BMCH2016-0332c&4 78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253. DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0332
Property Address: 54015 AVENIDA JUAREZ
APN: 774193013
Application Description: BLAKLEY / HVAC CHANGE OUT
Property Zoning:
Application Valuation: $7,300.00
VA
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
JACK BLAKLEY
Applicant: Contractor:
AIR EXPERTS AIR CONDITIONING & HEATING AIR EXPERTS AIR CONDITIO
84-160 MEADOWS LANE 84-160 MEADOWS LANE
COACHELLA, CA 92236 j COACHELLA, CA 92236
(760)397-3438
Llc. No.: 1008665
Date: 9/1/2016
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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.: 1008665
Dat ' 167 Contractor-.�
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 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 Address:
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 t e work for which this permit is issued.
12 , 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: NORGUARD INSURANCE COMPANY Policy Number: LUWC739940
_ 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 th abor Code, I shall forthwith
comply with those provisions.
D�:/ L/ Applican
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 relatin to building
construction, and hereby authorize representatives of this city to enter n the above-
mentioned property for inspection purposes.
Date: -4` �' Signature (Applicant or Agent.):
C
Date: 9/1/2016
.Application Number: BMCH2016-0332
Owner:
Property Address: 54015 AVENIDA JUAREZ
JACK BLAKLEY
APN: 774193013
Property Zoning:
1
Application Valuation: $7,300.00
Applicant:
Contractor:
AIR EXPERTS AIR CONDITIONING & HEATING
AIR EXPERTS AIR CONDITIONING & HEATING
84-160 MEADOWS LANE
84-160 MEADOWS LANE
COACHELLA, CA 92236
COACHELLA, CA 92236
• (760)397-3438
--------------------------------------------------------------------------------------------
Llc. No.: 1008665
Detail: HVAC CHANGE'OUT - (1) 16SEER/7.7HSPF SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALA.RM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2023 CALIFORNIA BUILDING CODES.
r
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
$72.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
Total Paid for CHANGEOUT: $108.78
DESCRIPTION
ACCOUNT •
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
Total Paid for PERMIT ISSUANCE: $91.85
w
Bin '#
Permit #
Project Address:
City of La Quito
Buildinb 8i- Safety Division
78-495 Cafie Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
C9I Q 2 2- 3
Contractor:
S
Tlehone.•
e —
P
Address:�
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Project Description: C 1 �
City, ST, Zip:
�
�'Z2 2�l
Telephone: C7
7-34133
Gv�
State Lic. # :0(�
6 6S'
City Lic. #;
Arch., Engr., Designer:
-Address:
City, ST, Zip:
Telephone:
CctiYPe: lU
nOccupancy:
State a ic. ,.
t L . •
ProJectype (circle one): New Add'n Repair r Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
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 HOUSE:-
Jrd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. \Vks. Appr
Date of permit issue
School Fees,
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
BLAKELY I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2016-08-31
A. General Information
CF113-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
BLAKELY
02
Date Prepared
2016-08-31
03
Project Location
54-015 AVENIDA JUAREZ
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
BLAKELY
07.
Zip Code
92253
08
Dwelling Unit Conditioned
1370
nstalling
I sn tailing
.Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
' system
Number of space conditioning
entirely new
09
Climate Zone
15
10
(SC) systems in this dwelling
1
I component?
components?
I feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Informationty
.01 -
02
03 .rte
041
05_ '+
06
07' LL
08
09
10
'�Is the SC
Installing a
SC System
SC System
CFA served
system a
r f ige ar nt "
•Installing ne SC
nstalling
I sn tailing
.Installing
Identification or
Location or Area
by this SC
ducted
containing
' system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
I component?
components?
I feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
.
- 1370
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 216-A0325516A-000000000-0000
Registration Date/Time: 2016-08-31 20:54:32
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-08-31 20:54:47
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)3E 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 split
All new
Central split
All new
This field or
This field or
System 1
H('
heating
HSPF
7.7
HP
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
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: 5 15%, or:5 10% 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 a 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Dud Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23 or Refrigerant Charge MECH=2L 5'
Existing duct systems constructed, insulated or sealed with asbestosware exempt from MCH -'2 rDuct4Leakage Testing rgguiments.
i4r '�''�-'� mow. -ay„,' t"- "' •.•-a.:•r .�.,..,.,:-n ...., .„;,.. Bks. n.:.a�' (4.j K. w ..i. ;.::r,-.-�• ,`
E. Entirely New or Complete Replacement Duct System, with or without,Equipment Changeout (Sections,150.2(b)iDiia.and 150.2(b)1E, F)
t*- . � *lp ;i 1 %7 i
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-A0325516A-000000000-0000 Registration Date/Time: 2016-08-31 20:54:32 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-08-31 20:54:47
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CERTIFICATE OF COMPLIANCE CF111-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:
Lira, Luis M
Company:
Signature Date:
Air Experts Air. Conditioning
2016-08-31 20:54:32
Address:
CEA/ HERS Certification Identification (if applicable):
PO Box 94
City/State/Zip:
Phone:
La Quinta CA 92247
1760-777-1724
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 forthe building design orsystemdesign identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of�R�egulatlons �
���'� �
��'°`
ax:m� . �-�,
4. The building design features or system design features identified on. his Certificate of Compliance are consistent wlth�"the information.provided on other applicable compliance documents, worksheets,
L.
-. ;i Y1
calculations, plans and specifications submitted to the enforcementagency for� }approval•with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of.Compliance shall.be;male,available with.the building permit(s), for the building, and made avail able.tolthe, enforcement agency for all applicable
inspections. I understand that a registered copy of thls Cert ficate of Compliance is required to be included with the documentation �the biillder provides to the building owner at occupancy.
Responsible Designer Name: Sk - ..+
Lira, Luis M
Responsible Designer Signature:
s(��•
Company:
Date Signed:
Air Experts Air Conditioning
2016-08-31 20:54:32
Address:
license:
PO Box 94
1008665
City/State/Zip:
Phone:
La Quinta CA 92247
760-777-1724 .
Digitally signed by Ca/CERTS. 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: 216-A0325516A-00000000020000 Registration Date/Time:, 2016-08-31 20:54:32 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance .Report Version: 2013 Rev 1.008 Report Generated: 2016-08-31 ' 20:54:47
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