BMCH2016-025678-495 CALLE TAMPICO D Tia/ 4 QUM&
LA QUINTA, CALIFORNIA 92253 COMMUNIvTY DEVELOPMENT DEPARTMENT
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BUILDING PERMIT
BMCH2O16-0256 nD a
45065 DESERT FOX DR
604280027 JUL 13 2016
BALLINAS RESIDENCE /HVAC CHANGE OUT
$6,853.00
Applicant:
TIMO'S AIR CONDITIONING & HEATING INC
72232 CORPORATE WAY
THOUSAND PALMS, CA 92276
CITY OF LA QUINTA
COMMUNITY DEPARTMENT
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.: 920062
D`a e: "?— If I ractor:
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 I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not iritended 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
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: .7/13/2016
EN BALLINAS
DESERT FOX DR
INTA, CA 92253
Contractor:
TIMO'S AIR CONDITIONING & HEATING INC
72232 CORPORATE WAY
THOUSAND PALM5,.,fA.92276. .
(760)770-4357
Llc. No.: 920062
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: �—� 3 —tc_ Aoolican .
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 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.
Date: \ � 13 � Signature-(re-((Appl cant or Age
FINANCIAL •• •
DESCRIPTIONACCOUNT 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 for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
'$0.00
PAID BY-,
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION "
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC; CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD "
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $108.78 $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
TOTALS:0•
Description: BALLINAS RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED Applied: 7/13/2016 MFA
Parcel No: 604280027 Site Address: 45065 DESERT FOX DR LA QUINTA,CA 92253 Approved: 7/13/2016 MFA
Subdivision: TR 23935-4 Block: Lot: 22 Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $6,853.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT -14 SEER/80AFUE SPLIT SYSTEM 12013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
FINANCIAL INFORMATION
Printed: Wednesday, July 13, 2016 3:09:12 PM 1 of 2 C
SYSTEMS
STATE ZIP
PHONE
FAX
EMAIL
""""' NAM IETYPE
""... NAME ............... . ................. . =
ADDRESSI
CONTACTS
CITY
APPLICANT
TIMO'S AIR CONDITIONING &
HEATING INC
72232 CORPORATE
WAY
THOUSAND
PALMS
CA 92276
(760)485-2782
CONTRACTOR
TIMO'S AIR CONDITIONING &
HEATING INC
72232 -CORPORATE
WAY
THOUSAND
PALMS
CA 92276
(760)485-2782
OWNER
CARMEN BALLINAS
45065 DESERT FOX DR
LA QUINTA
CA 92253
(760)485-2782
FINANCIAL INFORMATION
Printed: Wednesday, July 13, 2016 3:09:12 PM 1 of 2 C
SYSTEMS
INSPECTIONS
Printed: Wednesday, July 13, 2016 3:09:12 PM 2 of 2
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 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:•
INSPECTIONS
Printed: Wednesday, July 13, 2016 3:09:12 PM 2 of 2
SYSTEMS
Bin # -- — .
City of 1a . Q uih t.A.
T'eicpbone:
8
Construction Type: Occupancy:
"
_ ,� project type (circle on New Add'n Alter Repair Demo
• Building a Safety Division I .
Name of Contact Person: —:70 —7 Sq, Ft.
1
P.O. Box 15o4, 78-495 Calle Tampico .
'� O O
Tel tl,of Contact Persgn: . D -- �cf Estimated Value of Project: ct?
Permit # O IT" La Quinta, CA, 92253 - (760) 777-7012
�1 Sheet
wilding
Permit Application and Tracking
Project Address:
FA.
P. Numberner's
d ress; C�
xPgal Description:
City, ST, Zi �1��
Contractor: v
'oIePhane: ° �'
flan Ghcrk Deposit
Address:
Pro'ect DescYiption:
Truss Calcs.
City, ST. Zip: tt '�
3 �J
Telephone:
City Lic. #4
Plpn Check Balance.
State Lic. # : 00
'iitle 24 Cale;.
Arch„ Engr., Designers
Plans pickod up
d
Address:
Flood plain plan
City., ST. Zip:
T'eicpbone:
8
Construction Type: Occupancy:
"
_ ,� project type (circle on New Add'n Alter Repair Demo
.
State Lic. #: �
Name of Contact Person: —:70 —7 Sq, Ft.
# Stories:
#{ Units:
'� O O
Tel tl,of Contact Persgn: . D -- �cf Estimated Value of Project: ct?
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal Rcq'A Rec'dl 'TRAC]fCBVG PERMiT FEES
Plan Sets
Plao Chcek submitted
Item
Amount
Structural Calcs.
ReAcwtrcndy for corrcetjoas
flan Ghcrk Deposit
Truss Calcs.
Called Contact Persons
Plpn Check Balance.
'iitle 24 Cale;.
Plans pickod up
Construction
Flood plain plan
Plana resubmitted
A4cchanlc.zl
Grading plan
21 Review, ready for eorrectionslissue
Electrical
$ubeontaetor Litt
Called Contact )Person
Plumbing
Grant Dccd
Plans picked up
H.O.A.. ApproVai
Plans resubmitt&d
Grading
�.
IN HOUSE:
s,.
Revicw, ready for correctio�ssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.Y.
Pub. W4s. Appr
Date of permit issue
Sclsodl Fees
Total Pcrmit ices
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: Carmen Ballinas Date Prepared: 2016-07-12
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
Carmen Ballinas 02 Date Prepared
2016-07-12
03
Project Location
45065 Desert Fox Dr 04 Building Type
Single family
05
CA City
La Quinta O6 Dwelling Unit Name
Carmen Ballinas
07
Zip Code
92253 08 Dwelling Unit Conditioned
2468
A Floor Area (ft2)
System
SCS tem
'CIA served
"system a
Number of space conditioning
09
Climate Zone15
4 10 (SC) systems in this dwelling
1
Identification or
Location or Area
unit.
ducted
B. Space Conditioning (SC) System Information "r
Ol
02
,€ _ 03'r
A 04t
,fit
�r 1P51 W.
H
ft 071
110 U
09
10
-�{Is the St—
'Insl:alliAg a —
System
SCS tem
System
SCS tem
'CIA served
"system a
'�'"
refrigeyra�tInstallingTew'SCInstail�ng
rinstallf 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
1200
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.
V _ �
Registration Number: 216-A0258394A-000000000-0000 Registration Date/rime: 2016-07-12 17:06:15 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-07-12 17:06:33
Schema Version: O.SSSSDD
r
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 1S0.2(b)3E 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
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
gO
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Reaulred Documentation:
CF2R-MCH-01-E -Space Conditioning Systems Ducts and Fans,
-Duct Insulation requirement for new plenums: R6. 9
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 h of duct length Is replaced.
-Leakage rate compliance: 515%, or 510%leakage to outside,; or seal all accessible leaks.
MR -MCH -25-1-1 & CF3R-MCH-25-H Refrigerant Charge Ve[ificatien required when refrigerant containing components are installed or altered (applicable In CZ 2, 8-1S).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow ?.-300 CFMAon requGed when:MCH•2$ is required.
Excentlons: ryy r, �'-' ........ "111.1
-Duct systems registered with HERS provider as previously sealed are exemptfrom MCN 20 Duct Legxage Testing requirements..
-Heating-only systems and Air Handler/Furnace changes do not requlre verification"f A rl Flow irg ran Chace MCC. -ZS�
�MCH.:23,�"Ilef
-Existing duet systems constructed, Insulated or sealed with asbost s� are exemp""77tgfrom MCHO.pu4t Lokage Test ng ulsFeme is
9 k- �4 r.• �4.
E. Entirely New or Complete Replacement Duct,% -'em, wi h or withotxEquipment h ngeout ( etionsr150.2(b)3Dha•and 150.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 216-AO258394A-000000000-0000 Registration Date/rime: 2016-07-12 17:06:15 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2.013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-07-12 17:06:33
Schema Version: O.SSSSDD
• ,t
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:
Documentation Author Signature:
o1s
IQ/.�oG
Timo , Joseph
i/ '
Company:
Signature Date:
TIMO'S AIR CONDITIONING & HEATING INC
2016-07-12 17:06:15
Address:
CEA/ HERS Certification Identification (if applicable):
72-067 NORTHSHORE STREET STE A
City/State/Zip: -
Phone:
THOUSAND PALMS CA 92276
760-770-4357
Responsible Person's Declaration statement,
I certify the following under penalty of perjury, under the liws 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 Businessand 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, compo ents, and manufactured deY(ces for the building design,prsystem design Identified on this Certificate of Compliance conform to the.
requirements of Title 24, Part land Part 6 of the California -Code ofaulaons ih''sy
4. The building design features or system design features Identified this Certifleatedforrlpliance Inform
o are .tan_sLsteltwit't4he on.provided on otherapphcablecompliance documents, worksheets,
Eer�forcemant agency
calculations, plans and specifications submitted to he f eapprovat with this building Permh appiicatl6n �+
�+A xa4 tdF, !i is �{
ti
S. I will ensure that a registered copy ofthis Certificate�+�o6,t,A:ptnPllpnce shat! (utq made.;available wlth�thi buf_1.3[n8-Almit('111,,U; forahg bund!, and_ma avatlablectg„thc pnfprcement agency for all applicable
Inspections. I understand that a registered copy of tnl}Ccrttjlcate of Comp lance 0.jr qujred to b .(ncluded �yl,� theFd,�cum�rntatienAthe bre 1jer p1pyldes tq,thee hu.1'1owner at occupancy,
Responsible Designer Name: os
'0ing
Respgn3ibla Designer Sigeat re: V
w
Timo , Joseph
Company:
Date Signed: '
TIMO'S AIR CONDITIONING & HEATING INC
2016-07-12 17:06:15
Address:
License:
72-067 NORTHSHORE STREET STE A
920062
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-770-4357
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: 216-A0258394A-000000000-0000 Registration Date/Time: . 2016-07-1217:06:15 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 - Report Generated: 2016-07-12 17:06:33
• Schema Version: 0.555SDD