BMCH2017-0247.,.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: ' BMCH2O17-0247
Property Address: 54944 SOUTHERN HILLS
APN: 775120049
Application Description: SCHUTZ / 20SEER/81AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $13,825.00
Applicant:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201 JUN 20' 2,017
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
1 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: •20 C36 Al License No.: 906115
7' 100
Date: 1 % f'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.).
('. ) 1,=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
Date: 6/19/2017
Owner:
ELIZABETH SCHUTZ
414 MESA LILA
GLENDALE, CA 92253
Contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
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 for which this permit is issued.
Wrkave and will maintain workers' compensation insurance, as required by
ction 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: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600015264
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 wit those provisions.
Date: I 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 and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned pr perty f/r]inspection purposes.
Date: ' I Signature (Applicant or Agent):
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE, 101-0000-20306 0 $1.00 .
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: + $1.00
DESCRIPTION
ACCOUNT.
u FINANCIAL°INFORMATION
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM •
101-0000-42402
0 •
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 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
Bin #
Permit #
Project Address:
A. P. Number:
City of La QuInta
Building .& Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
I
Address: (Lum
Contractor: 1 6141 f!e�J
Address:
City, ST, Zip: Zildl C A
Telephone: Ga _ ZZdZ
State Lic. # : q C7C, �. City
Asch., Engr., Designer:
Address:
City, ST, Zip:
Telephone
-
City, S•T, Zip: l fn 1A ,A4. ('D 0f -n i
r15 A, i eiepnone: p
Project Description:
LiC. #: '-i k
Construction Type: Occupancy:
State Lic. #:
Project type (circle .11 one): New Add, 11 Alter Repair Demo
Name of Contact Person:
Sq. Ft
4 E#Stor7ies7: # Units:
Telephone # of Contact person:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading, plan
Subcoutactor List
Grant Deed
H.O-A. Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
Estimated Value of Project: t`5 D US. (jq
APPLICANT: DO NOT WRITE BELOW THIS UNE
Recd TW
Plan Check submitted
Reviewed, ready for corn
Called Contact Person
Plans picked up
Plans resubmitted
god Review, ready for torr
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for eorre
Called Contact Person
Date of permit issue
^.Is�IG PERMIT FEES
Item Amount
rtions Plan Check Deposit
Plan Check Balance
Construction
Mechanical
--tions/issue Electrical
Plumbing
SALL
Grading
etions/issue Developer Impact Fee
-------------
A.LP.P.
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) • (Page 1 of 3)
Project Name: 54944 Southern Hill Date Prepared: 2017-06-16
'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-
54944 Southern Hill
02
Date Prepared
2017-06-16
03
Project Location
54944 Southern Hill
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
54944 Southern Hill
07
Zip Code
92253
08
Dwelling Unit Conditioned
3020
D t.a "n
�, . s
s�.�•%' <^.
:
Floor Area (ft)
SC System
'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
Y. ='• s '�jp S�.fc
B. Space Conditioning (SC). System InformationK
Ne
Ol
02`69
Y
4.i,
04
� •-- U5
06 v
*� U7
OS
,U9
10
�Rt`
Is th'e SCr
Installing a
D t.a "n
�, . s
s�.�•%' <^.
:
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
2000
" =Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of. Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 217-A020204824A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-06-16 16:00:42
Report Version:.2016.1.005
Schema Version: rev. 10/16
HERS Provider: CaICERTS
Report Generated: 2017-06-16 16:01:14
CERTIFICATE OF COMPLIANCE CF111-ALT-024
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 split
All new
Central split
All new
This field or "
This field or
System 1
HP
heating
AFUE
81
AC
cooling
SEER
20
Setback
section is not
section is not
components
components
applicable
applicable
Reauired 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
Aeakage.rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks.
CF2R 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.
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23 �"r. Refrigerant Charge MCH -25 i`'
y
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH 0 Du Leakage Testing regwremeni
y
to a10.
`°'`+kA ....,ttS '-3i� '--' :iX'.:;�=.br4;:;,,.an e. ,4, •Kz�- �.• m, :� .x�sa: v."
E. Entirely New or Complete Replacement Duct System, with or without,Egwpment Changeout (Sections 150.2(b)1Dna.and 150.2(b)1E, F).
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IQ
This section does not apply to this project.
Registration Number: 217-A020204824A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-06-16 16:00:42 HERS Provider: CalCERTS
Report Version: 2016.1.005 Report Generated: 2017-06-16 16:01:14
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE'
CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-lR-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:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2017-06-16 16:00:42
Address:
CEA/ HERS Certification Identification (if applicable): .
_
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
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 R gula ions. ' "�a" '� Fye '� y
f:
:S'Y ,,...Y4..
4. The building design features or system design features identified omthis Certificate,of Compliance areyconsistent wifFi�the information.. provided on; otheu'applicable''compliance documents, worksheets,
calculation's, plans and specifications submitted to the enforcement agency fora"pproval:with this building permit application. i
y
S. I will ensure that a registered copy of this Certificate of Compliance sFiall;be'ma8e%available with+the Building permits) issued for.thebuildir g, and>inade.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 with the documentation` the builder provides to the building owner at occupancy.
Responsible Designer Name:Er--+•
Hyde, Mark..
Responsible Designer Signature:
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2017-06-16'16:00:42
Address:
License:
42949 Madio
906115. .
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202'
Easy to Verify. rni *T.A rTy �O
at CaICERTS.com
I
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 fc
r the accuracy of the infor
LJ .•
Registration Number: 217-A020204824A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time:
Report Version: 2016.1.005
Schema Version: rev 10/16
2017-06-16 16:00:42 - HERS Provider: CaICERTS
Report Generated: 2017-06-16 16:01:14