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BMCH2016-042578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: ADAM SIMMONS P 0 BOX 314 LA QUINTA, CA 92247 c&tr44Q" DESIGN & DEVELOPMENT DEPARTMENT BMCH2O16-0425 78705 DESCANSO LN LN 646340008 MACKESEY RESIDENCE / C $6,000.00 ' BUILDING PERMIT ZAS, NOV 2 3 2016 CITY OF LA QUINTA DESIGN AND DEVELOPMENT 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 ,N,ro�..:�7880534 Vr To DECLARATION ; I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the followirg 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 th basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for 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 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 Na Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/23/2016 Owner: DAVID MACKESEY 78705 DESCANCO LA QUINTA, CA 92253 Contractor: ADAM SIMMONS P 0 BOX 314 LA QUINTA, CA 92247 (760)564-7525 Llc. No.: 780534 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9054788 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: I I & plicant:�A'Z.l ei&4i/�� 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 repre tives of this city to ent r upon the above-mentioned property for inspecti rposes. D Si •i Date: 11/23/2016 Application Number: BMCH2O16-0425 Owner: Property Address: 78705 DESCANSO LN LN DAVID MACKESEY APN: 646340008 78705 DESCANCO Application Description: MACKESEY RESIDENCE / HVAC LA QUINTA, CA 92253 Property Zoning: Application Valuation: $6,000.00 Applicant: Contractor: ADAM SIMMONS ADAM SIMMONS PO BOX 314• PO BOX 314 LA QUINTA, CA 92247 LA QUINTA, CA 92247 (760)564-7525 --------------------------------------------------------------------------------------------- Llc. No.: 780534 . Detail: HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. f s FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $38.00 Total Paid for CHANGEOUT: $114.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 Bin # Permit i Project Address: Qty of La Quinto Buiiding & Safety Division . . 78-495 Ca1fe Tampico La Quinta, CA 92253 - (760) 777-701.2 Building Permit Application and Tracking Sheet Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: r o r: Contractor: I 5 T n. ele ho e P Address: PD , • Project Description: ^ I City, ST, Zip: 9247 h ne: Telephone: P Z z 5 State Lie. # : 5�. City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone. Occupancy: Con tructi n Type: an cY• Lie. #. dd n Atter Repair. r Demo Project (circle one • New A Name of Contact Person: ' �dJ Sq. Ft.: # Stories: # Units: Telephone # of Contact Perso . Estimated Value of Project: N Submittal Req'd APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Verson Plan Check Balance. Title 24 Calcs. 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. II.O.A. Approval Plans resubmitted Grading IN IIOUSE:- '`d 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, . I Total Permit Fees CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 1 of 7 ) Project Name: David Mackesey Enforcement Agency: City of La Quinta Permit Number: 2016 Dwelling Address: 78705 Descanso Ln City: La Quinta Zip Code: 92253 A. General Information O1 Dwelling Unit Name David Mackesey 02 Climate Zone 15 03 Dwelling Unit Total Conditioned Floor 2000 ' 04 Number of Space Conditioning SC Y CFA served Area (ft2) Installing a refrigerant Installing new SC Systems in this Dwelling Unit. 1 OS Certificate of Compliance Type / ,Prescriptive alterations (CF1R-ALT) 06 Method used to Calculate HVAC Loads NotApplicableEquipmentChangeout containing system than 40 feet of entirely new entirely new SC Alteration Type 07 Calculated Dwelling Unit Sensible F Cooling Load (Btuh) This field or section is not applicable 08 Calculated Dwelling Unit Heating Load (Btuh) This field or section is not applicable ducts? duct system? system? 09 Dwelling Unit Number of Bedrooms 3 Altered space System 1 WHOLE HOUSE 2000 Yes :-,w. �F ,.:�.. �� ;rte• �-� �:�:� �� �;v� �� ,�,� ,�.....�.,. .„�„.. MCH -01b Space Conditioning Systems Ducts ariWfans - P,rescrip,W Alterations r a n K. ;. s� '�`'`?'�a.�.�A' ^r�a;;rr�•��-�.ar �.�—^nr+rs, ., : �:.sra�, -:..s �a�.�� "�w� ..;rte. ,�;-. :r_. :::,,;.,. B. Space Conditioning (SC) System Information O1 02 03 04 05 06 07 08 09 10 SCS System Y SC Y CFA served Is the SC system a Installing a refrigerant Installing new SC Installing more Installing Installing. Identification or Location or Area by this SC ducted containing system than 40 feet of entirely new entirely new SC Alteration Type Name Served" System (ft) system? component? components? ducts? duct system? system? Altered space System 1 WHOLE HOUSE 2000 Yes Yes Yes No No No conditioning system Registration Number: 216-A0397921A-M0100002A-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2016-10-25 07:19:30 Report Version: 2013 Rev 1.008 Schema Version: 2013.1.008 HERS Provider: CalCERTS Report Generated: 2016-10-25 07:16:39 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 ) C. Space Conditioning (SC) System Alterations Compliance Information 01 02 03 04 0S 06 07 08 09 10 11 12 13 Heati6_ Ynif rial Rated Heating Capacity, Name Heating Efficiency Type' `�,. � Value r -g r. Manufacturer � * ` Model Number c �,f number Output (BTUH) `C :� Central Fan System 1 " A UE 78 Trane 4TTR6061C1000A : 1621'34 F 41000 Integrated A Heating Cooling New or (CFI) System Altered Heating Minimum Altered Cooling Minimum Required Replaced New Ventilation Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Duct Duct System or Name System Type Component Type Value System Type Components Type Value Type Length R -Value Status All new System 1 Central gas heating AFUE ' 78 Central All new cooling SEER 16 Setback LTE40Ft R8 Not a CFI furnace componen split AC components system is % !, • D. Installed Heating Equipment Information',-' 01 02 - " 03 04 .05 _ 06 07 System Identification or ,^ ` Heating Effichency , Heating Umt ,! Heating Unit Heati6_ Ynif rial Rated Heating Capacity, Name Heating Efficiency Type' `�,. � Value r -g r. Manufacturer � * ` Model Number c �,f number Output (BTUH) `C :� System 1 " A UE 78 Trane 4TTR6061C1000A : 1621'34 F 41000 A Notes: Registration Number: 216-A0397921A-M0100002A-0000 Registration Date/Time: 2016-10-25 07:19:30 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance - Report Version: 2013 Rev 1.008 Report Generated: 2016-10-25 07:16:39 Schema Version: 2013.1.008 "