BMCH2014-1022Applicant:
COOL FLO INC
79469 COUNTRY CLUB DR
BERMUDA DUNES, CA 92203
JUL 17 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: 43878
(Date: ) ) L-1 Contractor:
OWNER -BUILD R DECLARATION
I hereby affirm under penalty of perjury th 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.&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
Contractor:
COOL FLO INC
79469 COUNTRY CLUB DR
BERMUDA DUNES, CA 92203
(760)345-6606
Llc. No.: 438781
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. y workers' compensation insurance carrier and policy number are:
Cial
' Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
sn 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 thc)La Code, I shall forthwith
c5Fnply wit those provisions.
Date: 10Applicant:
WARNING: FAILURE TO SECURE WORKE ' COMPEN ATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO `INAL 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 of1a 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 lawVRjating to building
construction, and hereby authorize representatives oft ' ci toe er)upn the above-
/meentione prope y for inspection purposes.
'Date lX Signature (Applicant or Agent): 'ice
4v
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011COMMUNITY
LA QUINTA,. CALIFORNIA 92253
DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/16/2014
Application Number:
BMCH2O14-1022
Owner:
Property Address:
54830 AVENIDA HERRERA
JUAN SALAS
APN:
774303017
P 0 BOX 151
Application Description:
HVAC CHANGE OUT - 16.5SEER/13EER SPLIT -SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$5,700.00
Applicant:
COOL FLO INC
79469 COUNTRY CLUB DR
BERMUDA DUNES, CA 92203
JUL 17 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: 43878
(Date: ) ) L-1 Contractor:
OWNER -BUILD R DECLARATION
I hereby affirm under penalty of perjury th 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.&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
Contractor:
COOL FLO INC
79469 COUNTRY CLUB DR
BERMUDA DUNES, CA 92203
(760)345-6606
Llc. No.: 438781
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. y workers' compensation insurance carrier and policy number are:
Cial
' Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
sn 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 thc)La Code, I shall forthwith
c5Fnply wit those provisions.
Date: 10Applicant:
WARNING: FAILURE TO SECURE WORKE ' COMPEN ATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO `INAL 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 of1a 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 lawVRjating to building
construction, and hereby authorize representatives oft ' ci toe er)upn the above-
/meentione prope y for inspection purposes.
'Date lX Signature (Applicant or Agent): 'ice
0
' , t
C
1
� D CRI T6 ONS A�COUN}T QTY AMOUNT
PAID-AID{DAT
. YSu ...Bzt
>` km"'YRFx'.•t84 ,. 5 N �r u£'tao� N?e?kS'.R Y
..moi. ..3
..cJD:S•�F3SE
i� `ry•,
'BSA5581473 FEE 101m0000 -20j0'6
}.
0 ;$1 00 4$1.00
t'•
Rf
V113111=00
D,B ME=THOD.
WN,_R 10.1T # `_
CHE@K�# 512 BY
'
he . ., a .., t .- � �_ .�P �
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4i$ ,w . � n
{,r
' COOL FLO-INC ;' CHECK
_ R408 ` j,'
14856.
: AOR , -
V-1
J
Total,Paid fo_rBUILDING STANDARDS ADMINISTRATION BSAc $1 00
$1 00
rt:
IGN Orl' QTY��x�i4MOUNT
PAI,PAIDDAT�>;t
•
,'DESCRIPTIO
,A000UNTzz
HVAC CHANGEOUT - SPLIT SYSTEM,
01-000042402
io w
.; F '$71 50'
$11.50
7/17/14
e
PAID BY ° 0��
WPM
��MET;HOD.
a
ECEI#
CHECK #
�L BY
;
COOL FL'O INC tt
3 �{
R408
E. f
14856_
s.� .
DESCRIP ON
!r 1
i =r
M,�. I x
��
QTY ;AMOUNT
01'
PAID'
�zs atg
PAID DATES
x
;EACCOUUN�T
x�• .
�,
HVAC CHANGEOUT - SPLIT -SYSTEM PC_
101-00q&42600L° a
10� : ' 1 $35 75
r' $35.75.
7/17/14
; "•
`,
.
-PAID BY�,����'�
" �x
�,3€°;�. h RECEIPT'#�`
�� CFIECKa#t �
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- ...: ' ,. ..11f:✓ -;}y, .r, .:'�'fVJ DYJv , .4'J•VIrr.Y i tV y
COOL FLO INC CHECK--'—.-- .11408 '�r
14856
AOR
'�_
Ik
Total Paid forCHANGEOUT $107 25.x`
C $107 25
,Ik
• � • `fit'skr r.,�..;afa
DE 6C PT10N ACC OUNT f QTkY PAID MAID DATE
;
t
t
�YPERMIT ISSUANCE �, 101'-0000-42404. 0 i „ ' $90.5T`� _
f y.
a` $90 57
7/17/14;
.,
�3$�ai .dk b - -'�y' > _ X`k' ' iA +�A
PA�ID�BY'. MOOD J ry RECEI�#
' •' MY.A'th�tb •� k-
CHEC4:4
- 18?� �r�hC �"•se'
CLtT.D BY
{;
�w-14
;,,
'
COOL'FLOJNC +. * ;CHECK ' 11408 ti '
14856
AOR ' `
.
i
Total Paid'forPERMIT ISSUANCE
0:S1 s "
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City of La' Quints
Building & Safety DivWwl
P.O. Box' 11504, 78-495 Calle Tampico
La Qidnta, CA 92253 - (760) 777=7012
Budding Permit Application and'Tracking Sheet
Pit #
Project Address: -SAA-C
Owner's Nam ns as
A. P. Number:
Address: 5 .
Legal Description:
City, ST, Zip:
Contractor: ao/ " n,
Telephone•. ( a
Address:'.
l �q �/Q
Project Description:
City, ST, Zip: a� ok
� w
Telephone:1
State Lie. # : City Lic.
Asch., Engr., Designer.
;
Address:
City, ST; Zip:
Telephone: Construction Type: Occupancy:
State Lie. #: Project type (circle one): New Add'n Altai Repair Demo
Name of Contact Person:. Sq. Ft: #Stories: # Units:
Telephone # of Contact Person:/ O2O
Estimated Value of Project: / rs %d ,
APPLICANT: DO NOT WRITE BELOW THIS UNE
k Submittal RWd Reed TRACMG PERMIT FEES
Plaa Sets Plan Check submitted Item Amount
Structural Cases.
Reviewed. ready for corrections Plan Cheek Deposit
Huss Cal..
Called Contact Person Plan Cheek Balance
Titie 24 Calcs,
Plans picked rap Constractioa
Flood plain plan
Plans resubmitted Mechanical
Grading plan
Review, ready for eorrccdonsRssue 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 correctionshssue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit June
School Fees
Total Permit Fees
.'A"
S b
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Addres :
�n
Enforcement Agency:
Date Prepared:
Permit#:
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
❑ Evaporator Coil
AFUE
COP
❑ 2,8-13) Ducting
Served by system
etback
C9'S(plit System
❑Condensing Unit
R-8' (CZ 1, 14,1J5 Ducting
�sgft
(If not already
❑ Mini Split
❑ Compressor
`SEER
HSPFpresent,
❑ R-6 (all CZ's) Plenums
must
11 Furnace
Lin
❑Lineset
L;J EER
❑ R-5 or R7.5) Lineset°
be installed)
❑
HERS V RIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
forrTKs allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CFIR-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERSZ
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage (<_15%, or < 10% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CF111-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS,'MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts3 and one or more of the following CF111-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace2 CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (<_15% or, < 30% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
3 R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5 -3T -2Y.", 3.5 to 4T-2%", 5T-4%"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. 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 (CCR).
4. 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 CCR.
5. 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 pArmit ppligaon.
e on ible D Signe My
nsib esig r Signature:
Date ned:
Lice se:
n ati
i1
, 7
mpany:
Address: City/State/Zip:
Phone:
(
Cla G!4
-A
For assistance or questic(r)ts regarding the Energy Stanq%rds, contact the Energy Hotline at: 1-800-772-3300
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