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BMCH2016-014178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BMCH2O16-0141 Property Address: 47535 VIA MONTIGO APN: 643120027 Application Description: KURT MOMORTENSON / H' Property Zoning: Application Valuation: $6,548.00 Applicant: ARNOLDS A'/ C SERVICE 76987 OKLAHOMA AVE PALM DESERT, CA 92211 o uuitw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT OU 11AY 03 2035 CITYOFLAQUINTA - .CO_ �U DgELOPMENTDEPARTMENT 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 icense No.: 860682 Date: 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, 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, 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 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 Lender's Address: Owner: KURT'MORrENSON 92253 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/3/2016 Contractor:. ARNOLDS A / C SERVICE 76987 OKLAHOMA AVE PALM DESERT; CA 92211 (760)772-3.731 Llc. No.: 86.7682 WORKER'S COMFENSATION DECLARATION I hereby affirm under penalty of perjury, one of the following declarations: I have and will maintain a ce,-tificate 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 I have and will maintain wor-ers' compensation insurance, as required by Section 3700 of the Labor Code, for the 1performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Polity Number: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any mariner 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 the Labor Code, I shall forthwith comply with those provisions. Date:. Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO =RIMINAL 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 thi! application becomes null and void if work is not commenced within 180 days from este of issuance of such permit, or cessation of work for 180 days will subject permit tocancellation. I certify that I have read this applicationand 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 ofthis ci ent r up o above mentio d pr perty for inspecticn purposes. Date: c� Signature (Ap �licant or Age ): FINANCIAL INFORMATION v'' Y DESCRIPTIONS ACCOUNT ;QTY AMOUNT PAID £` '` PAID DATE{ ,' BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/3/16 �� : '" BYE METHODS >"�RECEIPT # nK# s T CL D�BY�� ,PAID _._ . K� �� rx• F;. ". ��. .�� t,.a :'�<CHEC ARNOLDS A / C SERVICE DEBIT R15226 RSE Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: - $1.00 $1.00 DESCRIPTION' '` ACCOUNT 4`AMOUNT , PAID y 01-:! PAIODATE Y !7. -.- ^` y ,R '. f r.- :',S .....e- .v -r �+ `..x+ '< F >.5 ➢. L� :_ n _ E9 r3 r wk Ti HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $72.52 5/3/16 BY °r'MsETHOD i RECEIPT# a:` CHECK# CLT,D BY •_ «� .. y : 3 - r �. w w y:. . ARNOLDS A / C SERVICE DEBIT R15226 . RSE ffiQTY AMOUNT�''� *� PAID;3 v*`�DESCRIPTION� `f`",ACCOUNT sr. $s W, PAID DATE: HVAC CHANGEOUT -SPLIT-SYSTEM PC 101-0000-42600 0 $36.26 $36.26 5/3/16 _,xPAIDk$Y °u� Frur `RECEIPT#�� �"{ CLTDBY; FAMETHOO aCHECK# ARNOLDS A / C SERVICE DEBIT R15226 RSE .Total Paid for CHANGEOUT:. $108.78 $108.78 DESCRPTION`` s 4: PAID ATE'" :A00OT°r� PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 5/3/16 PAID BY ":� Y METHOD g ` wRECEIP:T. #� h 'V,XHECK W, �C T. D BY - , R ARNOLDS A / C SERVICE DEBIT R15226 RSE Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: r z. ut 6yOFat11, Description: KURT MOMORTENSON / HVAC CHANGE OUT ARNOLDS A / C SERVICE Type: MECHANICAL Subtype: Status: APPROVED Applied: 5/3/2016 RSE Approved: 5/3/2016 RSE Parcel No: 643120027 Site Address: 47535 VIA MONTIGO LA QUINTA,CA 92253 Subdivision: TR 26152 Block: Lot: 255 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $6,548.00 Occupancy Type: Construction Type: Expired: No..Buildings: 0 No. Stories: 0 No. Unites: 0 - Details: HVAC CHANGE OUT - 16.5SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO,BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. APPLICANT ARNOLDS A / C SERVICE 76987 OKLAHOMA AVE PALM DESERT CA 92211 CONTRACTOR ARNOLDS A / C SERVICE 76087 OKLAWOMA AVE PALM DESERT r -.A 97.7.].]. OWNER KURT MORTENSON 92253 Printed: Tuesday, May 03, 2016 10:39:07 AM 1 of 2 SYSTEMS INSPECTIONS .......... .............. . ..... .......... . ........... ...... .. . . . . . ........................ 11-11 ............ .. .......... 7 L�3 'r:'ACCdUW, -V7 E af� DESCRIPTION. 0 %RECEIPT4' ETHOD'4.1, BYE .HVACCHANGEOUT- 10.1-0000-42402 0 $72.52 $72.52 5/3/16 R15226 DEBIT ARNOLDS A C RSE SPLIT -SYSTEM SERVICE HVACCHANGEOUT- ARNOLDS A C 101-0000-42600 .0 $36.26 $3616 5/3/16 R15226 DEBIT RSE SPLIT -SYSTEM PC SERVICE Total Paid for C.HANGEOUT: $108.78 $108.78 ARNOLDS A C PERM' IT ISSUANCE 101-0000-42404 0 $91.85 $91.85 5/3/16 R15226 DEBIT RSE SERVICE Total Paid for PERMIT ISSUANCE: $91.85 $91.85 INSPECTIONS .......... .............. . ..... .......... . ........... ...... .. . . . . . ........................ 11-11 ............ .. .......... 7 4 B;h # Permit # Project Address::V4Owner's City of iii QuInta q Building a Safety Division 78-495 Calle Tampico ' La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Name: A. P. Number: Address: Legal Description: City; ST, Zip: ` O' doGS Contractor: hO S E5720 t Ci h Telephone: one: 9 .......................................... Address: 7g . Project Description: City, ST, Zip V,' 'LC' TPele h one: State Lic. 9: , City .Lie. #.: Arch., Engr., Designer: Address: City., ST, Zip: ele h Telephone: one: ............................................... Cantructi n s o Type: ane Occu P -Occupancy: . # •. c, Lic,. StateLi 0roJ ecti tYPa (circle cle one)• New Ad j'n Alter Repair Dem Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: /^ Estimated Value of Project: APPLICANT: DO NOT WRITE'BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cht--k Deposit Truss Calcs. Called Contact Person Plan Chez-k.Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"' Review, ready for corrections/issue Electric Subcontactor List Called Contact Person Plumbin: Grant Dced Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' 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, t . Total Permit Fees STATE OF CALIFORNIA ALTERATIONS - HVAC CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address:* �� Enforcement Agency: Date Prepared: Permit#: Equipment Type Equipment Efficiency New Ducting, Plenums, Lineset: Conditioned Thermosta Required R -value Floor Area (sq ft) ❑ P oefaged System OlEppeltator Coil p'yUE COP O R-6 (CZ2, 8 Ducting Served by system Setback Split System ondensing Unit ❑ R-8' (CZ 11, 14, 15)Ducting sgft (lfnotalready ❑ Mini lit ❑Compressor SEER HSPF 's ❑ R-6 (a// CZ) Plenums present must rnace ❑ Lineset EER ❑ R-5 or R7.5) Lineset' be installed) ❑ TXV HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form ilaRoV9ed to be filled out by hand. Tor final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site. AEr-1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CF1R-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or24)'-HERS, MKH-25-HERSZ Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS,', MECH-25-HERS' Air Handler/Furnace2 (Can include new ducting) Installer Requirement: Dud leakage L15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFMIton, 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 cud in unconditioned space, or ❑ 3. Existing dud systems are constructed, insulated or sealed with asbestos (list manufacture date of building 1 ❑ 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF1R-ALT-02-E including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 cr 24) -HERS', MECH-25-HERS2 CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERE', MECH-25-HERSZ Mini Splits require CF111-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 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 Ducts' and one or more of the following CF1R-ALT-02-E replaced: Condenser Unit, Evaporator Coil, . CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MEC:+25-HERS Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Installer Requirement: Duct leakage < 6%, Air Flow z 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 L15% or, < 10% 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. ' 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 Duds 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) 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 -2W, 3.5 to 4T-2%", 5T -4Y." 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 Complence 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 fir the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Dart 6 of the CCR. 5. The building design features or system design features identified on this Certificate of Compliance are consistE nt with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submi_ted to the enforcement agency for approval with this building permit application. Responsible Designer Name: Responsible Designer Signature: Date Signed: License: Company: Address: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at:1-800-772-3300