 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: , o Owner's Name: e- -1 'M t Q A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Telephone: e hone: P Address: v Project Description: A City, ST, Zip: Telephone: hone: State Lic. # : City Lic. #.: 103 5 cl Arch., Engr., Designer: Address: City., ST, Zip: Telephone: n Co tructi s on Type: Occupancy: P to Ste Lic. # Project ect h'P e one): circle e . New Add' n Alter r ReA ai r Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'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 Cafes. 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 r Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' 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 W