BMCH2016-0378e
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O16-0378
Property Address:
80760 WEISKOPF
APN:
762160014
Application Description:
CHANGEOUT ON COIL
Property Zoning:
Application Valuation:
$600.00
Applicant:
PREC H & A INC
P 0 BOX 10991
PALM DESERT, CA 92255
C&JY 4lw4uba
DESIGN &• DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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, C36 License No.: 8187
Date; � � 20 '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.).
(_) 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/20/2016
Owner:
MOHAMMAD YAHYAVI
6016 155TH AVE SE
BELLEVUE, WA 922
nn _
Q
Contractor: C ( 2 0 2016
PREC H & A INC CfIY0FLA0UIMA
P O BOX 10991 COMMUNRYDEVELOPMWDEPA
PALM DESERT, CA
(760)776-1550
LIc. No.: 818759
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: TRUCK INSURANCE EXCHANGE Polity Number: N20087119
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 Section0 f the Labor Code, I shall forthwith
comply with
those provisi s.
Dat ` v _ f lice
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNIJUILIL,
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 enter upon the
above-mentioned proprerty1for�innspection purposes.
Da I vgignatuurree (Applicant or Agent
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
PREC H & A INC
P 0 BOX 10991
PALM DESERT, CA 92255
BMCH2016-0378
80760 WEISKOPF
762160014
CHANGEOUT ON COIL
$600.00
Owner:
MOHAMMAD YAHYAVI
6016 155TH AVE SE
BELLEVUE, WA 92253
Contractor:
PREC H & A INC
P O BOX 10991
PALM DESERT, CA 92255
(760)776-1550
Llc. No.: 818759
Date: 10/20/2016
Detail: REPLACE/CHANGEOUT INDOOR COIL FOR SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
FINANCIALINFORMAT110N
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 - REPAIR/ALTERATION
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION PC
101-0000-42600
0
$5.07
Total Paid for CHANGEOUT:
$17.74
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 -1R -ALT -HVAC)
Project Name:
Y. Mohammad I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2016-10-20
A. General Information
C17111 -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
Y. Mohammad
02
Date Prepared
2016-10-20
03
Project Location
80760 Weiskopf
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
House
07
Zip Code
92253
08
Dwelling Unit Conditioned
3567
compon��ent?�
iff ducts">
Floor Area (ft2)
pSystem
Number of space conditioning
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ho
3567 _
Yes,
Y,eYes'
unit.
No
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
SC System
Identification or
SC System'
Location or Area'
CFA served.
bythisSC
► Is.the;SC
systema
�ducfed
Instal.li�a
refrigerant
conta,i�ning,�
Installing new SC
system
Installing
more than 40
Installing
entirely new
Installing
entirely new
Name
Served
(_. 2),
s m.
compon��ent?�
iff ducts">
pSystem
components?
fe
duct system?
SC system?
Alteration Type
System 1,
ho
3567 _
Yes,
Y,eYes'
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
Registration Number: 316-A1035408A-000000000-0000
This section does not apply to this project.
Registration Date/Time: 2016-10-20 10:15:05
C11-° OF LA OU1147A
C01MMUNITY DEVELOPMENT
HERS Provider: USERA
CA Building Energv Efficiencv Standards - 2013 Residential Comolianre Rannrt \/arcinn• )nl Z Rax, 1 nm o.,...,- 17---A. 1^,1 — 11 ,
CERTIFICATE OF COMPLIANCE CF111-ALT-024
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 gas
Central split
Less than or
System 1
furnace
Indoor coil
HSPF
8.00
AC
Indoor coil
SEER
14
Setback
equal to 40
R-8
feet -
Reauired 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%, or 510% 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 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-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 Leakage Testing requirements.
-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 Duct Leakage Testing requirements.
Registration Number: 316-A1035408A-000000000-0000 Registration Date/Time: 2016-10-20 10:15:05 HERS Provider: USERA
CA Riiilding Fnprev Fffir.ianry .Stand;irric - 2(113 Rpcidpntial (mmnlianra Rannrt Warcinn• ')r)1'4 Rosi 1 nm o,....... r,..,...—.4. nn, C 1A nn 1 r,., r -r
CERTIFICATE OF COMPLIANCE CF111-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:
Alberto Aceves
Documentation Author Signature: �
(,
Signature Date:
Company:
Precision Heat & Air
2016-10-20
Address:
CEA/ HERS Certification Identification (if applicable):
68805 Perez Rd.F42
818759
City/State/Zip:
Phone:
Cathedral City CA 92234
760-776-1150
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.
S. I will ensure=that a registered copy of this.Cdrtificate of Compliance-shall*be,mad`e available-with=theFbuilding permit(s)lissued°for the building, and made available to the enforcement agency for all applicable
inspectior�s4-1., gnderstand t kat a;registere,copy-of,>iertif�cateof Complianceis required=to-be-inclutledwith the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
a .."}_,.
Responsible DesignerSignature: /
f �j Az xT ACe✓es
Alberto Aceves
~•...
A
�'
Albert ves Oct 20. 2016
Company:
;Datil,~ iSgned
Precision Heat & Ai`-
2016;10 20a
s -
Address:� n
U.S.
68805 Perez Rd.F42 . m IErt r + I �
License:
ei8�69�ssoiclation
City/State/Zip:
Phone:
Cathedral City CA 92234
760-776-1150
Registration Number: 316-A1035408A-000000000-0000
i. Tm
- a
U.S. Energy Raters Association
"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 Date/Time: 2016-10-20 10:15:05
HERS Provider: USERA
CA Building Fnprgv Fffir.ianry .Stanriarric - 9011 RP drlantial rmmnlianrp Ronnrt Wnrcinn• )r112 ao„ 1 nn7 0...,..... r_ ._. a. — c ,n —