BMCH2016-020278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Td4t 4 4o Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0202
Property Address:
49125 TANGO CT
APN:
646300005
Application Description:
WAGNER RESIDENCE / HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$6,000.00
Applicant:
L M C AIR CONDITIONING & HEATING
80-720 JASMINE LANE
INDIO, CA 92201
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 Profes ions Code,
and my License is in full force and effect.
License Class: C20 License No.: 1012807
Date: L C Tractor:
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 forj(/
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.).
(_) I am exempt under Sec. . . BAP.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
Owner:
PAUL WAGNER
49125 TANGO CT.
LA QUINTA, CA 92253
Contractor:
L M C AIR CONDITIONING & HEATING
80-720 JASMINE LANE
INDIO; CA 92201---,-.: ,
(661)343-1048
Llc. No.: 1012807
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, 1 s II forthwith
comply with P
ose provisions.
Date: d``04Applicant:
WARM G: FAILURE TO SECURE W RKERS' 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 toe terupon the
above -m tioned propeerty for' pection purposes.
Date: -W.Signature (Applicant or Agent):
FINANCIAL •• •
DESCRIPTION ACCOUNT ;AMOUNTS'.° PAIDt ^' PAID DATE'
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/10/16
PAID. BYa " METHOD `` '�", ¢ r R T CHECK # BYE;
,- .: r<,, :CLTD
L M C AIR CONDITIONING & HEATI DEBIT R16166 BMCH2016-0202 MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:$1.00 $1.00
.,DESCRIPTION>; a
:µACCOUNT ;_ �'_,
:QTY,
AMOUNT`:
PAID �.
PAID.DATE';
s
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$72.52
6/10/16
-.-.
PAID BY
METHOD ,
RECEIPT #
CHECK #
CLTD BY
f",
f
L M C AIR CONDITIONING & HEATI
DEBIT
R16166
BMCH2016-0202
MFA
u r 7DESCRIPTI ON_' a °`
`� uACCOUNT„� "»=
QTY.
t� •AMOUNT` T �'
= PAID= r
PAID DATE
}
4
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
6/10/16
_ PAID BYE �
11 METHOD
RECEIPT # a :: ,
CHECK # ' `
t CLTD BY
: p
L M C AIR CONDITIONING & HEATI
DEBIT
R16166
BMCH2016-0202
MFA
Total Paid for CHANGEOUT: $108.78 $108.78
4 =DESCRIPTION W !�
ffAMOUNT;
a
ACCOUNT
eq TY
`,,�t
y "PAID
PAID DATE:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
6/10/16
t ' PAID BY �`'
METHOD
`RECEIPT # k
CHECK # E
CLTD BY
L M C AIR CONDITIONING& HEATI
DEBIT
R16166
BMCH2016-0202
I MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS:
Description: WAGNER RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL. Subtype: Status: ISSUED Applied: 6/10/2016 MFA
Parcel No: 646300005 Site Address: 49125 TANGO CT LA QUINTA,CA 92253 Approved: 6/10/2016 MFA
Subdivision: TR 21555-1 Block: Lot: 5 Issued: 6/10/2016 MFA
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $6,000.00 - Occupancy Type: Construction Type: Expired: 12/7/2016 MFA
No. Buildings: 0 No. Stories: 0 No. Unites: 0 `
Details: HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
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W, YY •.C,HRONOLOGY M,
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Printed: Friday, June 10, 2016 10:11:08 AM 1 of 2
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,QTY
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PAID
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_CHEC'c #
METHOD
PAID BY
BY
LMC AIR
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
6/10/16
R16166
BMCH2O16
DEBIT
CONDITIONING
MFA
-0202
.&
HEATI
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00
• BSA: -
LMC AIR
HVAC CHANGEOUT -BMCH2O16
101-0000-42402
0
$72.52
$72.52
6/10/16
R16166
DEBIT
CONDITIONING &
MFA
SPLIT -SYSTEM
-0202
_ .
HEATI
LMC AIR
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$36.26
6/10/16
R16166
BMCH2O16
DEBIT
CONDITIONING.&
MFA,
SPLIT -SYSTEM PC
-0202
HEATI
Total Paid for CHANGEOUT: $108.78 $108.78
'LMC AIR "
PERMIT ISSUANCE
101-0000-42404
.0
$91.85
$91.85
6/10/16
R16166
BMCH2O16
DEBIT
CONDITIONING &
MFA
-0202
HEATI
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
....... , ..... ........
INSPECTIONS
PARENT.PROJECTS
Printed: Friday, June 10, 2016 10:11:08 AM 2 of 2
sysrrnns
STATE OF Cf. IA
ALTERA`_ �S - Hb'AC
CEC-CFIR-ALT- •itdd 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CRR -ALT -04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
Date Prepared:
Permit#:
4 A-IA�o CX �
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged SystemEvaporator
Coil
AFUE
COP
11R-6 (CZ 2, 8-13) Ducting
Served. by system
❑ Setback
14 Split System
KCondensing Unit •
❑ R-8' (CZ 11, 14, 15) Ducting
sgft
(If not already
❑ Mini Split
.9 Compressor
SEER
HSPFpresent,
❑ R-6 (all CZ's) Plenums
must
5kFurnace
4k Lineset
EER
❑ R-5 or R7.5) Lineset'
be installed)
,j$( TXV
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.
ik 1. HVAC Changeout/Repair.
Required Compliance Documents to be left on site for Final:
All Equipment,
CFIR-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage C<.15%, or < 30% to outside, or seal all accessible leaks), Air Flow Z 300 CFM/ton, Refrigerant Charge.
Exempted from dud leakage testing if:
❑ 1. Dud system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing dud systems are constructed, insulated or sealed with asbestos (list manufacture date of building .......
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New DuctS3 CF111-ALT-02-E
including Mini Split CF2R: MECH-OS, 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)-HERS2, MECH-25-HERS'
Mini Splits require CF111-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 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 CFIR-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 z 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 Ducts3 CF111-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (:L15% or, < 10% 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, duct material)
° 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-25/8", 2.5-3T-2%", 3.5 to 4T-2%", 5T-4%"
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.
Res onsible Designer Name:
Respo ibl Dei ner Si n ure•
Date Si ned:
License:
e-
t
o . 10= orb
ra So, -
Company:
A dres :
City/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
X�
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Bin #
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City of La Q uin to
Building 8£ Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit.##oy
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1
Project Address: 5 0 LA Owner's Name: L rip P
A. P. Number: Address: t4 ._ I;,s' r -r-
Legal Description: City, ST, Zip: a, 3
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ontractor:C Arty -s
T ele h n
1poB P o e: tto d
Address: q3 C7 _ 'cA ;),0 M roject Description: I
City, ST, Zip:."�-t~�t li?G
Telephone:
P 0 3 3- y
a P g_44t &-Nl
State Lic. # : (� Qj City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
e. n
Co structi on Type: Occupancy:
c
P Y:
State te Lic. #: PrJect hPa (circle one): New Add'n Alter Demo
ame of Contact Person: q..
��G✓ T� S-�C��M SFt: � or
# Sties: Units-..
:
1
Telephone # of Contact Person: timated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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 Cales.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Pians resubmitted
Grading
IN HOUSE:-
'^! Reyiew, ready for corrections/issue
Developer Impact Fee .
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees