BMCH2017-016778-495 CALLE TAMPICO V -`
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0167
Property Address: 54055 AVENIDA VELASCO
APN: 774214025
Application Description: CHALOUX RESIDENCE/ HVAC HD OUT
Property Zoning:
Application Valuation: $1,450.00
Applicant: MAY 0 4 2017
CARRERA AIR 0
82660 INDIO BLVD CITY OF LA QUINTA
INDIO, CA 92201 DESIGN AND DEVELOPMENT DEPARTMENT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
RAYMOND CHALOUX
54055 AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor:
CARRERA AIR
82660 INDIO BLVD
INDIO, CA 92201
(760)343-6675
Llc. No.: 959853
Date: 5/4/2017
----------------------------------------------- C - - - - - - - - - - - - - - - - - - - - - - - - - _ - - - - - - - - - _ - - - - - - - - - -
LICENSED CONTRACTOR'SDECLARATIO '
I hereby affirm under penalty of perjury that I am licensed u er pr isio of apter
9 (commencing with Section 7000) of Division 3 of the Bus ss P I ss'
and my License is in full force and effect. j
License Class: C20 License No.: 959853
DDate S-''�' 7 R^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 improvemenfis 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.).
( ) Lam exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
WORKER'S COMPENSATION DECLARATION
reby 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 wor r 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: STATE COMPENSATION INSURANCE FUND Polity Number: 9155895
_ 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 should01
ome subje e
workers' compensation provisions of Section 3700 of t L or Code ' hwit
comply with//those provisions.
Date- c�l 17 ...,---Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PENS/LTIES
O ERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENND 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 torr .
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 state laws rel ing to di
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city Eo e r up
above-mentioned property for inspection purposes.
Lender's Name: �j (�00,
/
Date:/ / + ( C— -Signature (Applicant or Agen
Lender's Address:
9,.
Date: 5/4/2017
Application Number: BMCH2017-0167 Owner:
Property Address: 54055 AVENIDA VELASCO RAYMOND CHALOUX
APN:, 774214025 54055 AVENIDA VELASCO
Application Description: CHALOUX RESIDENCE / HVAC CHANGE OUT LA QUINTA, CA 92253
Property Zoning:
Application Valuation': $1,450.00
Applicant: ` Contractor:
CARRERA AIR CARRERA AIR
'82660 INDIO BLVD 82660 INDIO BLVD
INDIO, CA 92201 1 INDIO, CA 92201
(760)343-6675
Llc. No.: 959853
Detail: HVAC CHANGE OUT-- 14 SEER/80AFUE PACKAGED SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES:
t
i -
I
S..
( 1 r
1
FINANCIAL) N •• MAT1,ON
DESCRIPTION ACCOUNT QTY AMOUNT
i BSAS SB1473 FEE 101-0000-20306 0 $1.00
-Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- PACKAGED UNIT
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- PACKAGED UNIT PC.
101-0000-42600
0.
$25.33
Total Paid for CHANGEOUT: $63.33.
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
1
t
a
Bi, -#'
Permit tt
Project Address:
Qty of La Quinto
Building 8i Safety Division
78-495 Ca11e Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
ner's Name:U
A. P. Number:
Address: �I ®
46,4
Legal Description:
City, ST, Zip:
Contractor:
2
Tel ehn
P 0 `
Address:
Project Description:
City, ST; Z•
Tel e h 0
P 3 C�
State Lic.
City Lie. #
l
Arch., Engr., Designer:
1
Address:
"
City, ST, Zip:
Telephone:
aneY
Construction Type: Occupancy:
P
S ta to Lic. #. •'
0ProJee wt tYP �circle one � Ne Add'n ]ter
Repair: Dem
Name of Contact Person:
(� t.
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person 7 .
Estimated Value of Project. �' L/ Dp
APPLICANT: DO NOT WRITE BELOW THIS LINE
M.
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FRES
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"" 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:-
'rd Review, ready for corrections/issuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
_
Total Permit Fees
D
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
54055 Avenida Velasco I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3) a
2017-05-04
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
54055 Avenida Velasco
02
Date Prepared
2017-05-04
03.
Project Location
54055 Avenida Velasco
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
54055 Avenida Velasco
Dwelling Unit Conditioned
I Lalli g a
07
Zip Code
92253
-
08
2
Floor Area (ft )
92253
SC System
CFA served
system a
refrigerant
Number of Space
Installing
09
Climate Zone .:15:.>;;::
-
10
Conditioning (SC) Systems in
1
ducted
containing
system
more than 40
this Dwelling Unit:
entirely new
B. Space Conditioning (SC) System Informat on � tl`ik7�"T*
F F
01
02
03."
04
OS
06
07
08
09
10
AI's. the SCr'
I Lalli g 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'(ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
1 Alteration Type
System 1
Location 1
1364
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: 217-A020146874A-000-000-0000000-0000 Registration Date/Time: 2017-05-04 13:11:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-04 13:11:03
Schema Version: rev 10/16
D. Altered Space Conditioning System (Sections 150.2(b)1E and F),
r•
01 -
02
D. Altered Space Conditioning System (Sections 150.2(b)1E and F),
01 -
02
03
04
05
06
07
08
09
10
it
12
r
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
All new
" •
All new
`This field or
This field or
System 1
Central gas
furnace
heating
AFUE •
81
Central
packaged HP
cooling
SEER
14
Setback
section is not
section is not
•
components
components
-
applicable
applicable
Reauired Documentation:
MR -MCH -01-E - Space Conditioning Systems Kt ,
- 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 CF311-MCH-20-H - Duct Leakage Test required wfien'heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced
-Leakage rate compliance: <=150 or <= 109 leakage to outside; or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
MR and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton requ'ed 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 Fl MCH-23-or'Ref igerrant Cha ge MCH 25.
-Existing duct systems constructed, insulated or sealed with asbestos�are exempt�from MCHm20 OuctMakage Testmg,,regwMements
Registration Number: 217-A020146874A-000-000-0000000-0000 Registration Date/Time:. 2017-05-04.13:11:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance r Report Version: 2016.1.005 Report Generated: 2017-05-04 13:11:03
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) o (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:
Carrera, Andrew
Company:
Signature Date:
CARRERA AIR
2017-05-04 13:11:34
Address:
CEA/ HERS Certification Identification (if applicable):
78-970 SONESTA WAY
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-343-6675
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 tancept.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 ReguOlns a
� �
4. The building design features or system design features identified on this Certificate.of Compliance are consistent with=the information;provided on otherapplicable,compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
1 k i #.,k L k k f t<. k
,. � ." r
5. I will ensure that a registered copy of ttiis.Ceitificate of,Compliance shall lie_made,available with'ttie buildh4pe�mit(s),issued for the ilding, andmade available tothe a forcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance,is,requiced to be.included with the.documentation.the.bullder provides to the building owner at occupancy.
� ter+b-- ate. M
Responsible Designer Name: ' L -t
Responsible Desi er Signature: V t � t—/� to
Carrera, Andrew
v(�!/ lid
Company:
Date Signed:
CARRERA AIR
2017-05-04 13:11:34
Address:
License:
78-970 SONESTA WAY
959853
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-343-6675
Easy to Verify Ell "FRI
at CaICERTS.com .
Digitally signed by Ca10ERTS. 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-A020146874A-000-000-0000000-0000 Registration Date/Time: 2017-05-04 13:11:34 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-04 13:11:03
Schema Version: rev 10/16