BMCH2015-024678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T,iht 4 lwQu&ro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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.: 985406 ,.
Date: -Z L//J 2 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
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, 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 forsale. 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.dia 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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760)777-7011
INSPECTIONS'(760) 777-7153
Date: 7/2/2015
Owner:
HOUSING AUTHORTY OF CITY OF
P 0 BOX 1504
LA QUINTA, CA 92253
Contractor:
GREENUP AIR CONDITIONING AND H
P 0 BOX 7431
LA QUINTA, CA 92248
(760)771-2920
Llc. No.: 985406
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of Uie 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: _ Policy Number: _
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: / Z Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM?ENSA OVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINA_ 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 applica-rion 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 thework 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 Vthin 180 days from date of issuance of such permit, or cessation of
work for 180 days vM 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 ordina.ues and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned
bove-
mention dproperttyjfor inspection purposes.
Date: / Signature (Applicant or Agent):
Xpplication Number:
BMCH2O15-0246
Property Address:
53880 AVENIDA NAVARRO
APN:
774175007
Application Description:
CITY OF LAQUINTA
Property Zoning:
Application Valuation:
$5,885.00
Applicant:
GREENUP AIR CONDITIONING AND H
P 0 BOX 7431
LA QUINTA, CA 92248
T,iht 4 lwQu&ro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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.: 985406 ,.
Date: -Z L//J 2 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
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, 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 forsale. 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.dia 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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760)777-7011
INSPECTIONS'(760) 777-7153
Date: 7/2/2015
Owner:
HOUSING AUTHORTY OF CITY OF
P 0 BOX 1504
LA QUINTA, CA 92253
Contractor:
GREENUP AIR CONDITIONING AND H
P 0 BOX 7431
LA QUINTA, CA 92248
(760)771-2920
Llc. No.: 985406
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of Uie 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: _ Policy Number: _
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: / Z Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM?ENSA OVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINA_ 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 applica-rion 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 thework 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 Vthin 180 days from date of issuance of such permit, or cessation of
work for 180 days vM 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 ordina.ues and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned
bove-
mention dproperttyjfor inspection purposes.
Date: / Signature (Applicant or Agent):
FINANCIAL INFORMATION
:DESCRIPTION ' Y" p ' L sQTY " ",s`AMOUNT=4 z PAID z `'' PAID DATE
,ACCOUNT
BSAS SB1473 FEE 101-0000-20306
0
$1.00
$0.00
PAID BY 3 METHOD
t ;RECEIPT # �Ai
h' CHECK # ` ;CLTD BY"
Total'Paid for BUILDING STANDARDS 'ADMINISTRATION BSA '$1.00 $0.00
-DESCRIPTION ��= ��� �`� �
Y�� s x�ACCOUNT �' �
9ygT.
AMOUNT'
PAID � � *�
+PAID„DATE.
4 '-3yb Fes. <i -hX` �
ori, ek 3l {,j
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
$�i PAID BY'r F�
”, METHODS
y ::RECEIPT #�
CHECKS
CLTD BY
.
g� DESCRIPTION,
A000UNT
QTY
§'
AMOUNT k
PAID � rt
`PAID DATE
a.
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0.
$36.26
$0.00
" � - PAID>BY
,E METHOD t
#a f
f g 5CHECK #
CLTD BY '
. a
K x:YRECEIPT
Total Paid forCHANGEOUT: $108.78 $0.00
,;DESCRIPTION':
*_,n'
s"qTY
AMOUNTs,s
PAID
PAID;DATE.
xf
; 4�ACCOUNT
t:`
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD " ��
RECEIPT#k. z
CHECK#
CLTO BY
j.
P f
;
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 00
Bin #
City of La Qulnta
Building 8'r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
bMC 0 201
Project Address: �3�0� �( Q UvQV�i��
Owner's Name: C� Lc'--Q'k� (* Q
A. P. Number:
Address: 53g$ O V Qn0 a- 1 VQVck-v-,r(---)
Legal Description:
City, ST, Zip: L-wQ Lk -"t n+ck- a 3
l,
Contractor:GQ en Lkp p IC -A N e -0J,
Telephone: -7W-7 _
<.
Address: R0 , Go>c— -14 -3 t
Project Description: 1 lie f.'
C ^ Q f
City, ST, Zip: l_1.J� Q�nf0.- - I ?Dq
Telephone: _ /
State Lie. # :
City Lie. #;.0
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
ep
:;:::;::::::>:->; :<<?z:3s•>.::>:=>>:<z:
't?i•:v: is
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Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n 'Alter Repair Demo
Name of Contact Person: kJr� 1(ee n
S Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plaa Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
M HOUSE:-
'"' Review, ready for correctionstiissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fee
Description: CITY OF LAQUINTA
Type: MECHANICAL Subtype:
Status: APPROVED
Applied: 7/2/2015 EVA
Approved: 7/2/2015 EVA
Parcel No: 774175007 Site Address: 53880 AVENIDA NAVARROLA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 251
Lot: 16
Issued:
UNIT 23
Lot Sq Ft: 0 Building Sq Ft: 0.
Zoning:
Finaled:
Valuation: $5,885.00 Occupancy Type:
Construction Type:
Expired: -
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: HVAC CHANGE OUT. -14 SEER /SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CONDITIONS
Printed:. Thursday, July 02, 2015 10:26:45 AM 1 of 2
CRWIMEMS
N
w
777777
DESCRIPTION,.
J
BY
MECHANICAL FINAL"
BLD
HVACCHANGEOUT-
101-0000-42402
0
$72.52
$0.00
SPLIT-SYSTEM
HVACCHANGEOUT-
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
Tota.1 Paid for PERMIT ISSUANCE: $91.85 $0.00
N
w
PARENT PROJECTS
`
. '
`
Phnted:.Thuraday July 02, '1S1O:Z6�SAw1 2nf2 '
____-_-- ----
MECHANICAL FINAL"
BLD
PARENT PROJECTS
`
. '
`
Phnted:.Thuraday July 02, '1S1O:Z6�SAw1 2nf2 '
____-_-- ----
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: City of La Quinta Date Prepared: 201S-07-01
A. General Information
CFIA-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be -
documented, use one CHR -ALT -02 document for each dwelling unit.
01
Project Name '
City of La Quinta
02
Date Prepared
2015-07-01
03
Project Location
S3880 Avenida Navarro
04
Building Type
Single family
OS
CA City
La Quinta
06
Dwelling Unit Name
City of La Quirita
07
Zip Code
92253
08
Dwelling Unit Conditioned
1434
new SC
Installing i
Installing
)astaIling
Floor Area. (ft2)
Identification or
Location or Area
by this SC
.ducted
containing
Number of space conditioning
more than 40
09
Climate Zane
15
10
(SC) systems in this dwelling
1
system?
component?
components?
feet of ducts?
unit.
SC: system?
B. Space Conditioning (SC) System Information 19taxa
-eu
01
02
03
04
'�O!�
Z-166 `
° 67'
1p 68 '
09
10
els
the SC
Installing a
SC System
SC System
CFA served
system a`-
Mee antInstalling
new SC
Installing i
Installing
)astaIling
Identification or
Location or Area
by this SC
.ducted
containing
system
more than 40
entirely new
encirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC: system?
Alteration Type
only system
complete home
1434
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1SO.2(b)1Diib)
This section does not apply to this project.
Registration Number: 21S-AO180037A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
I
Registration Date/Time: 2015-07-01 16:14:59
Report Version: 2014-03-31
Schema Version: O.SSSSDD
HERS Provider: CaICERTS
Rep.rt Generated: 2015-07.01 16:15:14
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -SR -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)SE and F)
01
02
03
04
OS
06
07
08
09
10
11
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
All new
This field or
This field or
Central split
Central split
only system
Fancoil AHU
HSPF
8.2
cooling
SEER
14
Setba.k
section is not
section is not
HP
HP
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 & MR -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 s replaced.
-Leakage fate compliance: <_ 15%, or 5 10-A leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF311-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in C2 2, 8-15).
CF2RCF3R-MCH-23 & CF3R.MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions: :LX H- ti ,Tesstin •equine
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct leakage Test ng r,`e�qu rements. fi
..@t°f'
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH,23 or Refrigerant Charge,MECH 2i.
1
duct insulated DucCLeakage Testing
-9.41
Existing systems constructed, or sealed with asbestos`afe exempt,from MCH 20 regmrements. z ?;�
a.
E. Entirely New or Complete Replacement Duct System, with or withouY_Equipment Changeout"(Sections 150 2(b)lDiia andtl58.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 1S0.2(b)1C) .
This section does not apply to this project.
Registration Number: 215-A0180037A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-07-01 16:14:59 HERS Provider: CaICERTS
Report Version: 2014-03-31 Report Generated: 2015-07-01 16:15:14
Schema Version: 0.555SDD
-ERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
%Iterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
OrianoCreeny
Greenup, Brian
Company:
Signature Date:
GREENUP AIR CONDITIONING AND HEATING
2015-07-01 16:14:59
Address:
CEA/ HERS Certification Identification (if applicable):
P O BOX 7431
City/State/Zip: •
Phone:
LA QUINTA CA 92248
(760)625-6537
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the Slate 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 Ccnpliance (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 land Part 6 of the California Code of Regulatio s AYp•,. ,/'+�'y`� � �`� t..
4. The building design features or system design features entified ork this Certifier hof Compliance arercon;ekt with the m��formation.p°rov-ided onother-apphcable' minpliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval;w ih this building permit application. ip i 7. t
S. I will ensure that a registered copy of this Certificate of Compliance shalbbe ade vailable wlth',the building poe mit(sLissued fo the build rig, a d.made avadable;toeehe enforcement agency for all applicable
inspections. I understand that a registered copy of th sCertrficate of Compliancesis,required to be, included with the�documenta[ on the builder provides to the bu ildfng owner at occupancy. '
Responsible Designer Name: 3 t ii,.-. a '" -•�
Responsible Designer Signasu a +
Greenup, Brian
�recna��
Company:
Company:
Date Signed:
GREENUP AIR CONDITIONING AND HEATING
2015-07-01 16:14:59
Address:
License:
P O BOX 7431
985406
City/State/Zip:-
Phone:
LA QUINTA CA 92248
(760) 625-6537
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document; and in no way implies Registration Provider responsibility for the accuracy o f the information.
Registration Number: 215-A0180037A-000000000-0000 Registration Date/Time: 2015-07-01 16:14:59 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-01 16:15:14
Schema Version: 0.555SDD