BMCH2016-010478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0104 Owner
Property Address: 51833 AVENIDA CORTEZ DAVID
APN: 773152016
Application Description: DAVID OBREN / HVAC CHANGE OUT 9225
Property Zoning:
Application Valuation: $8,500.00
Applicant:
PRIORITY ONE AIR CONDITIONING AND HEATIN
P 0 BOX 1681
PALM DESERT, CA 92261
VOICE (760) 777-7125
FAX(760)777- 7011,
INSPECTIONS (760) 777-7153
A Ll
-.2:9
APR I H20i0
CITYOFLAQUINTA
Contra W, XTY DEVELOPMENT DEPARTMENT
PRIORITY ONE AIR CONDITIONING AND HEATIN
P 0 BOX 1681
PALM DESERT, CA 92261
(760)773-0811
Llc. No.: 752180
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C20 License No.: 752180
of the ork for which this permit is issued.
e: y �y b �Co a_dor.
I have and will maintain workers' compensation insurance, as required by
CD td
Section 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:
OWNER -BUILDER DECLARATION
Carrier:- Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
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 `
Date: �H Applicant:
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(1 I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
apply to an owner of property who builds or improves thereon, and who does the work
himself oi• herself through his or her own employees, provided that the improvements
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(_► I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
I I I am exempt under Sec. . B.&P.C. for this reason _
2. Any permit issued as a result of this application becomes null and void if work is
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
Lender's Address:
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 ainformation is correct.
I agree to comply with all city and county ordinances and st to la s relating to building
construction, and hereby authorize representatives of this c y to a ter upon the
above-mentioneproperty for inspection purposes.
Date: y (`4 Signature (Applicant or Agent).
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT - QTY AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00 $1.00
4/14/16
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY
PRIORITY ONE AIR CONDITIONING
CHECK
R14743 2834
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 '. $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$72.52
4/14/16
• PAID BY
METHOD'
RECEIPT #
CHECK #
CLTD BY
PRIORITY ONE AIR CONDITIONING
CHECK
R14743
2834
RSE
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
4/14/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
PRIORITY ONE AIR CONDITIONING
CHECK
R14743
2834
RSE
Total Paid for CHANGEOUT: $108.78 $108.78
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
4/14/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
PRIORITY ONE AIR CONDITIONING
CHECK
R14743
2834
RSE
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS:
Description: DAVID OBREN / HVAC CHANGE OUT
CONDITIONS
Type: MECHANICAL Subtype:
Status: APPROVED
Applied: 4/14/2016 RSE
Approved: 4/14/2016 RSE
Parcel No: 773152016 Site Address: 51833 AVENIDA CORTEZ LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 29
Lot: 4
Issued:
UNIT 2
CONTACTS
A DDRESSl " CITY
STATE
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $8,500.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
92261
Details: HVAC CHANGE OUT - 16.SSEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CONTRACTOR
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
NAME TYPE....
NAME'
CONTACTS
A DDRESSl " CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
PRIORITY ONE AIR CONDITIONING
AND HEATIN
P 0 BOX 1681 PALM DESERT
CA
92261
CONTRACTOR
PRIORITY ONE AIR CONDITIONING
AND HEATIN
P 0 BOX 1681 PALM DESERT
CA
92261
OWNER
'DAVID OGREN
92253
Printed: Thursday, April 14, 2016 10:45:11 AM 1 of 2
SYSTEMS
INSPECTIONS
PARENT PROJECTS
REVIEWS
R�VL, W TY 'iu RtTURNEb, , STATUS
EVIEWER S
NT DATE D " VIII REMARKS
E UE DATE NOTES
1 7
DATE
BOND
INFORMATION
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
E4/1d4/16
R14743
2834
CHECK
PRIORITY ONE AIR
CONDITIONING .
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52.
$72.52
4/14/16
R14743
2834.
CHECK
PRIORITY ONE AIR
RSE'
SPLIT -SYSTEM
CONDITIONING
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$36.26
4/14/16
R14743
2834
CHECK
PRIORITY ONE AIR
RSE
SPLIT -SYSTEM PC
CONDITIONING
Total Paid for CHANGEOUT: $108.78 $108.78
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
4/14/16
R14743
2834
CHECK
PRIORITY ONE AIR
CONDITIONING
RSE
J
Total Paid for PERMIT ISSUANCE: $91.85. $91.85
TOTALS:
INSPECTIONS
PARENT PROJECTS
REVIEWS
R�VL, W TY 'iu RtTURNEb, , STATUS
EVIEWER S
NT DATE D " VIII REMARKS
E UE DATE NOTES
1 7
DATE
Printed: Thursday, April 14, 2016 10:45:11 AM 2 of 2
LYLY SYSTEMS
BOND
INFORMATION
ATTACHMENTS
Printed: Thursday, April 14, 2016 10:45:11 AM 2 of 2
LYLY SYSTEMS
B►n.#
r
City Of Quintd
Building 8i: Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
V+aC- 2d
Project Aadlrss: l' e_a-, c. Co - -ice
Owner's Name:.Q� M e 0 -,( -,,�
A. P. Number.
Address: S S 3Ali Co r _111_-Z
Legal Description:
Contractor. (c` a r .
City, ST, Zip: l Q v Ca aS3
Telephone:
Address: 1�0 ` - 4
Project Description::
City, ST, Zip:
Telephone7lpD _ �;r.
4: ��
State Lic. # : 1 )City Lic. #•. vp(p-133
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
�£
State Lic. #:a a t'
^, • , ,:....�` �
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Unit$:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project: QD . 00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Coles.
Called Contact PersonPlan
Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
V Review, ready for correctionstissue
Electrical
Subeoutactor 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.LP.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: David & Megan Ogren Date Prepared: 2016.03-22
A. General Information
CHR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CHR -ALT -02 document for each dwelling unit.
O1
Project Name David & Megan Ogren
D2
Date Prepared 2016-03-22
03
Project Location 51833 Avenida Cortez
04
Building Type Single family
OS
CA City La Quinta
06
Dwelling Unit Name David & Megan Ogren
07
Zip Code 92253
08
Dwelling Unit Conditioned 1600
Floor Area (ft2)
SC System
CFA served
Nlystem a
Number of space conditioning
09
Climate Zone 15 J� `
10
(SC) systems in this dwelling 1
i
Location or Area
unit.
B. Space Conditioning (SC) System Information '
ff
01
02
03 +
t pff
w D D4k4 �
4
^ bS I k4
i rt
I f-66 1
11 D7i) _
os
t
t 09
10
FIs the SCS`"
` `Installing a
SC System
SC System
CFA served
Nlystem a
r;frigeSnt
Zinstalling new SC
Installl. g
Installi g
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
whole home
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0108060A-000000000-0000 Registration Datefrime: 2016-03-22 08:25:12 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-22 08:25:30
Schema Version: 0.5555DD
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)3E and F)
O1
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
16
Setback
section is not
section is not
components
components
I
I
I
I applicable
I applicable
Required Documentation:
CF2R-MCH-01-E -Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. f -'
CF2R-MCH-20-H & 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: 5 15%, or 510%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).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing-equiremeents
-Heating-only systems and Air Handler/Furnace changes do not require venfica yfon of Ar Flow �MCH 23,Fo(Refngerdnt Charge MEC 25.
-Existing duct systems constructed, insulated or sealed with asbestorare exern from MCFi'-20 Du �t¢Leakage Testrng�reguiremen'ti.�
/►.. }[ 4!, _ FR .i5 7K FR.. r5 3b' !l !{ A$ .-n
i ^��w�w 7 W R+ M ^•aaw� `wv'
E. Entirely New or Complete Replacement Duct -System, with or without Equipment Changeout (Sections;1S0.2(b)1Diia.and.150.2(b)1E, F)
y . t 3F•"ii ih4 W k V i i 4 2"� C
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-A0108060A-000000000-0000
Registration Date/1-ime: 2016-03-22 08:25:12
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-22 08:25:30
Schema Version: O.SSSSDD
t
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: A�
Meghnagi, Roy
Company:
Signature Date:
PRIORITY ONE AIR CONDITIONING AND HEATING CO
2016-03-22 08:25:11
Address:
C -A/ HERS Certification Identification (if applicable):
P 0 BOX 1681
City/State/Zip:
Phone:
PALM DESERT CA 92261
760-773-0811
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
requirements of Title 24, Part 1 and Part 6 o the California Code of Reg rations. pg,illo
4. The building design features or system design features identified o ® this Certif ampl e tentwith�th�forma� .provided o 1 the�napplirable'co `mpliance documents, worksheets,
Sa}'^'sis k+Dari id
calculations, plans and specifications submitted to the enforcement agency for approval with this building
g permh application.}111(
�... .e�R.. *t 4�, 48 6 If
.Fk�.
S. I will ensure that a registered copy of this .Certificatetif,Compliance shalfbe'made,avadable wftktFie budding petmit(s),tssued foreiheRbuilding, and,made availpble,"e_enforcement agency for all applicable
inspections. I understand that a registered copy of thisCertiticate of Compl ance4.ls.,requ reed tone included with the documentation.thekbuilder provides to_tbe b wilding owner at occupancy.
W
Responsible Designer Name: - li ire i
Responsible Designer Signature: V ! I
Meghnagi, Roy
"
Company:
Date Signed:
PRIORITY ONE AIR CONDITIONING AND HEATING CO
2016-03-22 08:25:12
Address:
License:
P 0 BOX 1681
752180
City/State/Zip:
Phone:
PALM DESERT CA 92261
760-773-0811
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.
f t
Registration Number: 216-A0108060A-000000000-0000 Registration Date/riime: 2016-03-22 08:25:12 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-22 08:25:30
Schema Version: 0.555SDD