BMCH2016-026078-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0260 Owner:
Property Address: 53565 AVENIDA VALLEJO HOUSING AUTH(
APN: 774122016 P O BOX 1504
Application Description: HVAC CHANGE OUT / CITY OWNED PROPERTY LA QUINTA, CA 9
Property Zoning:
Application Valuation: $5,290.00 j
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Applicant: Contractor: �
GREENUP AIR CONDITIONING AND HEATING GREENUP AIR CONDIT
P 0 BOX 7431 P 0 BOX 7431
LA QUINTA, CA 92248 LA QUINTA, CA 92248
(760)771-2920
Llc. No.: 985406
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.: 985406
LL�
Date: / Contractor. • /�ohuE7�ji4 /f�(
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
Date: 7/18/2016
182 . 0 8Z4
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
o�heyLOrk for which this permit is issued.
�(�{k I have and will maintain workers' compensation insurance, as required by
9'ection 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity 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 l should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. /
Date: i4 Applicant: i
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 mention d property for inspection purposes.
Date: _ Signature (Applicant or Agent):
r
•FINANCIAL INFORMATION
+> DESCRIPTION} v F ` ACCOUNT` ; z Q71f AMOUNT'
_ ;PAID 'PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$1.00 7/18/16
'PAID BY'WETHOD", '� ,RECEIPT=#°�' "* -'CHECK
#�' �� �. CLTD BY,-
GREENUP AIR CONDITIONING AND H DEBIT R17155
MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 " $1.00
DESCRIPTION
_ r
Y r•PAID <
;PAID DATE
HVAC CHANGEOLIT - SPLIT -SYSTEM
101-0000-42402
0
$72:52
$72.52
7/18/16
PAID BY K
s °"METHOD S
eh ? "iRECEIPT #
'CHECK #
CLTD BY
GREENUP AIR CONDITIONING AND H
DEBIT
R17155
MFA
c DESCRIPTION �� y u•.
;�CCOUIVT ";`
`QTY?
AMOVNTy�
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36:26
$36.26
7/18/16
PAID,BY ,."<
,,,METHOD,
RECEIPT;^#e��3
CHECK#t� r
CCTDBY'
GREENUP AIR CONDITIONING AND H
DEBIT
R17155
MFA
Total Paid for CHANGEOUT: $108.78 $108.78
DESCRIPTION a . "'
` ";"
t ;ACCOUNTSg'
;QTY%►MOUNTw.+'<
PATI) §
.'.PAID DATE'
PERMIT ISSUANCE
101-0000-42404
0
"$91.85
$91.85
7/18/16
"° tv
'
PAID`BY�
' t <
Y s "
4
' RECEIP'
";CHECKx#
CLTD'BY,METHOD
GREENUP AIR CONDITIONING, AND H
DEBIT
R17155
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
•
Description: HVAC CHANGE OUT / CITY OWNED PROPERTY
Type: MECHANICAL Subtype:
Status: APPROVED
Applied: 7/18/2016 MFA
Approved: 7/18/2016 MFA
Parcel No: 774122016 Site Address: 53565 AVENIDA VALLEJO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 231
Lot: 4
Issued:
UNIT 22
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $5,290.00 Occupancy Type:.
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: HVAC CHANGE OUT - 14.OSEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printpd-. Mnnday,,hily 1R, 1(11fi 8:41:72 AM 1 of 1 ,
CRWIFSILMS
DESCRIPTION
CITY `
' AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #>
METHOD `
,PAID BY
`CLTD'�'
_
-ACCOUNT
BY.
GREENUP AIR
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
7/18/16
R17155
DEBIT
'CONDITIONING AND
MFA
H
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00: $1.00
BSA:
GREENUP AIR
HVAC CH T -
101-0000-42402
0
$72.52
$72.52
7/18/16
R17155
DEBIT
CONDITIONING AND
MFA
SYSTEM
SPLIT -SYSTEM
H
GREENUP AIR
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$36.26
7/18/16
R1715S
DEBIT
CONDITIONING AND
MFA
SPLIT -SYSTEM PC
H
Total Paid for CHANGEOUT: $108.78 $108.78
GREENUP AIR
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
7/18/16
R17155
DEBIT
CONDITIONING AND
MFA
H .
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS.i
„ .. INSPECTIONS
a.PARENT PROJECTS" ,
BOND INronMATION
!•ATTACHM.ENTS „
•:.'�:i! .:. �
PrintPri• Mnnriay, July 1R, ?nl6 R:41:22 AM 2 of 2 .,
SYSTEMS
Bin #
City of La QUlnta
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
Permit #
Project Address:5 . AVe
ava �' 0.
Owner's Name: C t+
A. P. Number:
Address:779 ,M Dic
Legal Description:
City, ST, Zip:( CA ntt6L CA 91?d 3
Co ntractor: Green A/c+- �- eco+►
el p one:
h - I a
Address: O 31
Project Description:
City, ST, Zip: CA- 2) 4 O
e 1A cl11,
Telephone`�.........
?><;:'%
Statc Lic. # : 5
City Li,. A
Arch., Engr., Designer:
1, f
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
Pr oJecttyP (circle one): New Add'n Alter Repair Derno
State'L ic. #:
- '^
Name of Contact Person:
Sq. Ft :
#Stories:
# Units:
Telephone #,of Contact Person:
mated Value of Project: D '�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INIIOUSE:-
'`d 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 CF1R-ALT-02-E .
Alterations to Space Conditioning Systems (.formerly CF -IR -ALT -HVAC) (Page 1 of 3.).
Project Name: City of La Quinta Date Prepared: 2016-07-18
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 CF111-ALT-02 document for each dwelling unit.
01
Project Name
City of La Quinta `
02-
Date Prepared
2016707-18
03
Project Location
53565 Avenida Vallejo
04
Building Type
Single family
05
CA City
La Qui'nta
06
Dwelling Unit Name
City of La Quinta
07
Zip Code
92253-
08
Dwelling Unit Conditioned
1434
.
Floor Area (ft2)
SC System
SC System
CFA served
system a
refrigerant t
Number of space conditioning
l'
ng
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information.
Ol
02 '
03
04
`05'
1` X06
11. 07` j°s
08
1 09
10
Nis the SC'., "
` `Installing aort
SC System
SC System
CFA served
system a
refrigerant t
installing=newSCstall
l'
ng
ilnstalli'ng
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
main house
1434
Yes
Yes
Yes
No
No
No
Altered space
conditioning. system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0263967A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
3
Registration Date/Time: 2016-07-18 07:59:23
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2016-07-18 07:59:51
CERTIFICATE OF COMPLIANCE CF111-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.
.0S
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
Outdoor
This field or
This field or
System 1
Central split.
Fancoil AHU
HSPF
8.2
Central split
condensing
SEER
14
Setback
section is not
section is not
HP
AC
unit
applicable
applicable
Reouired Documentation:
i
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans .
-Duct insulation requirement for new plenums: R6.
CF211-MCH-20-1-1 & CF3R-MCH-20. H — Duct Leakage testing 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: 515%, or 5 10% leakage to outside,.or seal all accessible leaks.
CF2R-MCH-25-H & CBR -MCH -25-H Refrigerant Charge `jerificaiion required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF311-MCH-23 AirFlow 2.300GFM,'ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH�20 Duct Leakage Testing requirements.
Air Handler/Furnace do Air Flow Refrigerant Charge MECH 25 ?WC-1�
-Heating-only systems and changes not require verification of MCH32 3/ or
rill
rom MCH 20 Du Leakage Testing requi�eme nts.
Existing duct systems constructed, insulated or sealed with asbestos,,are exempt fi
' :.. .: �`�"!� ".;«aJ.zar Wu,+'k..a N,w '�w�r .6.ewi�l i5D cuF. :.Y Mi:.;ss•- aw k wtx,m46;a w:
E. Entirely New or Complete Replacement Duct°System, with or without,Equ.ipment Changeout (Sections-150.2(b)1Diia<and 150.2(b)lE, F)
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.
Registration Number: 216-A0263967A-00000006)-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-07-18 07:59:23
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2016-07-18 07:59:51
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. 1 certify that this Certificate of Compliance documentation is accurate. and complete.
Documentation Author Name:
Documentation Author Signature:
�rlan�reenup
Greenup, Brian
Company:
Signature Date:
GREENUP AIR CONDITIONING AND HEATING
2016-07-18 07:59:23
Address:
CEA/ HERS Certification Identification (if applicable):
P 0 BOX 7431
City/State/Zip:
Phone:
LA QUINTA CA 92248
760-625-6537
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 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
...:
re uirements of Title 24, Part 1 and Part of the California Code of a ul`atlons.
4. The building design features or system design features identified onAhis Certificate'of Compliance are consistent with'the Vormation.provided on'other applicable compliance documents, worksheets,
".4''.
calculations, plans and specifications submitted to the enforcementagency for approval,with this bwlding permit application.
a a 4� � ls... �;# is a.d �
.t
S. - I will ensure that a registered copy of fhisCer4ificate ofCompliance shallwbe;made,available w�th:the building permit(s),issued for+the;building, and;made available Aothe enforcement agency for all applicable
inspections. I understand that a registered copy of t'h'is -Certificate of Compltiance�Js;regLVed to be. included witch the�documenta�tion�the�builder provides to,.the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature: V`0 1
�rran�reenup
Greenup, Brian
Company:
Date Signed:
GREENUP AIR CONDITIONING AND HEATING
2016-07-18 07:59:23
Address:
License:
P 0 BOX 7431
985406
City/State/Zip:
Phone:
LA QUINTA CA 92248
760-625-6537
Digitally signed by CaICERTS. 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: 216-A0263967A-0000000 0-0000 Registration Date/Time: 2016.07-18 07:59:23 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report.Generat_ed: 2016-07-18 07:59:51
o Schema Version: 0.5S5SDD