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BMCH2017-0163
78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 3 Titw 4 4oQ*rw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O17-0163 Property Address: 52885 AVENIDA VALLEJO APN: 773323020 Application Description: TAYLOR RESIDENCE / HVAC CHANGE OUT Property Zoning: Application Valuation: $5,330.00 Applicant: JOHN BORDEN HEATING AND AIR CONDITIONING P 0 BOX 459 YUCAIPA, CA 92399 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C20 License No.: 719570 '/^J -'Contract-,�� 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.). J ( ) 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 Lender's VOICE (760) 777-7125 FA0Xx,(760. _777-7011 ��' � 101�5�(76 -) 153 Date: 5/ 017 Own r MAY 0 12017 ROB MILLER 4980 sw LANDIr>v�R�210LA, QUINTA POWNWMELOPMENT DEPARTMENT Contractor: JOHN BORDEN HEATING AND AIR CONDITIONING P O BOX 459 YUCAIPA, CA 92399 (951)797-5669 Llc. No.: 719570 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 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031288 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 sha orthwith comply with those provisions. Date:' t/v Applica 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 property for inspection purposes. Date: �`/� / `Signature (Applicant or Agent): ' Date: 5/1/2017 Application Number: BMCH2017-0163 Owner: Property Address: 52885 AVENIDA VALLEJO ROBERT MILLER APN: 773323020. 4980 SW LANDING DR 203 Application Description:' . TAYLOR RESIDENCE / HVAC CHANGE OUT . PORTLAND, OR 92253 - Property Zoning: ' Application Valuation: $5,330.00 ; Applicant: Contractor: JOHN BORDEN HEATING AND AIR CONDITIONING JOHN BORDEN HEATING AND AIR CONDITIONING P 0 BOX 459 P 0 BOX 459 YUCAIPA, CA 92399 YUCAIPA, CA 92399 _ (951)797-5669. -, Llc. No.: 719570 -------------------------------=----------------------- --------------------------------------- Detail: HVAC CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR T,0 FINAL IN, SPECTION. 2016 CALIFORNIA BUILDING CODES. { '4: � r FINANCIAL ' 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 CITY 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 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 t 1 r A. General Information • 4 .' h... 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 ` MR -ALT -02 document for each dwelling unit. ', z - - '01 , - , A. General Information • 4 .' h... 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 ` MR -ALT -02 document for each dwelling unit. ', z '.'03 '01 , Project Name A WINTERS, PATRICK. 02 Date Prepared 2017-04-26 ; , 10 SC System Identification or Name • SC System Location or Area' Served ., CFA served by this SC System (ft 2) Is the SC . • r�fr'f system a ducted system? Installing -a ti r a :,�rVC refrigerant containing component?' 03 Project Location' = 52885 AVENIDA VALLEJO 04 Building Type y Single family OS CA City LA QUINTA '06 Dwelling Unit Name HOUSE ' SYSTEM HOUSE 1476 07 w-``- Zip Code 92253 8 Dwelling Unit Conditioned „ ' 1476 Altered space t conditioning system -' - - - I Tloor Area (ft2) IiW Number of Space ~' • • •F . 09 Climate Zone 15 10' fthis Conditioning (SC) Systems in -' 1 �:� . • - ->✓ ` • .. - r _ Dwelling Unit: _ , B. Space Conditioning (SC) System Information, ' [_ ' - 01 02 '.'03 04 U ti 05 -� 1 60, 07 ... 08 09_ ; , 10 SC System Identification or Name • SC System Location or Area' Served ., CFA served by this SC System (ft 2) Is the SC . • r�fr'f system a ducted system? Installing -a ti r a :,�rVC refrigerant containing component?' ti4+tt h iritpar)t Installing new SC system •. components?- Installing more than 40 feet of ducts? Installing • entirely.new duct system? ; Installing entirely new SC system? Alteration Type ' SYSTEM HOUSE 1476 Yes Yes Yes No' No No Altered space t conditioning system Registration Number: 417-A020091188A-000-000-0000000-0000 r Registration Date/Time: 2017-04-26 09:42:32HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance ' Report Version: 2016.1.005 ;: T Report Generated: 2017-04-26 09:42:33 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E 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 30 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 SYSTEM Centralas• g furnace All new heating AFUE 0.8 CentrAaCl split All new cooling SEER 14 Setback Less than or equal to 40 R-8 components components feet Required 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 1-10,42 and 13) and R8 (CZ 11 and 14-16) CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components areiinstalle'd in ducted -`systems, or when more than 40 ft of dud length is replaced -leakage 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: ` Dud 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, or Refrigerant Charge MCH -25. -Existing dud systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Dud Leakage Testing requirements. 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 no apply to th s�pro ect. F. Entirely New or, Complete Replacement Space Conditioning System (Section 1501(b)1C) This section does not apply to this project. Registration Number: 417-A020091188A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time: 2017-04-26 09:42:32 Report Version: 2016.1.005 Schema Version: rev 10/16 HERS Provider: CHEERS Report Generated: 2017-04-26 09:42:33 CERTIFICATE OF COMPLIANCE. - CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly C" -R -ALT -HVAC) ' • r (Page 3 of 3) - y Documentation Author's Declaration Statement 1.,l certify that this Certificate of Compliance documentation inaccurate and complete.. Documentation AuthortName:`i " Documentation Author Signature:' " Connie Goe �- CQy�ytie�C�der _ Company: •; ,. Russells HeatingAir Conditioning`' Signature Date: -� 2017-04-26 Address: . _ , CEA/ HERS Certification Identification (if applicable): 33145 Yucaipa Boulevard City/State/Zip.,o �y+'� .. Phone: } ;`•- • f. ice._`._ Yucaipa CA 92399 •- 909 797-5669 Responsible.Person's Declaration statement I certify the following under penaltyof perjury, under the laws of the State of California: "r t _ '� 1. The information provided on this Certificate of Compliance is true and correct. �L 101 2. I am eligible under Division ' g son 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). 1 '� 3. That the energy features and performance specifications, materials, components, and manufactured devices for building design the design or system 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 a gency,forapproval with this�builcling permit application. 5. 1 will ensure that.a registered copy of this Certificate of Compliance,shalll*be made�available-with the duilding.permit(s))ssued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of'Compli_ance is required.to berincluded with the documentation the builder provides to the building owner et occupancy. _ Responsible Designer Name: Connie Goe Unmaltej lSoMci ResponsibleDesigner Signature: . CovWli.Pi C7opi .. . Company: .. Date Signed: Russells Heating & Air Conditioning _ 2017-04-26 Address: License: • 33145 Yucaipa Boulevard 719570 r City/State/Zip: • Phone: Yucaipa CA 92399 - 14 ' , 909-797-5669'' x Digitally signed by CHEERS'".. This digital signature is provided in order to secure the,content of this registered y document, and in no way implies Registration Provider responsibility for the accuracy of the information. ' Registration Number: 417-A020091188A-000-000-0000000-0000 Registration Date/Time: 2017-04-26 09:42:32 $ HERS Provider: CHEERS A _ CA Building Energy Efficiency Standards - 2016 Residential Compliance ' Report Version: 2016.1.005 t Report Generated: 2017-04-26 09:42:33 ' Schema Version: rev 10/16 ' W. Bin. # City of La Quinta Btl<Wg Br Safety Division Pemlit # P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:{760} 777-7012 Building Permit Application, and Tracking Sheet Project Address: (� �+ 8 �� Owner's Name:. A. P. Number. Address: Q� Legal Description:City, Contractor. tTelephoner ST, Zip: 0— (P-73- 2717q Pe'rWa Description: R er Address: VIA Ca A 0Q d City, ST, Zig: �Q t �� + kxr' Telephone: q --791.15&9 ' `_ f. State Lie # : '7 —7 0 City Lic #;% q j V : � p� QG� UU OOH �T l Arch., Engr., Designer. IV lo - Address: City., ST, Zip: Telephone:Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft #Stories: { #Units: State Lic. #: Name of Contad Person: Telephone # of Contact Person: Estimated Value of Project: 3 . © .00 APPLICANT: DO NOT WRITE BELOW THIS UNE g Submittal Req,d Read TRACKNG PERhIITFEES Plan sets Plan Check submitted Item Amount StmetueW Cales. Reviewed, ready for corrections Plan Check Deposit. . Tross Calcs. Called Contact Person Plan Check Balance. Title 7A Calcs. Plans picked up Construction Flood plain plan Plans resubmitted.. Mecharilcal Girading plan V Review, ready for correctionsliissue Electrical Subeoutactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for correctionsAssoc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees