BMCH2015-0046f
78-495 CALLE TAMPICO C A D •� VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 „
' • BUILDING PERMIT
Date: 2/18/2015.
Application Number: BMCH2O15-0046 Owner:
Property Address:. 81095 SHINNECOCK HILLS a MICHAEL INGRAM ;
APN: 762340013 3010 N INGRAM DR,
Application Description: INGRAM RESIDENCE HVAC CHANGE OUT;:" Q SPRINGFIELD, MO 9.2253
Property Zoning: ,
Application Valuation: $11,400.00
Applicant: t - �^I1-+".-�..; � l •
+; ..; '•A OUINTq . Contractor:
_.-..' �Cv�4UPfyE
ESSER SERVICES INC DBA ESSER A "s W a.,� NtoE ESSER SERVICES INC DBA ESSER A
P 0 BOX 1636 'wTNENT P 0 BOX 1636
CATHEDRAL CITY, CA 92235 CATHEDRAL CITY, CA 92235
' (760)324-0550 t
LIC. No.: 489046
----•---------------------------- -
LICENSED CONTRACTOR'S DECLARATION . WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers',
and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C20 License No.: 489046 of the work for which this permit is issued. t
I have and will maintain workers' compensation insurance, as required by
Date: Z I Contractor:---- 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:.
OWNER -BUILDER DECLARATION Carrier: Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions.
Contractor's State License Law (Chapter 9 (commericing with Section 7000) of Division 3
of the Business and Professions Code) or that he or she is exempt therefrom and the Date: Applicant- 1'
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora 1
permit subjects the applicant to a civil penalty of not more than five hundred dollars WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(1 I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,.
(Sec. 7044; Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES.
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 APPLICANT ACKNOWLEDGEMENT `
are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose
(� I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued is a result of this application , the owner; and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta;
FINANCIAL INFORMATION
Y".'+DESCRIPTION, .74'xACCOUNT ,QTY` AMOUNT PAID IPAID DATE
t
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
ID BY RIPT W1,
i '„s s`; METHOD ECE CHECK #
CLTD BY ;.
,PA µ rt s;
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
;DESC
AID'
PAID DATES
'
.
L
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY Y
+ ' '' M D L n:_
ETHO
R
~ ECEIPT #
CHECK # z`
CLT BY'h
.�_.,
DESCRIPTION :
ACCOUNT `�'CtTY
` AMOUNT- :`
z'`"= > `PAID °"
PAID DATE:
.
HVACCHANGEOUT- SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
` 'PAID By-,
•,METHOD
2,"RECEIPT # . "`
�. CHECK #= -
.CLTD BY
Total Paid forCHANGEOUT: $108.78 $0.001
+ ,.DESCRIPTION
RI
ACCOUNT ".'. ,
QTY;
AMOUNTS
PAID
Ail
&eo_
�r
;
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY r '.
�> ,METHOD
:= k RECEIPT #'
CHECK # _
"t CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
1
'
.
L
Description: INGRAM RESIDENCE HVAC CHANGE OUT
Type: MECHANICAL , Subtype: Status: APPROVED Applied: 2/18/2015 MFA
Parcel No: 762340013 Site Address: 81095 SHINNECOCK HILLS LA QUINTA,CA 92253 Approved: 2/18/2015 MFA
Subdivision: TR 29147-1 Block: Lot: 21 Issued:
Lot Scl Ft:.O = - Building Scl Ff 0 Zoning:- Finaled: _
Valuation: $11,400.00- Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT -18 SEER/80AFUE SPLIT SYSTEM'[2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
i.•.," r F, .. A
FIN NCIAL INFORMATION
Printed: Wednesday, February 18, 2015 12:54:23 PM 1 of 2
CRWIYS'rcms
Y " Permit, Details PERMIT NUMBER
�,.
G� - BMCH,201�5=`004
La-Quinfa - �.
DESCRIPTION
r
' ACCOUNT"'. ^
.PAD
CITY:
,$a,,AMOUNT
'PAID
�PAID'DATE
'RECEIPT#•
:CHECK#
`tMETHOD'
f' B Y `-
It—•-
CLTD
ezr,
,,`
r+ ,..,.�.,.. s
F.. ,-=- n
"r
f '�
".>f
i..r. ,—
a ;a
^��
".a
BY.
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
-Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
'
BSA:
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
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
��
- , PARENT PROJECTS
BOND IN
,. ." FORIVIATION • •, ��
..... .....
_..,,. ATTACHMINTS , „,
Printed: Wednesday, February 18, 2015 12:54:23 PM 2 of 2 - FORWsysrenas
Bin #City
of La Quinta.
Building a Safety Division
�� P.O. Box 1504, 78-49$ Calle Tampico .
La Quinta,CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
9
Project Address: 8J OqS S1\; y�� tC o 4w—
k •i ll s
Owner's Namc:
A. P. Number:
A.
Address: $1095 Sh i nne-cook 14; 11 s .
Legal Description:
City,.ST, Zip: r' 1.�1h�A CA GZZ53
Contr actor:ne:
SSS Srvc..e s
TeleP ho �•i 7 - l
l Z
1 t
Address: 7Q BD -A
Project Description:
1W3(0
City, ST, Zip: CAAhe dtc.i Ci CA C1ZZ35
�e 1Gc_c 3�oY, . A)'G CGi l fob bUC)
Telephone: -71 C>-32_4 • C)SSo
State Lic. # : y Sq OI -i 6 CityLie, #;
Arch., Engr., Designer:.
Address:
City, ST, Zip:
Telephone:
::•::<:::::.>,.;•>;:.::::.:<:•:::•::.>::::>;<:>::
.......................................................
.Construction Type: 'Occupancy: .
State Lie. #•
Project (circle a ne) New Add n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
EIIUnits:
Telephone #,of Contact Person:
Estimated Value of Project: k 1, .4co oo
r APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 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 Decd
Plans picked up
S.M.I.
IiA.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub: Wks. Appr
Date of permit issue
School Fees
Total Permit Fecs
CERTIFICATE OF COMPLIANCE CF1R-ALT-02.E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
e
Project Name: 4 MIKE INGRAM FDate Prepared: 2015-02-16
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 _
MIKE INGRAM
02
Date Prepared..
2015-02-16..- ;
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 r '
Floor Area (ft2)
'SC System
SC Systems -
CFA served
systema `
refrigerant
Number of space conditioning
'
09
Climate Zone
15 +r<
10
(SC) systems in this dwelling
1
ducted
f •
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information
Ol
02
U
04'aR:^,
c06.€'rii07
3` - 09
10
-
#05 d
_
t%08
Installing•,w
'SC System
SC Systems -
CFA served
systema `
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?
k
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
_
System 1
Location 1
4947
.
Yes
A.
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.
4 Registration Number: 215-A0045193A-000000000-0000. Registration Date/Time: 2015-02-16 15:34:03 : ! HERS Provider: CaICERTS
-CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-02-16 15:32:51
+ • r Schema Version: 0.551SDD -
CERTIFICATE OF COMPLIANCE - CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) , (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
Ol,
02
03
04
05
06
07
08 -
�. 09
10
111•
12 '
Heating
Cooling
System'
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum,
Required;
New or
Identification
System
Heating
Efficier cj
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
- - or Name L
-Type
Components
` Type
Value
Type
System
Components
"' Type
Value
-Type
Duct Length
R -Value
Central gas
All new
'
Central split
All new
This field 'or
This field or
System 1 , t
furnace
heating
AFUE ,
0.8
AC
cooling
SEER
18
Setback
section is not
section is not
components
components
;
applicable
applicable
Required Documentation: .
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans.
-
-Duct insulation requirement for new plenums: R6.
ti
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: 5 15%, or 5 10% leakage to outside, or seal all accessible leaks. �
±
CF2R-MCH-25-H & MR4/ICH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
r
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM/ton required when MCH -25 is required
Exceptions: j' c r , -
..
-Duct systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct Leakage Testingirequirements
-Heating-only systems and Air Handler/Furnacechanges do not require verrfication:of Air Flow MCH=23`0t' Refngerant Charge MECH-25
tr
R.
-Existing duct systems constructed, insulated or seiled with:asbestos areexempt from MCH=20 DuctLeakage Testing requirements + " r F# # W
E. Entirely New or Complete Replacement Duct System; with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F) ,
? • -
Thissectiondoes not apply to this project. r
'F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project. ,
Registration Number: 215-A0045193A-000000000-0000 Registration Date/Time: 2015-02-16 15:34:03 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-02-16 15:32:51
- .Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE - CF11R-ALT-02-E t.
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: -
Jacoby, Ian
Documentation Author Signature:
Jan �ac0 f '
Nt,
Company: "'
Signature Date:
-
Stratz Permit Service-
2015-02=1615:32:52 -
Address:
CEA/ HERS Certification Identification (if applicable):
5858. Dovetail Drive
City/State/Zip:
Phone: -
Agoura Hills CA 91301
818-735-7876
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. a The information provided on this Certificate of Compliance is true and correct.
-2. I am eligible under Division 3 of the Busin�esss%and..P.rofessions Code to accept responsibilityyfor the buildmg.design or,system;design identified on this Certificate of Compliance (responsible designer).
r'l � f�-- F ,. '•�i`..�� -�T
3. That the features devices for building design design identified
energy and performance specifications, materials, components; and manufactured the or system on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part.6 of the California,Code of Regulations
.14 1,•„" �.
4. The building design features or system design features identified on this Certificate o(CompI'ance are consistent with the mformation provided on other applicable compliance documents, worksheets,
�
. , t � . • »r y r g
calculations, plans and specifications submitted.to-the enforcement agency for approval, with this building permit application.^° � #�,
#r..i-` of
:zf ,�a
5.. 1 will ensure that a registered copy of.this Certificate of_Compliance shall,be-made available with the building ,permrt(s}issued for,,the building and;made available to the enforcement agency for all applicable
u-.
inspections. I understand that a registered�copy of this Certificate of Compliance is required to belincluded with the documentation the Builder provides to the building owner at occupancy.
Responsible Designer Name:. > , **„
Responsible Designer Signature: A, • _ ��P�
Esser, Michael
Company: a.�'
Date Signed:
ESSER SERVICES INC
2015-02-1615:34:03
Address:_License:
P 0 BOX 1636 ` • :
489046 • ,
City/State/Zip: - r ,
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 noway implies Registration Provider responsibility for the accuracy of the information.. '
Registration Number: 215-A0045193A-000000000-0000 Registration Date/Time: 2015-02-16 15:34:03. i` HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31- < Report Generated: 2015-02-16 15:32:51>
Schema Version: 0.551SDD w