BMCH2017-0123Q�i aw
78-495 CALLE TAMPICO Ct D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0123
Property Address: 80475. WEISKOPF
APN: 762100001
Application Description: MAJESKI / HVAC CHANGEOUT 20SEER/81 AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $13,000.00
Applicant:
TIMO'S AIR CONDITIONING & HEATING INC
72232 CORPORATE WAY
THOUSAND PALMS, CA 92276
A
APR d7 2017
CITYOFLAQUINTA'
COPAMUNITY LEVEL OPPAENTDEPARTfi9ENT
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: CC20 License No.: 920062
Date: ` _ /Contractor.
OWNER-BUI ECLARATION
I hereby affirm under penalty of perjury that I am exempt from t ractor'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).:
(� 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 town owner of property who builds or improves thereon,
and who contracts for the projects with a contractors) 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
Date: 4/7/2017
Owner:
MAJESKI V R & T LIVING TRUST
80475 WEISKOPF
LA QUINTA, CA 92253
Contractor:
TIMO'S AIR CONDITIONING & HEATING INC a
72232 CORPORATE WAY
THOUSAND PALMS, CA 92276
(760)770-4357
Llc. No.: 920062
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 t for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sect 00 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: NORGUARD INSURANCE COMPANY Policy Number: TIWC721117
_ 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 370 the Labor Code, I sh ` forthwith
comply with those provisions.
Date: r 7-1 ( Applica
WARNING: FAILURE TO SECURE WORK OMPENSATI OVERAGE 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. >-,-7 _/5Q
Date: ,7 / Signature (Applicant or A
i
Date: 4/7/2017
Application Number: BMCH2017-0123 Owner:
Property Address: .80475 WEISKOPF MAJESKI V R & T LIVING TRUST
APN: 762100001 80475 WEISKOPF
Application Description: MAJESKI / HVAC CHANGEOUT 20SEER/81 AFUE SPLIT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $13,000.00
Applicant: Contractor:
TIMO'S AIR CONDITIONING & HEATING INC TIMO'S AIR CONDITIONING & HEATING INC
72232 CORPORATE WAY 72232 CORPORATE WAY
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
(760)770-4357
Llc. No.: 920062
--------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - 20SEER/81AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FinAlICIAL. IrIFURFI'IATI•
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
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin
Submittal
City of U -Quinta
-Building SL Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking- beet
Permit #
Project Address:
PERMIT FEES.
Owner's Name:
A P. Number.
Address: q-�4 /W— 'e
Legal Description:
City, ST, Zip: C14 �7
Contractor: "CrTTr� t}a% cite �,�
Address-Pro
��I �—t
Telephone:
ect DesaiP tion:
City, ST, Zip:61tx
Telephone:
Plan Check Deposit
WX �
State Lie. #
Truss C21cs.
City Lia #:
Arch., Engr., Desiv=.
Called Contact Person
Address:
City, ST, Zip:
Telcphonc:?-
State Lic. #:D4046rc-
�
?ri+l
„¢L�•, �;
r�isfi .
s<c?s<�_;y��M,��;,,^�>
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
.
Name of Contact Petson: �. ig
Sq. FL:
# Stories:
;91
Telephone #,of Contact Person:
Estimated Value of Project---
APPLICANT. DO NOT WRITE BELOW THIS LINE
t✓
Submittal
Rcq'd
Rec'd
TRACKNG
PERMIT FEES.
Plan Sets
P12 Check submitted
Item
Amount
Structural Catcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss C21cs.
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 eorrcctionsrissue
Electrical
Subcontactor List
C211cd Contact Person
Plumbing
Grant Dccd
Plans picked up
S.M.L
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
3" Review, ready for correctionsrusue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Scho61 Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3)
Project Name: Virgil Majeski Date Prepared: 2017-04-06
A. General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF111-ALT-02 document for each dwelling unit.
01
Project Name
Virgil Majeski
02
Date Prepared
2017-04-06
03
Project Location
80475 Weiskof
04
Building Type
Single family
O5
CA City
La Quinta
06
Dwelling Unit Name
Virgil Majeski
07
Zip Code
92253
08
Dwelling Unit Conditioned
4000
refrigerant
Installing new SC
Installing
Installing
Floor Area (W)
Identification or
Location or Area
by this SC
ducted
Number of Space
system
09
Climate Zone
15. '_ .-
10
Conditioning (SC) Systems in
1
System (ft)
system?
component?
components?
this Dwelling Unit:
duct system?
B. Space Conditioning (SC) System Informat; on*'\ t A 11 t( I�= K 11, * — II
1 11
C A
Ol
02
03 �
� � 04
OS
_ 06 _
_ '07 �
`y 08
_ 09
10
'1's the SCS
Installf g a
:
V t
L..0 r
M
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
morethan 40
entirely new
entirely new
Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
4000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1D1ib)
This section does not apply to this project.
Registration Number: 217-A020112523A-0OD-000-0000000-0000 Registration Date/Tme: 2017.04.0617:15:54 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-06 17:16:10
Schema Version: rev 10/16
El
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
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
81.
AC
cooling
SEER
20
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation: -
CF2R-MCH-01-E- Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and retum-air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 31 and 14-16)
CF2R and CF3R-MCN-20-H'- Duct Leakage Test required when heating or cooling components are installed in ducted systems, or when more than 40 it of duct length is replaced
-Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification.required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when.MCH-25 is required.
Exceptions:
- Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
- Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCHt23,�Refrigerant Charge M'aI 25.
ny r1 s .; ie. rr
-Existing duct systems constructed, insulated or sealed with asbestos are exemptifrom MCH -20 Duct leakage Testmgrequirements.
Ift. !A !\ rr ". If !1. Jt. JM !3 Jt I if ..-c. at 7t: ft 44
\ i4 t ��r..r ti..' m., — .,r '—' At
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections-150.2(b)SDiia,and.150.2(b)lE, F)
P K if.-' ii -e I l i 1_ W k 114
This section does not apply to this project. T '
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 217-A020112523A-0OD-000-0000000-0000 Registration Date/Time: 2017-04-06 17:15:54 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-06 17:16:10
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVC.C) (Page 3 of 3)
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation i5 accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Timo , Joseph
i/��
Company:
Signature Date:
TIMO'S AIR CONDITIONING & HEATING INC
2017-04-06 17:15:54
Address:
CEA/ HERS Certification Identification (if applicable):
72232 Corporate Way
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-770-4357
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 an 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 desig(n identified an this Certificate of Compliance conform to the
requirements of Tftle 24, Part land Part 6 of the California Code of,0 egulaSions'4
+
r+ �� ,rw
4. The building design features or system design features identified on this Certificate of Compliance are.consistent with -the inforrnation.palrovided ony
e6rr appli[kcab�{l(e�comPliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agenn for approval with this building permit app)Ication. i[ojtt
1 !�
.�. 'd}t.. ♦' 3� Nt le'd
S. I will ensure that a registered copy of this Certificate of�mpliance shalPb :made:avadable with the building pertnit�s),issued fori[he building, and, made available,to the enforcement agency for all applicable
inspections. I understand that a registered cop of this Certificate of Compwance required to be induded with the�documentationstheN wilder pro„ vldides tie building owner at occupancy.
`
Responsible Designer Name: -A ice. " .D
Respons[ le Designer Signature:'/' I L.10 ZZ
Timo, Joseph
Company:
Date Signed:
TIMO'S AIR CONDITIONING & HEATING INC
2017-04-06 17:15:54
Address:
License:
72232 Corporate Way
920062
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-770-4357
Digitally signed by CalCERTS. This digital signature is provided in order to secure the rnntenrW this registered document and in noway implies Registration Provider
responsibility for the accuracy of ilm information.
Registration Number: 217-A020112523A-00D-000-0000000-0000 Registration Date/Time: 2017-04-0617:15:54 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-06 17:16:10
Schema Version: rev 10/16