BMCH2014-1096M
78-495 CALLE.T.AMPICO .
LAQ_k . 1 CALIFORNIA 744
ceity, 4 4 Qum& - -
COMMUNITY DEVELOPMENT DEPARTMENT
Application Number:
BMCH2O14-1096
Property Address:
81095 SHINNECOCK HILLS
APN:
762340013
Application Description:
REPLACE 2 TON HVAC
Property Zoning:
Application Valuation:
$7,304.00
Applicant:
ESSER SERVICES INC DBA
ESSER A
F 0 BOX 1636
CATHEDRAL CITY, CA 92235
BUILDING PERMIT
SEP 2 S 2014
CITY OF LA OUINTA
IY 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.
License Class: C20 License No.: 489046
Date:q Lzt Contractor: f�
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 2
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 riot 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 Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/25/2014
Owner:
MICHAEL INGRAM
3010 N INGRAM DR
SPRINGFIELD, MO 92253
Contractor:
ESSER SERVICES INC DBA ESSER A
P 0 BOX 1636
CATHEDRAL CITY, CA 92235
(760)324-0550
Llc. No.: 489046
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-# ' ZJo IL4 Applicant:Sv r�
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.
Daterr7� I7
2.110114 Signature (Applicant or Agent): \` A���
CERTIFICATE OF COMPLIANCE' CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name:' _ MIKE INGRAM Date Prepared: ° 2014-09-25
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 MR -ALT -02 document'for each dwelling unit. _
01
Project Name
MIKE INGRAM
02
Date Prepared
2014-09-25
03
Project Location
81095 SHINNECOCK HILLS
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
MIKE INGRAM `
07
Zip Code
92253
08
Dwelling Unit Conditioned
4947
Prow
.'
Floor Area (ft2)
,
SC System
CFA served
system a.
refrigerant
Number of space conditioning
Installing
09
Climate Zone .
15
10
(SC) systems in this dwelling
1
-
containing
system
more than 40
unit.
entirely new
_
B. Space Conditioning (SC) System,lnformation
L
O1
02`
03
04
05 c'
06w
8'07
` 08
= 09
10
x
° Is the SC
,;;Installing a
Prow
r
SC System .
SC System
CFA served
system a.
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
=byahis 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
•Location
Altered space
System 1
1
4947
Yes
Yes
.
Yes
r
No
No
No
conditioning. system
Rggistration Number: 214-A0101700A-000000000-0000 Registration Date/Time: 2014-09-25 18:58:42 HERS Provider: CaICERTS
CA Building Eriergy'Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 - Report Generated: 2014-09-25 18:58:47 '
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of'4 )
D. Altered Space Conditioning System (Sections 1S0.2(b)1E 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
All new
All-new
This field or
This field or
System 1
Central gas
heating
AFUE
0.78
Central split
cooling
SEER
15.5
Setback
section is not
section is not
furnace
components
AC
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans-
-Duct insulation requirement for new plenums: R6.
CF2R-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 duct length is replaced.
-Leakage rate compliance: <_ 15%, or <_ 10% leakage to outside, or seal all accessible leaks.
MR -MCH -25-H & MR -MCH -25-H Refrigerant Charge Verification required when refrigerant containing components
are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2:300 CEM/ton required when MCH 25 is required
Exceptions:,�y
-Duct systems registered with HERS provider as pr" eviously sealed armee exemp from MCH -20 Duct Leakage�Testing
uirements
-Heating-only systems and Air Handler/Furnacerchariges do not requirerveriNeifLori of Air Flow MCH 23; or Refrigerant Charge MECH=25
Leaka i
Existingducts stems constructed, insulated or sealed with asbestos are exem Cfr'om MCH 20 Duct a Tes re turf ents
Y t,4.......zW x p<..,:. �. g a....,. g, q
4
.r
E. Entirely New or Complete Replacement_ Duct System; with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F)
This section does not apply to this project.
Registration Number: 214-A0101700A-000000000-0000
Registration Date/Time:
2014-09-25 18:58:42
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards -.2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-25 18:58:47
Schema Version: 0.551SDD
• Y' F.-Entirely;New or Complete Replacement Space Conditioning System (Section 150.2(b)iC) t -
This section does not apply to this project:: -
- y . „ ,fie., r , V•+ :! ,,. • , .. ... � - -., i. �... -. •'l wl�..• _ ' -. _ .. -. � t . Y ., .. � r.� .
• ;� ��i -'� g 1� � / tr�rr "��T ^;�"' ^r ��' _. 'moi
.r - ,. •...:'.x^a,.. ..- ,:,_ " •:"�." `tK+�` h.. .wY'..Ni� t._ t t; ?fix :y` , .� � r: .. �-r ...
Registration Number: 214-A0101700A-000000000-0000 Registration Date/Time: 2014-09-25 18:58:42 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-25 18:58:47
- • Schema Version: 0.S51SDD ;
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 4 of 4 )
Documentation Author's Declaration Statement `
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
GCi1C'�Q� }
Esser, Michael
c -
Company:
Signature Date:
ESSER SERVICES INC
2014-09-25 18:58:42
Address:
CEA/ HERS Certification Identification (if applicable): .
P 0 BOX 1636
City/State/Zip:
Phone:
CATHEDRAL'CITY CA 92235
(760) 324-0550
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 to accept responsibility forr the building design or system design identified on this Certificate of Compliance (responsible designer).
ti f: syr, he
is Vii' rr § .4 kw ti d +tt. S*,
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 Cahforma;Code of R gulafions. - M
4. The building design features or system design features identified on this Certificate of Compliance are consistent withjthe information'o. ovided ori other applicable compliance documents, worksheets,
7,��
calculations, plans and specifications submitteclto:the ennfomement agency for approval with'this building permit application .
5. 1 will ensure that a registered copy of -this Certificate of Compliance shall be made,available;with rth
the building permit(s)'issued foe building and; made available to the enforcement agency for all applicable
,.._-.
inspections. 1 understand that a registered copyof thisCertificate of Compliance is requ,red o`be'induded with the "documentatioritke builder provides to the building owner at occupancy.
Responsible Designer Name:
�'
Responsible Designer Signature:l.�f1�O4P��
t
Esser, Michael
l
Company :
Date Signed:
ESSER SERVICES INC
2014-09-25 18:58:42
Address:
License: -
P 0 BOX 1636
489046
City/State/Zip:
Phone:
CATHEDRAL CITY CA 92235
(760) 324-0550
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.
Registration Number: 214-A0101700A-000000000-0000 Registration Date/Time: 2014-09-25 18:58:42 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-25 18:58:47
Schema Version: 0.551SDD
FINANCIALINFORMATION
t+ DESCRIPTION*3� ACCO NT AMOUNT
t. r
YP.AID 1
Ti
PAID DA E,.
x
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
9/26/14
j `,-"PAIDtBY
x t
{`METHOD�R §`
',
` CHECK#
CLTD BY
.l>
<_.�...ya� §,
•f._*
:. �
,RECEIPT#F x�
,
IE INC
CHECK
R1509
19680
MFA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00,
$1.00
�
xDESCRIPTION
F
k4' AMOUNT :
PAID{
.`" DATE
,ACCOUNT€
r
rtQTY
, x
,PAID
HVAC CHANGEOUT - SPLIT -SYSTEM •
101-0000-42402
0
$72.52
$72.52
9/26/14
i; ��� J
� r r .+� s
'METHOD
Y - a � f R
:=PAID Blf
&; ; ,r;
RECEIPT #f
CHECK #
CLTD BY
4
b ..
IE INC
CHECK
R1509
19680
MFA
' 1 "" � v'�
Es DESCRIPTION S
,. .� 'M•.� V3' Y � TE
QTY
fi'
AMOUNT "
PAID $ H
PAID DATE
. t
_ACCOUNT y
,
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
9/26/14
c PAID BW::HECK
w
<METHOD
_REi
CEIPT#
C#s
:.
CLTDAY
s
IE INC
CHECK
R1509
19680
MFA
Total Paid forCHANGEOUT: $108.78
$108.78
`;DESCRIPTION
x g
ACCOUNT
QTY
AMOUNT;
r PAID `s�
PAID DATE:
v ,xk'
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
9/26/14
PAID BYy t
r-
METHOD
�. RECEIPT #
r
CHECK # LF
tLT B
w
Y Y
:. ,.
IE INC
CHECK
R1509
19680
MFA
Total Paid for PERMIT ISSUANCE: $91.85
$91.85
TOTALS:
Description`. REPLACE 2 TON HVAC
h
'-n[
Type: MECHANICAL
Subtype: Status: SUBMITTED
Applied: 9/26/2014 MFA
Approved:
Parcel No: 762340013 Site Address: 81095 SHINNECOCK HILLS LA QUINTA,CA 92253
Subdivision: TR 29147-1
Block: Lot: 21
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $7,304.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT-1S.5SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES
.'1. .� �,. •. �. ..,. r .y iir M1 �, ---...-ADDITIONAL..,.
h
'-n[
!k i u � ., �. � ..�.�. .,....•.., � .... ,-
'!!f VV,:., ".A':..r4 . 1A ..,� f. 1 r �
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li.'. eM1 .
f.HR0
CONDITIONS.
Or;Y „���� v..l�. n,:� ..... 1���! M1f �„ �� �1
, ,..,.. .. ,. ....... . .. .• ., ...... :,.
FINANCIAL INFORMATION
Printed: Friday, September 26, 2014 2:38:07 PM 1 of 2
'DESCRIPTION
g :ACCOUNT
CZTYs-
AMOUfNT
PAID
PAID DATE
RECEIPT #4
CHECK #-
METHOD;
PAID BY
.,
,
BSAS S61473 FEE
101-0000-20306
0
$1.00
$1.00.
9/26/14
R1509:-
19680
CHECK
IE INC
MFA
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$72.52
9/26/14
R1509
19680
CHECK
IE INC
MFA
SPLIT -SYSTEM .
HVAC CHANGEOU
101-0000-42600
0
$36.26
$36.26
9/26/14
R1509
19680
CHECK
IE INC
MFA
SPLIT -SYSTEM PCC
Total Paid forCHANGEOUT: $108.78 $108.78
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
9/26/14
R1509
19680
CHECK
IE INC
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS c
PARENT PROJECTS
Printed: Friday, September 26, 2014 2:38:07 PM 2 of 2
Bin #
Permit #
Project Address: ?1895
Qty of La QuIntd
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 -
eCoGk- Ho 1 Owncr'sNamc: M;k e lr ram,
A. P. Number:
Recd
Address: $1 0 Cie a c cA<
Legal Description:
City, ST, Zip: �viv� CA . Q z-z�3
r -
Contractor: . uS� Sex
7 -
I 1
Telephone: O a5�
Plan Check submitted
Address: �
l b3
Project Description:
City, ST, zip:
Cj� 9 ZZ33
ct cp— Z A G Coo coo 1�U
Telephone: �iaQ- 32�}
rSsS�
i\JTY\ Oct
Statc Lic. # : 44. -Ci 01AC
City Lic. #:
Arch., Engr., Designer:
Called Contact Person
Address:
City, ST, Zip:
Plans picked up
:;::.Ielephonc:
nstruction Type: Occupancy:
3tatc Lic.
Flood plain plan
Add'n Alter Repair Demo
a orie : New o
ect type (circle
ProJ
vamc of Contact Person:Sq.
Ft.:
#Stories:
# Units:
Telephone # of Contact Person:Estimated
Value of Project: -71 304. 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Recd
TRAC <ING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for' correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`d Review, ready for eorrcctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fccs
Total Permit Fccs