BMCH2014-1129Applicant:
PREFERRED AIR CONDITIONING DBA
P 0 BOX 5120
PALM SPRINGS, CA 92263
T4tit44-v QuIOrw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
14.5SEER/80AFUE SPLIT SYSTEM
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: C36, C16, C30, C20 Licens No.: 457554
Dat �C a� %�l Con4a ' r IVC
OWNER -BUILDER DEC TION
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).:
(_) 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.0.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: 10/28/2014
Owner:
SYDNEY BROWN o c
54535 WING:=D FOOT
LA QUINTA, CA 92253 Z CD
rn
m � �
rn
o t�
� o0
Contractor: o c
PREFERRED AIR CONDITIONING DBA v a
P O BOX 5120 9
PALM SPRINGS, CA 92263 . C
(760)863-0832
Llc. No.: 457554
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 Sectior 3700 of the Labor Code, for the performance
of the work for which this permit is issue 1.
_,X -have and will maintain workers' compensation insurance, as required by
Secti` n 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insirance carrier and policy number are:
Carrier: Policy Number:
I certify that in the performar re of the work for which this permit is issued, I
shall not employ any person in any manrer 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 Secion 37 0 of the La r C I shall forthwith
comply with those provisions.
Da L Applicant-
't
��
WARNING: FAILURE TO SECURE WORKEF.S' COM
N COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($300,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT A•:KNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the. conditions and restrictions set forth Dn this application.
1. Each person upon whose behalf thi: 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 d ate of issuance of such permit, or cessation of
work for 180 days will subject permit to zancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and coun-y ordinances and state laws relating to building
construction, and hereby authorize repr=sentatives of this cit to enter upo above•
mentioned. property for inspection purposes.
Date:///Q/'n-// Signature (Applicant or Age t
78495 CALLE TAM PICO
LA QUINTA, CALIFORNIA 92253
Application Number:
YMCH2O14-1129
Property Address:
54535 WINGED FOOT
APN:
775110014
Application Description:
HVAC CHANGE OUT -
Property Zoning:
Application Valuation:
$9,995.00
Applicant:
PREFERRED AIR CONDITIONING DBA
P 0 BOX 5120
PALM SPRINGS, CA 92263
T4tit44-v QuIOrw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
14.5SEER/80AFUE SPLIT SYSTEM
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: C36, C16, C30, C20 Licens No.: 457554
Dat �C a� %�l Con4a ' r IVC
OWNER -BUILDER DEC TION
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).:
(_) 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.0.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: 10/28/2014
Owner:
SYDNEY BROWN o c
54535 WING:=D FOOT
LA QUINTA, CA 92253 Z CD
rn
m � �
rn
o t�
� o0
Contractor: o c
PREFERRED AIR CONDITIONING DBA v a
P O BOX 5120 9
PALM SPRINGS, CA 92263 . C
(760)863-0832
Llc. No.: 457554
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 Sectior 3700 of the Labor Code, for the performance
of the work for which this permit is issue 1.
_,X -have and will maintain workers' compensation insurance, as required by
Secti` n 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insirance carrier and policy number are:
Carrier: Policy Number:
I certify that in the performar re of the work for which this permit is issued, I
shall not employ any person in any manrer 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 Secion 37 0 of the La r C I shall forthwith
comply with those provisions.
Da L Applicant-
't
��
WARNING: FAILURE TO SECURE WORKEF.S' COM
N COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($300,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT A•:KNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the. conditions and restrictions set forth Dn this application.
1. Each person upon whose behalf thi: 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 d ate of issuance of such permit, or cessation of
work for 180 days will subject permit to zancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and coun-y ordinances and state laws relating to building
construction, and hereby authorize repr=sentatives of this cit to enter upo above•
mentioned. property for inspection purposes.
Date:///Q/'n-// Signature (Applicant or Age t
Description: HVAC CHANGE OUT - 14.5SEER/80AFUE SPLIT SYSTEM
'� NAMES r:`'� * - _ �ADDRESSI T7QUINTA
Type: MECHANICAL •
Subtype:
Status: SUBMITTED
Applied: 10/28/2014 SKH
Approved:
Parcel No: 775110014 Site Address: 54535 WINGED FOOT,LA QUINTA,CA 92253
Subdivision: 28149
Block: Lot:
14
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $9,995.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
' No. Unites: 0 -
92253
Details:.-
ADDITIONAL SITES
IF
CHRONOLOGY
CONDITIONS
-;NAMETYPEs%"�^t
'� NAMES r:`'� * - _ �ADDRESSI T7QUINTA
STATE
rZIPPHONE'
FAX EMAIL R'APPLICANT
CITY..
PREFERRED AIR CONDITIONING DBA P O BOX 5120
M SPRINGS
CA
92263
(760)485-5649
ONTRACTOR
PREFERRED AIR CONDITIONING DBA P O BOX 5120
M SPRINGS
CA
92263
(760)485-5649
OWNER
SYDNEY BROWN 54535 WINGED FOOT
CA
92253
(760)485-5649
Printed: Tuesday, October 28, 2014 3:08:23 PM ' 1 of 2
SYSTEMS
.iia, .• _ . .. .'? r" �. � .1r. : s. r. hi
DESCRIPTION 4 ACCO UNT r }
BSAS SB1473 FEE 101-0000-20306
Total Paid forBUILDING STANDARDS ADMIN
Printed: Tuesday, October 28, 2014 3:08:23 PM ' 1 of 2
SYSTEMS
t
Description: HVAC CHANGE OUT - 14.5SEER/90AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 10/28/2014 SKH
Approved: 10/28/2014 SKH
Parcel No: 775110014 Site Address: 54535 WINGED FOOT LA QUINTACA 92253
Subdivision: 28149 Block: Lot: 14
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $9,995.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
STATE
Details: HVAC CHANGE OUT - 14.5SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAMETYP -',,.NAME ;;0Kti
AbDRE��Sl
t:
CITY'
STATE
PHON0,:-+1'j
�_
FAX EMAIL 7,
APPLICANT PREFERRED AIR CONDITIONING DBA
P 0 BOX 5120
PALM SPRINGS
CA
92263 (760)485-5649
CONTRACTOR PREFERRED AIR CONDITIONING DBA
P 0 BOX 5120
PALM SPRINGS
CA
92263 (760)485-5649
OWNER SYDNEY BROWN
54535 WINGED FOOT
LA QU I NTA
CA
92253 (760)485-5649
FINANCIAL INFORMATION
CLTD
:`.ti.QTY ..AMOUNT �PAID", "PAID DATE �RECEIPT.# CHECK # METHOD
DESCRIPTION _41ACCOUNT�jf'.';,' !BY
r r.J,
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
BSA: $1.00
$0.00
6r
Printed: Tuesday, October 28, 2014 3:13:09 PM 1 of 2
C6?WSYSTEMS
OF
PARENT PROJECTS
mmmmm�
BOND INFORMATION
f
CLTD',"
Z,DESCRIPTIOI41
ACCOUNT
:,.QTY
AMOUN
P A I D A'-
PAID DATE,
RECEIPT
METHOD.�,
PAID BY
Y
HVACCHANGEOUT-
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVACCHANGEOUT-
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 for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63 $0.00
PARENT PROJECTS
mmmmm�
BOND INFORMATION
f
Sitllplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations C&' -IR -ALT -HVAC
Climate Zones 10 to 15
Site Address: aj�Enf ceme ency: 'Dale: Permit #:
�� c .1 loODvl4
r went 1 e' List Minimum Efficiency' Duct insulation requirement Area Thermostat
❑ Packaged Unit
L2E
ac Over 40 ft of ducts added or
WER
_ ❑COP Setback
or Cor Coil •S ❑ HSPF replaced in unconditioned space Served by system (Ifnoralready
densing Unit ❑ Resistance ❑ R 6 (CZ 10-13) �(} S' present, must be
er ❑ R 8 (CZ -14r]5) installed)
ipment Type: Choose the equipment being installed," if more than one system, use another CF -IR ALT -HVAC for each system.
imum Equipment Efficiencies: 13 SEER, 78% AFEa ; 7.7HSPFfor typical residential systems.
VERMCATION SUIV MARY Listed below are four HVAC alteration Options" The installer decides what work is being done and
ne of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final
on and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the
r. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and
Be ' October 1, 2010, a re istered copy of the CF -1R and CF -6R shall also be on site for final ins ection.
IVAC Changeout Required Forms:
o All HVAC Equipment replaced CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CFAR forms: MECH- 21 and (fors lit stems) MECH-25
a Condenser Coil and /or
0 Indoor Coil and /or CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
o Furnace CF -4R forms: MECH- 21 and (for split systems) MECH-25
For Split Systems: Duct leakage < 15 percent; RC, CCA> 300 CFM/ton(N nimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existina duct systems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System I Required Forms:
o Cut in or Changeout with new CF -6R forms: 1%oIECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF -4R forms: MECH 20-, and fors lit stems
new equipment) ( p sy )MECH-22, and MECH 25
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CBNton, FWD, TMAH, STMS, and either HSPP or PSPP
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with
Forms:
Includes.replacing or installing all new ducting CF -6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage <6 percent, RC, CCA> 300 CFNVton, TMAH
For Packaged Units: Duct leakage < 6 nercent
❑ 4. New Ducting over 40 feet
Forms:
a Includes adding or replacing more than 40 CF 6R forms: MECH-04, MECH-2I-HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned s ce.
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
o I certify that this Certificate of Compliance documentation is accurate and complete.
o I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Parts 1 and 6 of the California Code of Regulations.
The design features identified on this Certificate of Compliance are consistent with the information documented on r Applicable compliance forms, worksheets,
calculations, laps ands ifications submitted to the enforcement agency for approval with the
Varve:Signature: peStiorys
. ` � — 9F R—E V 6`�i d L . a ai ' r ate:
Address. ,,��qq ��
�V License:
City/State/Zip: /)� Phone:
(� �CaC - �CBJ i 3 2
City ®f La QuAnta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Ouinta. CA 92253 - (7601 777-7012
Project Ad -dr
i3Llilding Permit Application and Wracking Sheet
Fo 0 Owner's Namd: e5ypN . /✓ Ro
A. P. Number'.
Address:
Legal DescziptioiZ� => .`
r_Gon it137ng dba
Coniraetbi:. , t:
:P�:e'fe�ri^:e:�;Pliimbin Heatin &Ai
City, ST, Zip: LA QI!!�7% f az oZ.S�•3
Telephone: 76e %� �S S tI0
Project Description:
Ad&css.. }? 0 <°.`B q . ° Q °:..
:5°=s
City;s';ZpPari�OP_-gs::
CA. 9226
�C G!� "CdVOC7USZ'7Q �/4
Telephone:`.(:7.6:00=`�Q�..-0S3a•
f
f�MO �tl. DR►�i7i✓G'" L'41 /
State Lic: #i: 4::7:55:4`
City Lic. #:
Arch...
Address:
City,.ST; Zip:;.:;
State
Constrgction Type: Occupancy:
Praject`type (circle on New Add''n Alter Repair Demo
Name.of:ConactPeF;gp.s?�
/9 T
Sq. Ft :
# Stories:
# Units:
;...:::.Zr i .:.:.::.::
Telephone:#-O;Crnif r{tl3erson;:; �a0 glo 3 0Ir,3a
Estimaied Value of Project 9' 9
<< < - > `>: `t . -• APPLICANT: DO NOT WRITE BELOW THIS LINE
# .$ubmitta[ ; .::=:geg'd .. . Recd TRACKING ; YERMYT FEES
PIan:Set :.:'
Plan Checkfi8mitted
IteAmount
.StructpraL alis....
Reviewed, ready for corrections
Pla Check Deposit
Called Contact Person
ria Check Balance
Energy Ca1cs.::
Plans ticked up
Con truction
Flood il plan,
Plans.resubmitted
Me anical
;ra. ing.plan' ' -.. :
Z"d Review, ready fo�'correctionsrssue
Ele Ical
$ube6pitaetor.L1st
Called Contact Person
Plu b ng
GrantDeed.
Plans picked up
S.MI.
�O A Approval
Plans resubmitted
Gra
W;HOUSE:=
Review, ready for corrections/issue
Dev to}er Impact Fee
Ylsnniag Approval-.
Called Contact Person
A.4.
...Pub. Wks. Appr
Date of permit issue
Sehool Fecs '
Tot Plrmit Fees •