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BMCH2015-035778-495 CALLE TAMPICO LA QUINTA, CALIFORNR k253.i 4 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O15-0357 Property Address: .79330 TORONJA - APN:. 776260016 Application Description: GARCIA / (2)16SEER/78AFUE SPLIT SYSTEMS Property Zoning: Application Valuation: $11,000.00 Applicant: ADAM SIMMONS P O BOX 314 LA QUINTA,.CA 92247 t 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. 80 : 7534 Date: c Contractor: • 1 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).: (__j 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.). (� ],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 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: LARRY GARCIA 79330 TORONJA LA QUINTA, CA 92253 Contractor: ADAM SIMMONS P 0 BOX 314 'LA QUINTA, CA 92247 (760)564-7525 Llc. No.: 780534 Date: 9/15/2015 U L__ z LU Ln Cr Q LU C==� CV z C3 r S a CL� �z 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 ork 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 ould become subject to the workers' compensation provisions of Section 370 of he Labor Code, I shall forthwith comply with tPose provisions. &//1'/f&. Date: 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. 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 ter upon the above- mentioned property for inspection purposes. Date: 7 Signature (Applicant or Agent FINANCIAL INFORMATION �T, r°�rEDESCRIPTION _'A000UNTra: QTY� 64 AMOUNT y PAID`�e PAID DATE: BSAS 581473 FEE I 101-0000-20306 0 $1.00 $0.00 THOD _ CHPAID RECEIPT CLTD BYE Total Paid forBUILDING STANDARDS ADMINISTRATION BSA ` $1.00'. $0.00 DESCRIPTI ' . w•� � ,. ,ONa QTY AMOUNTS ��X PAID PA-ID:DATEN : HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $145.04 $0.00 `',} J PAID ;BY ., _::: .�4F% :i: , �.§. ���..sch.., � ^b•t. METHOD- r �� `. .. <.E.✓."% e? w.Y'Y,si: ,r.v n,::...:. {H' [+....: t. .. z ,#q RECEIPT #T `, ''i fir.. r. h,a;e K:• .,.D.e .mer-. n CHECK # Vi >' .—,.3 : �': -.�rvs f �. CLTD BY 41 DESCRIFTION���ACCOUNTr e nX ;QTY t 3 p 4 ¢AMOUNT PAID`_; rPAID DATE° HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $72.52 $0.00 a .< £ PAID BYu 3.; €� mss i+�.nr a� METHOD <.F,T, ' x,`„RECEIPT #ter :F '. CHECK # ra CLTD BYE; Total Paid forCHANGEOUT: $217.56 $0.00 ”, x • , DESCRIPTION _ r + '� r # z ACCOUNT= $, t; QTY L AMOUNT; E rk PAID IAP -DATE 'PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 M* PAID{BY : S;z ; METFIOD � � '�f RECEIPT # k CHECK . =CLTD BYE , Total Paid forPERMIT ISSUANCE: $91.85 $0.00 t • _ 0.4 0 �� y , r Description: GARCIA (2)16SEER/78AFUE SPLIT SYSTEMS Type: MECHANICAL Subtype: Status UNDER REVIEW Applied: 9/15/2015 SKH Approved: Parcel No: 776260016, Site Address: 79330 TORONJA LA QUINTACA 92253 Subdivision: TR 287-97 Block: Lot: 16 Iss6ed: Lot Sq Ft: 0- Building Sq Ft: 0 Zoning: Finaled: NAMEg,- "Sk Valuation: $11,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 - No. Stories: 0 No. Unites: 0 LA QU I NTA Details: - GARCIA (2)16SEER/78AFUE SPILITSYSTEMS [2013 ENERGY] CARBON MO - NOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. 1. . . '�!, I , _. . vry wn, 4 1. 1 .. ........ CONTACTS . . . . . . . . . . . . . . . . . . . . . . . . . . ............. .... JqAMJE TOE NAMEg,- "Sk CltY" ­ STATE �,'PHONE, JAX; �.77 2�- AIL j - LA QU I NTA CA -92253 - . .. ........... ......... FINANCIAL APPLICANT 'ADAM SIM -MONS, P 0 BOX 314 • LA QUINTA CA 92247 Simmonscda@yahoo.6 CARWSYSTEMS - om CONTRACTOR ADAM SIMMONS P 0 BOX 314 LA QU I NTA CA 92247 Si d @ h • M1110.5, Y. 00., 0 OWNER LARRY GARCIA 79330 TORONJA LA QU I NTA CA -92253 . .. ........... ......... FINANCIAL ......... . -INFORMATION . ..... ......... . . ..... ...... .. . ...... . . .......... Printed: Tuesday, September 15, 2015 3:42:55 PM CARWSYSTEMS - ............. . .... .... .. . .... ... . r ........... . . ..... ........ . .... ........ ...... ........ .... . ..... ........ J ........... . 1.1'� ..141. t. "'.I ...... . ... 4 V I .. .... . . .. .... . ....... . . .. .. ............. . .. . . . . . . . . ... .... ..... .............. ..... ... . ....... ....... PARENT PROJECTS . ... . . ..... ... . ..... ....... . . ..... ...... ... . ... . .... ... .......... ...... .... . ..... .. .. ... .. . ... .. . .. . ..... ... . . ...... MON .. ..... .. ....... .. .. ...... .. . ....... . . . ......... . ....... . ... HUNDINFMMA .............. ... ..... ... ..... .. ... ... ............ . ... . . ...... . ... .. ..... ........ . .. ....... ..... .............. r.-.HMFNT,% ................. .. . ............. ... . .. ..... . ........ .. ... ... .. . ....... Printed: Tuesday, September 15, 2015 3:42:55 PM 2 of 2 C§FWIYSTrMS - --- -------- --- '15 DESCRIPTION Axcouw-�' 'CITY, ;AMOUNT - PAI A I DATE 1:RECEIPT# 3 CHECK'# METH v. BY BSAS SB1473 FEE 101-0000-20306 .0 $1.00 0.60 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $145.04 $0.00 SPLIT -SYSTEM - HVAC CHANGEOUT- 101-0000-42600 0 $72.52 $0.00 SPLIT -SYSTEM PC Total Paid forCHANGEOUT: $.217.56 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 T $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 .... . .. . ... ...... ............. . .... .... .. . .... ... . r ........... . . ..... ........ . .... ........ ...... ........ .... . ..... ........ J ........... . 1.1'� ..141. t. "'.I ...... . ... 4 V I .. .... . . .. .... . ....... . . .. .. ............. . .. . . . . . . . . ... .... ..... .............. ..... ... . ....... ....... PARENT PROJECTS . ... . . ..... ... . ..... ....... . . ..... ...... ... . ... . .... ... .......... ...... .... . ..... .. .. ... .. . ... .. . .. . ..... ... . . ...... MON .. ..... .. ....... .. .. ...... .. . ....... . . . ......... . ....... . ... HUNDINFMMA .............. ... ..... ... ..... .. ... ... ............ . ... . . ...... . ... .. ..... ........ . .. ....... ..... .............. r.-.HMFNT,% ................. .. . ............. ... . .. ..... . ........ .. ... ... .. . ....... Printed: Tuesday, September 15, 2015 3:42:55 PM 2 of 2 C§FWIYSTrMS CERTIFICATE OF COMPLIANCE CF1R-ALT b2 -E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of. 3 ) .Project Name: Larry Garcia Date Prepared: 2015-07 24 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 CF11R- ,ALT=02 document for each dwelling unit. 01 : Project Name Larry Garcia 02 Date Prepared 2015-07-24 X03 Project Location. 79332 Toranja 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name Larry Garcia -07 Zip Code 92253 08 Dwelling Unit Conditioned 3000 Installing Installing .Installing FloorArea (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 15 10 (SC) systems in this dwelling 2 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Is the SC Installing a SC System SC System 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? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 KITCHEN AND 1600. Yes Yes Yes No No No Altered space LIVING AREA conditioning system System 2 Bedrooms 1400 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.Z(b)1Diib) This section does not apply to this project. Registration Number: 215-AO2044SIA-000000000-0000 CA Building Energy Efficiency Standards- 2013 Residential Compliance Registration Date/Time: .2015-07-24 08:29:15 Report Version: 2014-03-31 Schema Version: 0.555SDD HERS Provider: CaICERTS Report Generated: 2015-07-24 08:29:21 CERTIFICATE OF COMPLIANCE CF111-ALT-02-E 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) 01 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Altered Heating Minimum Altered Cooling Minimum Required New or IdentificationHeating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Jan Components Type . Value System Type Components Type Value Type Duct Length R-ValuAll new Central split No cooling This field or This field or Less than or System 1 heating AFUE 0.78 ACaltered component section is not section is not Setback equal to 40 R-8 components applicable applicable feet All new Central split No cooling This field or This field or Less than or System 2 furnace heating AFUE 0.78 AC component section is not section is not Setback equal to 40 R-8 components altered applicable applicable feet Required Documentation% CF211-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF211-MCH-20-H & CF311-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%, or15 10% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & CF311-MCH-25-1­1 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 CFM/ton required when MCH -25 is required. Txceptions; -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. -Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. E. Entirely New or.Complete Replacement Duct System, with or without Equipment Changeout (Sections 1S0.2(b)1Diia and 150.2(b)lE, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150:2(b)X) This section does not apply to this project. Registration Number: 215-A0204451A-000000000-0000 Registration Date/Time: 2015-07-24 08:29:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07.-24 08:29:21 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 3) Documentation ) Documentation Author's Declaration Statement Li certify that this Certificate of Compliance documentation is accurate and complete. . Documentation Author Name: Documentation Author Signature: Simmons, Donna h/B1LK��i�G'�Gl�G6�ld' Company: Signature Date; ADAM SIMMONS 2015-07-24 08:29:15 Address: CEA/HERS Certification Identification (if applicable): 54440 AVENIDA CARRANZA City/State/zip- - Phone: LA QUINTA CA 92253 (760) 564-7525 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. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified 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 Regulations. ' 4. 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. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcerent agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. . Responsible Designer Name: Responsible Designer Signature: Simmons, Donna_' Company: Date Signed: ADAM SIMMONS • 2015-07-24 08:29:15 Address: = License: 54440 AVENIDA CARRANZA 780534 City/State/Zip: Phone: - LA QUINTA CA 92253 (760) 564-7525 Digitally signed by CaICERTS. 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:.215-A0204451A-000000000-0000 Registration Date/Time: 2015-07-24 08:29:15 HERS Provider: CaICERTS - CA Building Energy Efficiency Standards - 2013 Residential Compliance t Report Version: 2014-03-31 Report Generated: 2015-07-24 08:29:21 Schema Version: 0.555SDD