BMCH2017-009078-495 CALLE TAMPICO Ct 0 D �i�MCl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0090
Property Address: 53980 AVENIDA VALLEJO
APN: 774163012 [,� n
Application Description: GONZALES / HVAC CHANGE 16 SEC\ U
Property Zoning: Ir"
Application Valuation: $8,000.00 D 201
Applicant:PA
LAQU,NTP it,1J0A
IE INC ,\V0� FKEt�OEP
31225 LA BAYA GONtthOhISVOE�1ti`G
WESTLAKE VILLAGE, CA 91362
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.: 763937
\Date: 441-1 Contractor: �' A
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 contractors) 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/27/2017
Owner:
DANIEL GONZALES
53980 AVENIDA VALLEJO
LA QUINTA, CA 92253
Contractor:
VOTTA ENTERPRISES INC DBA COMFORT AIR
72248 NORTHSHORE ST STE 101
THOUSAND PALMS, CA 92276
(760)320-5800
Llc. No.: 763937
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 permi:
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5034539
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.
Date: 3 11-7 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 b
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.
a
Date: » V') Signature (Applicant or Agent)
Date: 3/27/2017,
Application Number: BMCH2O17-0090
Owner:
Property Address: 53980 AVENIDA VALLEJO .
DANIEL GONZALES
APN: 774163012
53980 AVENIDA VALLEJO
Application Description: GONZALES / HVAC CHANGE OUT 16 SEER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $8,000.00
Applicant:
Contractor:
IE INC.
VOTTA ENTERPRISES INC DBA COMFORT AIR
31225 LA BAYA
72248 NORTHSHORE ST.STE 101
WESTLAKE VILLAGE; -CA 91362
THOUSAND PALMS, CA 92276
(760)320-5800
Llc. No.: 763937
Detail: HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 '
CALIFORNIA BUILDING CODES.
DESCRIPTION ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
FINANCIAL
INFORMATION`_
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-426000
DESCRIPTION ACCOUNT CITY
AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-426000
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
CITY
.AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page i of 3)
Project Name:
DAN GONZALES I Date Prepared:
2017-03-22 1
A. General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented; use one
CFI11=ALT-02 document for each dwelling unit.
01
Project Name
DAN GONZALES
02
Date Prepared
2017-03-22
03
Project Location
53980 AVENUE VALEJO
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
DAN GONZALES
07
Zip Code
92253
08
Dwelling Unit Conditioned
1248
Floor Area (ft2)
SC System
CFA served
system a
refrigerant
Installing new SC
Number of Space
Installing
09
Climate Zone ::,;:.:,...
,...«:,
.
..:.::....:.:..
Location or Area
Conditioning SC Systems I
1
containing
system
.......
` °
"i :: ::•^. a64Ci.:enJt•TL WC. al.:+nvswwui
entirely new
this Dwelling Unit:
-.,..v:�r.na,.. ...moo._,.-..T�.. .-.._..... ....
information,
B. Space Conditioning (SC) System"nu-,
0 1
02
03,
"
04 . ..
r .
05
�....
Q6..
07
-09
10
r
-
`'Is the Sd,
I Qns i a I 1041 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
System 1
Location 1
1248
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System; Greater Than 40 Feet (Section1S0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 217-AO2009134OA-000-000-0000000-0000
Registration Date/Time: 2017-03-22 17:54:09
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.00S acne r+ r. an crnt-4-')n,'7_nz_» ,'7 -CA -00
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)IE 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
Identfflcation
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
All new
Central
All new
This field or
This field or
System 1
packaged HP
heating
AFUE
80
packaged HP
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Reauired 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, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test required wH* Wheating 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 outside :or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification requl[ed 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:
-Duct systems registered with HERS provider as previously sealed are exempt froin� CH -20 Duct Leakage Testing krequirements-
- Heating -only systems and Air Handler Furnace changes do not require'4erificatiin of 'Air Flow MCH -23 Refrigerant'Chdrge MCH -25.',
-Existing duct systems constructed, insulated or seal etl with asbestos are exempt/"from MCH 20 Ducj�Leakage Testing requiAement's
'fixia ' «,Q�.: .�� .:.. :=,.tee rs+�«. � � �.: �:rn-'- �• wa :.,+. »r'�v��..;. ,�r,
E. Entirely New or Complete Replacement Duct System, with .or without�Equipment Changeout (Sections,150.2(b)1DUa and 150.2(b)lE, F)
0*41
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 217-A020091340A-000-000-0000000-0000 Registration Date/Time: 2017-03-22 17:54:09 HERS Provider: CaICERTS
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: �
Jacoby, Ian
can dacobt
Company:
Signature Date:
I PERMIT E RATERS
2017-03-22 17:54:09
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
Responsible Person's Declaration statement;:;
I certify the following under. penalty of perjury, under the lawsof the State of California:
1. The information provided oq_this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of�the Business"and Professions Code to accept.respohsibillty 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
requirements of Title 24, Part 1 and Part Cof the California Code of Regulations. a
.N s S TM4 �i Y� X sa.r"gs�.w,a.
4. The building design features or system design features'identified on this Certifcate.pp_f Compliance areconsistent with7the Information,provided oRother-applicatile'compliance documents, worksheets,
.; *+Kk tie x h w _...- -^»tith rte.
calculations, plans and specifications sub`mlttetl fo.the enforcement agency fonapprgval.,,wit1%this bmlcl)ng tit application.
perr
M1
S. I will ensure that a registered copy of this CerEfficate of,Compliance shall be marde available with'the buildiol ing permit(;);Issued for therbulldTng, and,.maiie available=to the`enforcement agency for all applicable
inspections. I understand that a registeted copy tFiis Cerdfaicate of Compliance is reg4lred to bgjncluded yi,h the documentation the builder to the building owner at
UrIov des occupancy.
Responsible Designer Name:
P g H.
"" "`
Responsible Designer Signature: ""� x 'N..
Jacoby, Ian
can �acobJr,
Company:
Date Signed:
I PERMIT E RATERS
2017-03-22 17:54:09
Address:
License:
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
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: 217-A020091340A-000-000-0000000-0000
Registration Date/Time:
CA Building Energy Efficiencv Standards - 2016 Residential Compliance Ronna XrorcinnA. 1 nns
2017-03-22 17:54:09
HERS Provider: CaICERTS
M. B
City. d' La Quints
.&Aft at Safety Whio»
Pemdt
P.O Box 1504,'78-495 CMe Tampko
LA Qt 94 CA 92233 --(760) 777-7012
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