BMCH2017-0122Q�i Qu�& VOICE (760) 777-7125`
78-495 CALLE TAMPICO D -`
LA CIUFAX (760) 777-7011INTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/6/2017
Application Number: BMCH2O17-0122 Owner:
Property Address: 78758 VIA CARMEL TOBERT TOPOR
APN: 646430010 78758 VIA CARMEL
Application Description: TOPOR / A/C REPAIR - CONDENSER AND COIL 145EER LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $3,000.00.
D LX__X_X_1
Applicant: Contractor:
JOHN BORDEN HEATING AND AIR CONDITIONINGAPR 0 6 2017 JOHN BORDEN HEATING AND AIR CONDITIONING
P 0 BOX 459 P 0 P 0 BOX 459
YUCAIPA, CA 92399 CITY OF LA QUINTA YUCAIPA, CA 92399
DESIGN AND DEVELOPMENT DEPARTMENT (951)797-5669
Llc. No.: 719570
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:
C20 / License No.: 719570
`Date: / {O —/ 7 Contractor:46��/
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 Cade: 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 Na
Lender's Address:
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 th ork for which this permit is issued.
Ilhave 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: WSDS031288
_ 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: L%� to '� % Applicant•
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE ISUN UL,
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
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: .'- [O — Signature (Applicant or Agent): � ��
Date: 4/6/2017
Application Number: BMCH201.7-0122
Owner:
Property Address: : `` 78758 VIA CARMEL
TOBERT TOPOR
APN: 646430010
78758 VIA CARMEL
Application Description: TOPOR /A/C REPAIR -CONDENSER AND COIL 14SEER
LA,QUINTA, CA 92253
Property Zoning:
Application'Valuation: $3,000.00.
Applicant:
Contractor:
JOHN BORDEN HEATING AND AIR CONDITIONING
JOHN BORDEN HEATING AND AIR CONDITIONING
P O BOX 459
P O BOX 459
YUCAIPA, CA 92399
YUCAIPA, CA 92399
'
(951)797-5669
------------------------------------------------------------
Llc. No.: 719570
Detail: HVAC REPAIR - 14SEER SPLIT SYSTEM CONDENSOR AND COIL REPLACEMENT. CARBON
--------------------------------
MONOXIDE ALARM(S) TO BE-INSTALLED PRIOR TO FINAL
INSPECTION. 2016 CALIFORNIA BUILDING CODES. '
FINANCIAL • ' ' •
....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 - CONDENSER ONLY
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- REPAIR/ALTERATION
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
HVAC CHANGEOUT - REPAIR/ALTERATION PC
101-0000-42600
0
$5.07
Total Paid for CHANGEOUT: $81.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
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: $5.00
Bin. #.
City. Of. La Quinta
BiAlft a Saks Division
P.O. Box 1504,78-495 Calle Tamploo
ta.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: V lCA, C 6..
Owner's Name:.
A P. Number.
Address:
Legal Description:
City, ST, Zap: a, � 0202 S 3
Contractor.
Telephone: —a8'0 — S1Wg
Address: 3s I S
Project Description:
City, ST, Zip:&Uao AL PA 9 z1 7
Telephone:
Fi
State Lir #: Ca - City #;
i -4411
+ O
Arch, Engr., Designs.
� G G
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: yl I
Construction Type: , occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: P. (0 `4 2�
1 # Stories: I#Unit$:
Telephone # of Contact Person: .��%� —S&& X: 001
Estimated Value of Project: ?j i DC)
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKYNG
PERMITFEFS
Plan Sets
Plan Check submitted
Item
Amount
Structural Gales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Tide 24 Calcs.
Pians picked up
Construction
Flood plain plan
Pians resubmitied..
Mecharilcal
Grading plan
Z'! Review, ready for correctioneissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE-,
7i° Review, ready for correctionsfrssae
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
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
ROBERT TOPOR I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2017-03-30
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
ROBERTTOPOR
02
Date Prepared
2017-03-30
03
Project Location
78758 VIA CARMEL
04
Building Type
Single family
05
CA City
LA QUINTA
06
Dwelling Unit Name
SYSTEM
SC System
SC System
CFA served
systema
�MrVI
refrigerant
Installing new SC
07
Zip Code
92253 -
081
Dwelling Unit Conditioned
2648
by this SC
ducted
containing
system
Floor Area (ft2)
entirely new
entirely new
Name
Served
System (ftz)
system?
component?
components?
G
duct system?
Number of Space
I Alteration Type
09
Climate Zone
15
10'
Conditioning (SC) Systems in
1
No
No
No
Altered space
this Dwelling Unit:
B. Space Conditioning (SC) System Information n TS {
i 1�.,' 1
01
02
03
04
i 105 I
r 06 `
07
08
09
10
Is the SC
��iry
Installing a
atL
'-;" %W I' J� tn4vr't
SC System
SC System
CFA served
systema
�MrVI
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 (ftz)
system?
component?
components?
feet of ducts?
duct system?
I SC system?
I Alteration Type
SYSTEM
HOUSE72648
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 1S0.2(b)INb)
This section does not apply to this project.
Registration Number: 417-A020088058A-000-000-0000000-0000
Registration Date/Time: 2017-03-30 11:22:11
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-30 11:22:13
Schema Version: rev 10/16
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)1E 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
No heating
This field or
This field or
Central split
All new
Less than or
SYSTEM
furnace
component
section is not
section is not
AC
cooling
SEER
14
Setback
equal to 40
R-8
altered
applicable
applicable
components
feet
Required Documentation: " '1
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 CF311-10CH-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. y !i
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 verification of Air Flow MCH -23, or Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. EntirelyNew or Complete Replacement Duct System, with or`without E ui Yment Chan eout Sections 150.2 b iDiia and 150.2 b 1E F
p p Y q P g ( () () )
{This sectio does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC)
This section does not apply to this project.
Registration Number: 417-A020088058A-000-000-0000000-0000
Registration Date/Time: 2017-03-30 11:22:11
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-30 11:22:13
Schema Version: rev 10/16
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:
Connie Goe
CoyutLeic1cer
Company:
Signature Date:
Russells Heating & Air Conditioning
2017-03-30
Address:
CEA/ HERS Certification Identification (if applicable):
33145 Yucaipa Boulevard
City/State/Zip: - %^ti
Phone:
Yucaipa CA 92399
9097797-5669
Responsible Person's Declaration statement 4
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
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. l `
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement' age ncy for approval with thislbuilding permit application.
S. I will ensure that a registered copy of this Certificate of Compliance'' ahall'be madeiavailable with the building p"e�mit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required io be included with`the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Ualrr:j"e~d S:krV.0
Responsible Designer Signature:
Connie Goe
Cryotu,U G
Company:
Date Signed:
Russells Heating & Air Conditioning
2017-03-30
Address:
License:
33145 Yucaipa Boulevard
719570
City/State/Zip:
Phone:
Yucaipa CA 92399
909-797-5669
Digitally signed by CHEERS"^. 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: 417-A020088058A-000-000-0000000-0000 Registration Date/Time: 2017-03-30 11:22:11 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-30 11:22:13
Schema Version: rev 10/16