BMCH2017-0033VOICE (760) 777-7125
78-495 CALLE TAMPICO TAtyl D iQubtr
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/21/2017
Application Number: BMCH2O11-0033 Owner: ' .
Property Address: 52920 AVENIDA VELASCO KRYSTENA BLONDELL
APN: 773326010
Application Description: BLONDELL / A/C CHANGEOUT 92253
Property Zoning:
Application Valuation: $13,047.00
Applicant: Contractor:
pp D
A R S AMERICAN RESIDENTIAL SERVICES OF C A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD SUITE 201 FEB. 21 2017 965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, TN 38120 MEMPHIS, TN 38120
CITY OF LA QUINTA (951)276-9744
DESIGN AND DEVELOPMENT DEPARTMENT Llc. No.: 765074
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: C36 C10 C20 License No.:55074
Date: Contractor: ",Of �'
OWNER-BUILTFER 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).:
(1 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.).
(__j 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
1 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.
CP'---I.4ave 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: LIBERTY INSURANCE CORPORATION Policy Number: WC7631508631
_ 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 of the Labor , I shall f rthwith
comply with those rovisions.
Date: -2/z1 `7 Applican .
WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION C AGE 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 tQbuildiDE
construction, and hereby authorize representatives of this city ter u ov -
mentioned p oper y for inspection purposes:
Date: Z Z� 7 Signature (Applicant or Agent
Date: 2/21/2017
Application Number: '. BMCH2017-0033
Owner:
Property Address:. 52920 AVENIDA VELASCO
KRYSTENA BLONDELL
APN: 773326010
Application Description: BLONDELL / A/C CHANGEOUT
92253
Property Zoning:
Application Valuation: $13,047.00
Applicant:
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD SUITE 201
965 RIDGE LAKE BLVD SUITE 201
MEMPHIS, TN 38120
MEMPHIS; TN 38120
(951)276-9744
Llc. No.: 765074
----------------------------------------------------------
Detail: 4 TON HEAT PUMP & AIR HANDLER REPLACEMENT - 15SEER/8HSPF SPLIT SYSTEM
----------------------------------
[2016 ENERGY] CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES.
0
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
0
FINANCIAL • •MATI •
DESCRIPTION ACCOUNT
QTY AMOUNT
BSAS SBI473 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
Credit Card Fee
101=0000-43505
0
$3.89
Total Paid for Credit Card Fee: $3.89
DESCRIPTION
'ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE F
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
0
Iain Ii
Permit ;
Project Address: 29Zo
City of La Qul)ta
Ci "
I Building 81- Safety Division
78-495 Ca11e,Tanipico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
��IQh.� Ve� Owner's Name: j�0t11&kk \� n
A. P. Number:
Address: '6"'z'JW J Ve_kQSGp
Legal Description: �v C '9mer
City, ST, Zip: , e4'9z Z5 3
r o
Cont act r: SAW v-Q
or
Tele ho nc: Z O aO
Address: 3O
5 —0 �_
_
Project Description: '
City_ ST, Zip: (2
9'Z50 3
TOAkeojr �M
Telephone: 150.0 4(0 O
O l
State Lie. # :
Arch., Engr., Designer:
%olq City Lie.
Address:
City, ST, Zip:
is
Telephone: one'
Can traction Type: NV A C O ccu an cT:
State Lie. -
Pro"ect type circle one):' Alter Repair Demo Add'n
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: , O 1
APPLICANT: DO. NOT WRITE BELOW THIS LINE
9
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviaved, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person-
Plan Check Balance.
Title 24 Cates.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. .
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Rcvicw, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I:P.P.
I'ub. NVks- Appr
Date of permit issue
Sd1061 Fees,
TocaL Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: BLONDELL Date Prepared: 2017-02-21
A. General Information
CFiR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF111-ALT 02 document for each dwelling unit.
01
Project Name _
BLONDELL
02
Date Prepared
2017-02-21
03
Project Location
52920'AVENIDA VESCO
04
Building Type
Single family "
05
CA City
LA QUINTA .-'
06
Dwelling Unit Name
HOME
SC System
SC System
CFA served
system a
efrigera t
Installing new
Installing
Installing
I1`' E
(Dwelling Unit Conditioned
Location or Area
07
Zip Code _
•
92253 �'"�.
� r"s 4.,...
08
Floor Area (ft)
1391
entirely new
�''
Served,
Number of Space
system?
09
Climate Zone
15
10
Conditioning (SC) Systems in
1
HVAC1
1391
1391'
Yes
this Dwelling Unit:
Yes
No
No
4�
Altered space
conditioning system
B. Space Conditioning (SC) System Information
01
02
03
04
0 -U 05'0
L6 -m i 6606 i �Q
07
08
09
10
Is the SC,
fT
Installingp,.,
SCS
SC System
SC System
CFA served
system a
efrigera t
Installing new
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
HVAC1
1391
1391'
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: 417-A020028519A-000-000-0000000-0000 Registration Date/Time: 2017-02-21 09:13:19 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-21 09:13:23
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CFiR-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 split
All new
'
Central split
All new
Less than or
HVAC1
HP
heating
HSPF
8
HP
cooling
SEER
15
Setback
equal to 40
R-8
components
components
feet
Reauired Documentation:
CF211-MCH-014 - Space Conditioning Systems
-Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums:'R6.(CZ 1-10, 12 an613) and R8 (CZ 11 and 14-16)
CF2R and COR -MCH -20-1-1 - 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 outside, or seal all accessible leaks. 'i ' - 4
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 ton required when MCH -25 is required.
Exceptions:
Duct systems registered 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 MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. EntirelyNew or Complete Replacement Duct System, with or without E` ui mint Chan eout Sections 150.2 b 1Diia and 150.2 b lE F
P P Y q P g ( () O)
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.
N
,W Registration Number: 417-A020028519A-000-000-0000000-0000 Registration Date/Time: 2017-02-21 09:13:19
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-02-21 09:13:23
,;;�
CERTIFICATE OF COMPLIANCE CFiR-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:
Jim McEligot
Company:
Signature Date:
Rightime Home Services
2017-02-21
Address:
CEA/ HERS Certification Identification (if applicable):
965 Ridge lake Blvd, Suite 201
City/State/Zip: �"" �
''
Phone:
.,
'9511276-9744
Memphis TN 38120
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California: _
fY g P Y P 1 rY,
/
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 responsibilityjor thwilding 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. -"
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for -approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be_made,availabliiwith theYbwlding:permit(s) issfued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required fo be included with°the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
lin=. tiCled ServiollW1f,'3RiWgril-y
Responsible Designer Signature:
Jim McEligot
Company:
Date Signed:
Rightime Home Services
2017-02-21
Address:
License:
965 Ridge lake Blvd, Suite 201
765074
City/State/Zip:
Phone:
Memphis TN 38120
951-276-9744
, Registration Number: 417-A020028519A 000 000 0000000 0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Digitally signed by CHEERSTM. 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.
Registration Date/Time: 2017-02-21 09:13:19
Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-02-21 09:13:23