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BMCH2014-1097LICENSED 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.: 936600 Date: 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).: (1 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.). (1 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 lendingagency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's 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. 4!!2�_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: Policy Number: 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 Co , I shall forthwith comply with those provisions. Date:' (�� i 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 th bove- mentioned property for inspection purposes. 17 Date: Signature (Applicant or Agent) VOICE (760) 777-7125 78-495 CALLE TAMPICO FAX(760)777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/29/2014 Application Number: BMCH2O14-1097 Owner: Property Address: 61002 DESERT ROSE DR z DENNIS ASHER APN: 764350001 Z 61002 DESERT ROSE DRIVE Application Description: REPLACE COIL er a LA QUINTA, CA 92253 Property Zoning: D N is o Application Valuation: $600.00 8 w 4 � Applicant: _ W o Contractor: BARNETT'S A/C c� BARNETT'S A/C P 0 BOX 741 P 0 BOX 741 LA QUINTA, CA 92247 C�,� LA QUINTA, CA 92247 (760)391-0350 Llc. No.: 936600 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.: 936600 Date: 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).: (1 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.). (1 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 lendingagency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's 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. 4!!2�_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: Policy Number: 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 Co , I shall forthwith comply with those provisions. Date:' (�� i 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 th bove- mentioned property for inspection purposes. 17 Date: Signature (Applicant or Agent) CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF-IR-ALT=HVAC) Project Name: asher I Date CF1R-ALT 02-E (Page i of 4 ) 2014-09-29 1 A. General Information CF11R-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelli u i hen multiple dwelling units must be T documented, use one CF1R-AL02 document for each dwelling unit. 0 01 Project Name asher 02 Bate Prep 2014-09-29 03 Project Location 61002 desert rose dr 04 Ou 1 n ype Single family OS CA City La Quinta , 06 Mii Unit Name asher `Oybelling Unit Conditioned SC System 07 Zip Code 92253 8 * loor Area (ft2) 1400 09 Climate Zone 15 + ,°`j '10 ; Number of space conditioning (SC) systems in this dwelling 1 by this SC containing unit. more than 40 B. Space Conditioning (SC) System Information0 01 02 03 4 > OS 06 07 08 09 30 C IsSted Installing a SC System SC System CFA served s as refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC containing system more than 40 entirely new entirely new Name Served System( ystem? component? components? feet of ducts? duct system? SC system? Alteration Typow e System 1 Location 1 X410 40 Yes No Yes No No No Altered space 4J conditioning system C. Extension of Existing Duct Than 40 Feet (Section1501(b)1Diib) This section does not apply to this project. Registration Number: 214-A0103466A-000000000-0000 Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Schema Version: 0.551SDD HERS Provider: CalCERTS Report Generated: 2014-09-29 14:00:03 CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 4 j 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 o I Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling ency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Compone pe Value Type Duct Length R -Value Central gas No heating This field or This field or Central large This field or This field or System 1 furnace component section is not section is not packaged AC In r c� SEER 13 Setback section is not section is not altered applicable applicable applicable applicable $ggufred Documentation: CF2R-MCH-01-E -Space Condltioning Systems Ducts and Fans -Duct Insulation requirement for new plenums: R6. CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage tes ng required when heating or cooling compo'e 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; orseal all accessible leaks: CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant..o taining 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,requi d. ' l Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt frorl, : 0 Dud Leakage Testing requirements. Heating only systems and Air Handler/Furnace changes do not require verificatlo'�o�fj irFJo MCH -23, or Refrigerant Charge MECH-25. -Existing duct systems constructed, insulated or sealed with asbestos are e=pt froff CH -20 Dud Leakage Testing requirements. E. Entirely New or Complete Replacement Duc,KgfSte�with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F) Registration Number: 214-A0103466A-000000000-0000 This section does not apply to this project. Registration Date/Time: HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-29 14:00:03 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 4 ) F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 214-A0103466A-000000000-0000 Registration Date/Time: HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-09-29 14:00:03 Schema Version: 0.5S1SDD CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 4 of 4 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. NOW Documentation Author Name: Documentation Author Si rMU e: Barnett, Scott Company: Signature Date: BARNETT'S A/C Address: CEA/ HERS rt c Ion Identification (If applicable): .51390 AVENIDA NAVARRO City/State/Zip: P e. LA QUINTA CA 92253 (- OU: 91-0350 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 res on��sibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, compo of I~s�anp�►nanufactured devices forahe 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 Rel;lat o s. 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 enforce er agen - r approval with this building permit application. S. I will erasure that a registered copy of this Certificate of Complianc hall 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 C Ifi to o' mpliance is required to be Included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: 144W Responsible Designer Signature: Barnett, Scott � 6ompany : IVW Date Signed: ,BARNETT'S A/C Address: License: 51.390 AVENIDA NAVARRO 936600 t`.ity/State/Zips Phone: I,A IWNTA CA92253 (760) 391-0350 Mjlttratioi' Numlper: 214-A0103466A-000000000-0000 Registration Date/Time: HERS Provider: CaICERTS CA BUlidlre, •Energy Efficiency Standards - 2013 Residential Compliance Report Version; 2014-03-31 Report Generated: 2014-09-29 14:00:03 Schema Version: 0:551SDD FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY Total Paid forCHANGEOUT: $16.92 $0.00 DESCRIPTION ACCOUNT QTY' AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:0• 00 Description: REPLACE COIL CHRONOLOGY Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 9/29/2014 SKH Approved: Parcel No: 764350001 Site Address: 61002 DESERT ROSE DR LA QUINTA,CA 92253 Subdivision: TR 30023-1 Block: Lot: 124 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $600.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 BARNETT'S A/C Details: HVAC CHANGE OUT - REPLACE (1) COIL [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. CA 92247 FINANCIAL CHRONOLOGY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 CONDITIONS CONTACTS Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: NAME TYPE NAME ADDRESSI CITY STATE -ZIP PHONE FAX EMAIL APPLICANT BARNETT'S A/C P O BOX 741 LA QUINTA CA 92247 ( FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Monday, September 29, 2014 3:22:37 PM 1 of 2 C SYSTEM S ` 'PAID LCLTD� DESCRIPTION^~ ACCOUNT QTY AMOUNT PAID DATE RECEIPT # CHECK # METHOD PAID BYa BY HVAC CHANGEOUT - 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION HVAC CHANGEOUT - 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PC Total Paid forCHANGEOUT: $16.92 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS:0• 00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE MECHANICAL FINAL" Printed: Monday, September 29, 2014 3:22:37 PM 2 of 2 N?�SYS TEMS Description: REPLACE COIL CONDITIONS NAME TYPE NAME' Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 9/29/2014 SKH Approved: Parcel No: 764350001 Site Address: 61002 DESERT ROSE DR LA QUINTA,CA 92253 Subdivision: TR 30023-1 Block: Lot: 124 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $600.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 LA QUINTA Details: HVAC CHANGE OUT - REPLACE (1) COIL [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ( Printed: Monday, September 29, 2014 3:22:37 PM 1 of 2 CR SYSTEMS INSPECTIONS RESULT REMARKS NOTES - CLTDJ DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD~ PAID BY BY HVAC CHANGEOUT - 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION HVAC CHANGEOUT - 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PCI I Total Paid forCHANGEOUT: $16.92 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid forPERMIT ISSUANCE: $91.85 $0.00 TOTALS:•• • 00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL" Printed: Monday, September 29, 2014 3:22:37 PM 2 of 2 C�� SYSTEMS Bin # Permit # IVl(�=fiZFj1 ll-- j City of La Quinta . Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: Owner's Name: A. P. Number: Address:6`QQ �r A Legal Description: City, ST, Zip: 4 �;rs Contractor: S Telephone: Address: d Project Description: hce 41� '0,' City, ST, Zip: u`✓}Fl�lj� t �� ne: Telephone: _p 3 S2) Statc Lic. # : 3G City Lic. #: Arch., Engr., Designer: Address: City,, ST, Zip: telephone: :: Construction Type: Occupancy: 3tatc Lic. #: : New Add'n Repairair Demoter Project type circle one) lame of Contact Person: Sq. Ft.: L100 # Stories: 1 # Units: Celcphone # of Contact Person: Oct Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd Rcc'd TRACIGNG PERMIT FEES- Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections. Plan Check Deposit Trusi Calcs. Called Contact Person Plan Check Balance. Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2' Review, ready for corrcctions(ssue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. 1-Y.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Reyiew, ready for eorrectionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees