BMCH2015-003278-495 CALLE TAMPICO •C& 0 D QuiRrcu VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT FAX (760) 777-7011
FAX
(760) 777-7153
BUILDING PERMIT
Date: 2/2/2015
Application Number: BMCH2O15-0032 Owner:
Property Address: 51395 AVENIDA DIAZ NIKKI MICHELIZZI
APN: 773043026 51395 AVENIDA DIAZ
Application Description: HVAC CHANGE OUT,�SPLLT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $6,000.00' �N
Applicant: FEB Contractor:
PRIORITY ONE AIR CONDITIONINGPRIORITY ONE AIR CONDITIONING
P O BOX 1681 CITY OF lA OUINTAM� P 0 BOX 1681
PALM DESERT, CA 92261 COMMUNITY DEVELOPMENT DEPARTMENT PALM DESERT, CA 92261
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.: 752180
Date a,— Contractor:
•
OWNER -BUILDER DECLARATIO
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
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 af
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 Name:
Lender's Address:
(760)773-0811
Llc. No.: 752180
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: _ 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 Code, I shall forthwith
comply with those provisions.
Date: - / Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATI VERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI D 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.
Date: Signature (Applicant or Agent):
Bin #
' City of La Q�rrnia.
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
Permit #
Project Address: 13 � O1'a 2—
Owner's Name:
A. P. Number:
Address:]; Pr/ � �\
Legal Description:
City, ST, Zip:
Contractor: �� Y,�
Telephone:
Address: '� I 1
Project.Description:
City, ST, Zip:.
_PVA _- i O
Telephone:
Statc Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
:s,;..;.,::::;;;:
Construction Type: Occupancy:
S tat Lic. #:
oJect �Pc �circ1eone • New Add'n Alter. Repairair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:ozo
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Rcq'd Rcc'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
T7itic'24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrcctionsrssue
Electrical
Subcontactor List
Called ContactPersou
Plumbing
Grant Deed
Plans picked up
S•M•I•
If.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
''6 Rcvinv, ready for eorrectionstissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permIt issue
School Fccs
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: nikki michelizzi Date Prepared: 2015-01-19
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
nikki michelizzi
02
Date Prepared
2015-01-19
03
Project Location
51395 avenida diaz
04
Building Type
Single family
CIS
CA City
La Quinta
06
Dwelling Unit Name
nikki michelizzi
07
Zip Code
92253
08
Dwelling Unit Conditioned
1600
... xa+�.,......
" -
..-.,.r�,M..• 'd,
Floor Area (ft2)
SC System
SC System
CFA served
.
system a
refrigerant
Number of space conditioning
Installing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
r
more than 40
unit.
entirely new
B. Space Conditioning (SC) System'I frmati' n �./� /f#/ (f% _ j ■rj' {)y /#9 } 1
01
02 y
03, �g
04} `.E
05
x.06,:.
07 ;'.'
OSP'''
I 09
10
-
" • Is the SC :
......
, Installing a
... xa+�.,......
" -
..-.,.r�,M..• 'd,
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
whole home
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0021759A-000000000-0000 Registration Date/Time: 2015-01-19 15:57:10 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-19 15:57:04
Schema Version: 0.5515DD
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)lE and F)
01
02
03
04
05
06
07
OB
09
30
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
0.78
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Reauired Documentation:
MR•MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct Insulation requirement for new plenums: R6.
CF2R•MCH-20-H & MR -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: 515%, or 510%leakage to outside, or seal all accessible leaks.
CF2R•MCH-25-H & MR -MCH -25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8.15).
CF2RCF3R-MCH-23 & MR-11VICH-23 Air Flow 2 300 CFM/ton required when MCH 25 Is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct LeakagelTesting:requirements- -
.
-Heating-only systems and Air Handler/Furnace changes do not fegqulre verifircauonvof Air Flow MCH 23 or Refriger Charge MECH 25.V�41r:
-Existing duct systems constructed, Insulated orgeeled wit asbestos are exempt from MCyr20 DpcCLeakage Testing requirements?' .,"
AI
E. Entirely New or Complete Replacement.:Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)IE, 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: 215-A0021759A-000000000-0000 Registration Date/Time: 2015-01-1915:57:10 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015.01-19 15:57:04
Schema Version: 0.5515DD
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:
Meghnagi, Roy�dv
Registration Date/ Time:
Company:
Signature Date:
PRIORITY ONE AIR CONDITIONING AND HEATING CO
2015-01-19 15:57:10
Address:
CEA/ HERS Certification Identiflcation (if applicable):
P0BOX 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 n sponsibility forthe building de sign or.system design Identified on this Certificate of Compliance (responsible designer).
n
but)dmg-deilgsyitem design identified on this Certificate of Compliance conform to the
3. That the energy features and Performa c specifications, materia s comp ents ,and manufactured devices for n oi
requirements of Title 24, Part i and Part -6 of the Callfornla;Code of Regulations.
4. The building design features or systep design features ntified on thls Certificate of Compllance 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 pqrmit application.'
5. [will ensure that a registered copy of this CeNFlcate of Compliance shall be made avaflable.with the bull Ing permit(s) issued for the balWing a6d.rrliid'epvallable to the enforcement agency for all applicable
inspections. I understand that a registered copy,of this, Ce'rtiFlcatewf Compllance is requlredao be Included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature: A�
Meghnagi, Roy
Company: "'.:
Date Signed:
PRIORITY ONE AIR CONDITIONING AND HEATING CO;4 .'
2015-01-19 15:57:10
Address:
License: '
P 0 BOX 1681
752180
City/State/Zip:
Phone:
PALM DESERT CA 92261
(760)773-0811
Digitally signed by CsICERTS. 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: 215-A0021759A-000000000-0000
Registration Date/ Time:
2015-01-19 15:57:10
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015.01-19 15:57:04
Schema Version: 0.551500
FINANCIAL •• •
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 - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY'.
METHOD.
RECEIPT'#
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $108.78 $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:i 0•
J
Permit Details IERMIT NUMBER
City of La Quinta MCH2O�15-0032
Description: HVAC CHANGE OUT SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 2/2/2015 PJU
Approved:
Parcel No: 773043026 Site Address: 51395 AVENIDA DIAZ LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 49 Lot: 12
Issued:
UNIT 4
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $6,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: REPLACE ONE CENTRAL GAS /SPLIT COOLING SYSTRM .78 AFUE 16 SEER 2013 MECHANICAL CODES 2013 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION
Printed: Monday, February 02, 2015 11:55:37 AM 1 of 2
OLJ U SYSTEMS
DESCRIPTION
ACCOUNTV
QTY
A AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 00
Printed: Monday, February 02, 2015 11:55:37 AM 2 of 2 CR
SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL**
Printed: Monday, February 02, 2015 11:55:37 AM 2 of 2 CR
SYSTEMS