BMCH2015-006378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0063
Property Address:
78830SAN ITA DR
APN:
604163008
Application Description:
BENNYMADHO/REPLACE 16SEER/80AFUE SPLIT
Property Zoning:
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Application Valuation:
$8,500.00
Applicant:.
t ----
�,3I
ESSER SERVICES INC DBA
ESSER A
P 0 BOX 1636
CATHEDRAL CITY, CA 92235
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.: 4890466
Da�te� 3 S )5 Contractor �C. --
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner: .
GREGORY BENNYMADHO
, 92253
Contractor:.
ESSER SERVICES INC DBA ESSER
P 0 BOX 1636
CATHEDRAL CITY, CA 92235
(760)324-0550
LIC. No.: 489046
Date: 3/5/2015
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 664ork 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:
OWNER -BUILDER DECLARATION
Carrier: Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ !any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
t ----
�,3I
of the Business and Professions Code) or that.he or she is exempt therefrom and the
Date: S I Applicant:
basis for the alleged exemption. Any violation`of Section 7031.5 by any applicantfor a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
WARNING: FAILURE TO SECURE WORKERS'.COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� 1, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES. '
apply to an owner of property who builds or improves' thereon, and who.doesthe work
himself or herself through his or her own employees, provided that the improvements
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made•to the Building Official for a permit subject to
within one'year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(� I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner'of property who builds or improves .
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. , B.&P.C. for this reason
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.
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.).
tender's
Lender's
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:'.S L] Signature (Applicant or Agent), �G—�—
01 IBM
� � DESCRI?TION m A00011NTSAM r ,� .02
PAD�� DATE�s
, : ��' _ a��� PAID
BSAS SB1473 FEE 101,0000-20306',0 $1 00 $0.00
,a. <,.<K-g;:`=yt' c;Y, ...�3'
SON.� ,111, Mill, p ? � "' i y �ra i C r r saeffi W
PAID METI OD RECEIPT #N"v _
�IRTD�BY
�«k� Y � h r <W CHECK #
Total Paid forBUILDING'STANDARDS ADMINISTRATION BSAt', $100' i, $0.00 '
. .
�hDESCRIPTION :
Bill,
Ilk! :L4'4bxw _:o'�ts'
,,r'�
QTY
.�5�,,,.�-.10 �'A`:.�"i"ab'�m
.
AMOUNTS
"PAID DATE=
.e� �r a 5
T1:P:t �,.,'<:,:,Ei......:isf:S.I:.�E,-wk`a'.R$--FHf;t'L'M.-x.�..v."`.'aY.A3T`;iS v^:?uc& ?la...,+£i.,
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�PtAID $
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^'f�v*T.R.t-.5k:34.$v
HVAC CHANGEOUT-SPLIT-SYSTEM
`1010000=42402•
0
$7252
$0.00
NO :4n':F Y`ry`C {sYv=8r-"`: ter' - X i
BYE �� �,
` ry�j "$ae- H�j'fyi S�`e`,..yY''V
METHODS
IP, T #
NOT
CHECK #
CITD
., ,PAID r „. r s
? rs.s :;r: ryas e _k
10 A ,
BYE;
i
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s
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'.',�.. ,a imn s`"°.C°'.. u'� F...:�
ACCOUNT
_i �.
QTY•
?'' ?x,S°,".a.A`2L! .`.
%..'i, `Y' �'t•7,�',�,1 Fa`�ek"+ n,s¢
PAID
sem.. Y3tf:. -.;
PAID"DATE
,' .DESCRIPTIONS
re"s< ,8„..„^;.bxa,:, ' FY?•"':?e. i..&.!.D„ i<..b'i:..irt'.... rk':.a,.4 M=:-.'.
.<...,'es.. < ,:s mak.”»Ns`:.:Y.7E..r2..v. .v.ea,-u[fi..
,Y r AMOUNT_
P» °.::d�"m'9t3'i.<.J.vr ,t3'3Y.k.:.:�c4
ppg
HVAC CHANGEOUT-.SPLIT-SYSTEM. PC
101 011�-000-42600
0
-$36 2@ . ”
$0.00
t 4q a?v-�,:.zri'+
��METHOD
rH '�'R 4', . {. 4 @
a� �
-..'�iT'�' im.'i`
r„RECEIPT.#�CFiECKe#p1#``
CLTD BY
'v, aJi9h�S� k�T.,,: F�.::.. .*.?.Hve£.: 2i':�`?fl�S ('je^.91:Q:✓>A��4,�','r+�V.. 3m��,.'Sti'�
:���
t
`Total PaidforCHANGEOUT:.•�,$1087$0.00
�q 3p,�'�N' <36fi E�Cfi�`�, iz„xYv��''i{£ Y?< it �n�, �
lkix^eASi _. = �ti�G.9Sck*i,�s3f F.� & �..
ACCOUNT_
q[§ ^�{C4.� i -1 i}{ 3'�#id�F:�
AMOUNT_ "
r8°Yx: x dE£�' t”' A �.x"k":N,
: PAI D V�, Y
i. `x4"�frl".,. rvK •sF`� g
4 fD.ESCRIPTION r ::,,*
,R.~r {i� 4,.. ii—,
,
_ ;
PERMIT ISSUANCE
301-0000-42404
0
$0:00
1;� :x. {=�i.,T:k.,^`.:ig
PAID BY z.;
.r. �"m'R ;g-r+r,:::>F.,:£d
METHOD,
9*.ra„Sak-�,
g ";,�sRECEIPT #�
--- -....,rrsx'!�:iak� 5s �{'�F�` .,
#� M
:CHECK##Y
dt�'x<vGX4"..�±+4' •.°ikarak
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Total Paid'forPERMIT ISSUANCE $9185 $0:00..
Bin #
cit'y Of
Budding 8t Safety Division'
P.O. Box 1504, 78-495 Calle 7amPiC .
Permit #
La Quinta, CA 92253 -(760)'777-7012:
Building Permit A4 lication andMag:Sheet
:..:.... g..._, s PP ._
Project Address: % g & 3O ` So x» cr
Owner's Name: %i .11eah ae
A P Number:
y'
Address: '78 8.30 Sc "" ,kc, �Y
,
Legal:Description: ', _ ?tl
s City ST, Zip:�'tZZS
Lc. CA 3_
Contractor. -
S
Telephone
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Address:Project
Description: `
City, ST, Zip:
A
L C 1 bb, coo
Telephone: -J(,p_ 321-
••«:::,:::..::::.:
� �_..
t7S.90
StatcUc # y gCf (Xi(o
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Arch , Engr , Designer ... a
,
Address:: ..:
- -a
City, ST, Zip.
Telephone
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Construction Type Occupancy
:•<::..;:.:<«;:Y;:.::.;:•;F;:.F�Pro�ect
e t
type (circle oie) •New" Add'.n Alter Repair Demo
•
Name of Contact Person:
#Stones-4.
# Umts
Telephone;# of Contact Person „ _Estimated
Value of Project $ SOO_ oma?.
APPLICANT DO4NOT�NW kT—E;BELOW THIS LINE
,. s,. _..
#..
Submittal ,
Req'd
12ec'ci
t STRACICIIQC�
PERMIT+F)rrS:
?Itcin
Plan Check submitted
Amount
n.s,Calcs.
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Pia nCheckDepost
:., �..Structural
readY :orrectixvo.
Truss Calcs .
Called Contact Person .
9
Plan Check-Dalance •
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Title:24 Calcs.
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..,
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Plans resubmitted
Mechanical. .
.,.- ,.., ...
.
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:
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; Electrical
Subcontattor List.
Called Contact Person'
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GraniS -d
,. _ v
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k I'la'ns picked up :• �
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$Plans resubm�ttcd
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`IN ROUSE'
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,,
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To t ahPcrmit Ices
Description: BEN NYMADHO/REPLACE 16SEERj8dAFUE SPLIT > .
Type:. MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 3/1/2015 SKH
Approved:
Parcel No: 604163008 Site -Address: 78830 SANITA:DR LA QUINTA,CA 92253.
Subdivision>TR-23269 Block: Lot: 108
Issued:
Lot,Sq Ft: 0 Building'Sq Ft: 0 Zoning:
Finaled:
Valuation: $8;500:00 Occupancy -Type: Construction Type:
Expired:
No, Buildings:. 0. No: Stories: 0. No. Unites: 0
Details: _'_'HVAC CHANGE.OUT 16SEER/78AFUE SPLIT SYSTEM:[2013 ENERGY] CARBON MONOXIDE ALARNI(S)'TO BE INSTALLED PRIOR.TO
FINAL INSPECTION. 2013'CALIFORNWBUILDING CODES:
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gr ,. EINANCIALINFORMATION
3�1.. ,. �i �
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Printed: Thursday, March 05, 2015 1:47:07 PM 1 of 2
• .. SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PATO BY
D
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
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: .$108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
, . . , . PARFNT PROIFCTS , „
:
DOND INfORMAf ON
Printed: Thursday, March 05, 2015 1:47:07 PM 2 of 2 .
SYS TEinS
STATE OF CALIFORNIA
r
ALTERATIONS - HVAC
I'$ ~a
I's
CEC-CFIR-ALT-04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address: \
Enforcement Agency:
Date Prepared:
Permit#:
% 8' $ 30 Soar, ; � c. 1_)C
C: O�- L C- &I n iol
3 -5 i S
Equipment Type
Equipment Efficiency,
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
9 Evaporator Coil
�AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
XSetback
JK Split System
1R Condensing Unit
AR -8' (CZ 11, 14,15) Ducting
sgft
(If not already
❑ Mini Split
❑ Compressor
i to SEER
HSPFpresent
❑ R-6 (all CZ's) Plenums
must
D11 Furnace
❑ Lineset❑
EER
R-5 or R7.5) Lineset'
be installed)
❑ TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
X1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)' -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CFIR-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
1:13. All New Duds with Replacement
Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace'
CF3R: .MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' I CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS.
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5 -3T -2'/e", 3.5 to 4T -2%e", 5T -4%e"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Responsible Designer Name:
Responsible Designer Signature:
Date Signed:
License:
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Company:
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Address:
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City/State/Zip:
Phone:
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For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1'800-772-3300