BMCH2017-002978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O17-0029
Property Address:
61427 TOPAZ DR
APN:
764530007 .
Application Description:
HANSEN / A/C CHANGEOUT
Property Zoning: • .
Application Valuation:
$8,500:00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
T,uY'44Quwfw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20 License No.: 763937
Date: Z I Zt I i1 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 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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: INSURANCE COMPANY OF THE WEST' Policy Number: WSD5034539
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: Z •� 11 Applicant:
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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
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 relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Lender's Name:
Date: ZI signature (Applicant or Agent):
Lender's Address:
Date:
2/21/2017
Owner:
LORA HANSEN
61427 TOPAZ DR
LA QUINTA, CA 92253
C=)
Q' N
g
o
oLU
Contractor:
CD
o
VOTTA ENTERPRISES INC D
FCt T AI , v
72248 NORTHSHORE ST ST
101 ��
e
THOUSAND PALMS, CA 922
C)
(760)320-5800
Llc. No.: 763937
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: INSURANCE COMPANY OF THE WEST' Policy Number: WSD5034539
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: Z •� 11 Applicant:
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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
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 relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Lender's Name:
Date: ZI signature (Applicant or Agent):
Lender's Address:
Date: 2/21/2017
Application Number: BMCH2O17-0029
Owner:
Property Address: 61427 TOPAZ DR
LORA HANSEN
APN: 764530007
61427 TOPAZ DR
Application Description: HANSEN / A/C CHANGEOUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $8,500.00
Applicant:
Contractor:
IE INC
VOTTA ENTERPRISES INC DBA COMFORT AIR
31225 LA BAYA
72248 NORTHSHORE ST STE 101
WESTLAKE VILLAGE, CA 91362
THOUSAND PALMS, CA 92276
(760)320-5800
----.-----------------------------------------------------------------------------------------
Llc. No.: 763937-
Detail: (1) HVAC CHANGE OUTS (1)16SEER/80AFUE SPLIT SYSTEM [2016 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. PER 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT I CITY I AMOUNT
BSAS 561473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
'AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM.
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
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
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
#
..:
Crty of La Qurnta
Building a Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta; CA 92253 - (760) 777-7012
a`9 Building Permit Application and Tracking Sheet
Permit #
8MCH x.017 -'00
Project Address: 61427 Topaz Drive
Owner's Namm. Lora Hansen
A. P. Number.
Address: 61427 Topaz Drive
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: Comfort Air
gg
Telephone: 909-230-2346 `8
Address: 4803 E Sunny Dunes Road
Project Description: Replace 4 ton / 110,000 BTU complete.
City, ST, Zip: Palm Springs,' CA 92264.
HVAC system
Telephone: 760-320-5800
State Lic. # : 763937 City Lie. #•:
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone: `�
P 'Y. � ., ,l
State Lic. #: -----
Name of Contact Person: Steven Schnierer
Construction Type: . Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: #Stories: #Units:
Telephone # of Contact Person: 818-735-7876
Estimated value of Project: $8,500.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES .
Plan Sets
Pian Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit,
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up.
Contraction
Flood plain plan
Plans resubmitted •
Mechanical
Grading plan
2'd Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plan resubmitted
Grading
IN IIOUSE:-
'^' Review; ready for correetionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3) 1
Project Name: Lora Hansen I Date Prepared: 2017-02-20
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
Lora Hansen
02
Date Prepared
2017-02-20
03
Project Location
61427 Topaz Drive.
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Lora Hansen
Dwelling Unit Conditioned
IstaIIir g'a
07 ,
Zip Code
92253
08
Floor Area (W)
1900
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
-1.1 ..._s.+ 3 f ,Y!".-'" i C'::— 3 -C "-N % ,,.,..^..3 e`." ,f /`-.'""r i_ ti
B. Space Conditioning (SC) System Information.. { in,
C..
Ol
02.
03
04
O5
66 06.
07
X08
09
10
Oki- 01�`AI`s
s
.«w..
the SCS;
IstaIIir 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?
Alteration Type
System 1
Location 1
1900
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 217-A020055133A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016' Residential Compliance
Registration Date/Time:
Report Version: 2016.1.005
2017-02-20 14:05:35 HERS Provider: CalCERTS
Report Generated: 2017-02-20 14:06:10
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)lE 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
Central gas
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
80
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- 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 CF3R-MCH-20-H - Duct Leakage Test 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.
WR and CF3R-MCH-25-H Refrigerant. Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required.
Exceptions:
Duct systems registered with HERS provider as previously sealed are exempt from .MCH; 20 Duct Leakage Testing.requirements.., _ C
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23; or Refrigerant Charge N1CH 257 '
}. e c s z
Existing duct systems constructed, insulated or sealed with asbestos are exemptfrom MCH=20 Duct Leakage Testing requirements
�"�,'. .... h'� '14 � ''�t.-»r.r. ":'1.-.+''a' p=a ��».�rr:.+.� .. a �_..r-d � i alv snx ^m...,�p"-' d,� L.Y e��.F ... ( ."°s..ti••^ ad
E. E0Xirely New or Complete Replacement Duct.System, with or without.Equipment Changeout (Sections>1350.2(b)1Diia�and,150.2(b)1E, F)
s! "'�. tom* � it 1 x1if 1 4 1 i�_
This section.does not apply to this project. .
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 217-A020055133A-000-000-0000000-0000 Registration Date/Time: 2017-02-20 14:05:35
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005
HERS Provider: CaICERTS
Report Generated: 2017-02-20 14:06:10
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Documentation Author Signature: �
cyan dacobJt
Jacoby, Ian
Company:
Signature Date:
i PERMIT E RATERS
2017-02-20 14:05:35
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya.Drive #213
City/State/Zip:
Phone: -
West Lake Village CA 91362 A
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. The information provided on this CertificateofCompliance is true and correct. -
2. 1 am eligible under Division 3'of the Business and Professions Code to accept responsibility for the building design or system designidentified 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 Reg lations.
i.� .may �+c
4. The building design features or system design features identified on this Certificate of Compliance are consistent.withi the informatiomprovided on other applicable'compliance documents, worksheets,
14 .:�t , 9,
calculations, plans and specifications submitted to the enforcement agency for approval, with this building permit application.
1 a'�1h. �I" 4 !C f$'1 �Z ; l L./ �.. 3c- .,'+14 si* _
.+ ,i.
5. I will ensure that a registered copy of,this Certificate of Compliance shall be made;avallable with the building permits► issued for the building, and made available<to,the ehforcement agency for all applicable
inspections. I understand that a registered copy of this, Certificate of Compllanc&ie_required to be. -included with the .dYocumentation�the`builder provides to he building owner at occupancy.
Responsible Designer Name: _
Responsible Designer Signature: I ' " � UN
Jan
Jacoby, Ian
L7acobJr
Company:
Date Signed:
i PERMIT E RATERS
2017-02-20 14:05:35
Address:.
License:
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362 - -
818-735-7876
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-A020055133A-000-000-0000000-0000 - Registration Date/Time: 2017-02-20 14:05:35 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-20 14:06:10