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BMCH2016-0185;I 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: , GREEN TECH A/C INC .22744 INGOMAR STREET .WEST HILLS, CA 91304 C&tvl 4 .4v Qum& COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BMCH2O16-0185 51650 AVENIDA VALLEJO 773132007 SENA / HVAC CHANGE OUT $7,000.00 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.: 1001732 j Date: 3 Contractor: `I 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 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: 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, Liv. C.). Lender's Name: Lender's Address: 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 t e rk"for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Secti n 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Date: 1 — JI -1110 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 b 'tiding construction, and hereby authorize representatives of this city to enter upo e above-mentioned property for inspection purposes. Date: Signature (Applicant or Agent) C Owner: DELIA SENA n 51650 AVENIDA VALLEJO T � D LA QUINTA, CA 92253io S C� Ml O yc �a tv C==3 c) Contractor: Contractor: GREEN TECH A/C INC y 22744 INGOMAR STREET WEST HILLS, CA 91304 (818)458-0180 LIC. No.: 1001732 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 t e rk"for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Secti n 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Date: 1 — JI -1110 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 b 'tiding construction, and hereby authorize representatives of this city to enter upo e above-mentioned property for inspection purposes. Date: Signature (Applicant or Agent) INFORMATION. k�4FINANCIAL ` ' DESCRIPTION'x��r s ACCOUNT yrl QTY °` '' `AMOUNT E PAID,; : PAID DATE F -' BSAS SB1473 FEE . 101-0000-20306 0 $1.00 $0.00 "RECEIPT. # f 7 CHECK #r CLTD BY ,r t Total Paid for.BUILDING STANDARDS ADMINISTRATION.BSA: ..$1.00 ', .' $0.00 � DESCRIPTION t�# vu f ACCOUNT' WQTY< '43: z' AMOUNT' PAID �, �,{ DATE ,PAID . HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $0.00 PAID BYY Ya"'1p, r; 3 ,li I_ �.- METHOD �L' {'# {. ,y9 #w CHECK #4 CLTD BY h : ,., : s= ; ".Ail .RECEIPT �9 i� r syh DESCRIPTION :$ :.: E ACCOUNT � QTY ; °' AMOUNT r PAIDi� '; `PAID'DATE 4f , ,IH :A. � r' HVAC CHANGEOUT — SPLIT—SYSTEM PC 101-0000-42600 0 $36.26 $0.00 t R" PAID 13Y ; s Z 'METHOD,"x i RECEIPT # k �y, CHECK # � CLTD BY ``` _ '� Total Paid for CHANGEOUT: $108.78 $0.00 3.DESCRIQTION��.,�£� Ael t• ACCOl9NT�$t� `QTYr ':AMO �p PAID{ :£ PAID DATEI PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 ¢ t : h D # METHOg t� -RECEIPT# CHECK'W i` CLTD BY , • »....�s,w. , rza�' , �. Total Paid for PERMIT ISSUANCE: $91.85 $0.00 • • •0 .11 i � t r � Description: SENA / HVAC CHANGE OUT Type: MECHANICAL Subtype: -Status: UNDER REVIEW Applied: 5/31/2016 SKH Approved: Parcel No: 773132007 Site Address: 51650 AVENIDA VALLEJO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 53 Lot: 18 Issued: UNIT 5 Lot Sq Ft: 0 Building Sq Ft:0 Zoning: a - Finaled: _ Valuation: $7,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC CHANGE OUT - 14.SSEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SiTES W. r i CONTACTS, • .r k,NAME'' .TYPE- .,NAME': * ADDRESSl =CITY STATE ZIPS- rTM :,PHONE'FAX=: _ :EMAIL c:x < . <'°', .. + "�:=�R°.e '6rrr. 6+`'v3 4: APPLICANT GREEN TECH A/C INC 22744 INGOMAR WEST HILLS CA 91304 - EDGAR@GREENTECHA, . STREET- C.COM CONTRACTOR GREEN TECH A/C INC 22744 INGOMAR WEST HILLS CA 91304 EDGAR@GREENTECHA STREET C.COM OWNER DELIA SENA 51650 AVENIDA LA QUINTA CA _92253 VALLEJO ! ! Printed: Tuesday, May 31, 2016 10:44:48 AM. 1 of 2 sysrenns DESCRIPTION ACCOUNT '' QTY x AMOUNT PAID ° _< PAID'.DATEN RECEIPT # CHECK#'' METHOD ' '' .PAID BY n aw ;: g. ^ t. 5 �?° �. t o- Vie. z:, i •,,� �� .. c®s_. `^ tri. ` 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 $72.52 $0.00 SPLIT-SYSTEM HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $0.00 SPLIT-SYSTEM PC Total Paid for CHANGEOUT: $308.78 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:i �• Printed: Tuesday, May 31, 2016 10:44:48 AM 2 of 2 SYS 7Eti1S Bin # City of La Quinta . Building 8t Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # oJect Address: as o 61- uck.. e Owner's Name: be -Ilk A. P. Number: Address:I/t Legal Description: Yy; ST, Zip; ntra ctor. 1 0— �G. lehn J -f-one. � �'reo e.� c� 3 ddress: ;Z�— L( I 141d pr et Description: � p T, Zip: C cves�- fps L� O...l....... G'� 4 ktg; �+c.h G Vely,— ne0.gd Q .4 to orie. # :. 406 ,3 City Lie. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: Construction T e: P YP. Occu an cY: State to Lic. # PrJect type (circle one): . New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: Units: -;<# Telephone # of Contact Person: -mated Value of Project: r l k _ (� c0 D . 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 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2qd Review, ready for corrections/issue . Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^! Review, ready for corrections/issue 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 : • • J - CF111-ALT-024 Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) e - (Page 1 of 3 ) Project Name: Avenida Vallejo Date Prepared: 2016-05-30 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 CF111-ALT 02 document for_each dwelling unit: 01'- Project Name ,Avenida Vallejo. ,' - - 02 Date Prepared . '' 2016-05-30 - 03 , Pr'oject Location 51650 Avenida Vallejo . ... '.- �_- -04 Building Type z: d Single family,° 05 CA City ` ; La Quinta' • " ' j - 06 Dwelling Unit Name Avenida Vallejo" • .10 ` * '08 Dwelling Unit Conditioned ._ Insos•zaling g athe -07 Zip Code 92253 Floor Area (ft2) 1409 SC System CFA served systema refrigevrant k. Installing new;S,C sta'lip ' � Installing xn � Number of space conditioning . 09 Climate Zone 15 1 10, (SC) systems in this dwelling - 1 ` = Name. .. t System (ft2) unit. 'component? B. Space Conditioning (SC) Syste Information 44-55 .r . i Ol - 02 • . 0414` 05"` � x 06 07 08 - 33aa¢¢r$ • 09 ` ��{{.03,Ey _ yU t .10 SC ._ Insos•zaling g athe ' *'o+►` - `s".x 44 SC System SC System CFA served systema refrigevrant k. Installing new;S,C sta'lip ' � Installing Identification or location or -Area by this SC ducted containing A. system-. - more than 40 , -in—stalking entirely new entirely new` ` = Name. Served '' System (ft2) system? -- 'component? components? feet of ducts? duct system? SC system? Alteration Type Entirely new or complete - t- System 1 • 'Location 1- - 1409 <}- Yes ` , Yes Yes "' `Yes . Yes '� ' Yes ' 7 a *_. replacement space - k " conditioning system 1 Registration Number: 216-4198847A-000000000-0000 '' Registration Date/Time: 2016-05-30 22:09:47 - HERS Provider: CalCERTS, f CA Building Energy Efficiency Standards - 2013 Residential Compliance` i Report Version: 2013 Rev 1.007 — Report Generated: 2016-05-30. 22:10:19 r yw• - ' Schema Version: 0.555SDD - ` CERTIFICATE OF COMPLIANCE , . f CFIR-ALT 02-E . Alterations to Space Conditioning Systems (formerly CF-lR-ALT HVAC)+, (Page 2 of 3 ) E. Entirely New or Complete Replacement Duct System, with'or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)IE, F) ry " • This -section. does not apply to this project. r i F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) - -' 01 02 ; 03 ` • 04 10 05 06' - . 07. 08 ; 09 10.7 . 11 - Heating ------------- '* Cooling' System ^•s kA Heating _ Minimum r + Cooling "Minimum • . Required - - Identification or Heating System, Altered Heating Efficiency Efficiency: ``Cooling . Altered Cooling -Efficiency .Efficiency Thermostat' New Duct " - Name - Type o `ponent "Ty a Value ' System Type Component _ r =Type Value Type R -Value System 1 • Central gas ,, furnace Wl,,peW heating - AFUE R ''J`*')Cerftr,61-"Split 0 78 ; cAll'new Cooling - aX -)"'Acorn SEER 14.5 SetbackTher mostat R-8'_ ycom onents�s ACS pone . n Required Documentation:0 1W CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums R6;.' CF2R & CF3R-MCH-20-H Duct Leakage Verification required. = -Leakage rate compliance: 5 69C CF2R & CF3R-MCH-22 Fan Efficacy Verification ^� - CF2R & CF3R-MCH-23 System Air Flow Rate Verification -Compliance: Fan Efficacy 5 0.58 W/cfm and System Airflow 2 350 &m/ton. -• ' - - - r' - " * -Alternative Compliance: CF2R & CF3R-MCH-28 Return Dud Design Verification is an alternative to M_6-22 and MCH -23 verification.'.. - CF211 & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).. jr '•r Exceptions: Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements. • . • .. r x-', `• o An :'entirely new or replacement dud system" means at least 75 percent of the dud system is new duct material, and up to 25percentmay consist of reused parts from the dwelling unit's existing dud system (e.g., _ registers, grilles, boots, air handler, coil, plenums, dud material) if the reused parts are accessible and can be sealed to prevent leakage ' • + ' F 4F Registration Number: 216-A019.8847A-000000000_ -0000 ,�, - _ ~ +.` Registration Date/Time:... 2016-05-30 22:09:47• , ` -` .HERS Provider: CaICERTS 'r i CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2.013 Rev 1.007 r -, Report Generated: 2.016-05-30 22:10:19' T . Schema Version: 0.555SDD X CERTIFICATE OF�COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly, CF -IR -ALT HVAC) _ - - (Page 3 of 3 ) Documentation Author's Declaration Statement = * . - ° �" - • " 1: I certify that this Certificate of Compliance documentation is accurate and complete: k_-^ • , ' , - Documentation Author Name: 4.- • hernandez, Documentation Author Signature: '' •� ' edgar Company:' Jti, Signature Date: - - GREEN TECH A/C INC" ' ",� * ' -� "' - 2016-05-30 22:09:47 ,`; __ : -- Address: -'r 4; r -. CEA/ HERS Certification Identification (if ap'plicable'): 22744 INGOMAR STREET, - t` + '� f�' , ' - ' , :`• - .• City/State/Zip: ' ' : " r - r Phone: <� +� WEST HILLS CA 91304818-458-0180 X123 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the law's 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 Businessand Professions CodeL o� acceptresponsibility 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 Code and Part 6,of the California of Regulations 1 - 4. ya The building design features or system design features identified on this Certificate of Compliance are consistent with -the information,provided on'other-applicable'compliancedocuments, worksheets;' c r ,+` ;.:,,' ,f4.-:. it ....w.v .'_.-. =:6 1 F calculations, plans and specifications sutimftted o the en orcemenVagency foyrr'approvaR witF this building permit application. 5. ;1 will ensure that a registered copy of,this.Certiflcate of Compliance shahbe:made available with.the building permits) issued forcthe buildmg, and available to the enforcement agency for all applicable -made inspections. I understand that a registered copy of this Certificate of Compliance js required to be included with the documentation the builder provides to the building owner at occupancy. ' Responsible Designer Name: hernandez, Responsible Designer Signature:a edgar - Company: 3 , w +. , Date Signed: GREEN TECH A/C INC_` ." . ' �. 2016-05-30 22:09:47 -" �`� ` Z Address - ' �t. ~��` f' License: 22744 INGOMAR STREET ' 1001732 City/State/Zip: ' .. •' Phone: • . - �- WEST HILLS CA 91304_ f _ _ r - �"' 818-458-0180 X123 �. Digitally signed by CaICERTS. This digital elgnature is provided in order to secure the conteni of this registered document, and in no way Implies Registration Provider responsibility for the accuracy of the inforrnarlon.., Registration Number: 216-A0198847A-000000000-0000 ' z. Registration Date/Time: 2016-05-30 22:09:47 HERS Provider: CaICERTS �` 4 ` CA Building Energy Efficiency Standards - 2013 Residential Compliance " . Report Version: 2013 Rev 1.007 ' '.» - " Report Generated: 2016-05-30 .22:10:19 Schema Version. 0.555SDD