BMCH2016-037178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BMCH2O16-0371
Property Address:
78196 CALLE NORTE
APN:
770011010
Application Description:
JACOY RESIDENCE / HVAC
Property Zoning:
Application Valuation:
$12,000.00
Applicant:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
Twr °F 4 Q"
DESIGN & 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 "f the Business and Profess, o TC -ode,
and my License is in full force and effect.
License Class: Q0, C36 License No.: 7
Date: � 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, 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
v� Date: 10/13/2016
Owner: /n
ALEX JA�P/Y �-
78196.&A'LLE NORTE-1
LA Q 1NTA! C�C92253 �(�•
CC4ftli CITyCI 4016
J�Iryn F�
Contractor: ��F�Gr?ffli�o�
1 ANTHONY PLUMBINGHEATfN.fi &AIR CONDITI
72216 NORTH SHORE ST #101'
THOUSAND PALMS, CA 92276
(760)328-8096
Llc. No.: 777794
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: MIDWEST EMPLOYERS CASUALTY COMPANY 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 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with t ose provisions.
Date: Ail)� Applicant:
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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and st'te laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives o this ty to enter upon the
above-mentio�jed property for inspection purposes
Lender's Name: Ind _ II . � �1
Lender's Address: I,
Date: 10/13/2016
Application Number: BMCH2O16-0371
Owner:
Property Address: 78196 CALLE NORTE
ALEX JACOY
APN: 770011010
78196 CALLE NORTE
Application Description: JACOY RESIDENCE / HVAC
LA QUINTA,-CA 92253
Property Zoning:
Application Valuation: $12,000.00
Applicant:
Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92276
(760)328-8096
Llc. No.: 777794
Detail: (2) HVAC CHANGE OUTS - 14 SEER/78 AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
FINANCIAL • .
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
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$76.00
Total Paid for CHANGEOUT: $228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
Qin #
City of La Quinta
Building 8T Safety Division
/ . P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # r
!
Project Address:
Owner's Name: L ,,JA-(_? O
A. P. Number: Q
Address:
Legal Description:
City, ST, Zip:
Contractor: J ANTHONY SERVICES
Telephone:
Sffl,E 3f FE i6i
Address: THOUSAND PALMS, CA 92276
Project Description:
City, ST, Zip:
Telephone: 7
le P 3 3 -2
State Lic. # :
CityLic. #-..1b#66S
/
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
;;:t:;;::;:;::;;::;._.:;:;;;:;::;;; ;;:::::::;:s;<::>;:
Construction Type: Occupancy:
State Lic. #:
Project hPa circle one):: New Add'n Alter Repair 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
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person '
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
tad Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue .
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
JACOY I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2016-10-13
A. General Information
CF1R-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
JACOY
02
Date Prepared
2016-10-13
03
Project Location
78196 CALLE NORTE
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
JACOY
07
Zip Code
92253
08
Dwelling Unit Conditioned
4000
... ,•-+. ,w—.
SC
y
Clpstailing
,�: Ms•.r
:Installing
'*a
Installing
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted
containing
Number of space conditioning
more than 40
09
Climate Zone
15
10
(SC) systems in this dwelling
2
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SC) System Information,
01
02
03 .� .
,. 04
� 05
y # U6
07 t
08
09
10
: ikls the SC
Installing a
SC System
SC System
CFA served
r.
`• system a
Pt^-^ sew. ;
refrigerant 14
... ,•-+. ,w—.
SC
y
Clpstailing
,�: Ms•.r
:Installing
'*a
Installing
Identification or
Location or Area
by this SC
ducted
containing
rrnstalling,new
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
Location 1
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
2000
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-A0383617A-000000000-0000
Registration Date/Time: 2016-10-13 09:51:03
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-13 09:51:33
Schema Version: 0.555SDD
"ICATE OF COMPLIANCE CF1R-AL
tions to Space Conditioning Systems (formerly CF-iR-ALT HVAC) (Page 2
f3)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
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.
Central gas
Gas furnace
Central split
Outdoor
This field or
This field or
System 1
furnace
AHU
AFUE
78
AC
condensing
SEER
14
Setback
section is not
section is not
unit
applicable
applicable
Central gas
Gas furnace
Central split
Outdoor
This field or
This field or
System 2
furnace
AHU
AFUE
78
AC
condensing
SEER
14
Setback
section is not
section is not
:
unit
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 & CF311-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%, ors 10% leakage to outside, or seal all accessible leaks.
.ra
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant conta mg'components-are installed or altered (applicable in CZ 2; 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH 25 is regwred:
Exceptions: _ s ... . •
inc
,
-Duct systems registered with HERS provider as previously sealed are, exempt from MCH 20 DuctJkageje ting
d,
requirements.
w t:
-Heating-only systems and Air Handler/Furnace changes do not require verifi cation of Air Flow MCH -23 or Refrigerant Charge MECH-25. -
-Existing duct systems constructed, insulated or sealed with asbestos are�exempt from WICH 20 Duct Leakage Testing regwrements. -
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-A0383617A-000000000-0000 - , Registration Date/Time: 2016-10-13 09:51:03 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance , Report Version: 2013 Rev 1.008' Report Generated: 2016-10-13 09:51:33
` Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Robinson, Kevin
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2016-10-13 09:51:03
Address:
CEA/ HERS Certification Identification (if applicable):
72216 NORTH SHORE ST #101
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
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 Regulations.)f i
4. The building design features or system design features identified omthis Certificate of Compliance are consistent with the information provided on other,- applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency forJpproval with this building permit application.
Y1)d i
5. 1 will ensure that a registered copy of this Certificate of Compliance shaa:..,-Wbemade:avah11ilable with the building permit(s):issuerd for4he_building, an 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: V
KP�/G�l/(�LQBst/
Robinson, Kevin
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2016-10-13 09:51:03
Address:
License:
72216 NORTH SHORE ST #101
777794
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
Digitally signed by CaICERTS. 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-A0383617A-000000000-0000 Registration Date/Time: 2016-10-13 09:51:03 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-13 09:51:33
Schema Version: 0.555SDD