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BMCH2014-115378-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 9*53 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: BMCH2O14-1153 54215 AVENIDA VELASCO 774214022 A/C CHANGE QHT r, $2,500.00 Applicant: REGENCY ENERGY SOLUTIONS 53800 POLK STREET COACHELLA, ST 92236 DVOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/16/2014 Owner: REBECCA FOSSUM 54215 AVENIDA VELASCO LA QUINTA, CA 92253 0E.0 16 2.014 C1ITy QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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. .. A License Class: _ License No.: _ SS 1 11 /Date: G /Contractor: 1 UJ 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 permit subjects the applicant to a civil penalty of not more than five hundred dollar ($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 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 Lender's Contractor: REGENCY ENERGY SOLUTIONS 53-800 POLK ST COACHELLA, CA 92236 (760)272-1421 Llc. No.: 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 wit ht ose provisions. Date: (2 Applicant: . Z== 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 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. �2 ` date: Signature (Applicant or Agent):11i FINANCIAL INFORMATION CITY OUNAID ' • +r? ,`ACCOUNTw _1 TY AMT ;; ; PAID, {.< PDATE 4.rn" DESCRIPTION " _ 5'• BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 �PAID'BY METHOD > - RECEIPT# CHECK # CLTD BY .rr � + � v a _ i y Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 'DESCRIPTION,," + �' ACCOUNT; f 'QTY ",,AMOUNT s'" PAID PAID DATE ,:« HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $0.00 "' `°tea PAID,BY -,- '` ' METHOD,„K�,.:RECEIPT;# .£>"°Y �'' 'CHECK# r .. ;, CLTDBY-_' z r Tu +*: •..DESCRIPTION �r.�`: ' MACCOUNT " s yQTY �s AMOUNT t PAID., ` PAID DATE t HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $0.00 '4'c PAID BY � Ifl' �° "� �:� 'METHOD � � �� `s,��,. RECEIPT# CHECK #,.,' s CLTD.BY;'T y .r ,° Total Paid forCHANGEOUT:' $108.78 $0.00 DESCRIPTION ; '> ACCOUNT'-. QTY t4 x -AMOUNT ' PAIDb,`', 4 RAID,DATE , PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 AID BY :' ;� zw` F CHECK t CLTD BY` y,lF.'METHOD h ,,RECEIP,T#5 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 h ' + I Description: A/C CHANGE OUT Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 12/16/2014 PJU Approved: Parcel No: 774214022 Site Address: 54215 AVENIDA VELASCO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 282 Lot: 30 Issued: UNIT 26 Lot Sq Ft: 0 Building Sq Ft: 0 - Zoning: ,. Finaled:, Valuation: $2,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 '+,NAME TYPE Details: A/C 4 TON 14 SEER CHANGE OUT CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. 2013 CMC. W STATE w r�ZIP. PHONE•� �' FAX EMAIL:. Printed: Tuesday, December 16, 201411:34:53 AM 1 of 2 COTSYS7EM5 CHRONOLOGY CONDITIONS CONTACTS '+,NAME TYPE t w " NAME � - ADDRESSl.r.; CITY -4 W STATE w r�ZIP. PHONE•� �' FAX EMAIL:. �' S� -J fi APPLICANT REGENCY ENERGY SOLUTIONS 53800 POLK STREET COACHELLA ST 92236 (253)576-3130 CONTRACTOR REGENCY ENERGY SOLUTIONS. 53-800 POLK ST COACHELLA CA 92236 (253)576-3130 OWNER REBECCA FOSSUM 54215 AVENIDA LA QUINTA CA 92253 (253)576-3130 VELASCO " Printed: Tuesday, December 16, 201411:34:53 AM 1 of 2 COTSYS7EM5 DESCRIPTION y - ACCOUNT QTY AMOUNT t PAID PAID DATE RECEIPT # 'CHECK # ' METHOD' PAID BY +: -- r` t. s` �, "i~ ' BY, HVAC CHANGEOUT - 101-0000-42402 0 $72.52 $0.00 SPLIT -SYSTEM HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $0.00 SPLIT -SYSTEM PC Total Paid forCHANGEOUT: $108.78 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS:• 00 INSPECTIONS eSEQIDrINSPECTION�TYPE ' .. TINSPECTORf m� 'SCHEDULED COMPLETED' -- RESULT'S REMARKS, '"NO"TES DATE DATE T `� ' n • .. -: _ �� MECHANICAL FINAL" i Printed: Tuesday, December 16, 2014 11:34:53 AM 2 of 2 CR SYSTEMS Bin # ... Qtrof b Quinta Building 8i: Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:T Q U2 0. Owner's Name: C G U A. P. Number: AddJ ress: 2 S �q Ue aSC o Legal Description: City, ST, Zip: A 9 22S� Contractor' i Telephone: �- S?b -3 1 33 Address: 3_ ,O Po I k S+ Project Description: City, ST, Zip: COCAJC_�e CA7 122Z-6 Telephone: p 7 2. i State Lic. # : Arch., Engr., Designer: Address: City, ST, Zipt Telephone.: an Construction -Type Occupancy: Y•U State L ic. #• Project hP (circle one):: New Add'ri Alter a air - Demo Name of Contact Pe'rson:' C ld Sq. Ft.: S #. Stories: # Units: Telephone #,of Contact Person: ?60' z_ (�(2 ( Estimated Value of Project: O"tJ APPLICANT: DO NOT. WRITE BELOW THIS LINE It Submittal Req'd Recd TRACKING PERMIT FEES. Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called•Contaet 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 Dccd Plans picked up i S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`" Review, ready Cor. correctionstiissue Developer Impact Fee . Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue .School Fces Total Permit Tees �G'L,t3Zoi�—Jam 0 0 STATE OF CALIFORNIA ALTERATIONS'- HVAC CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address: (�. G vi(� Enforcement Agency: Date Pr pare Permit#: e cos �v C A 22 S L v i 1 = i Equipment Type •. Equipment Efficiency New Ducting, Plenums, Lineset: Required R -value Conditioned Floor Area (sq ft) Thermostat ❑ Packaged System Pq Evaporator Coil AFUE COP ❑ R-6 (CZ 2, 8-13) Ducting Served by system .EMetback Split System J4 Condensing Unit ❑ R-8' (CZ 11, 14, 15) Ducting sgft (If not already ❑ Mini Split 9 Compressor SEER HSPF ❑ R-6 (all CZ's) Plenums present must ❑ Furnace ❑ Lineset ❑ R -S or R7.5) Lineset' be installed) ❑ TXV EER HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site. K1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CF1R-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 br 24)2 -HERS, MECH-25-HERS' Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' Air Handler/Furnace' (Can include new ducting) Installer Requirement: Duct leakage (< 15%, or < 10%to outside, or seal all accessible leaks), Air Flow ;-> 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: ❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3.1xisting duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building ....... I ❑ 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF1R-ALT-02-E including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2 CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2 Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: All New Ducts' and one or more of the following CF113-ALT=02-E replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Installer Requirement: Duct leakage < 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS Installer Required to: Duct leakage (:L15% or,:30%to outside or, or seal all accessible leaks) ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. ' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc. ' Heating only systems and Air Handler/Furnace changes do.not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25 3 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, ductmaterial) R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter with insulation as the following 1.5-2T-2%", 2.5-3T-2'/<", 3.5 to 4T-2%", 5T-4Ys" Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR). 4. 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 CCR. S. 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. Responsible Designe Name: Responsible Designe Signat e:V Date Signed: License: �c ( (2116/ Company: PO -C "C Cn C (VAe . Address: 53-£� Po SV City/State/Zip: Cmc ket C 9 w s Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 �� . v. Cy EI\�tv 501- -5