BMCH2016-036978-495 -CALLE TAM PICO
LA QUINTA, CALIFORNIA 92253
`mss °G lFQuiftZ
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0369
Property Address:
54778 TANGLEWOOD
APN:
775052012
Application Description:
RAY / CHANGE OUT (2)16SEER/80AFUE SPLIT SYSTEMS
Property Zoning:
"
Application Valuation:
$12,000.00
Applicant:
FIRST CHOICE A / C & HEATING INC
79-747 CASSIA STREET
Contractor:
LA QUINTA, CA 92253
FIRST CHOICE A / C & HEATING INC��
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.: 968138 1 .. _
Date:,"10 ?Ol �� 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 Cade: 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
Lender's Address:
VOICE (760) 777-7.125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/12/2.-016
Owner:.
LORI RAY
54778 TANGLEWOOD
LA QUINTA, CA 92253
o
- N z
r � a
,ai
Contractor:
c
FIRST CHOICE A / C & HEATING INC��
79-747 CASSIA STREET
LA QUINTA, CA 92253 L--�--
o
(760)989-2369
Llc. No.: 968138
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 th w rk for which this permit is issued.
I have and will maintain workers' compensation insurance, as requires 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: MID-CENTURY INSURANCE COMPANY Policy Number: A09478960
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-/0J—//�z2&1 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTO
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 wodc 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 orrect.
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: 10/12/2:016
Application, Number: BMCH2O16-0369
Owner:.
Property Address: 54778 TANGLEWOOD
LORI RAY
' APN: 775052012
54778 TANGLEWOOD
Application Description: RAY / CHANGE OUT (2)16SEER/80AFUE SPLIT SYSTEMS
LA QUINTA, CA 9225.3
Property Zoning: .
Application Valuation: $12,000.00
Applicant:
Contractor:
-FIRST CHOICE A / C & HEATING INC
FIRST CHOICE A / C & HEATING INC .
79-747 CASSIA STREET
797747 CASSIA STREET
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(760)989-2369
ilc. No.: 968138
Detail: HVAC CHANGE OUT - (2)16SEER/80AFUE SPLIT SYSTEMS [2013 ENERGY) CARBON,MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES
f.
M1
FINANCIALINFORMATION:
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
$1S2.00
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
TOTALS: $325.27
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
CF1R-ALT 02-E
(Page 1 of 3 )
RAY I Date Prepared: 2016-09-16 I
A. General Information
CHR -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
RAY
02
Date Prepared
2016-09-16
03
Project Location
54778 TANGLEW.00D
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
RAY
07
Zip Code
92253
08
Dwelling Unit Conditioned
2300
,�
ems:. k" 44
*.. 36f!
Floor Area (ft2)
SC System
CFA served
ystem +-1,
re rf igerant t
Installinrg �e SC
Number of space conditioning
Installing
09
Climate Zone
15
10
(SC) systems in this dwelling
2
containing
system
more than 40
entirely new
unit.
B. Space Conditioning (SC) System Information e
01
02
03
A 0-d
05 k�
06 n
07
08
09
10
SC -- M
�Is the ,
Y g a —
:`stallin
Inst
,�
ems:. k" 44
*.. 36f!
SC System
SC System
CFA served
ystem +-1,
re rf igerant t
Installinrg �e SC
Instal. Ig
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
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
1300
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
1000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Regi9trOtion Number: 21G A0342G14A 000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
'JO Rcgishaliuii DaLe% ] me. 2010-09-16 1 1:21.09
Report Version: 2013 Rev 1.008
c't,— veal....• n ccccnn
HERS Pruvlder: CaICEkTS
Report Generated: 2016-09-16 11:21:46
CERTIFICATE OF COMPLIANCE CF111-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)lE 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
All new
This field or
This field or
System 1
furnace
AHU
AFUE
80
AC
cooling
SEER
16
Setback
section is not
section is not
components
applicable
applicable
Central gas
Gas furnace
Central split
All new
This field or
This field or
System 2
AFUE
80
cooling
SEER
16
Setback
section is not
section is not
furnace
AHU
AC
components
applicable
applicable
Required Documentation:
CF2R-MGH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CBR -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: 515%, or 510% leakage to outside, or seal all accessible leaks.
& CBR Refrigerant Charge Verification are installed or altered;( applicable in CZI2; 8-15).
MR -MCH -25-H -MCH -25-H required when•ref-rigeraat containing componenEts
CF2RCF3R-MCH-23 & U313 -MCH -23 Air Flow >_ 300 CFM/ton required when MCW25 is req
nLruireol
Exceptions: iii
-Duct systems registered with HERS provider as previously sealed,are,exempt from MGH20,4Duct Leakage Tem sting requl-rements.
a. aJ
f�
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
Existing duct systems constructed, insulated or sealed with asbestos are exempt from -MCH req'uir`ement
1�Dua�Ld%bkagejesting
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150Z(b)1Diia and 150.2(b)IE, F)
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-A0342614A-000000000-0000 Registration Date/Time: 2016-09-16 11:21:05 HERS ProviW:_Ca10ERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-16 11:21:46
c,ti— n ccccnn
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:
ASotft
Both, Atila
U1�a
Company:
Signature Date:
FIRST CHOICE A / C & HEATING INC
2016-09-16 11:21:05
Address:
CEA/ HERS Certification Identification (if applicable):
79-747 CASSIA STREET
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-989-2369
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
i. The information provided Oh LOIS 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 ofdgulations��
4. The building design features or system design features identified onahis Certificate of Compliance are consistentwrtti the ihformation<provided o other/applicable^compliance documents, worksheets,
pPte.
,mow. a�
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. n
i'
.�
UK „f# .t 4lk. �i r6 .'4. 3.f w r
5. 1 will ensure that a registered copy of this Certificate of Compliance shall bemade,a_vadable with thb building permit(s),issued for+the build tng, and made available to�the!enforcement agency for all applicable
inspections. l 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: $s H. .
a ;Y ' x tr _
Respons I Designer Signature: V I
Both, Atila
v [tila 170th
Company:
Date Signed:
FIRST CHOICE A / C & HEATING INC
2016-09-16 11:21:05
Address:
License:
79-747 CASSIA STREET
968138
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-989-2369
Digitally signed by Ca10ERTS. 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 of the information.
r� Registratinn Wornhor: 216-A0342614A-000000000 0000 RegiSlPeCiwn Dale%ilme. 20 16-09-16 11:2,i:06 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-16 11:21:46
c„h— W.—i— n ccccnn
z
Iain it
Permit #
Project Address: Sti -T 7e
-------------
Qty 05f, U Quh i ta
- Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701.2
Building Permit Application and Tracking Sheet
Owiier'sNamc:.
A. P. Number:
-A� O
Address: i
Legal Description:
�n
City, ST, Zip:. 92zs3
Contractor: e O
AST H t
i tit IN
T ele
Telephone:
P
•Address: CASSIA
_
Project Description: E�1-Acf2> YAC -lel
City, ST, Zip:
9�%zs3
Telephone: -9 9-ro
9 �. 3 9
State Li c. # :
City Lic. #.'
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
one:
Occupancy:
Pan
cY�Co
ns tructi n Type:
State to ,ic-
L#.
Pro'ect c circle one): New Add'n Alter Re air • Dc
J type ( ) p mo
Name of Contact Person: i I
T
Sq. Ft.:#S
to ries:
# Units:
Telephone # of Contact Person:
-49 -�
Estimated Value of Project: • b
'C)
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Rcc'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submittedItem
Amount
Structural Cafes.
Reviewed, ready for corrections
'Plan Check Deposit
Truss Cafes.
Called'Contact Person
Plan Check Balance.
Tile 24 CaIcs.
flans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrcclions issue
Electrical
_
Subcontactor List
Called Contact Person
,
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
ITV IIOUSE:-
'`J Repiew, ready for corrcctionsrissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of per issue
School Fees,
.
I
Total Permit Fees