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BMCH2017-0115Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 r 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, andrmy License is in full force and effect. License Class: C20 License No.: 763937 Date: 4 ('7 Contractor: 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 he(self 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Datgb. 4/,V2017 C 78-495 CALLE TAMPICO • 0 D LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT LA QUINTA, CA 92253 BUILDING PERMIT Application Number: 'BMCH2O17-0115 l M CDn Property Address: 4854] VIA AMISTAD APN: 646122011 ' zC= ry Application Description: WERNER / HVAC CHANGE OUT - 25SEER/80AFUE SPLIT SYSTEM Property Zoning: rn v THOUSAND PALMS, CA 92276 Application Valuation: $16,000.00 z Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 r 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, andrmy License is in full force and effect. License Class: C20 License No.: 763937 Date: 4 ('7 Contractor: 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 he(self 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 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: 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: 414111 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. � r Date: `� y� Signature (Applicant or Agent):.a� Datgb. 4/,V2017 Owner: m JEANIE WERNER Z 48547 VIA AMISTAD n Z LA QUINTA, CA 92253 C M CDn O O Contractor: zC= ry VOTTA ENTERPRISES INC DBA COMFEfRiakIR o 72248 NORTHSHORE ST STE 101 rn v THOUSAND PALMS, CA 92276 . (760)320-5800 z 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 permit 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: 414111 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. � r Date: `� y� Signature (Applicant or Agent):.a� Date: 4/4/2017 Application Number: BMCH2O17-0115 Owner: Property Address: 48547 VIA AMISTAD 1EANIE WERNER' APN: 646122011 48547 VIA AMISTAD Application Description: WERNER / HVAC CHANGE OUT - 25SEER/80AFUE SPLIT SYSTEM LA QUINTA, CA 92253 Property Zoning: Application Valuation: $16,000.00' Applicant: Contractor: IE INC VOTTA ENTERPRISES INC DBA COMFORT AIR 31225 LA BAYA 72248 NORTHSHORE ST STE 101 WESTLAKE VILLAGE, CA 91362 ` THOUSAND PALM_ S, CA 92276 (760)320-5800 Llc. No.: 763937 ------------------------------------------------------------------------ Detail: HVAC CHANGE OUT - 25SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.`2016 CALIFORNIA BUILDING CODES. t N FINANCIAL o• • 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 QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-426000 $38.00 Total Paid for CHANGEOUT: $114.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 .0 $96.27 r 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 TOTAL I I r sin.# City.,Of U. Quif?ta 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 # Project Address: 48547 Via Amistad Owner'sName:.Jeanie Werner A. P. Number. Address: 48547 Via Amistad Legal Description: City, ST, Zip: La Quinta, CA 92253 Contractor. Comfort Air .,s t' "��`` Telephone: 949-322-8626,.�s x w Address: 72248 Northshore Street Suite 101 Project Description: Replace5 ton A/C, coil, and 90,000 BTU City, ST, Zip: Thousand Palms, CA 92276 furnace Telephone: 760-320-5800 City Lic. #; State Lie. # : 763937 Arch., Engr., Designer Address: City., ST, Zip: Telephone: State Lic. #: '- :: Name of Contact Person: Steven Schnierer Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft :# Stories: -T# -Units: Telephone # of Contact Person: 818-735-7876 Estimated Value of Project: $16,000.00. APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Reed TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss C21cs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Pians resubmitted Mechanical Grading plan Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '^' Review; ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees � _ . � �. . � ~ � . . ^ � A. General Information MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling.units must be d6culmented, use one CF1RzALT02 document for each�dwelling unit. 01 Project Name JEANIE WERNER* 02 Date Prepared 2017-04-03 03. Project Location 48547 VIA AMISTAD 04 Building Type Single family 05 CA City La &inta 06 Dwelling Unit Name JEANIE WERNER Ns the SCrl 1'r�ialli'Qa X01 M %.11A Dwelling Unit Conditi6ned 07 Zip Code 92253 08 Floor Area (ft2y 1980 * Installing new SC Installing Installing Installing Number of Space Identification or 09 Climate Zone clucted, 10 Conditioning (SC) Systems i'n' 1 entirely new entirely new !I -N, Name this Dwelling Unit: System (ft2) R. Space Conditioning (SC) System lnfdrmitiii;�n'l Ns the SCrl 1'r�ialli'Qa X01 M %.11A SC System SC System CFA served system a refrigerant * Installing new SC Installing Installing Installing Identification or Location or Area- by th.is SC clucted, containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? ducit system? SC system?' Alteration T�' pe System 1 Location 1 '1980. Yes Yes Yes No N No Altered'space conditioning system � "r ^ ~ C. Extension of Existing Duct Sysiem, Greater Than 40 Feet (Seition1SO.2(b)1Diib) This section does not apply to this pr1oJect. � . ~neu,�auon�umbecz17+mzozose9 Registrationoo�/T�`e: 2017-04-03 15:59:10 ` .. '_ HERS Provider: ca|csnTs ' . . �- C��ui|din8�no�Y��donn/�zndard�`%Ol6��idwmia|Cnmp|ianow ° . / nepo�vep:nn��ols\oos ' ..��`' - ,Repo�6enomtmJ�1017�4�J l5�59�l5 - _ 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 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 This field or This field or System 1 furnace heating AFUE 80 AC cooling SEER 25 Setback section is not section is not components components applicable applicable 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, 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 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: Duct 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 venficatiori'of Air Flow MCH:23 or Refngerant'Cha#rge MCH=25� -Existing duct systems constructed, insulated or sealed with asbestos -are exempt from MCH" -20 Duct{Leakage Test ngrequirements.R�` 'tAA, a i 1:f '4 - ... t t3, w 14 S E A, E. Entirely New or Complete Replacement Duct,�System, with or without Equipment Changeout (Sections.w150.2(b)1Diia;-and 150.2(b)1E, F) 4P Nk i.< vi 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: 217-A020105997A-000-000-0000000-0000 Registration Date/Time: 2017-04-03 15:59:10 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-03 15:59:15 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: � Jacoby, Ian c;an Jacob Company: Signature Date: i PERMIT E RATERS 2017-04-03 15:59:10 Address: CEA/ HERS Certification Identification (if applicable): 31225 La Baya Drive #213 ` City/State/Zip: Phone: West Lake Village CA 91362 n 818-735-7876 Responsible Person's Declaration statement..k I certify the following under penalty of perjury, under the laws of the State of California: r 1. 'The information provided on this Certificate of Compliance,is true and correct. 2. lam 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 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'ahis Certificate of Compliance are consistent with>the information>provided another apphcalile compliance documents, worksheets, calculations, plans and specifications submitted.to the enforcement'agency for approval�with this building permit application. � 5. I will ensure that a registered copy of this Certificate of Compliance shall°be'made available with'the building pe�mit(s) issued fort e�ilding, and -made availableYotthe.enforcement agency for all applicable inspections. I understand that a registered copy of thmCertificate of Compl ance_is required to be included with thedocumenta�tion�the builder prrav�des to,the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: V o'� Jacoby, Ian cQan L7acobJt. Company: Date Signed: i PERMIT E RATERS 2017-04-03 15:59:10 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 no way implies Registration Provider responsibility for the accuracy of the information. r Registration Number: 217-A020105997A-000-000-0000000-0000 Registration Date/Time: 2017-04-03 15:59:10 CA Building Energy Efficiency Standards 2016 Rocidontial Compliance Rpport Versinn• 7f116 1 nns HERS Provider: CaICERTS Report Generated; 2417-04-03 15;59:15