BMCH2014-1158t
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BMGH2O14-1158
Property Address:
79726 OLYMPIA FIELDS
APN:
775051045 .
Application Description:
HVAC CHANGE OUT=1I
Property Zoning:
IFApplication
Valuation:
$8,360.00
V�NIfCl/ mom
VOICE (760) 7.77-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777=7153
BUILDING PERMIT
Date: 12/22/2014
Owner:. .
PEDERSEN, RAYMOND M
653 SYCAMORE CR
R/-78AFUE-SPUT SVST-liM BRAWLEY, CA 922.27 .
Applicant: U D E C 2 2 2014 h Contractor:
HYDES HYDES
0 OUTSIDE CITY LIMITS CITY OF LA QUINTA 0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
LA QUINTA, CA 92253
(760)360-2200. .
Llc. No.: :LIC -0004822
---------•---------------------------------------------------------------------------
LICENSED
----=-- ----- -LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of -the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation, as provided for by Section 3700of the Labor Code, for the performance
License Class: License No.: :LIC -0004822 of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
ate: 12 ntra Section 3700 of the.Labor Code, for the perfornance of the work for which this permit
is issued. My workers' compensationinsurance 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 thai in"the performance of ne work for which this permit is, issued, 1
License Law for.the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so s s 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 Thai, 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 3-00 of t or Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the comply with th se provisions. '
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 ate: pli
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 WARNING: FAILURE TO SECURE WORK COMP ATION COVERAGE IS UNLAWFUL,
($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMIN. PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,00[). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure isnot intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR ON 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 does the 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 setforth 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 contractors) licensed pursuant to employees for any actor omission related to fh2 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 applic.-tion becomes null and void if.work is
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: 1
Lender's Address: Vim+
not commenced within 180 days from date of i°suance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and stace that the above information is.correct.
I agree to comply with all city, and county ordinances and siate'laws ,relaiing to building
construction, and hereby authorize representat-ves of this city to enter upon the above-
mentio ed property for inspection purposes.
te: nature (Applicant cr A
CERTIFICATE OF COMPLIANCE _ 1CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) - Y (Page'1 of 3 )
Project Name: 79-726 Olympia Fields Date Prepared: 2014-12-19
A. General Information .
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented; use one CFIR-ALT 02 document for each dwelling unit.
01
Project Name
79-726 Olympia Fields
02
Date Prepared
2014-12-19
03
Project Location
79-726 Olympia fields
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name.
79-726 Olympia Fields
07
Zip Code
92253
08
Dwelling Unit Conditioned
1283
Floor Area (ft2)
SC System
SC -System
CFA served
system a
refrigerant
Number of space conditioning
Installing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted_
containing
system
more than 40
unit.
. entirely new
B. Space Conditioning (SC) System'Information j° j"•J _ -
01
02
03;
04 ".:
05
j 06_
* 07 x''
�' ' O8 �"`
r� 09
10
r�
Is the SC
Installing a
SC System
SC -System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
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
Living Area
1283
Yes
Yes
Yes
No
No
No _
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project. s^_
iY
' Registration Number: 214-A0164554A-000000000-0000 Registration Date/Time:v 2014-12-19 11:53:14 HERS Provider:.CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version 2014-03-31 ! 'Report Generated`. 2014-12-19 11.53:27. ,
Schema Version: 0.551SDD
r
S.
CERTIFICATE OF COMPLIANCE •CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )'
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08 .
09
10
it
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
. All new
Less than or
System 1
furnace
heating
AFUE
0.78
packaged AC
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Required 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: <_ 15%, 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_ 300 CFM/ton required when MCH -25 is required. + -^-----"�^
f ' "'S''�"" ;r
i
Exceptions:
with HERS as eviously sealed are exempt from MCH -20 Duct Leakage;Testin ,,requirements.
-Duct systems registered provider p
"` {
-Heating-only systems and Air Handler/Furnace'changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-2S.
-20 Duct Leakage Testingre uirements.Existin duct systems constructed, insulated or sealed with asbestos areem t from MCH
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)1E, F)
This section does not apply to this project.
Registration Number: 214-A0164554A-000000000-0000- Registration Date/Time: 2014-12-19 11:53:14 -HERS Provider: CalCERTS F
CA Building Energy Efficiency Standards - 2013 Residential Compliance ReportVersion: 2014-03-31 Report Generated: 2014-12-19 11:53:27. ;
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)_ (Page 3 of 3)
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: 214-A0164554A-000000000-0000 Registration Date/Time: 2014-12-1911:53:14 ` HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-19 11:53:27
Schema Version: 0.551SDID
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Hyf1e, Mark
}moi
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2014-12-19 11:53:14
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
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 Re ulations. dd r
q g J 1 r:. 1- ! :• t.
4. 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. }
5. 1 will ensure that a registered copy of this Certificate oftompliance shall be made available with the building permit(s) issued for the building and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2014-12-19 11:53:14
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
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: 214-A0164554A-000000000-0000 Registration Date/Time: 2014-12-1911:53:14 ` HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-19 11:53:27
Schema Version: 0.551SDID
Total Permit Fees
Bin # '
City of La' Quino
Building .& Safety Division
Permit .#
P.O. Box 1504, 78-495 Calle Tampico:
�M1Lb�?Qt�• 115$
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's Name:
A P. Number:
Address: -7 —
Legal Description:
Q
Contractor: �,�
//�� // City, ST. Zip: n�-<,%
- 7
5 A•I Telephone — 27
Address: % Z � K �-
"
lCt Project Description:
City, ST, Zip: �
ACi Z Z d
Telephone: 6Cj _ ZZd
State Lie. # : q 0C
% City Lic. #: ZZ
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
5 U
State Lic. #:
Construction Type: Gccupancy:
Name of Contact Person:
Project type (circle one): New Add'n Alter Repair' Demo
Telephone # of Contact person:
Sq. Ft : # Stories: # Units:
Esti2i
mated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Rec•'d TRACMG
Plan Sets
PERMIT FEES
Plan Check submitted
Structural Calcs.
Item Amount
Reviewed, ready for corrections
Truss �l�'
Plan Check Deposit
Called Contact Person
Energy Calcs
Plan Check Balance
Plans picked up
Flood plain plan
Construction
Plans resubmitted '
Grading plan'
Mechanical
god Review,
ready for correciions/issue Electrical
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
SALL
resubmitted
IN HOUSE:-
Grading
iew,
JE
ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
A.LP.P.
Date of permit issue
School Fees
Total Permit Fees
Description: HVAC CHANGE OUT - 16SEER/78AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 12/19/2014 AOR
Approved:
Parcel No: 775051045 Site Address: 79726 OLYMPIA FIELDS LA QUINTA,CA 92253
Subdivision: TR 21846-1 Block: Lot: 4
Issued:
Lot Sq Ft: 0 Building Sq 'Ft: 0 Zoning:
Finaled:
Valuation: $8,360.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE -OUT. 4 TON 16 SEER/78 AFUE SPLIT SYSTEM, 2010 ENERGY. CARBON MONOXIDE ALARMS TO BE INSTALLED PRIOR
FINAL. 2013 CALIFORNIA BUILDING CODE.
Printed: Monday, December 22, 2014 8:35:26 AM 1 of 2
SYSTEMS
Printed: Monday, December 22, 2014 8:35:26 AM 2 of 2
• -
CR?W.1YSTEMS-
CLTD ;,
DESCRIPTION
ACCOUNT
QTY
AMOUNT
'PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY...
BY .:..
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
TOTALS:00
Printed: Monday, December 22, 2014 8:35:26 AM 2 of 2
• -
CR?W.1YSTEMS-
INFORMATION
4 " 5 DESCRIPTIONS # s ACCOUNT = ? 'r QTY AMOUNT
PAIsD' PAID'DATE
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$0.00
'',° PAID;BY�q', ` METHOD t :ke i sRECEIP.T #
CHECK # ,s j CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1:00 $0.00
yy 9e= t` 3�ta-�"x
-� .- ., DESCRIPTION ` �,, 4 �,
z..Y $ ._£
f S ACCOUNTS .. ,3 ,.:
§
QTY
E
£ AMOUNT f }
4
1oPAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY�;a�x
METHOD r -F
RECEIPT # Xr
_ CHECK #��CLTD
BY r
a DESCRIPTIONS +
_._D
µ ``rACCOUNTI
rQTY
Y( v
AMOUNT "
Y tt i;Y
PAIDPAID�DATE'
'•�aa
iYY w
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000742600
0
$36.26
•$0.00
�METHODrr
...y.
` 1 RECEIPT'CHECK
b. �.i
#
• % Y..dz . i.
CLTD BYE
Total Paid forCHANGEOUT: $108.78 $0.00
4^ DESCRIPTION"�"s x ' f
ACCOUNT„
QTY`
t AMOUNT ` `
* PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
t x ` �PAID$Y-
cMY...
METHOD
, t� F" ``��� `
,RECEIPrTS#E�x-�
CHECK #�<CLTD
BYE
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00