BMCH2016-0327Applicant:
IE INC
31225 LA BAYA
V.1ESTLlSM.E VILLAGE, CA 91362 .
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.
Licens Clas :C20, License No.: 489046
Date � � , A' Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contr'actor'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, Civ. C.):
Lender's Name:
Lender's Addre!
Contractor:
ESSER SERVICES INC DBA ESSER AIR CONDITI
P 0 BOX 1636
CATHEDRAL CITY,.CA 92235
(760)324-0550
Llc. No.: 489046
WORKER'S COMPENSATION DECLARATION
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'
:ompensation, as provided for by Section 3700. of the Labor Code, for the performance
:)f the 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
s issued. My workers' compensation insurance carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEST ' Policy Number: WSD5030167
- 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
comq wi 'those provisions.
Datev` Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI ES 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- en 'oned property for inspection purposes.
Date: Signature (Applicant or Agent):
'i �NIILf�it/
VOICE (760) 777-7125
78-495 CALLE.TAMPICOD
U `�1
`
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN &DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
o
BUILDING PERMIT
y
Date: 8/31/2016
Application Number:
BMCH2O16-0327
-A �I
-�
(Owner:
Property Address:
52725 AVENIDA VALLEJO
CHRIS MONTGOMERY
APN:
Application Description:
773292022 I, t; 2 0,j ^
MONTGOMERY RESIDENCE /HVAC
52725 AVENIDA VALLEJO
IA QUINTA, CA 92253
Property Zoning:
C fYGi=Lfj�Ulld_
Application Valuation:
$10,491.00
COi:(;G;(�;'fYOEGrCr'::c�T,EFATI:`��T
Applicant:
IE INC
31225 LA BAYA
V.1ESTLlSM.E VILLAGE, CA 91362 .
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.
Licens Clas :C20, License No.: 489046
Date � � , A' Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contr'actor'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, Civ. C.):
Lender's Name:
Lender's Addre!
Contractor:
ESSER SERVICES INC DBA ESSER AIR CONDITI
P 0 BOX 1636
CATHEDRAL CITY,.CA 92235
(760)324-0550
Llc. No.: 489046
WORKER'S COMPENSATION DECLARATION
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'
:ompensation, as provided for by Section 3700. of the Labor Code, for the performance
:)f the 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
s issued. My workers' compensation insurance carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEST ' Policy Number: WSD5030167
- 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
comq wi 'those provisions.
Datev` Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI ES 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- en 'oned property for inspection purposes.
Date: Signature (Applicant or Agent):
Date: 8/31/2016
Application Number: BMCH2O16-0327 Owner:
Property Address: 52725 AVENIDA VALLEJO CHRIS MONTGOMERY
APN: :773292022 52725 AVENIDA VALLEJO
Application Description: MONTGOMERY RESIDENCE/ HVAC LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $10,491.00 ;
Applicant: Contractor:
IE INC ESSER SERVICES INC DBA ESSER AIR CONDITI
31225 LA BAYA P 0 BOX 1636
WESTLAKE VILLAGE, CA 91362 CATHEDRAL CITY, CA 92235
(760)324-0550
Lic. No.: 489046
---------------------------------------------------------------------------.------------------
betail:'CRANGE OUT HEAT PUMP. -17 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. PER 2013 CALIFORNIA BUILDING CODES
i
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
FINANCIAL,
INFORMATION
DESCRIPTION
ACCOUNT'
.
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
$72.52.
DESCRIPTION
ACCOUNT'
QTY
AMOUNT `
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
Total Paid for CHANGEOUT: $108.178
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
#
city. of.La Quinol
&dkbw & Safety Division
Pemllt #
P.O. Box 1504,78-495 Calle Tampko
La -Q&4 CA 92253 --(760) 777-7012
Building Permit Applicadon' and Tracking Sheet
Project Ad&=: Ot ?a a G. F� ' o owner•$ Names S
A. P. Number. -
Adder:
Legal
City, sr, LA QUINTA, CA
Co,mactoc ESSER SERVICES
feleptro
Address: P.O. BOX 1636
Projeat)escciption:
City. ST, zip: CATHEDRAL CITY, CA .
92235 CQV I
Tekphonc: 760-324-0550
OAQ r)
State Lia #: 489046. City uc, B: -- —
Atrb.,
Address:
Ct4+. ST, Zip:
Telephone:
Construction Type:. Oxnpanay:
Stft Lie. 9:
Project type (cede one): New Add'n Alter Repair Demo
Name of Cootta Pamw MICHAEL E_S S E R sq: Ft : n stories a unftx
Telephone i of ContactPasnn: 760-324-0550' Essiunatod- Vatic of Pro'
APPUCANT: DO NOT WRITE BElAW THIS Io �,
N
Sobo,teai
ReVd
TEACKMG PERMIT FEES
Plan Seb
Moa Cbak $wwd ted item Anoaat
Strgdarai Cala
Reviewed, ready for boas I Pias Cbak Deposit.
TV= Cabs.
Called Contact Person Man Ckeek Bataan
1ffie U Cases.
Ptah picked tap Construction '
Flood plan plea
Plans raubmitted Medkaikd
Grading plen
P' RMcw, ready for enrrediownssae Electrical
8abcoaactor List
Called Contact Pawn Yianbiag
Grant Deed
Plans OdA ups
H.O.A. Approval
Plans submitted Gradlug
IN HOUSE:-
*Review. rady for cormctions'ltrsae Developer Impact Fee
Planning Approval
Cytled Contact Paws A.I P.Y.
Pub. Who Appy
Date of permit issue
School Fes
Total Permit Fees
v,•'011L it t ..,t; •,r-. , l._ ,
CERTIFICATE OF COMPLIANCE ` "' ' - 3d iF 1 CM -ALT -02-E
Alterations to Space Conditioning Systems (formerly CF-1R•ALT HVAC) (Page 1 of 3 )
Project Name: Chris MontgomeryDate Prepared: 2016-08-26
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 CRR -ALT -02 document for each dwelling unit_. _
03
01-
Project'Name -
Chris Montgomery' - '"`�' `
' 02-
Date Prepared__ — " '�
2016-O8-26'
'03'
Project location
5272 S. Avenida valleJo"` ''
04
Building type.
Single family._
-OS -
CA City
LAQUINTA--- - _ -_ _ -__ _
06-
Dwelling Unit Name -- --
WHOLE HOUSE -- - - - -- - -- -
07 -Zip
Code _
92253 - - - ' .
1 O8
Dwelling Unit Conditioned
Area ft2
( )
1900
t_
rtl .'f`. •t. -!j
-t :'+ t,? 'a.r?f It t #efEi:..�Yi "Y.1 t
:' r!'
.Floor
'Tti a't 1'.'
by this SC
ducted.!"ft
_ _
more than 40
Number of space conditioning-
09
climate Zone - _ -
15 -T - _ ^_ _` , ,< ; ,� L ::;
ti
10
(SC),systems in this dwelling—
1,-
i componentaP
feel of ducts?
duct system?
'SC system?
unit.
SYSTEM 1,
HOUSE
I
1900
Yes
Yes
Yes
I
No
B. Space Conditioning (SC) System information
01
02,-
03
044,7.-�
p r 0S
m; 06jfi ti`
07
08
09
10
Is the SGS
'installing
SC System
SC System
-CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification_ or
Location or Area
by this SC
ducted.!"ft
..,.containing \.
► ' ystemz ^rpt;+
more than 40
entirely new
entirely new
Name
Served
System (ft2)'
system?
cpmponent?
i componentaP
feel of ducts?
duct system?
'SC system?
-Alteration Type
SYSTEM 1,
HOUSE
I
1900
Yes
Yes
Yes
I
No
Not
No
"Altered space
p
-condittoningsystem-
_ . _..
'tit 3.. t -.. . �• 3C: f 't,
C. Extension "of Existing DuctySystem, Oreater,Tian 40 Feet•(SectioniSO.2(b)iDilb) z { fZ,
,
w• u. ,.,, w
This s�ctlondoes not,applyto-this project. - -------- - -•- __ _ . ._._ _ ._..._
!ii'.fll-r:a;"a" `,z.,+� ui_, t L 7c'ia.C1;r'1:rl,;
tflbr: �:i rl. 11 %,tG C 1, i{t'{'� �,.t� 3:',Zt,".c..2 (t a.°ai:� %{ btS`t1.—'Ct
! tegistrafiori,N6M;eF:`416-A0003579A-0000800000-e0000 — _ J ✓ Registration Date/Time; 2016-08-26 09:39:39 HERS Provlder-CHEERS j
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-26 09:39:49
Schema Version: O.S5SSDD
0 6t.Ngn,QoN
s
a•1
1
C
w
AAHMg.
s c
I
en
2n zw •3�gNe:r
3
.23 1
3 �
i
o
06
i
7 Z
Z
�a
�J
m I c 1 - -•
1.
7D
y •W =O� 20 7
CL
u ss D7D yt 1 Fw !
S w
I i
O
A �
7
�t
2 p Ap
}
8
N N 3 •• �oFj � n •
•�]
1
'�•S
V
a
{D
CLW
as ?ora
•m
" D
S
3
n
M •'
_ m
�
Fl
s
v '
-
�f
1
�
c�3S
{cp
3 N� sw
9D
r
O
N
I
3
'
�
I
1
N
N
c
i t
to
d 4 r
LL
m
v
0
Fri
SII
I
1
.
I
3
O
I j I
!
m
i
pa
{
_:
CL,
,
c
m
I's t
N
N
N
m
3
o
I
ro
0
o
PA
OR
v.
i
— n
" `
{
N
a
A
o
cr
to ,,,
�_
. 1+
��
•
ur
V
1
Q.� 06
�
o O
0,
'?A
{
1 O -
3 A
r 1
ba
N
IF ; o
Z
t
I t
I
N 1
I
w
,
1
to
s
m
1
�
Q
{ II
_
'
yA
yM1
I
{
rn
R
N 1
m
90
CL
tD m I -
A
t0
1
`
1
0 6t.Ngn,QoN
s
a•1
1
C
w
AAHMg.
s c
I
m
2n zw •3�gNe:r
3
.23 1
3 �
i
o
06
2'- 32. -=tea 1.
�a
�J
1.
7D
y •W =O� 20 7
CL
u ss D7D yt 1 Fw !
S w
I i
O
A �
7
�t
}
A
N N 3 •• �oFj � n •
•�]
1
'�•S
Q 3 —0=3 `
{D
as ?ora
•m
mow=
S
3
n
M •'
_ m
�
Fl
s
3
a�a� r�-
�
c�3S
{cp
3 N� sw
r
O
N
d
a
N
v
0
i
— n
" `
{
N
a
ur
1
Q.� 06
�
o O
0,
'?A
{
1 O -
3 A
r 1
ba
N
IF ; o
Z
t
I t
I
N 1
I
t
CERTIFICATE OF COMPLIANCE CFiR-ALT-02-E
Alterations to Space Conditioning Systems (formerly Cf -1R -ALT HVAC) (Page 3 of 3
Documentation Author's Declaration Statement
1.1 certify that this Certifleate of Compliance documentation is accurate and complete.
Documentation Author Name;
Documentation Author Signature:
Shantel Faugno
Shantel Faugno
Company:
Signature Date:
Esser Services, Inc.
2016-08-26
Address:
CEA/ HERS Certification Identification (if applicable):
PO Box 1636
Clty/StateAlp: . a
_Phone;
Cathedral City CA 92235
7603240550
Responsible Person's Declaration statement
1 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 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 manufactu,'t :'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 Certlficata 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 applk ation.
S. I will ensure that a registered copy of this Certificate of Compliance shall be;made avellahie with the building .permlt(s) Issued for the building, and made available to the enforcement agency for all applicable
Inspections. I understand that a registered copy of this Certificate of Compliance Is required io be Included wRh'the documentatlon the builder provides to the building owner at occupancy.
Responsible Designer Name:k 1,;r r u; i,.I l f ; ,E
Responsible Designer Signature.
§ iI In l Fa' u
Shantel Faugno
e g n o
Company:
Date Signed:
Esser Services, Inc.
2016-08-26
Address:
License:
PO Box 1636
489046
city/State/Zlp;
Phone:
Cathedral City CA 92235
760-324-0550
Digitally sigyned by CHEERS"". 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: 416-A0003579A-000000000-0000 Registration Date/Time: 2016-08-26 09:39:39 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-08-26 09:39:49
Schema Version: 0.5S5SDD
1h�
,!
•
I i
'.wry
�
r..
J I
1
f
I ;
� I
V'
�
'
I N
C
'
�
' -
i
•r
•
ll , J