BMCH2015-0104`""" s a� ,v auiftil6v
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 9225! COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0104
Property Address: 48767 VISTA PALOMINO
APN: 602200018
Application Description: SHIRLEY RESIDENCE HVAC CHANGE OUT
Property Zoning: ,
Application Valuation: $7,600.00
Applicant:
AIR EXPERTS AIR CONDITIONING -H
PO BOX 94
LA QUINTA, CA 92247-0094
APR 0 1 2015
CmoFLAQUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
9 (commencing with Section 70001 of Division 3 of t usiness a
and my License is in full force and effect.
License Clas C20 License No.: 725283
ate: f / I Contractor:
provisions of Chapter
pd Professions Code,
OWNER -BUILDER D LARATION
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 Divih
of the Business and Professions Code) or that he or she is exempt therefrom and basis for the alleged exemption. Any violation of Section 7031.5 by any applicant 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.).
(1 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
Lender's
Owner:
PAUL SHIRLEY
P 0 BOX 18135
RENO, NV 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/1/2015
Contractor:
AIR EXPERTS AIR CONDITIONING -H
PO BOX 94
LA QUINTA, CA 92247-0094
(760)777-1724
Llc. No.: 725283
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 wdrk 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:- 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 become subject to the
workers' compensation provisions of Section 37 of th abor Code, I shall forthwith
comply with t o provisions.
e: Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION 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 td, 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 ' formation is correct.
,I agree to comply with all city and county ordinances a state law relating to building
construction, and hereby authorize representatives of this cit nter upon the above'
mentioned property for inspection purposes..
Date: f Signature (Applicant or Agen
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page Y of 3 )
Project Name: Shirley Date Prepared: 2015-03-31
A: General Information
CHR -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
Shirley
02
Date Prepared
2015-03-31
03
Project Location
48767 Vista Palomino
04
Building Type
Single family
05
CA City
La Quinta ,
06
Dwelling Unit Name
Shirley .
Name
Served
System (ft2)
system?
Dwelling Unit Conditioned,
components?
07
Zip Code
92253
08
Floor Area (ft2)
1600
1600
Yes
Yes
Yes
Number of space conditioning
No
09
Climate Zone
15 `:=`
10
(SC) systems in this dwelling
1 `
unit.
4111'
B. Space Conditioning (SC) System InformationJ
i. ..._..
v ,
Ol
02
-03
f 04aaa05+06
�"
07
�8
09
10
SC System
Identification or
SC System a
Location or Area
CFA served
by this SC
• .,Is the SC
4 S
system! a
ducted
Installing a
r{''c.0 �+°'.4.
r�++e�frige ant
containing
'�i^= � EP"'q
Yylnstallmg�new:SC
system
U't9ka $ ,4�'
Installing
more than 40
Ynrw ( '+
�Installmg*Installin
entirely new
entirely new .
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type .
System 1
living room
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system.
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project,
Registration Number: 215-A0084663A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-03-31 14:53:36
Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS.Provider: CalCERTS
Report Generated: 2015-03-31 14:53:43
r,,
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
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
0S
06
07
08
09
10
it
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
0.78
AC
cooling
SEER
13
Setback
section is not
section is not
components
components
applicable
applicable
Reauired Documentation:
CF213-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. -
MR -MCH -20-1-1 & MR -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: 515%, ors 10%. leakage to outside, or seal all accessible leaks.
CF211-MCH-25-1-1 & CF3R-MCH-25-H Refrigerant Charge,Verification required when refrigerant containing components are installed or altered (applicable.in CZ 2, 8-15).
MRCF3R-MCH-23 & CF3R-MCH-23 Air Flow x,300 CFM/ton required when MCH -25 is required.
Exceptions:
gi
-Duct systems registered with HERS provider as previously sealed are exempt from MCH-2QDuct Leakage Testing requirements
�x Flowil, t -,
Heating -only systems and Air Handler/Furnace changes do not require veriffcatfon of Air Flow MCH -23 for Refrigerbnt;gharge�MECH 25s -
-Existing duct systems constructed, insulated or sealed with asbestos are exempl4rom MCH -20 puetteakage Testing requirements.
E. Entirely -New or Complete Replacement Duct System, wif h.- uvithout Eqy pment Chang quti(Se¢tions 150 2(b Dn and 150.2(b)lE, F.)
This section does not apply to this project.
F. Entirely.New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 215-A0084663A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
Report Version: 2014-03-31
Schema Version: 0.555SDD
2015-03-31 14:53:36 HERS Provider: CaICERTS
Report.Generated: 2015-03-31 14:53:43
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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:
Documentation Author Signature:
Van Vlymen, Paul
Company: •
Signature Date:
Air Experts Air Conditioning
2015-03-31 14:53:36
Address:
CEA/ HERS Certification Identification (if applicable):
-PO Box 94
City/State/Zip:
Phone:
La Quinta CA 92247
760-777-1724
Responsible Person's Declaration statement_
I certify the following under penalty of perjury, under the�aws' o& 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 Busi"nes"s'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 Re u'`latrons �'`
q gr g a X41
4. The building design features or system design features j entified on,this Certificate of Compliance are consistent t %the innformationaprovided on othersapplicable compllance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for'approval with this building permlt application:
�.
N" .a 2r5 8t rn tq the for
inatle building for the;bwlding,
S. I will ensure that a registered copy of thls.Certificate�of Compliance shall;ge available with the permit(sJassued and:made available enforcement agency all applicable
nlficate des
inspections. I understand that a registered copy of th sisi of Complianc .ls,requ�ired to be,.included withh the,docum�enfationjhe�,builder p4q tosthe building owner at occupancy.
Responsible Designer Name: v"
Responsible Designer Signature:
Van Vlymen, Paul
Company:
Date Signed:
Air Experts Air Conditioning
2015-03-31 14:53:36
Address:
License:
PO Box 94
725283
City/State/Zip:
Phone:
La Quinta CA 92247
760-777-1724
Digitally signed by Ca10ERTS: 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 Number: 215-A0084663A-000000000-0000 Registration Date/Time: 2015-03-31 14:53:36 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-31 14:53:43
Schema Version: 0.555SDD
T
FINANCIAL • 1 -
xY DESCRIPTIONV�'�*ACCOUNT r"w ;`QTY
c`AMOUNT $'"ht� PAID "# , .PAID DATE'
BSAS SB1473 FEE 101-0000-20306 0.
$1.00
$0.00
METHODS g .'; Xh 'RECEIPT`#
.CLTD BY ,
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
`z#y",DESCRIPTION«'r�,°�;',9
ACCOUfVT�{rY;=''4'CtTYs
Y:µAMQIINT�{`' i
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HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
1$0.00
PAID BY s'•aSs�
FI
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. ) .
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°'�' 'RECEIPT,4 t�
'�:..'..7w..Z.
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'' ��ac'rDESCRIPTION `�Y� r�k�
t CCOUNT t_riyt
eQTY
TtAMOUNTr k'
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PAID DATE
HVAC CHANGEOUT : SPLIT -SYSTEM PC
101-0000-42600
0
.$36.26
$0.00
c+; r _PAID'.BY +�r+'Y?�. f uY
::'e+ c r iMETHODCEIPT'#t
r, ,
, jr, CHECK'#
. CLTD BY.
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIP,TION �pf; f, ' '
a; x >' ;ACCOUNTS ak v,v,
}CITY
AMOUNT S
'''?,? PAIDR'�s` "'rPAID
rat:
DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85 E
$0.00
BYu� .., r x <" a �sr « ' '
'. ` ..x. METHOD y „§. , ',
y., s' ,, a 1:
ii ; RECEIPT:# x
i .,.-.CHECK # J "i4
CL TD` BY '
. .
Total Paid for PERMIT ISSUANCE: -- $91.85 $0.00
TOTALS:• •-
I
1.
Description: SHIRLEY RESIDENCE HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 4/1/2015 PJU
Approved:
Parcel No: 602200018 Site Address: 48767 VISTA PALOMINOLA QUINTACA 92253
Subdivision: TR 29306' Block: Lot: 58
Issued:
Lot SqFt: 0 Building SqFt: 0 Zoning:
Firialed:
Valuation: $7,600.00. Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC UNIT CHANGE OUTCENTRAL SPLIT 78% AFUE,13 SEER 4TON PER 2013MECHANICALCODES 2013 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.,
CHRONOLOGY
CONDITIONS
CONTACTS
'STATE
ZIPtPH
-
U
A
APPLICANT
AIR EXPERTS AIR CONDITIONING -H
PO BOX 44
LA QUINTA
CA
92247-
0.094
CONTRACTOR
AIR EXPERTS AIR CONDITIONING -H
PO BOX 94
LA QUINTA
CA
92247-
0094
OWNER
PAUL SHIRLEY
P 0 BOX 18135
RENO
NV
922.53
FINANCIAL INFORMATION
Printed: Wednesday, April 01, 2015 10:04:07 AM 1 of 2
Cffw1YSTEMS
P ON
INSPECTIONS
INFORMATION
ATTACHMENTS
MECHANICAL FINAL"
BLD
low
BSAS SB1473 FEE.
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
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 ISS UANCE
101-0000-42404
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63 $0.00
PARENT PROJECTS
BOND
INSPECTIONS
INFORMATION
ATTACHMENTS
MECHANICAL FINAL"
BLD
PARENT PROJECTS
BOND
INFORMATION
ATTACHMENTS
. -
' .
Printed: Wednesday,- April 01,2O15oO:04:07AM 2nf2 '
' 07----.'_
Bin #
City of 'La Quinta
Building SL Safety Division
P.O. Box 1504, 7.8-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: ISS q iN
Owner's Name:
A. P. Number:
Address: int
Legal Description:
City, ST, Zip: ZA &U,1 7-A U 9 Z�
Contractor: r�2C
/
Telephone:
Address: �� w 7
Project Description:
City, ST, Zip: G -t l r .r i—A VA 7 u L% 7
/4 N
- �7
?Z Telephone:
o ?
c R i
State Lie. # : -7 ZS—Z
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
�
Construction tion TY Pe: Occupancy:
aneY
/.
tate Lie. #
S .
Project ect tYPa circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq.- Ft.: ���
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: , co
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked no
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees