BMCH2014-103178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Twy, 4 4ev' Qui'KrAv
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O14-1031
Property Address:
52505 AVENIDA DIAZ
APN:
773281013
Application Description:
HVAC CHANGE OUT - 16SEER/78AFUE SYSTEM
Property Zoning:
Application Valuation:
$11,650.00
Applicant:
VENVEST BALLARD INC DBA RIGHTI
3030 MYERS STREET
RIVERSIDE, CA 92503
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: C2,,0`` License No.: 878533
Date: -7' 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 o 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.).
(_ 11, 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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 thew k r 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.
DateApplicant:,--,)
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 the above-
mentioned property for inspection purposes.
Date/ i -\q t� Signature (Applicant or Agent) /
u
Date:
7/24/2014
Owner:
LAURENCE COX
52505 AVENIDA DIAZ
LA QUINTA, CA 92253
O
o
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N
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Contractor:
d.
Q
w7,
VENVEST BALLARD INC DBA R GHTI
0
3030 MYERS STREET
_1
c
RIVERSIDE, CA 92503
z
(951)276-9744
f
$
Llc. No.: 878533
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 thew k r 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.
DateApplicant:,--,)
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 the above-
mentioned property for inspection purposes.
Date/ i -\q t� Signature (Applicant or Agent) /
u
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 - PACKAGED UNIT
101-0000-42402
0
$35.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
0
$23.83
$0.00
PAID BY .
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $59.58 $0.00
DESCRIPTION
- - ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
• ••
Din #
City of La - Quinta
-Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La QuInta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
WA414-
Ind,
Project Address:
Owner's Name:L
A. P. Number 0 L_j
Address: 5?&!5 NAMeL 'Dina
Legal Description:
City, ST, Zip: LoL &vw& r ct5:)-G
Contractor.
U
Address: a—c5b
Telephone:
Project Description:
City, ST, Zip:
Telephone q&m, Al 4!1.
h2
IVA
State Lie. # V>
City Lie. C.
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lir— M
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Pawn:
Sq. FL:
# stories: �TwUnits:
Telephone #,of Contact Person:
Estimaictl Value of Project: 4F
APPLICANT: DO NOT WRITE BELOW THIS LINE
N 'Submittal Reqld Rec1d TRACKMG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check 13.1.,cc,
Tide 24 Calcs:
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2! Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
'Grading
IN HOUSE:-
Review, ready for correctionsrassue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
Scho6l Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name:' LAWRENCE COX Date Prepared: 2014-07-16
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 CFIR-ALT-02 document for each dwelling unit.:
01
Project Name:
LAWRENCE COX
02
Date Prepared:
2014.07-16
03
Project Location:
52505 AVENIDA DIAZ
04
Building Type:
Single family
05
CA City:
La Quinta
06
Dwelling Unit Name:
LAWRENCE COX
07
Zip Code:
92253
OS
Dwelling Unit Conditioned
2000
duct system
floor Area (ft2):
(packaged unit, or
Number of space conditioning
accessible
09
Climate Zone:
15
10
(SC) systems being altered in
1
condensing unit,
Installing
for sealing,
this dwelling unit:
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
OB
09
10
Installing new
Is the entire
components?
duct system
(packaged unit, or
accessible
Are all of the
condensing unit,
Installing
for sealing,
system's
Is the altered
Altering or
or
more than 40
and is more
components
or installed
installing a
cooling/heating
linear feet of
than 75% of
and ducts new
SC System
SC System
CFA served
system a
refrigerant
call, or
new or
the duct
or replaced?
Identification or
Location or Area
by this SC
ducted
containing
air -handling unit,
replacement
system new
(entirely new
Name
Served
System (ft2)
system?
component?
etc)
ducts?
or replaced?
system)
Alteration type
AMANA
2000
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Dud System, GreaterThan 40 Feet (Section150.2(b)11311b)
This section does not apply to this project.
Registration Number: 214-A0057019A-0000000000000
Registration Datefnme: 201407-16162028
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2023 Residential Compliance ReportVersion: 2014-03-31 Report Generated: 2014-07-16 16:20:40
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 4 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
as
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
System7ype
Components
Type
Value
Type
Dud Length
R -Value
Central gas
All new
Central split
All new
This field or
This field or
AMANA
furnace
heating
AFUE
0.78
AC
tooling
SEER
16
Setback
section is not
section is not
components
components
I
applicable
applicable
Reoulred Documentation-
CF2R•MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R•MCH-20-H & MR -MCH -I0 -H —Dud leakage testing required when heating or cooling components are Installed In ducted systems, or when more than 40 ft of duct length Is replaced.
dcakage rate compliance: s 1S%. or!9 10% leakage to outside, or sea) an accessible leaks.
CF2R•MCH-25-H & CF3R.MCH-25-H Refrigerant Charge Verinration required when refrigerant containing components are Installed or allered (applicable in CZ 2, S -IS).
CF2RCF3R-MCH-23 & CF3R.MCH-23 Air Flaw a 300 CFM/ton required when MCH -2S Is requlred.
Excentlanst
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct leakage Testing requirements.
-Heating-only systems and Air Handler/Fumace changes do not require verif cation of Air Flow MCH-23, or Refrigera t Charge MECHdS.
-Existing duct systems constructed, Insulated or sealed with asbestos are exempt from MCH -20 Duct leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDlla and iS0.2(b)M, F)
This section does not apply to this project.
Registration Number: 214-AOOS7019A-000000000.ODOO
Registration Date/Time: 2014-07-16162028
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03.31 Report Generated: 2014.07-16 1610:40
CERTIFICATE OF COMPLIANCE CF1R-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.
Doeumentatlon Author Name:
Documentation Author Signature:
McEligot, Jim
Company.
srgnatureOate:
VENVEST BALLARD INC dba RIGHTiME AIR CONDITIONING AND HEATING
2014-07-16 16:20:28
Addfess:
CEA/ HERS Certl(latlon Idemtficatlon III applicable):
3030 MYERS ST
City/State/Zip-
Phone.
RIVERSIDE CA 92503
(951) 276.9744
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
2. The information provided on this Certificate of Compl*ame Is true and correct.
2. 1 am eliglble under Olvlston 3 of the Business and Professions Code to accept responsibility for the butldingdeslgn orsystem design Identified on this Certifiate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the buiding design orsystem destgn Identified an this Cerfincate of Compliance conform to the
mquYements of Title 24, Part i and Pert 6 of the California Code of Regulations.
4, The boding design features or system design features Identified op this Certificate of Comp4ance are consistent with the information provided on other applicable compliance documents, worksheets,
alculattons, plans and specifications submitted to the enforcement agency for approval with this bugling permit aplocation.
S. I w11 ensure that a registered copy of this Certt ate of Comp9ance shall be made evallable with the building penm(4 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 req ulted to be Included with the documentation the builder provides to thebuildingowner at occupancy.
Responsible Designer Name:
Responsible Designer S'gnature:
McEligot, Jim
Company:
Date Signed:
VENVEST BALLARD INC dba RIGHTIME AIR CONDITIONING AND HEATING
2014-07-161620:28
Address:
Ucerse:
3030 MYERS ST
878533
Oly/Stale/Zip:
Phone:
RIVERSIDE CA 92503
(951) 276-9744
Digitally signed by CaICEA75. This digital signature is provided in order to secure the content o/ this registered document, and in noway implies Registration Provider responsibility for the accuracy of the
information
Registration Number. 214-AO057019A-000000000.0000 Registration Date/Time: 2014-07-16 16:20:28 HERS Provider: CaICERTS
CA Building Energy Effidency Standards - 2013 Residential Compliance Report Version: 2014.03-31 Report Generated: 2014.07.16 16:20:40
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 4 )
F. Entirety New or Complete Replacement Space Conditioning System (Section 1S0.2(b)1C)
This section does not apply to this project.
e
Registration Number: 214-A0057019A-0000000040000 Registration 0ate/nme: 2014-07-1616:20.28 HERS Provider: CaICERTS
CA Building Energy Effidency Standards- 2013 Residential Compliance Report Version: 2014-03.31 Report Generated: 2014-07-16 16:20:40