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 "