BMCH2014-108479-495-CALL;�,TAMPICO C` 0 U VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
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, C43 License No.: 276586
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
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 1, 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 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:
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:_ 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:
Applicant:
WARNINGJAILURE 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 relating to building
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Date:
9/24/2014
Application Number:
BMCH2O14-1084
Owner:
Property Address:
49470 AVENIDA CLUB LA QUINTA UNIT 10
JOSHUA LEWIS
APN:
658320010
49470 AVENIDA CLUB LA QUINTA
Application Description:
REPLACE FURNACE & COIL
LA QUINTA, CA 92253
�=
Property Zoning:
Application Valuation:
$4,994.00
n
M
i
Applicant:
Contractor:
;m p
I D rT
O
DESERT AIR CONDITIONING
INC
DESERT AIR CONDITIONING
{:-p
INCj O
Z�.
590 WILLIAMS ROAD
590 WILLIAMS ROAD
" z
"
O
PALM SPRINGS, CA 92264
PALM SPRINGS, CA 92264
b
(.760)323-.3383
M
_..�
Llc. No.: 276586
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, C43 License No.: 276586
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
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 1, 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 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:
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:_ 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:
Applicant:
WARNINGJAILURE 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 relating to building
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
.�
ONS TE
DESCRIPTIACCOUN T
Cv �'��� .t
.,�
BSAS SB1473 FEE 101-0000-20306. 0 .
$1.00 $0.00
- a 4->""'T i (�� 'J'�, F _ .d CF '^:
�i. x PAID BY i�`xMETHOD`{CEIRT#r yr CHECK# CLTD BY
Total Paid forBUI.LDING STANDARDS, ADMINISTRATION BSA $1.00 $0.00
I PT - s
IONACCOUNT��
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AMOUNT,
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PAID
-
PAID DATE
�DESCR
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HVAC CHANGEOUT - FURNACE ONLY
101-0000-42402
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$36.26
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s�PAID BY
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W "rMETHODRECEIPT#^,
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-;
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HVAC CHANGEOUT - FURNACE ONLY PC
101-0000-42600.
0
$24.17
$0.00
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`,^.a. '-' a,�i. f y,.
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ME`METHODS
RECEIPT #r�
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CLTD BY
kCHECK
Total Paid forCHANGEOUT: $60.43 $0.00
# DESCRIPTIONt y r s��
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ACCOUNT
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v- vl'..L: io_ .i.'.=. 3v..
PAID
'iP ,' . Mt .✓w.FS ._ �..,<$1<.�"'
PAIDbATE
PERMIT ISSUANCE
101-0000-42404
0
$91:85
$0.00
i�;2L65`y .:t 5..x_3.'i>< �.t
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Total Paid forPERMIT ISSUANCE: $91:85. $0.00
i.
I
Description: REPLACE FURNACE & COIL
ADDITIONAL
Type: MECHANICAL
Subtype:
Status: SUBMITTED
Applied: 9/17/2014 KHE
Approved: 9/17/2014 MFA
Parcel No: 658320010 Site Address: 49470 AVENIDA CLUB LA QUINTA UNIT 10LA QUINTA,CA
PLAN CHECK SUBMITTAL KAY HENSEL
.92253
9/17/2014
Subdivision: TR 16786 CM 040/168
Block:
Lot: 1
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0
Zoning:
Finaled:
'Valuation: $4,994.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details: REPLACE 31/2 TON FURNACE AND COIL, LIKE FOR LIKE
NAME TYPE
NAME
___j Applied to Approved
Printed: Wednesday, September 24, 2014 3:15:42 PM 1 of 2
SYS7Eti1S
ADDITIONAL
CHRONOLOGY TYPE STAFF NAME
ACTION DATE
CHRONOLOGY
COMPLETION DATE
NOTES
PLAN CHECK SUBMITTAL KAY HENSEL
9/17/2014
9/24/2014
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS
CA
a_
92264
(
Printed: Wednesday, September 24, 2014 3:15:42 PM 1 of 2
SYS7Eti1S
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
1 101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
FURNACE ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
FURNACE ONLY PC
Total Paid forCHANGEOUT: $60.43 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $1S3.28 00
Printed: Wednesday, September 24, 2014 3:15:42 PM 2 of 2
SYSTF. ti1S
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL"
Printed: Wednesday, September 24, 2014 3:15:42 PM 2 of 2
SYSTF. ti1S
BFn {#
Cry. Of. 'La QUin to
Buildlog 8t Safety Division
F.-O. Box 1504,78.495 Calle Tampico
La •Quin4, CA 92253 -:(760) 777-7012
Building Permit-AW[cadon, and Traddng Sheet
Perin-,t#14 - (
�""
Prgject,Add�rss: 49470 AVENIDA CLUB LA QUINTA
Owner's Name, JOSHUA LEWIS
A_ P. Nymber.
Addresa: .49470 AVENDIA CLUB LA QUINTA
Legal DeScriptia2Cit,.
Contractor: Desert Air Conditioning, Inca
ST, jp. LA QUINTA, CA 92253
Telephone: X.
Address: 590 Williams Rd.
ProjeaDacrlption: REPLACE 3'/ TON FURNACE & COIL
City, ST, Zip: Palrn Springs, CA 92264,
ON GROUND LIKE FOR LIKE
Telephone- 760-323-3383
State E.io. # : 276586 u' #s 363
G ty
Arch., Engr, Designer: N/A
Address:
City, ST. Zip:
Telephone:
Stole Lic. #: •, MPmject
Name of CoatattPcrson: Kerl Skov
Construction Typc: Occupancy:
type (circle one): Ncw Add'n Alter Repair Demo
Sq. Ft , a Stories: #Units:
Talsphone # of Contact Person: 760-3230383
Estimated Vaiiue of Project: $4994.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
it
Sob mittal
Pisa Sets
Wd
Reed7RAC�II`I(G+
a
Pian.0mk submitted. '1' q x 7 7
YERMrI VM-
Item Amount
Structural Calm
Rcvicwed, reads for corrections
Plan Cbeek Deposit. .
'hoar talcs.
Called Contact Person
plan Check Butanes
Title 24 Ca1cs,
plat gieked up
Cotwtractlon
Hood Plaip plan
Plans rembnitted, ,
Meeharikal
Grading plan
2'i Review, ready ibr torreetiou�raus
Electrical
Subeontactor List
Called Contact Person
Ptuptbing
Grata need
Plans picked up
S.M,L
R.O.A. Approval
Mus resubmitted
Grading
iN FSOLLSEs-
''d lievlew; ready tUr eorrectionsltesue
peveloper Impact Bee
Plianing Approval
Ca11ed Contact Person
AJ.P.P.
pub. t'•1'ks• Appr
Aare of permk issue
School Fees
Total Permit Fete
CERTIFICATE OF COMPLIANCE CFMAG-024
Alterations to Space Conditioning Systems (formerty CF-iR-AIT-HVAC) (Page. 4 of 41
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name.
Documentation Author Signature:'
Skov, Keri
Company:
Signature Date:
Desert Air Conditioning Inc.
2014-09-17 13:14:08
Address:
CWHERS Certificadon Identification (if applicable):
590 Williams Road
City/State�p:
phone:
Palm Springs CA 92264
760-323-3383
Responsible Person's Declaration statement
I certify the fallowing under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Complia nce is true and correct.
2. 1 am eligible under Divfslon 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).
I 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.
4. The building design features or system design features identified an this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, xvorksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this buifding permit application.
5. 1 wil I ensure that a registered copy of this Certificate of Com pl iance shall be rna.de available with the building permit(s) issued for the buildi ng, and made avai lable to the enforcement agency for a II applicable
inspections. I understand that a registered copy of this Certificate of Complia nee is required to be included with the documentation the buil der provides to the building owner at occu panty.
Responsible Designer Name:
Responsible Designer Signature:
K
Skov, Keri
Company :
Date Signed:
Desert Air Conditioning Inc.
2014-09-17 13:14:08
Address:
License:
590 Williams Road
276586
City/State/Zip:
Phone:
Palm Springs CA 92264 '
760-323-3383
Digifafly signed by UCERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for lite accuracy, of the
information.
Registration Number: 214-A0096204A-000000000-O000 Registration Date/Time: 2014-09-17 93:14:08 HERS Provider. CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance ReportVersion: 2014-03-31 Report Generated: 2014-09-17 13:24:51
Schema Version: 0.5515DD
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
JOSHUA LEWIS ( Date Prepared:
MR -ALT -02-E
(Page 1 of 4 )
2014-09-17
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 MR -ALT -02 document for each dwelling unit.
01
Project Name
JOSHUA LEWIS
02
Date Prepared
2014-09-17
03
Project Location
49-470 AVE NIDA CLUB LA QUINTA
04
Building -Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
JOSHUA LEWIS
07
Zip Cade
92753
system a
Dwelling Unit Conditioned
2200
Installing
Installing '
Installing
Floor Area (ftZ)
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
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
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 (ftZ)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System I
Location 1
1400
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 214-A0096204A-000000000-0000
Registration Date/TJme
2014-09-17 13:14:08
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-17 13:14:51
Schema Version: 0.551SUD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 4 )
D. Altered Space Conditioning System (Sections 150.2(b)IE and F)
01.
02
03
04
05
D6
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
Dud length
R -Value
Central gas
All new
Central split
No cooling
This field or
This field or
This field or
This field or
System 1
furnace
heating
AFUE
O,IS
AC
component
section is not
section is not
Setback
section is not
section is not
components
altered
applicable
applicable
applicable
applicable
Required Documentation:
CF213-10CH-01-E - Spare Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums! 116.
MR -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 dun length is replaced.
-Leakage rate compliance: <_ 15% or _s 10% leakage to outside, or seal all accessible leaks.
MR -MCH -25-H & CBR -MCH -25-1i Refrigerant Charge Verification required when refrigerant contalnitV components are installed or altered (applicable in CZ 2, g-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFWton required when MCH -25 is required.
Exception
-Duct systems regfswred with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
-Heating -only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MEM -25.
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 1502(b)1E, F)
This section does not apply to this project.
'Registration Number: 214-AO096204A-OOOOOOODD-0000
Registration Date/Time: 2014-09-17 33:14:08
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compilanee Report Version: 2014-03-31 Report Generated: 2014-09-17 13:14:51
Schema Version:0.551SDD
CERTIFICATE OF COMPLIANCE Cf1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -MVAC) (Page 3 of 4 )
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b}1C)
This section does not apply to this project.
Registration Number: 214-A0096204A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 20140947 13:14:08
Report Version: 2014-03-31
Schema Version: 0.55150D
HERS Provider: CaICERTS
Report Generated: 2014-09-17 13:14:51