BMCH2015-002178-495 CALLE•TAMPICO,
LA QUINTA, CALIFORNIA'9225301 J
Application Number: BMCH2O15-0021
r
VOICE (760) 777-7125
FAX .(760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
` Date: • 1/21/2015
Property Address:
54259 SOUTHERN HILLS
APN:
775101061
Application Description:
REPLACE (1) SYSTEM
Property Zoning:
Application Valuation:
$6,800.00
Applicant: FF -i AIR EXPERTS AIR CONDITIONING -H
PO BOX 94 d 12015
LA QUINTA, CA 92247-0094
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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 ness nd Professions Code,
and my License is in full force and effect.
License C`las 12,_ License No.: 725283
Date: /Contractor: I
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 D1vis110Q 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 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 Address:
Owner: •
BALMUKUND PATEL
54259 SOUTHERN HILLS
LA QUINTA, CA 92253
t Contractor:
AIR EXPERTS AIR CONDITIONING -H
PO BOX 94
LA QUINTA, CA 92247-0094
(760)777-1724
Uc. No.: 725283
s
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
UrTlie 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 sh ec a subject to the
workers' compensation provisions of Section 3700 the La Code, I shall forthwith
comply witl those provisions.
bate: ) Z/ 5 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.
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 an s relating to building
construction, and hereby authorize representatives of is city to ter upon the above-
mentioned roperli for inspection purposes.
bate: ' Z ( 15 Signature (Applicant or Agen ):
CERTIFICATE OF COMPLIANCE CFiR-ALT-024
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 )
Project Name: - _ r _ — Balmukund Patel Date Prepared: - * 2015-03-21
.A. General Information
MR -ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one MR -ALT -02 document for each dwelling unit. '
01
Project Name.
Balmukund Patel
02
Date .Prepared
2015-01-21
03
Project location
54259 Southern Hills
04
Building Type
Single family
05 .
CA City
La Quinta , -
06
Dwelling Unit Name
Balmukund Patel
07
Zip Code
92253
08
Dwelling Unit Condition_ ed
4000
Floor Area (ft2)
SC System
`
CFA served
-
refrigerant
Number of space conditioning
Instelling
09
Climate Zone
.15-,-,.
10
(SC) systems in this dwelling
3
3,-.,....;
ducted
containing
system
more than 40
unit.
i
- ria. •�"e�?,+•r:..�aa�:�.', •,�..�,. •� °t'': ��r
�+ K .:.^ •-•�f sitB. S ace Conditionin SCS stem�Informationi� ` • :
p g( )-Y
Kr <
61
- 02PIP,
+ .. p3
�?< 04)US�A�'
y{�'
06.�� °
r� 07X>
09
10
..X€.'
,,..3.0u. :,•
., fH:.:,... �A'
taw. w.. .`!")a:i#i.^
~ 7•,;+#"
k" *,f...^
-
-
•
`
�T;
x is the SC Y'
rte' -':s'
Installing a
SC System
SC System.
CFA served
systeri a
refrigerant
Installing new SC
Instelling
Installing '
Installing
Identification or
Location or Area
.�..rww,h.
, : kiy this SCy_
3,-.,....;
ducted
containing
system
more than 40
entirely new
entirely new '
-
Name '
Served
System M2).•
'sem?
component?
components?
feet of duds?
duct system?
SC system?
Alteration Type
-,
Altered space
System i
living area .
2000;s
:Yes
Yes
,Yes
_ % No
No. '
No
:.conditioning system
System 2
Location 2
800.
No' _
1 No
No -
No
No
No
�
No alteration
performed
No alteration
System 3 . •
Location 3
-
1200
No
No -
No
No
No
No
performed -
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Di1b) -
This section does not apply to this project. -
Registration Number: 215-A0023503A-000000000-0000 Registration Date/Time: 2015-01-21 10:32:19- , HERS Provider: CalCERTS ,
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 _ Report Generated: 2015-01-2110:32;25
Schema Version: 0.551SDD _ _
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
_ 06
07
08 .
_"09
10
it "
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.
-
•"
or
This field or
System 1
furnace
heating
AFUE
0.78
..
cooling
SEER-
_i3
Setback
Fis
not
section is not
components
AC
components
le
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts 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: 515%, ors 30% leakage to outside, or seal all accessible leaks.-
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable)n CZ 2, 8-15i..
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow.a 300 CFM/torr required when MCH -255 is regwred-
Exceptions:�1
�
-Duct systems registered with HERS provider as previously sealed aarre exempt frdm Mtre
CH 20 Duct Leakage Testmggwrements
-Heating-only systems and Air Handler/Furnace changes do not require.yerification-of Air Flow MCH'23 or Refrigerant Charge MECH 25:. 34'-
Existingduct systems constructed; insulated or Baled withasbesto are^exempt f om MC 20 Duct leakage.Testing require rents
r,
t.;
•.. -. rkj� ,'�`;?�;+?'<.`y�� tai 'r�fiy3�.t,-r.�3,'9'n`a., k^o "-#'da�'} ...:� �[.�4c» •�"�'�+f... :-*m'�'u'1 nha�`;s'� $'.' .G.'R" 's�'�+"•€i . -
_ _:.. ., ., .. .. .
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F)
+ This section does not apply to this project.
F..Entirely'NeWor Complete Replacement Space Conditioning System (Section 150.2(b)1C) _
4 r ' This section does not apply to this project.
.Registration Number: 215-A0023503A-000000000-0000. Registration Date/Time: 2015-01-21 10:32:19 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance . Report Version: 2014-03-31 Report Generated: 2015-01-21 10:32:25
Schema Version: 0.551SDD
Documentation Author's Declaration Statement-
tatement.1'1
1'lcertify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: _
Van Vlymen; Paul
Documentation Author Signature:_
Company:
SignatureDate:
Air Experts Air Conditioning
wl
2015-01-21 10:32:19 .
Address: } ` ' - _ .- -
CEA/ HERS Certification Identification (if applicable):
PO Box 94: _ • f
W _
City/State/Zip:
Phone:
La Quinta CA 92247 -
760-7774724 ; • ~
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. 1 am eligible under Division 3 of the Busin,Ness.and.Professions Code to accept responsibility for the building design or system.desiign identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials 'components and manufactured devices for the bui'ldml' 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. �•'r <, I
_Afw
Y 4. The building design features or systm dew
e3ign features identlfi�ed on thdis Certificate ofCompltance re consistentwitht formation pro ided on other applicable compliance documents, worksheets,
- calculations; plans and specifications submitted-toahe enforcementagenty for-approvaUwith this building -permit application - -
� ":5' '�jrrV '�
�.y ` �i4 � f e,; ''€ aq' ,�' - � .r •e.o gTi.• z w 'z• �
5. I will ensure that a registered copy of -this Cprtifi6teofsComplian eeahall be made available with the buildmg_permit(s} issuedfor�the buliding and:m de available to the enforcement agency for all applicable
inspections. I understand that a registered copy of.this Certificate of:Compliance is required to be included witii the documentation the'tiuilder provides to the building owner at occupancy. '
Responsible Designer Name: }
Responsible Designer Signature:
�R��1(/%/SGP.!(/
Van Vlymen, Paul :' - • f� r'iTM
Company: - r '
Date Signed:
Air Experts Air Conditioning '
2015-01-21.10:32:19
Address:
License: ' -
PO Box 94 •.
725283
City/State/Zip:
Phone:
La Quinta CA 92247 - -
760-777-1724 ,
r , Y Digitally signed by Ca10ERTS. 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=A0023503A 000000000 0000 Registration Date/Time: 2015-01-21 10:32:19 HERS Provider: CaICERTS
• CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 t - Report Generated: 2015-01-21 10:32:25
Schema Version: 0.551SDD ,
JINANCIAL INFORMATION
DESCRIPTIO
PAID ^` PAID DATE
BSAS SB1473 FEE
101-0000-20306.
0
$1.00
$0.00
YPAID BY}
RECEIPT'# n r `
CHECK #' �: t CLTD-BY•'
xE. K
,
�.
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00, ` $0.00.
kit, DESCRIPTIONS .' r ' 3c t
`ST _" ACCOUNT
QTYj'".
AMOUNTPAID
DATEi
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
"[f, `' PAI D.BY '
rw. b ;METHObC„^c
RECEIPT#w,
c x t
a;CHECK#�
CLTD.BY,
b .„fit!;C,'?;
�. i' 4rACCO,UNT�i s#"a'
QTY
'=� AMOUNT„"APAID
r
'-'PAID DATE
#DESCRIPTION!k
i
, td'
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
•PAID,BY' `'
s'aMETHOD
'"L RECEIPTn#
CHECK:#T1`
CLTD;BY
F1”
l,i'
�:.hi.• "iL,'
P ..`.
.f
1 Total Paid forCHANGEOUT: $108.78 ' $0.00
DESCRIPTION ,t ' 4
AMOUNT,PAID
DATE
y.
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00 .
ar'; '<[N " - 4 bHy:r^r%,..n.'!Q'j '�+}
r �, ',PAID BY { ”
;..ti'
;,; , RMETHO.D� �:.r r
. " � RECEIPT;# '# Fx";,
°, '�CHECKY# f ,ri -y
i CLTD`BYK
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
• 00
r
t
`
i
Description: REPLACE (1) SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 1/21/2015 PJU
Approved:
Parcel No: 775101061 Site Address: 54259 SOUTHERN HILLS LA QUINTA,CA 92253
Subdivision: TR 22432-2 SEE ASSESSORS MB 769/43 Block: Lot: 6
Issued:
FOR CMS
Lot Sq Ft: 0 Building Sq Ft_ 0 Zoning: _
Finaled:
Valuation: $6,800.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details% REPLACE ONE SYSTEM A/C & HEATING 5 TON 13 SEER .78 AFUE 2013 CALIFORNIA MECHANICAL CODES.CARBON MONOXIDE ALARM
(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES
_ ADDITIONAL SITES
CHRONOLOGY
,-. - .. ., , . I , , I I CONDITIONS
FINANCIAL INFORMATION
Printed: Wednesday, January 21, 2015 11:48:51 AM 1 of 2 _ C V SYSTEMS
.+. � s,. -ate,,. �-':i 'S' -Y"" -_,.yKG' = 'rC; �y�- � � .€'dip: -3•�, -t �}„ a
� � �.s�,"w�•�. +n ,{'r`. �,��` S v� •.r �',y • "�'.-�e A ' - `� .�:+:: .,i-3: w" ' �> �y.r �
�t r•, .w-.37� _ �_ ""' `Y'y"".','i-`� �e.-a�` ak" x - _ ri K;g - a- e^ +•{•
5 'rR C 'f` �/, `r'�i�'�r7��� � ® -• ..��.,+- `�` 1'`.5�. • Y.npv.,,,,.�s
77
:DESCRIPTION
�, ACCOUNT
QTY
s AMOUNT
PAID -
PAID DATE
, RECEIPT#
CHECK` #.
=METHOD
PAID BY
.. `BYb
; w,
t ,
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
TOTALS:•-
SEQID - F. -INSPECTION TYPE �:. K INSPECTOR &HEDULED COMPLETED 4 RESULT REMARKSr y "NOTES
c ;y' • Vis.,
M ,
DATE, DATE
MECHANICAL FINAL"
PROJECTSPARENT
BOND INFORMATION
ATTACHMENTS'
Printed: Wednesday, January 21, 2015 1148:51 AM 2 of 2 CB?SYSTEMS
City of La Quinta.
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta,CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit ##
Project Address:ZS Sou //����) ff�S
Owner's Name
A. P. Number:
Address: .J L)zs
r
Legal Description:
City, ST, Zip: ZA- C1c ,-r- 1 ''CA ?Z7-93
Contractor:
Telephone: / I -S
'Address: q
Project Description: 1����Z L# d/nf
City, ST, Zip: L— �` u sN�CA
Tbvf
Telephone: `� U —277 1'7 /n
<{"........:.,....:.,..:::,.......::::::::.
I
State Lic. # : '7ZS--Z
City Lie. #-.
Arch., Engr., Designer:
S E t
Address:
City., ST, Zip:
TelePhone.
hi:'fi•
...:... ....State ...... ......................
aneY
Pe• Occupancy:
n TY •
Construction o
Lu. #:
Add n Alter Repairair Demo
' hP (circle l ne :N w
Name of Contact Person:
Sq. Ft.:#
Stories:
#Units:
Telephone #,of Contact Person:
Estimated Value of Project:
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
2pd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing.
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'rd Review, ready for corrcctionsCssue
Developer Impact Fee
Planning Approval
Called Contact.Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees