BMCH2017-002478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O17-0024
Property Address: 78086 CALLE NORTE
APN: 770012024
Application Description: ROBERTS RESIDENCE/ HVAC
Property Zoning:
Application Valuation: $6,500.00
Applicant:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
c&ty/ 4- 4 Q91az
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 of the Business and Professions Code,
and my License is in full force and effect.
Licensee Class: C20�, CC36 License No.: 7777 4
Date `— 1 _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.).
(1 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 Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
D te: 8/2017
Owne .
CAR OBERTS
7808 ALLE NORfi6:8 O'p 2417
LA QUINTA, CA 92253 O
NAbD
ND D I F,
DES/G 4U/NTq
DPhgF DfpgRTMEN
Contractor,
J ANTHONY PLUMBING HEATING & 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'
crppensation, 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 I should become subject to the
workers' compensation provisions of Section 37 0 of the Labor Code, I shall forthwith
comply with those provisions.
DateZ [ 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.
I certify that l have read this application and
I agree to comply with all city and c0�nlSo
construction, and hereby authorizabovv�%%e��mentioned property for ins
that the above information is correct.
ces and state laws relating to building
s of this city to enter upon the
Date: 2/8/2017
Application Number: BMCH2017-0024.
Owner:
Property Address: 78086 CALLE NORTE
CAROL ROBERTS
APN: 770012024
78086 CALLE NORTE
Application Description: "ROBERTS RESIDENCE / HVAC
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $6,500.00
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: HVAC CHANGE OUT - 14 SEER/81 AFUE SPLIT SYSTEM [2016 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
Fl NANCIALI N FORMATION
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
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Din 1Y .
Permit #t
Project Address: m C.A#e
.1ty of i u« to ,
Building 8f Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
(Le- Owner's Name: C L Rob "
A. P. .Number.
Addre.ss:
Legal Description:
City, ST, Zip:
Contractor:
T P �/�
ele hone: f� `'fU O
�V (9-725
Address:
Project Description:
City, ST, - Zip: 7�2% NORTH SHORE ST STE 101
- THOUSAND PA ,
Telephone:
`l
State Lic. # :17-7'7q.
1 ?
City Lic. ##., pOS
Arch.,`Engr., Designer:
Address:
City, ST, Zip:
Telephone: ePh
one:
Construction s ton T •
OcuancY•
YPe: c P
to
S toi
Lc.4
Pr J" ect tYPa (circle one • New Add'n Alter RePair • De mo
' Name of Contact Person: �� (�+
Sq. Ft.:#
Stories:
#. Units:
Telephone # of Contact Person:
Estimated Value of Project: �j t
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl Submittal Req'd Rcc'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
~
Flood plain plan
Plans resubmitted ,
Mechanical
Grading plan
.2' A Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
i
Ii.O.A. Approval
Plans resubmitted
Grading
IN If OUSE:-
'r0. Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date or permit issue
School Fees,
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
ROBERTS I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2017-02-08
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
CF1R-ALT-02 document for each dwelling unit.
01
Project Name
ROBERTS
02
Date Prepared
2017-02-08
03
Project Location
78086 CALLE NORTE
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
ROBERTS
��� �
a
Dwelling Unit Conditioned
07
Zip Code
92253 y
08
Floor Area (ft)
1600
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Number of Space
Identification or
09
Climate Zone ``
15
10
Conditioning (SC) Systems in
this Dwelling Unit:
1
entirely new
entirely new
Name
Served
System (ft)
B. Space Conditioning (SC) System Information µ I
01
02
_ 03
04
01
06
07 �'.
08
09
10
a.='x�� �
�+ oma �'±4:a.
� ;A �
��� �
a
FIs the SCS a
1 Lalli gra I41110
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 (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 217-A020043165A-000-000-0000000-0000
Registration Date/Time: 2017-02-08 10:03:14
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-08 10:03:30
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE
CFiR-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
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
81
AC
condensing
SEER
14
Setback
section is not
section is not
unit
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply. air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test 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 <= 10% leakage to 6&N6,or seal all accessible leaks.
F I::.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate > "300 CFM per tonrequired wfiemMCH-25;is required.
,...
Exceptions:
Duct
- systems registered with HERS provider as previously sealed are exempt brn MCC% -20 Duct Leakage Testing re�quire ments
Heating -only systems and Air Handler Furnace changes do not requir&venficatian of Air Flow MCW23 Refrigerant Charge MCH-
-Existing duct systems constructed, insulated or sealed with astiest s are exempCfrom MCHC 0 OuctlLeakage Testing requi�emerrts
AV rm, 1%%_ fp — :Aw -o�
E. Entirely New or Complete Replacement DuctSystem, with, out Equipment Changeout (Sections 150 2(b:}1Dlia>and iS0.2(b)lE, F)
. x .
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: 217-A020043165A-000-000-0000000-0000 Registration Date/Time: 2017-02-08 10:03:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-08 10:03:30
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-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:
1<2Uwl
Robinson, Kevin
w9AA/rGOd
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-02-08 10:03:14
Address:
CEA/ HERS Certification Identification (if applicable):
72216 NORTH SHORE ST #101
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276 Ak
1760-343-2121
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 oyf Compliances true anccorrect.
2. 1 am eligible under Division 3'0 Busineis'and Professions Code to accept ress-ponsibilitV for the building design or system design identified on this Certificate of Compliance (responsible designer).
fthe
3. That the energy features and performance specifications materials; components, and manufactured devices_: for the buildingdesign or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part`6bf the California Code of Regulations,._ ,
of ilia
4. The building design features or system design features identified on this Certifi bt Compliance are consisteht wltt informatlnn provided on'gther lica1511 compliance documents, worksheets,
' '. P M:.
.ef '...""' wg• .r,�.p' } £: 1"F.4 y 8 .. ^Y.. i2 _ 1
calculations, plans and specifications submitted to the enforcement agency fof"approval witfi this built3ing permit application;
5. 1 will ensure that a registered copy of this Certificate o�Compliance shalt be Wavailable with e; buildingspermit(sizissued for( Wpuilding andrmade available Lo ttie enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Co�mplliianc%ji Vequ�ire�d to be)ncluded v0t�h the�docum�en ti0n,�the�bu lder p�ov�des to�the bt!cliing owner at occupancy.
Responsible Designer Name: ! m
Res on'sitile Desi ner Si nature: VRA
p ' g ig V'oe
/�E!/G/f/%G/G4B�Ui
Robinson, Kevin
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-02-08 10:03:14
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: 217-A020043165A-000-000-0000000-0000
Registration Date/Time
2017-02-08 10:03:14
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-08 10:03:30
Schema Version: rev 10/16