BMCH2016-0448.i
78-495 CALLE TAMPICO O.�i
D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN &DEVELOPMENT DEPARTMENT FAX
(760) 777-7153
BUILDING PERMIT
Date: 12/13/2016
Application Number: BMCH2O16-0448 r Owner:
Property Address: 78262 CALLE LAS RAMBFAC
RON BEELER
APN: 770015001 78262 CALLE LAS RAMBLAS
Application Description: DEVEREAUX RESIDENCE/ANgR14 2016 LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $11,000.00 CITY OF LA QUINTA
Applicant: DESIGN AND DEVELOPMENT DEPARTMENT contractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET 42-949 MADIO STREET
INDIO, CA 92201 INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
LICENSED CONTRACTOR'S DECLARATION
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, C36 License No.: 90611
of the work for which this permit is issued.
__ —" -1I
'Z
have and will maintain workers' compensation insurance, as required by
Date: — - Contractor:
Sec tion 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:
OWNER -BUILDER DB TION
Carrier: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600015264
1 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
I certify that in the performance of the work for which this permit is issued, I
city or county that requires a permit to construct, alter, improve, demolish, or repair
shall not employ any person in any manner so as to become subject to the workers'
any structure, prior to its issuance, also requires the applicant for the permit to file a
compensation laws of California, and agree that, if I should become subject to the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
comply with those provisions.
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
Date: 1� . Applicant:
permit subjects the applicant to a civil penalty of not more than five hundred dollars
91 --
($500).:
S COVERAGE IS UNLAWFUL,
WARNING: FAILURE TO SECURE WORKEReFORIN
(_) I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO TIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS 1ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PRO CTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT .
within one year of completion, the owner -builder will have the burden of proving that
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(_) I, as owner of the property, am exclusively contracting with licensed contractors
1. Each person upon whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any permit
State License Law does not apply to an owner of property who builds or improves
issued as a result of this application , the owner, and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
the Contractors' State License Law.).
employees for any act or omission related to the work being performed under or
(� I am exempt under Sec. . B.&P.C. for this reason
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
Date: Owner:
work for 180 days will subject permit to cancellation.
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
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 p/rroperty for inspection purposes.
: 1 2 "/I lP
Date -Signature (Applicant or Agen
Date: 12/13/2016
Application Number: BMCH2016-0448
Owner:
Property Address: 78262 CALLE LAS RAMBLAS
RON BEELER
APN: 770015001
78262 CALLE LAS RAMBLAS
Application Description: DEVEREAUX RESIDENCE /HVAC CHANGE OUT
LA QUINTA, CA 92253 -
Property Zoning:
Application Valuation: $11,000.00
^
Applicant:
Contractor:
CERTIFIED COMFORT SYSTEMS INC.DBA HYDES
CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET
42-949 MADIO STREET
INDIO, CA 92201
INDIO, CA 92201
(760)360-2202
Llc. No.: 906115
-------------------------------------------
---------------------------------------------------
-Detail: (2)HVAC CHANGE OUT -16 SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. PER 2013 CALIFORNIA BUILDING CODES
FINANCIAL INFORMATION
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
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$76.00
Total Paid for CHANGEOUT: $228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC)
Project Name:
78262 Calle Las Ramblas I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 ).
2016-11-10
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 documented,
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
78262 Calle Las Ramblas
02
Date Prepared
2016-11-10
03
Project Location
78262 Calle Las Ramblas
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
78262 Calle Las Ramblas
07
Zip Code
92253
08
Dwelling Unit Conditioned
2412
Installing
-Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted.
containing
system
Number of space conditioning
entirely new
09
Climate Zone
15
30
(SC) systems in this dwelling
2
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
01
02
03
04
05
06�
07 .'
08
09
10
Is the SC
Installing 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
Bedrooms
1200
Yes
Yes
Yes
No
No
No
Altered spaceconditioning
system
System 2
Living Area
1200
Yes '
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System. -Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 216-A0419152A-000000000-0000
Registration Date/Time: 2016-11-10 09:51:49
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-10 09:51:31
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-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 split
All new
Central split
All new
This field or
This field or
System 1
HP
heating
AFUE
78
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Central split
All new
Central split
All new
This field or
This field or
System 2
HP
heating
AFUE
78
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
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%, or15 10% 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 21 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions: t
-Duct systems registered with HERS provider as previously sealed are exempt from MCH720 Duct Leakage Testing requirements...: s
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Dud Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F)
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-A0419152A-000000000-0000 Registration Date/Time: 2016-11-10 09:51:49 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-10 09:51:31
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2016-11-10 09:51:49
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
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 of the California Code of Regulations.
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 agency for approval,with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(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 to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature: ZZ•
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2016-11-10 09:51:49
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
760-360-2202
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: 216-A0419152A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-11-10 09:51:49
Report Version: 2013 Rev 1.008
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2016-11-10 09:51:31