BMCH2016-0094VOICE (760) 777-7125
78-495 CALLE TAM PICO D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/12/2016
Application Number: BMCH2O16-0094 Owner:
Property Address: 57269 ST ANDREWS WAY DEAN AND CATHY GRAVES
APN: 762210038 2357 COLUNDANE LN #54
Application Description: GRAVES / CHANGE OUT (2) SPLIT SYSTEMS EVERG EEN L0.804>3
Property Zoning:
Application Valuation: $23,400.00
Applicant: Contra jt �R �:. ����
DESERT AIR CONDITIONING INC ' DESER AIR CO DI ZONING INC
590 WILLIAMS ROAD 590 WI LIAMS AB
PALM SPRINGS, CA 92264 PALMS RINGS, CA U6OF LAQUINTA
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 I
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:
-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 infoimation 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.
Date:- L ! ✓ Signature (Applicant or Agent}✓�
rnnAn�
(760)32LC�.�� 1
Lic. No.: 276586
-----------------------------------------------
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, C43 License No.: 276586
of the work for which this permit is issued.
Date: 1 �+ Contractor:
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. duly workers' compensation insurance carrier and, policy number are:
OWNER -BUILDER DECLARATION
Carrier: PolicyNumber:
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 Coder 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 (commencing with Section 7000) of Division
3 of the Business and Professions Code). or that he or she is exempt therefrom and the
Date: "1 `�� Applicant: ,✓moi
basis for the alleged'exemption:. Any violation of Section'7031.5 by anyapplicant fora
.
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, 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-PROYIDED 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
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 I
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:
-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 infoimation 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.
Date:- L ! ✓ Signature (Applicant or Agent}✓�
FINANCIAL INFORMATION
I DESCRIPTIONS, ` *:-� ACCOUNT x - °QTY 's: AMOUNT': & _ PAID 1PA10bATE'
BSAS SB1473 FEE 101-0000-20306 0 ' $1.00 $0.00
PAID. BY k '�' . Y :ECEIPT # ;.;. E : CHECK # CLTD BYE
METHOD R
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION .'z E ,+ `s ACCOUNT Y� QTY ':` AMOUNT ;. xrr i PAID r PAID DATE
HVAC CHANGEOUT - SPLIT-SYSTEM • 101-0000-42402 0 .$145.04 $0.00
PAID BYe,ry i F METHOD`£ Y x , d RECEIPT #* 'tt ' A CHECK # x� r CLTD BY '
77
DESCRIPTION S` x z::yzA000UNT9 �z .,QTY' ANIOUNTr ' PAID �PAI D,DATE
`f
HVAC CHANGEOUT - SPLIT-SYSTEM PC 101-0000-42600 0 $72.52. ' $0.00
'Z
* ,F PAID BY r METHOD x� " RECEIPT # °CHECK # ' '4 CLTD BY}'
Total Paid for CHANGEOUT: $217.56 $0.00 .
a .DESCRIPTION J: 4.. +ir
� ACCOUNT ,yQTYRYAMOUNT ch r PAID ; c3 y* PAID'OATE: .
PERMIT ISSUANCE i, 101-0000-42404 - 0 $91.85 $000
PAIO'BY` u _ METHOD r � � � � RECEIPT #€ CHECK # '
. e „ CLTD BY
}.
Total. Paid, for PERMIT ISSUANCE: $91.95, '-$0.00.
OTALS $310.41 $ 0.00
C
Description:'GRAVES/ CHANGE OUT (2) SPLIT SYSTEMS .
Type: MECHANICAL Subtype: Status: APPROVED
Applied:'4/12/2016 SKH ,
Approved: 4/12/2016 SKH
Parcel No: 762210038 Site Address: 57269 ST ANDREWS WAY LA QUINTA,CA 92253
Subdivision: TR 28603-1 Block: Lot: 17,
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $23,400.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories:,0. No. Unites: 0
Details: HVAC CHANGE OUT - (2)20SEER/78AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED. PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
................
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DESCRIPTION
ACCOUNT p
QTY
AMOUNT
�r PAID
PAID#DATE'
.RECEIPT #
CHECK #:
METHODS
a, RAID BY,
g,
BY.
BSAS SB1473 FEE.-
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING 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 for CHANGEOUT:. $217.S6 - $0.00
PERMIT ISSUANCE
101-0100.0-42464..'
0..'
$91.8S.•.
$0.00-..
Total Paid for PERMITISSUANCE: $91.85- . $0.00
TOTALSi $310-41i�
FIC
m
�0
Bin #
City. Of j.a Quinta
Buiidtng 8L Safety Division
P.O.- Box 1504, 78-49S Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
:
Permit #
Project Address: `1 1 ��
Owner's Name: ,
A. P. Number.
Addru ress V—Y--N
Legal Description:
City,.ST, Zip:
Contractor: Desert Air Conditioning;, Inca
Telephoner
::: "- , y
Address: 590 Williams Rd.
Project Description:
City, ST, Zip: Palm Springs, CA 92264 •
�-
Telephone: 760-323-3383
Li c. #; 363
State Lit:: # : 276586Giry
Arch., Engr., Designers N/A
Address:
City, ST, Zip:
"Telephone:
State Lic. #: -
Nime of Contact Person: N \ GQ\Q, V��
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair
Demo
Sq. Ft.:#Stories:
# Units:
Telephone A of Contact Person: 760-323=3383
Estimated Value of Ptnjerx y
APPLICANT: DO NOT WRITE BELOW THIS LINE
0
Submittal
Req'd
' Ree'd
TRACMG
PERMIT FEES-
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss C21c4.
Called Contact Person
Plan Check Balance
Title 24 Calor.
Plans picked up
Construction
Flood plain plan
Mans resubmitltd
Mechatiteal
Grading plan
2•1Rtview, ready-ElectricalCor corrcctiou;tissue
Subcontactor Last
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.L
ILO -A— Approval
Plans resubmitted
Grading
IN I10USE;-
' ' Review; ready for correctionslssae
Developer Impact Fee
Planning Approval.
Called Contact Person
A,I,P,P.
Pub- NY4- Appr "
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OFCOIVIPLIANCE
Alterations to Space Conditioning-lR-ALT-HVAC),
Systems.,(formerly CIF
Project Name:
57269 SAINT ANDREWS' WAY Pate, Prepared:
CIFIWALT-027E
(Page 1 of 3
2016=04722
A. Gene6ll WOrnatioln
UIR-ALT02 is applicable to multiple spaceconditiohiihg systems co'ntained.withih a single dwelling, unit.. When multiple dwellinIg units must be documented,
use one CF1R-ALT-'02�'d&um6nt for each dwelling unit.
01
Project Name
57269 SAINT ANDREWS WAY
02
Date Prepared
2016-04'12
03
Project Location
5.7269 SAINT ANDREWS WAY
04.
Buildine.Type,
Single family
05
CA City
La Cwin'ta
0.6
Dwelling Unit*Name
57269 SAINT ANDREWS WAY
07
Zip,Cocle
92253
68
Dwelling Unit Conditioned"
2379
Floor Area (ftZ)
SC System:
CFA served,
'-Jsystern arra-'efrigerant
installing
Number of space conditioning
Gnstalligg:
4--
EO9
Climate Zone
Identifica.6on'or
10
(SC) systems in this dwelling
2
containing
system
-more.than 40
io—
entire new
unit.
B. Space Conditioning (SC) System' Information
ff ff
ecr.
01
02
013
04
0195
_06i-
i
07
68
09
10
Is the S'C
Installing a--"'4- ' ' '—'I " '
l
SC System,SC
SC System:
CFA served,
'-Jsystern arra-'efrigerant
installing
i'Joitalliiiii'
ir ,i I
Gnstalligg:
4--
J;"l irfis ing
Identifica.6on'or
(ocationcir. Area,
by this SC
ducted
containing
system
-more.than 40
io—
entire new
entirely new
Name
Served
-System (ft2)
system?
component?
componehti?
feit df.ducts?
duet system
SC. system?
Alteration Type
System 1 of'2
Locaticial
1600
Yes
Yes
Yes
No
No
No
Alt&red space
conditioning system
system 2 of!.2.
lL6pti6n'2
'1600
Yes
Yes
Yes
No
No
No
Alt&ed.sp'ace:
conditioning system
G. Extension of Existing, uct 5ystemiGreater Than 40 Feet (SectionlSO.2(b)lDilb)
This section does,not apply to this project.
Registration Number: -216-AO13641i3A-000000000-0000 Registration Dateitime: 201604-12 15:43:33
CA Building.Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1:007
Schema Version: 0.555SQD
HERS Provider CaICERTS
Report Generated: 2016.04-12 15:43:57
CERTIFICATE OF COMPLIANCE CFIR-ALT=02-E
Alterations to Space Conditioning Systems. (formerly CF -IR -ALT -HVAC) (Page 2. of 3 )
D. Altered Space Conditioning System (Sections 1502(4)lE and F)
01
'02
03
04.
05
06
47
018
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling.
Minimum
Required.
New or
Identification
System
Heating
Efficiency
Efficiency
Coolirigt
Cooling
Efficiency
Efficiency
Thermostat.
Replaced"
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct length
R -Value
Central gasCenfral,split
All new
All,new.
This field,or
This field;or
is
System hof 2
heating
AFUE-
0.78
AC
cooling
SEER
:20
Setback.
section isnot
section not,,
furnace .
components
components
applicable
applicable
-Central gas
All newAll
Central split
new
This field or
This field:or
2 of 2
heating
AFCIE
0,78
AC
cooling
:SEER
20
Setback
section i5 not
section isnot
_System
furnace
components
components
applicable
applicable.
Required Documentation: —
CF2R•MCH-01-E.- Space Conditioning.Systems Duc6.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
inducted
systems, or when more than 40 ft of duct length, is replaced.
-Leakage rate compliance: :15%, or 5 10� leakagedo outside, or seal all accessible.leaks.
verification
y,,wi y
CF2R-MCH 25 H F� CF3R-MCH-25•H Refrigerant Charge. required when refngeran�t containing components are inst`alletor alt red (applicable in:CZg2
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2.300 CFM/ton required when MCH -25 is required r ` ». s3 ( r • 1 l"
Fxceotioos: 4
Duct registered HERS sealed are:exempt (rom'MCH-20 Duxct Leakage Testing
iegwrements�}
rystems with provider -as previously
Heating-onlysystems and AirHandler%Furnace changes,do not require venficationbf Arr Flow MCH 23,,or Refrigerant
Charge MECH-25.
Existing ductsystems constructed, insulated oc sealed with asbestos are exempt from MCH 0 DudL akage esting requiremen 5 C) -
E. Entirely New or Complete,.Replaurnent Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia arid 150:2(b)1E, F) .
This.sectiondoes not apply to. this project.
R Entirely New or Complete Replacement Space Conditioning.System (Section 150.2(0)1C)
Thisssection does not apply to this project.
Registration Number 216=A0136478A-000000000-0000
CA; Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-04-12 15:43:33 -
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2016-04-12 15:43:57
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
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.
Docu'rrieritation-Author-Name:
Documentafion Author Signature:
Watson, Nicole.
Company:.
Signature Date:
Desert Air Conditioning Inc.
201.6-04-12 15:43:33
Address:
CEA/ HERS Certification Identification (if applicable):
590 Williams Road
8304077
City/State/Zip:-
Phone:
Ralm.Springs CA'92264
760=323-3.383
Responsible Person'sbeclaration statement
I certify the following under penalty of perjury,. under.the laws of theState of California:
3. The information provided bn this Certificate of Compliance is'trueand correct:,
2. tam eligible under, Division 3 of the Business and Professions Code to accept responsibility for the building design orsysteni design identifiea on this Cer1ificA6,*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
Tide 24, part: ]and Part 6 of ttsc California Code of Regulations 1r "`isY T
requirements of 4 - t�
4- The building design features or system design features identified on,- this -Certikate'of Compliance are: consistent with the information provided on other pa plicabli'comptiance documents, worksheets,
calculations, plans and specifications submitted to the enforcenreni:agency fo(approval with this building permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall be`made wadable with the building permit(s) issued for the. uilding, and.made available to the enforcement agency focal! applicable
f�
inspections. I understand that a registered copy 'of this Certilicate of Compliance is required to be.included with the ,documentation thekbuilder provides o the build ng owner at occupancy:
R� ; - —j
Responsible Designer Name:.
Responsible DeslgnerSignature
Watson,, Nicole
B!U
Cdhipany :
Date Signed:
Desert Air Conditioning Inc.
201.6-04-12 15:43:33
Address:
license:
590 Williams Road
276586
Cty/State/2ip:`
Phone.
Palm Springs CA 92.264
760-323-3383
Digitally signed by CalCERTS. 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: 216-A0136478A-000000000-0000 Registration Date/flime: 2016-04-1215:43:33 HERS Provider.: CaICERTS
CA Building Energy Efficiency Standards- 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated:.2o16-04-12 15:43:57
Schema Version:0.555SDD