BMCH2015-006078-495 CALLE TAMPIC��� • VOICE (760) 777-7125 .
LA QUINTA, CALIFORNIA 92253
'FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
'': �•
t--- BUILDING PERMIT'
'
Date: 3/4/2015
Application Number: ." BMCH2O15-0060
Owner:
Property Address: 52770 AVENIDA VALLEJO
DOUGLAS ROBERSTON
APN: 773324001
52770 AVENIDA VALLEJO J.
Application Description: ROBERTSON/HVAC CHANGE OUT 3TON 17 SEER/78AFUE PACKAGE LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $7,980.00
,
Applicant: Y
Contractor: N-414 Qj
CERTIFIED COMFORT SYSTEMS INC
CERTIFIED COMFORT SYSTEMS INC S
42-949 MADIO STREET
42-949 MADIO STREET p
INDIO, CA 92201 '
INDIO, CA 92201 c
\
(760)360-2202
^
- +Llc. No.: 906115 LVA $
i
-------------------------------------------=-------------------------------------------------
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, C36 License No.: 906115'
of the work for which this permit is issued.
7_11�1 have and will maintain workers' compensation insurance, as required by
Date: Contracto .
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:
OWNER -B ER DECLARATION
Carrier: Policy Number: •_
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 Code: 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
bate:' Applica
• basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
;',
permit subjects the applicant to a civil penalty of not more than five hundred dollars
COM
WARNING: FAILURE TO SECURE WORK ' PENSATION COVERAGE IS UNLAWFUL,
($500).: ,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, 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 PROVIDED 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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restriction's set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon: whose behalf this application is made, each person at whose
(� I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose.benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to; and
State License Law does not apply to an owner of property who builds or improves
shall defend) indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(_) I am exempt under Sec. B.&P.C. for this reason
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.
Date: Owner:
I certify that I have read this application and state that the above information is correct.
CONSTRUCTION LENDING AGENCY
I agree to comply with all city and county ordinances and state laws relating to building
I hereby affirm under penalty of perjury that there is a construction lending agency for
construction, and hereby authorize representatives of this city to enter u on the above
the performance of the work for which this permit is issued (Sec. 3097,'Civ: C.).
' Lender's Name:
mentioned propefor inspection purposes.
Date: Signature (Applicant or
Lender's Address:
+
CERTIFICATE OF COMPLIANCE i CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT. HVAC) (Page 1 of 3 )
Project Name: • - T - r- - V - 52-770 Avenida Vallejo Date Prepared: 2015-03-04
A. General Information
CRR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be '
documented, use one CFIR-ALT 02 document for each dwelling unit.
01
Project Name
52-770 Avenida Vallejo
02
Date Prepared
2015-03-04
03
Project Location -
52-770 Avenida Vallejo
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
52-770 Avenida Vallejo
07
Zip Code
92253
08
Dwelling Unit Conditioned
1314
Floor Area (ft2)
SC System
SC System
CFA served
system a
refrigerant
Number of space conditioning.
_� _ _ • _ . _ _ ..
X09
_
Climate Zone` r
15 T _r _
10
(SC) systems in this dwelling:'
1
ducted
containing
system
more than 40
unit.
entirely new
17
B. Space Conditioning (SC) System In ormation
01
02
0,3
#+
'SOS
• 07y
t i/08
09
10
I3 d
;A_04V-
,+'./%06
h L
;•t
Is the SC-``
r.l sn Lalling a�.'
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 'T
-__ :System 1- -
= Living Area -s=
• - 1314 =
•- Yes- •-
- - = Yes- '"
- -Yes`
Noi-
No "`
� No
Altered space -
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project. '
C_ -
-Registration Number: 215-A0059992A-000000000-0000 Registration Date/Time: 2015-03-04 11:50:28
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
�,rhamn varcinn• n rsscnn
HERS Provider: CalCERTS
Report Generated: 2015-03-04 11:50:20
D. Altered Space Conditioning System (Sections 150.2(b)1E 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 gas
All new �
-
Central
All new
This field or
This field or
System 1
furnace
heating
AFUE
0.78
packaged AC
cooling
SEER
17
Setback
section is not
section is not
components
components
applicable
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 coolingcomponents are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: <_ 1S%, ors 10% leakage to outside, or seal all accessible leaks. ,
CF2R-MCH-2S-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300C,F-�M/ton required when MCH-25 _
Exceotions:
Duct systems registered with HERS provider as Previously sealed a,exempt from MCH-20 Duct Leakage lTesting regwrements. xs
F.
-Heating-only systems and Air Handler/Furnace changes do not regwre venficatiori of Air Flow MCH-23; or Refrigerant Charge MECH 25.
Existing duct systems constructed, insulated or�sealed with asbestos are exempt from MCH 20 DuctAleakage Testing re'_quirements;_.,.',, 0,�`'
,
F. Entirely New or Complete Replacement Space Conditioning System (Section 150..2(b)IC) _
This section does not apply to this project.
Registration Number: 215-A0059992A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-03-04 11:50:28 HERS Provider: CalCERTS
Report Version: 2014-03-31 Report Generated: 2015-03-04 11:50:20
Crhomn X/crcinn• n SSScnn -
CERTIFICATE OF COMPLIANCE CF111-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.
Documentation Author Name:
Documentation Author Signature:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2015-03-04 11:50:28
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. 1 am eligible under Division 3 of the Business -and Professions Code to -accept .responsibility the building design or, system design identified on this Certificate of Compliance (responsible designer).
lfor
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 Regulations.
4. The building design features or system design features identified on this Certificate 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 application. n E J `' ��
5. I will ensure that a registered copy of this Certificate of Compliance shall be -made available with the building permit(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 to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2015-03-04 11:50:28
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0059992A-000000000-0000 Registration Date/Time: 2015-03-04 11:50:28 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-04 11:50:20
�ncam2 Vorcinn• n SSSCtIn
FINANCIAL •R •
.J ESCRIPTION.
� ;A000UNT rid hQTY AMOUNT
ar PAID ' PAID DATE
BSAS SB1413 FEE
101-0000-20306 0 $1.00
$0.00
PAID BY.,:
METHOD , $; ,w ;f• RECEIPT #'. ;. r
CFIECK # ".' CLTD BY
,
t
- Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 r $0.00
t DESCRIPTION'
-ACCOUNT .
QTY ,
' AMOUNT, : `
PAIDs
'PA -D DATE
HVAC CHANGEOUT - PACKAGED UNIT
101-0000-42402
0
$36.26
$0.00
' PAID BY , fi
METHODr :
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION a''t
ACCOUNT �'
QTY':S.`AMOUNT
.'`
;;,'PAIDa
PAID DATE.
HVAC CHANGEOUT - PACKAGED UNIT PC
101-000042600
0
$24.17
$0.00
'F PAID BY,P ' a,
;'METHOD.
aRECEIPT #
CHECK #'
CLTD BY
,
Total Paid forCHANGEOUT: $60.43 _$0.00
„'DESCRIP,TION--'°
�-`,ACCOUNT ��_
.G�TY�'��"`a'AMOUNT-';
PAID,
PAID DATE,
PERMIT ISSUANCE
101-0000-424.04
0
$91.85
$0.00
PAID BY
METHOD ' ,.
s RECEIPT # ,
"'CHECK #''
g CLTD BY�
Total Paid forPERMIT ISSUANCE:' $91.85 $0.00
• 00
1
�
�
Description: ROBERTSON/HVAC CHANGE OUT 3TON 17 SEER/78AFUE PACKAGE
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 3/4/2015 SKH
Approved: 3/4/2015 SKH
Parcel No: 773324001 Site Address: 52770 AVENIDA VALLEJO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 159 Lot: 26
Issued:
UNIT 16
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $7,980.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 • No. Stories: 0 No. Unites: 0
`
Details: HVAC CHANGE OUT - 175EER/78AFUE PACKAGE SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2,013 CALIFORNIA BUILDING CODES.
Printed: Wednesday, March 04, 2015 2:33:04 PM 1 of 2
CRFWIYSTEA4S
DESCRIPTION
ACCOUNT l
' QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
«.
BY
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
PACKAGED UNIT
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
PACKAGED UNIT PC.'
Total Paid forCHANGEOUT: $60.43 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Printed: Wednesday, March 04, 2015 2:33:04 PM 2 of 2
CR��1l�/f�9fJ�
LJ SYSTEMS
- I .
BOND
.,
. INFORMATION
.,
. .•...
ATTACHMENTS
Printed: Wednesday, March 04, 2015 2:33:04 PM 2 of 2
CR��1l�/f�9fJ�
LJ SYSTEMS
- I .
Bin #
Permit .#
Project Address: _
A P. Number:
Legal Description:
Contractor: /ver• 41 f/
Address: • (� ` LY el y�
City, ST, Zip: r
/O
Telephone: 6
State Lie.. # : 6( C76�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
City of La Quinta
Building .8L 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: .
Address: ,t —
City, ST, Zip: / e
Lic. #: "i Y Z•
G; -. W, r__ �.Z
Project Description:
0
0
Construction Type: Occupancy:
P1°ject type (circle one):. New Add'n
Repan' Demo
jSq:.F:tt:I #.Stories:
# Units:
Total Permit Fees
Amount
'Mumated Value of Proj
i
APPLICANT: DO NOT WRITE BELOW THIS LINE
V
# Submittal
Req'd Recd
'
TRACKIIYG
Plan Sets
Plan Check submitted
PERMIT FEES
Structural Calcs.
Item
Reviewed, ready for corrections
Truss Calcs.
Plan Check Deposit
Called Contact Person
Energy Calcs
Plan Check Balance
.
Plans picked up
Flood plain plan
Construction .
Plans resubmitted
Grading plan-
Mechanical
Subcontactor List
20° Review, ready for correctioas/issue
Electrical
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
SALL
.
Plans resubmitted
INHOUSE:
-
Grading '
Planui A pproval
3,d Review, ready for corrections/rssue
Developer Impact Fee
Called Contact Person
Pub, Wks. APPr
A.LP.P.
Date of permit issue
School Fees
.
Total Permit Fees
Amount