BMCH2017-0321lu
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O17-0321
Property Address: 53160 AVENIDA VALLEJO
APN: 774053008
Application Description: HVAC CHANGE OUT
Property Zoning:
Application Valuation: $1,000.00
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Owner:
DESIREE PURCELL
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/9/2017'
Applicant: Contractor:
T L C AIR CONDITIONING & HEATING T L C AIR CONDITIONING & HEATING
50235 CALLE TOLOSA 50235 CALLE TOLOSA
COACHELLA, CA 902236^ COACHELLA, CA 92236
��1
AUG ®� 7 (760)343-8020
Llc. No.: 922168
--------- -.-------------------------- - DE? AF1T1�f1�1VT
---------------
--
010
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 License No.: 922168 of the work for which this permit is issued.
C—io/] , (� I have and will maintain workers' compensation insurance, as required by
Da' ' � te"I Contract _o Section 3700 of the Labor Code, for the performance of the work for which this permit
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, Civ. C.).
Lender's Name:
Lender's Address:
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: EXEMPT 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. —�
1 l�G
.--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 property for inspection purposes.
Date: Signature (Applicant or Agent •
' Date: .8/9/2017
Application Number: BMCH2017-0321 Owner:'
Property Address: 53160 AVENIDA. VALLEJO DESIREE PURCELL
APN: 774053008
Application Description: HVAC CHANGE OUT
Property Zoning:
Application Valuation: $1,000.00
.Applicant: Contractor:
T L C AIR CONDITIONING & HEATING T L C AIR CONDITIONING & HEATING
50235 CALLE TOLOSA 50235 CALLE TOLOSA
COACHELLA, CA 92236 COACHELLA, CA 92236
(760)343-8020 '
Llc. No.: 922168
i
Detail: HVAC CHANGE OUT - 14 SEER/80 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 20.16
CALIFORNIA BUILDING CODES:
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY, AMOUNT
BSAS 561473'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.-..
o
Total Paid for PERMIT ISSUANCE: $96.27.-..
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: - 53160 AVENIDA VALLEJO Date Prepared: 2017-07-27
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
53160 AVENIDA VALLEJO
02
Date Prepared
2017-07-27
03
Project Location
53160 AVENIDA VALLEJO
04
Building Type
Single family
OS
CA City
La Quinta
06
Dwelling Unit Name
53160 AVENIDA VALLEJO
DwellingUnit Conditioned
I s aIIi g'a
07
Zip Code
92253
08
Floor Area (ftz)
1200
SC System
CFA served
E �ti
refrigerant-
Number of Space
Installing
09
Climate Zone 'v-- "
15_ }VT : -y r _
30
Conditioning (SC) Systems in
1
ducted
containing
system
more than 40
this Dwelling Unit:
entirely new
B. Space Conditioning (SC) System Informa it on
01
02
03
? - 04
-�
05
,� 40'
06
+ . �.f. '
07
8 t
08
•,,, '16
09
10
"711 the SCr"
I s aIIi g'a
I N
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
1200
Yes'
Yes
Yes
No
No'
No
Altered space
•
conditioning system
C. Extension'of Existing Duct System, Greater Than 40 Feet (Section150.2(1b)1Dii1b)
This section does not apply to this project.
Registration Number: 217-A020254842A-000-000-0000000-0000 Registration Date/Time: 2017-07-27 11:45:38 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards.- 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-27. 11:45:30
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
-Alterations to Space Conditioning Systems (formerly CF -IR -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 gas
All new
Central split
All new
Less than or
System 1
furnace
heating
AFUE
81
AC
cooling
SEER
14-. '
Setback
equal to 40
R-8 "
components
" .
components
feet
'
Reauired Documentation: -
CF2R-MCH-01-E - Space Conditioning Systems
y
- 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 .
-Leakage rate compliance: <=15%or <= 10% leakage to out .or seal all accessible leaks.
-
-
CF2R and MR -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 >= 3z0�,C��,F�M penton, required when MCH -25 is required.
Exceptions: 'a°+,"�' i
Duct systems registered with HERS provider as previously sealed are.exempt fro cH-20 Duct Le fkage Testingsrequirem�ents -
Heating -only systems and Air Handler Furnace changes do not require v'enfication of Air Flow. MCH -23, -Refrigerant Charge MCH!2_8'. '
-Existing duct systems constructed, insulated or sealed with asbestos are exemptifrom MCH 20,.Duct�Leakage Testing requirrements.
3z � 1,� *a�, _... ... RX J" Y & V'i4. _ - .__ 94 .__..__ • AA
i<,•', `. , iA ...,,,fir. '—e-f� "' `+xmm�.�+ savr � t:ea 071
E. Entirely New or Complete Replacement Duct�Sj+stem, with or without Equipment Charigeout (Sections-150.2(:b)1Diia�and 1-50.2(b)1E, F),
I . i
This section does not apply to this project. -
F. Entirely New or•Complete Replacement Space Conditioning System (Section 150.2(b)1C) _
— _ This section does not apply to this project. -
r
Registration Number: 217-A020254842A-000-000-0000000-0000 Registration Date/Time: 2017-07-27 11:45:38 - HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-27 11:45:30
Schema Version: rev 10/16 ;
CERTIFICATE OF COMPLIANCE CUR -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: C/-,
C��ZC�
Chormicle, Tyrus
vvw
Company:
Signature Date:
T L C AIR CONDITIONING & HEATING
2017-07-27 11:45:38
Address:
CEA/ HERS Certification Identification (if applicable):
50235 CALLE TOLOSA
City/State/Zip:
Phone:
COACHELLA CA 92236 3's
760-343-8020
Responsible Person's Declaration statement t
I certify the following under penalty of perjury, under the la`ws'of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3bf 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, las components, and manufactured devices for -the building design_ or. system design identified on this Certificate of Compliance conform to the
_materi
requirements of Title 24, Part 1 and Part 6 of the California Code of R g lot ons.
4. ' The building design features or system design features identified on this Certificate of Compliance are consistent with;the informatprvprovided on:other licatile pliance documents, worksheets,
:-s
t " w _
calculations, plans and specifications submitted fo'the enforcement;agency forapproval with this building permit application.
5. .I will ensure that a registered copy of this C_ertifica"e of,Compliance shall be madg available withwthe buildingipermit(s)xiss etl for the bauildi g, and_made'avallable to tkieenforcement agency for all applicable
inspections. I understand that a registered copy of this=Certificate of Compliance,is.required to be included witthh the oocumeentaation, thevbu lder prroovl� to�the building owner at occupancy.
".,�.�,
Responsible Designer Name: ,
r.:-g*� .- W
Responsible Designer Signature: 'r—;..:.; T
Chormicle, Tyrus
Company:
Date Signed:
T L C AIR CONDITIONING & HEATING
2017-07-27 11:45:38
Address:
License:
50235 CALLE TOLOSA
922168
City/State/Zip:
Phone:
COACHELLA CA 92236
760-343-8020
Easy to Verify
at CaICERTS.com .�
Digitally signed by Ca10ERTS. 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 inforrnab
Registration Number: 217-A020254842A-000-000-0000000-0000 Registration Date/Time: 2017-07-27 11:45:38 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-27 11:45:30
Schema Version: rev 10/16