BMCH2015-0083• .,vim � , —_
78-495 CALLE TAMPICO
LA'QUINTA, CALIFORNIA 92253
Application Number: BMCH2O15-0083
(eiti�, 4 44*z
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address:
53700 AVENIDA VALLEJO
APN:
774123011
Application Description:.
YOSJI KOZIMA HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$6,500.00
Applicant:
FIRST CHOICE A/C & HEATING INC
79747 CASSIA ST
n
LA QUINTA, CA 92253
lfl MAR 2 0 2015
Owner:
YOSHINORI-KOJIMA
, 92253
VOICE (760) 777-7125.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/20/2015
Contractor:
- FIRST CHOICE A/C'& HEATING INC
79747 CASSIA ST
LAQUINTA, CA 92253
(760)989-2370
Llc. No.: :LIC -0109319
LTVOFLAUDI�'^ -
________________________LCg:NITYDEVELOPMENTDEPARTMENT
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.
License Class: License No.: :LIC -0109319
NI
ate:f%✓%/�D�� Contractor:
OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury that l 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 Divisio
of the Business and Professions Code) or that he or she is exempt therefrom and th 1
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant f r a
permit subjects the applicant to a civil.penalty.of not more than five hundred doll s
($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 no:
apply to an owner of property who builds or improves thereon, and who does the wort
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
heor, 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: / `y
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: = 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
owqr compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. , -
Datg: A 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. with in 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.
1Dlate:0 Signature (Applicant or Agent):
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Yoshi Kojima Date Prepared: .2015-03-20
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 MR -ALT 02 document for each dwelling unit..
01
Project Name
Yoshi Kojima
02
Date Prepared
2015-03-20
03
Project Location
53-700 Avenida Vallejo
04
Building Type'
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Yoshi Kojima
07
Zip Code
92253
08
Dwelling Unit Conditioned
[Floor
1560
v,
I�nstaling
more than 40
s �'
als;alli
entirely new
rs
Installing
entirely new
Area (ft2)
Served
System (ft2)
system?
component?
components?
Number of space conditioning
duct system?
09
Climate Zone.
15
10
(SC) systems in this dwelling
1
Yes
Yes
No
No
unit.
Altered space
conditioning system
B. Space Conditioning (SC) System Information. 4
M,
Ol
02
03-
04'
OS
,06c
07y'
0$ ' IIIL
09
10
; . Is the SC
,dam Feu
Installing a
wow�s � U. "
W uW
- 6
SC System
Identification or
SC System
Location or Area
'CFA served
by this SC'
system a
ducted
r 4.,
refrigeant
containing
f�
Installing-nevSC
system
v,
I�nstaling
more than 40
s �'
als;alli
entirely new
rs
Installing
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
.Location 1
1560.
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: 215-A0074845A-000000000-0000 Registration Date/Time: .2015-03-20 16:26:07 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03720 16:26:14
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFiR-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
System 1
Central split
Fancoil AHU
HSPF.
Central split
All new
cooling '
SEER
16
Setback
Less than or
equal to 40
R-8
HP
'79.5
HP
components
feet'
Reouired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
=Duct insulation requirement for new plenums: R6. a '
CF2R-MCH-20-H & MR -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: 5154, or:5 30% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CURMR-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions:
Duct systems registered with HERS provider as previously seal ed.are exempt fro' MCH -20 Duct Le kage;Testing i metnts
ges do,not not -req a venhcap n of Air F MCH 23 or RefngerapL hapge MMECH 2 .
Heating -only systems and Air Handler/furnace channi
-Existing duct systems constructed, insulated or sealed with ass esto5 a exempttifrrom M ZOiDuc Le ge Testing requirements.-*
IA- nH
I
` w _. __- M
E. Entirely New or Complete Replacement Duct Sys#em, with pr virithoyt f_quipment Chan&.&ut`(S,gctioh$ 159.2(I )l.Dn�,'and :50.2(b)1E, F)
This section does not apply to this project.
R Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 215-A0074845A-000000000-0000 Registration Date/Time: 2015-03-20 16:26:07 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-20 16:26:14
CERTIFICATE OF COMPLIANCE CFiR-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: / �"
Both, Atila
v�tc a. of
Company:
Signature Date:
FIRST CHOICE A / C & HEATING INC
2015-03-20 16:26:07
Address:
CEA/ HERS Certification Identification (if applicable):
79-747 CASSIA STREET
City/State/Zip:
Phone:
LA QUINTA CA 92253
(760) 989-2369
Responsible Person's Declaration statement'
I certify the following under penalty of perjury, under the. lawsofthe.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 perfo,imance specifications materlals,`comgonents, and tganufactured devices for the.buildmg design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part -6 -of the Califorma.Code of Reg l"a ns.
a I
rFax mdO w
4. The building design features or system design features identified o,47! his Certificate of Cgmpiance are copsi-stet itj� the informat( ,provided on;; thei�ap ,licable compliance documents, worksheets,
calculations, plans and specifications submitted to the a Yorcemen*yd�Qency foyrrappr vaF�l wltl�this bull per'jjj f epQlicati n. '
fIng
hY'Y V"MA Q. 4SY Re .' �y}� W iT .S�'i F{i '!4} y�h
5. 1 a registered copy of this.Certlficate shalltLe made aV,ailable wit the b,ulldlog 0 fmrt('s) issued forath,@;buil andgmade avail"able to therenforcement agency for all applicable
will ensure.that �o�jc pliance di g,
inspections. [understand that a registered copy of this+C ( lcate of Co npi ance i req jf d to bfe included �jth theadoxcume�ntation,�the�bull�er prc2v des to the b filjo4ipg owner at occupancy.
Responsible Designer Name:
Respons b e Designer Signature:%/ /'
Both, Atila
v�tc ,Goth
Company :
Date Signed:
FIRST CHOICE A / C & HEATING INC
2015-03-20 16:26:07
Address:
License:
79-747 CASSIA STREET
968138
City/State/Zip:
Phone:
LA QUINTA CA 92253
(760) 989-2369
Digitally signed by Ca10ERTS. 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-A0074845A-000000000-0000 Registration Date/Time: 2015-03-20 16:26:07 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-20 16:26:14
Schema Version: 0.555SDD
n
'ii3`=-�
-}DESCRIPxTION .,A000UNTF� CfTY�:�� AMOUNTS PAID:. "P>AID DATE:
-:-.-
BSASSBl'473FEE: ' ;,`1010000-20306 0 :
$100,: $0.00
si.e�n ''('P. ��'�; ..:� r, ,;am
� #� � CHECKS#
�: RCCEIPT � E .M I Ai
- =
Total Paid forBUILDING:STANDARDS ADMINISTRATION BSA $1:00 $0.00
DESCRIPTIO,N�
s3ae%, r..4'� .:
N ACCOlJNT> t
riAMOUNT -
sx� PAID
DATEe
E _.:
Is
LAI,
HVAC CHANGEOUT - SPLIT -SYSTEM
'101-0000-42402
0,
.$72.52
$0.00
SY'4 w, ll" ,f iJY+ik` T$z i'£,_e .rdY •'''r_^T:u- ?"tee ,.,,_,f'ai=yh4-ft..s.�,s.'i
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:
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r<3�„>._.
,RECEIPTS#
<. :�si�rPk u'.-�18.ti4
�"NYRxi'v�^�A_'SZi�.Nis
OES@RIPTIONj aAC@OUNT�
QTY�AMOUNT
'
�.i.
PAID
�KS...:.
PAID DATE,
.+aA 'C '`&C� ..,
....: t:t.�,Ah-RY,xw
x,
..i�. ,`!'':Jf.,.%.<.
,yz3's,..'}»4v E,.-'tA;ti4>,wr2
HVAC CHANGEOUT;- SPLIT -SYSTEM PC'
101y0000-42600 `
0
$36 26
$0:00 . '
r$� 3£..:'c='''Y' `Fi'>'Y%{''.. ��s',,f.,,.54'c�&`a,:yP'':n •: i3wt.�Dk.G:
:.: 2..x�., `°e .:".€ai s?:5'e �a.N;.�ze
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RECEIPT # '
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.,§_,3'x,,,-201?c',:a�i'a§:�rz215;= `rot
,CHECK=#
A,..:
Total Paid forCHANGEOUT: 108.7
DESCRIP...TION�x�
az
'!l`,yY-L-�k-aSTk'4Y.-.�ex4'.'&''-`x F,x.Y Wim'-,
�;-:ACCOl1NT u>
TYAMOUNT
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?.,3A�S,z
P.AID'PWAID'DATE
,."n:. s.
WIN
PERMIT IS%S�UANC¢,Ey
101-0000-42404
0
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Total Paid forPERMIT ISSUANCE. :' $91 85 - $0.00
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Description: YOSJI KOZIMA HVAC CHANGE OUT
Type: MECHANICAL Subtype:
Status: UNDER REVIEW
Applied: 3/20/2015 PJU
Approved:
Parcel No: 774123011 Site Address: 53700 AVENIDA VALLEJO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 230
Lot: 14 Y
Issued:
UNIT 22
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $6,500.00. Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: HVAC CHANGE OUT SPLIT SYSTEM 2013 CALIFORNIA MECHANICAL CODES.
Printed: Friday, March 20, 2015 4:50:58 PM- 1 of 2 .
. + sYsri�Ms
` DESCRIPTION
' ACCOUNT
QTY
'AMOUNT
�. PAID
PAID;DATE
i:RECEIPT #
# r
METHOD
r PAID
LTD
;
,'CHECK
HVAC CHANGEOUT =
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
1 $0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
• $0-00
:PARENT PROJECTS
1
Printed- Fririay, hAarrh 7n, N115,4.sn-gg PM ? of 7
SYS7[AAS
air, #City
of La Quinta.
Building a Safety Division
P.O.. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit N
Project Address: 5 3 .7o O A
Owner's Name:
'A. P. Number:
Address: ..
n V N 4 /
Legal Description:
City, ST, Zip:V/,,� Z�
Contractor:-�T1Di +�
Telephone:4/ —2 sn 09
Address: 9 .
Project Description: — --
City, ST, Zip:
led-AOU&VU9.2 21 57
ee
T 1P hone v- -
9
State Lic. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Construction Type: Occupank.
State Lie.
ProJecttyP (circle rc] one): Addn Alter Repair D emo
Name of Contact Person:
Sq. Ft.: /Cz/0
# Stories:
#! Units:
Telephone # of Contact Person:
Estimated Value of Project: 'Sf�
APPLICANT: 00 NOT WRITE BELOW THIS LINE
# Submittal Req'd Rcc'd TRACMG PERMIT FEES
Plan Sets
PIan Check submitted.
Item
Amount
Structural Calcs.
Revictived,' ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance • '
Title 24 Calcs.
Plans picked up,
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"Revicw, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing •
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:- '
''4 Revicw, ready for eorrectionstissuc
Developer Impact Fee
Planning Approval
Called Contact.Person
A.I.P.P.
Pub. Wks. Appr
Date of pcirmit issue
School Fees
Total Permit Fees