BMCH2015-022278-495 CALLE TAMPICO
'LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:•
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
PREC H' & A INC
P 0 BOX 10991
PALM DESERT, CA 92255
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BMCH2O15-0222
47570 VIA MONTESSA '
643120007
VANDERDUSSEN RESIDENCE HVAC CHANGE OUT
$15,000.00
VOICE (760) 777-7125
FAX(760)777-7011
INSPECTIONS (760) 777-7153
Date: 6/18/2015
Owner:
RENEVANDiRDUSSEN
47570 VIA IV 0NTESSA
LA QUINTA, =A 92253
LU
I hereby affirm under penalty of perjury me of the following declarations:
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Q a
F-
and my License is in full force and effect.
o
o
Contractor:
0W
.
PRECH&ANC
Pb BOX 10991
Z
tow
PALM DESERT, CA 92255
OWNER -BUILDER DECLARATION
v
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performanoe of the work for which this permit is issued, I.
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
(760)776-1550a
city or county that requires a permit to construct, alter, improve, demolish, or repair
g
C)
LIC. No.: 818'59
workers' compensation provisions of Section 37 N e Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION.
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury me of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a cert Ficate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class:. License No.: 818759.
of the work for which this permit is issuec.
I have and will maintain workers' compensation insurance, as required by
Date: Contractor:
Section 3700 of the Labor Code, for the p-erformance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier:- Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performanoe of the work for which this permit is issued, I.
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the .
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 37 N e Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with thos rovi 'ons.
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
Date: Applicant.
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($10,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDE[ FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND•ATTORNEY'S FEES.
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
APPLICANT ACFNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
Within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on, this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(_) 1, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is per-ormed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the cwner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents; and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. B.&P.C. for this reason
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.
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 Na
Lender's Add
I certify that I have read this application arrJ 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 to enter upon the above-
mentioned grope yfo nspection purp s:
Date: � �,Signatur Applin w€rit]
r
FINANCIAL INFORMATION
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'DESCRIPTION s '
°€ a Y -.. qt .: �t • `�-ac •'* .z -...c'4 d -:y h:.
rACCOUNT� QTY AMOUNT, PAIDr �PAID.:DATE
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BSAS SB1473 FEE
101-0000-20306 0 $1.00 $0.00
PAIDBY *z�;
#! r¢¢ x „ CHECK # 4a a
�' METHOD ��' i BY it
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si. zRECEIPT ..CLTU
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Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
k
DESCRIP,TIONf�
"A000UNT
QTY
AMOUNTt�
p PAIDtxk
DATE
c, .
t�
i
PAID
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
.p4 3. P "T •�-« r X
PAID BY "�
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RECEIPT #1.
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a� DESCRIPrTIONAE
r..`<3"ACCOUNT
QTYY
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AMOUNTR
PAID '
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PAIDDATE? '.
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HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
c bx PAID BYr t V " E n
#iMETHOD r
" RECEIQT #
CHECK #CLTD
BYx
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Total Paid forCHANGEOUT: $217.56• $0.00
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DESCRIPTION
ACCOUNT
QTY
'�
AMOUNTS
F' ; r'E,*s�
a PAID May
i.
:PAID'DATE
r x a;arg�u
r
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
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#
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&+ CHECK #
aY.
TD BY
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.RECEIPT t,
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Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:0•
r
Bin #
City of La Q uin to .
'Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
02-2-2— Building Permit Application and Tracking Sheet
Permit #
�Ci4 -�-O'S
Project Address:
Owner's Name:US5E�,
A. P. Number:
Address: 7 l �'VI V _rx) 5 sft
Legal Description:City,
ST, Zip:
Contractor:
A� s�� �� � r
T ele P Bone• ps
Address: Y G ( 0 F0
Project Description:
City, ST, Zip: _Pq' Des er— _ G 9,2j -6o
S (,7 nn
ele h one•
TP O ss
v r nQo- P
State Lic. # : / 7 c5
City Lie: #.:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
e.
State Lc i . #.'
Co nstructi n Type: e•
Y P .. Occupancy:
P Y• CRJ �r
Project tY oa circle one): New Add'nAlter
" Repair r Dem
Name of Contact Person:
Sq. Ft.:#Stories:
.L
#Units:
Telephone # of Contact Person:
Estimated Value of Project: / S/—
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Chect: Balance
Title 24 Cales.
Plans picked up
Constructi-on
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°a 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 ._mpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r
Description: VANDERIDUSSEN RESIDENCE HVAC CHANGE OUT
Type: -M ECHAN ICAL Subtype:
Status: APPROVED
Applied: 6/18/2015 EVA
Approved: 6/18/2015 EVA
Parcel No: 643120007 Site Address: 47570 VIA MONTESSA LA QUINTACA 92253
Subdivision: TR 26152 Block:
Lot: 23S
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0'
Details: HVAC CHANGE OUT - 13 SEER/ (2) SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CONTACTS
' '
Printed: Thursday, June 18,ZO155131:04PK4 1ofZ
'
PARENT PROJECTS
. ... . ... . . . .. ......... .. .. ...... .. . .. .... .
. ......... ... ............
Printed: Thursday, June 18, 2015 5:01:04 PM 2 of 2 CRW.1yS*TEMS
DESCRIPTION.'
COU
AMOLIN
t
HVAtCHANGEOUT-
101-0000-42402
0
$145.04
$0.00
SPLIT -SYSTEM
HVAC-CHANGEOUT-
101-0000-42600
0
$72.52
$0.00.
SPLIT-SYSTEM PC
Total Paid forCHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
1101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
.41 . . ...... ....
TOTALS: $310 P 00
PARENT PROJECTS
. ... . ... . . . .. ......... .. .. ...... .. . .. .... .
. ......... ... ............
Printed: Thursday, June 18, 2015 5:01:04 PM 2 of 2 CRW.1yS*TEMS
'ERTIFICATE OF COMPLIANCE CF111-ALT-02-E
41terations to Space Conditioning Systems (formerly CF-1WALT-HVAC) (Page 1 of 3 )
Project Name: Vanderdussan Date Prepared: 2015-06-15
A. General Information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit..When multiple dwelling units must be
documented, use one CF1R-ALT-02 document for each dwelling unit.
01 1
Project Name
Vanderdussan
02
Date Prepared
2015406-15
03
Project Location
47570 Via Montessa
04
Building Type
Single-family
05
CA City
La Quinta
06
Dwelling Unit Name
Hous
SC System
Identification or
SC System
f Location oar Area
served,
Eb't his:S,C
system
duded'h
Dwelling Unit Conditioned
3400
07
Zip Code
92253
08
Floor Area (ft2)
q?.h?z*-
? Served
. k
System lft2)
( systems
t
components
components?
;
Number of space conditioning'
duct systsm?
09
Climate Zone
15
30
(SC) systems in this dwelling
2
q Yes
�
aYeskr,K
allo>,
No
unit.
Altered space
B. Space Conditioning (SC) System Information '
O1
02
03
04
05
06
07
08
09
10
R -r 3r
CFA
Is the SC S
a
.„ Installing a''
refrigerant
,� k
Installing new SC -.:F
7
Installing
Installing
Installing
SC System
Identification or
SC System
f Location oar Area
served,
Eb't his:S,C
system
duded'h
containing
system
morre.than 40
entirely new
entirely new
SG
Alteration Type
Name
q?.h?z*-
? Served
. k
System lft2)
( systems
t
components
components?
;
feetyof ducts?
duct systsm?
system?
c
Bedrooms
1ZOd,Yes
*'t
q Yes
�
aYeskr,K
allo>,
No
No
Altered space
System 1
h
_r .
conditionirig system
Altered space
=Syst.mLiving
Space
1700
Yes �
Yes
No
No
No
conditioning system
�. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Dlib)
This section does not apply to this project.
Registration Number: 315-A100813SA-000000000-0000 Registration Date/Time: 2015-06-15 10:13:09
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
Schema' Version: 0.555SDD
a
HERS Provider: USERA
Report Generated: 2015-06-15 10:13:22
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CERTIFICATE OF COMPLIANCE 7r /r C1`111 -ALT -02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) a'' (Page 2 of 3:)
aD.
tkf'
Altered Space Conditioning System (Sections 150.2(b)IE and F)
`
r
` 01
02
03
04
10S
06
07
08 .e
09
10
�
11
12
+
Heating.
10:13:09 ,
Cooling
I '
C
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 r
System Type
Components
Type
Value
Type
Duct Length
R -Value
- -Central
Central gas
-! All new
heating
AFUE
split
All new
cooling
SEER _
13
Setback
Less than or
equal to 40
"
R-8
System l
�.
furnace
components
.78
AC
2
components
feet
All new
-
All new
Less than or
-
f
/ .
System 2
Central gas
heating
AFUE -
78
Central split
cooling
SEER
_
13
1 Setback
equal to 40
-8
furnace
components
AC
components
r
feet
LR
Reouired Documentation:'
L
,
t
CF2R-MCH-014 - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: RE.
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. .r - "",4 , •.
-Leakage rate compliance:5 15%, or s 10% leakage to outside, or seal all accessible leaks. ' .' -
• *
-
in CZ 2, 8-15). [
' r
CF2R-MCH-25-H & CF311-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed
or altered (applicable
j
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions:• ,;r+•,,"• �, a+5,.s;x^,•
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testmgrequvements.
of
-Heating-only systems iadd fAir Handle r/Wmace changes do not requ re verification of Air Flow lvl&i3, or Refrigcrii ftharge MECH
25IZI
-Existing duct systemsc�onstructed, in suWted or sealedlwtrth-asb-tos are`exem, from MCH 20 Ducf Leakage Testing'requircmentsY
.P�`,' a 'iK6.n
E. Entirely New orzComPlete Replacement-Dr:System wfth-:or wrthout`Egwpment Changeout (Seetfons 150.2(b)10iis and 150.2(b)IE, F) "
•..'iL•d..;f", � a-tT�.,...3 t,. ?1r s5 . �4 .,.ss�;.
U.S. GIm oR2 tef8tM Wation
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project. i
1
1 u e
A .♦ r
Registration Number: 315-A1008135A-000000000-0000
• �xCA Building Energy Efficiency Standards - 2013 Residential Compliance '
< y Jit
Registration Date/Time: 2015-06-15r
10:13:09 ,
HERS Provider: USERA
I '
Report Version: 2014-03-31
'
Report Generated: 2015-06-15 10:13:22
Schema Version: 0.555SDD
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CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems -(formerly CF -IR -ALT -HVAC) (Page 3 o 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:
Alberto Aceves
Signature Date:
Company:
Precision Heat & Air
2015-06-15
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 Declaraiion 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 Certif tate of Compliance (responsible designer).
3. ' That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identdied 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.
5. 1 will ensure:that a registered.copy of this Certificate of Compliance shall be made available with the,building permit(s) asued,for the building, and made available to the enforcement agency for all applicable
W;;r:;k +r; rwt t
mspectionrsylunderstand that.a regisjered copµofthls Certd¢ate,of Compliance a regdiiGd�to be IndluEed ,with the dowmentation the builder provides to the building owner at occupancy.
w
Responsible Designer Name: i*.�
aa 7 "-M
Rei nsible Designe�5igna�tku Vii, A bir}OABile. .
Alberto.Aceves
Company: ,, y
Precision Heat & A'ii"''� t u s 1 ;
..
Date SignedY
2b15 06 15 ;. -
Address:
U.S. Energy Ra
License:
96-ssociation
68805 Perez Rd.F42
City/State/Zip: -
Phone: ,
Cathedral City CA 92234
760-776-1150
IT TM
=�`
-This digital signature is provided in order to secure
F *
U.S A
the content of this registered document, and in no
way implies Registration Provider respoasitNtilyJor
., -
U.,S. Energy Raters Assoclatlon
the accuracy of the infomlation.'
Registration Number: 315-A1008135A-000000000-0000 Registration Date/Time: 2015-06.15 10:13:09 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 _ Report Generated: 2015-06-15 10:13:22
Schema Version: O.SSSSDD
1