BMCH2017-0196f �
VOICE (760) 777-7125
78-495 CALLE TAMPICO Q�i Ct� 0 D
LA QUINTA, CALIFORNIA 92253 FAX (760) 77.7-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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. C36 License No.: 977333
e
Date: S 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 Ccde: 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).:
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. )f, 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
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. My workers' compensation insurance carrier and policy number are:
Carrier: REPUBLIC UNDERWRITERS INSURANCE COMPANY Polity Number: ATW
+010094
_ 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 I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
a
Date: 512:411-1 ! Applicant:�7
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 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 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 laws relating to building.
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
r
Date: s �7 Signature (Applicant or Agent): sqliz_� S�_Z�
Date: 5/24/2017
Application Number:
BMCH2O17-0196
Owner:,
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Property Address:
80330 VIA VALEROSA
ROBERT TURNER
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APN:
777250016
80330 VIA VALEROSA
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Application Description:
TURNER / (2) HVAC CHANGEOUTS - 14SEER / 80AFUE SPLIT SYSTEM
LA QUINTA, CA 92253
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Property Zoning:
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Application Valuation:
$7,482.00
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Applicant:
A#1 SERVICES HEATING & AIR CONDITIONING
Contractor:
A#1 SERVICES HEATING & Al
DITblI LNG
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78206 VARNER RD #D-189
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78206 VARNER RD #D-189
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PALM DESERT, CA 92211
PALM DESERT, CA 92211
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(760)565-2691
Llc. No.: 977333
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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. C36 License No.: 977333
e
Date: S 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 Ccde: 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).:
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. )f, 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
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. My workers' compensation insurance carrier and policy number are:
Carrier: REPUBLIC UNDERWRITERS INSURANCE COMPANY Polity Number: ATW
+010094
_ 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 I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
a
Date: 512:411-1 ! Applicant:�7
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 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 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 laws relating to building.
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
r
Date: s �7 Signature (Applicant or Agent): sqliz_� S�_Z�
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Date: . 5/24/2017
Application Number: BMCH2O17-0196
Owner:
Property Address: 80330 VIA VALEROSA
ROBERT TURNER
APN: 777250016
80330 VIA VALEROSA
Application Description: TURNER / (2) HVAC CHANGEOUTS - 14SEER / 80AFUE SPLIT SYSTEM.
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $7,482.00
Applicant:
Contractor:
. A#1 SERVICES HEATING & AIR CONDITIONING
A#1 SERVICES HEATING & AIR CONDITIONING
78206.VARNER RD #D-189_
78206 VARNER RD #D-189
PALM DESERT, CA 92211
PALM DESERT, CA 92211
(760)565-2691
Llc. No.: 977333
Detail: (2)HVAC CHANGE OUTS - (1&2) 14SEER/80AFUE SPLIT SYSTEMS. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO.FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
♦ I 1 I T / •
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS 561473 FEE 101-0000-20306 0
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- SPLIT -SYSTEM PC
101-0000-42600
0-
$76.00
Total Paid for CHANGEOUT: $228.00
DESCRIPTION
ACCOUNT.
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for.PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
S02-0000-43611,
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $330.2
#
CI / Of La. Quit h
Building 8t Safety Aivision .
P.O. Box 1504,78-495 Calle Tampico.
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 80330 Via Valerosa
Owner'sName:.Rol ert Turner
A P. Number
Address: 80330 Via Valerosa
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. A#1 Services Heating & A/C ' . �
Telephone: 760-771-5012.�:�w
Address: 78206 Varner Road #D-18.9
Project Description: Replace 2 3.5 ton / 90,000 BTU
City, ST, Zip: Palm Desert, CA 922.11
complete HVAC systems
Telephone: 760-342-3610?
State Lic. #: 977333
City Lie. M.
Arch., Engr , Designer
Address:
City., ST, Zip:
Telephone: •.
State Lia #: w�
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Buries:
#Units:
Telephone # of Contact Person: 818-73577876
Estimated Value of Project: $7,482.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact PersonPlaa
Check Balance _
Title 24 Calcs.
Placa picked up
Construction
Flood PWU plan
Plans resubmitted
Mechanical
G:mding plan
Z'' Review, ready for correctionsftssue
Electrical
Subcontactor.List
Called Contact Person
Plumbing
Grant Deed
Plans picked by
S3LL
H.O.A. Approval
Plans resubmitted
Grading .
IN HOUSE--
'j° Review; ready for correetiomsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
F.
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
ROBERT TURNER I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3)
2017-05-24
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
Project Name
ROBERTTURNER
02
Date Prepared
2017-05-24
03
Project Location
80330 VIA VALEROSA .
04
Building Type
Single family -
05
CA City
La Quinta ,�
06
Dwelling Unit Name
WHOLE HOUSE
SC System
SC System
CFA served
system a
refrigerant
07
Zip Code
9225308
Installing
Dwelling Unit Conditioned
2536 .
Location or Area '
by this SC
ducted
containing
Floor Area ft2
more than 40
entirely new
entirely new
�P
Name
Number of Space
System (ft2)
09
Climate Zone
15 ""'
10''
Conditioning (SC) Systems in
1
Alteration Type
SYSTEM 1
WHOLE HOUSE
t'
this•Dwellin Unit:
Yes
B. Space Conditioning (SC) System Information
( i
01
02
03
04 +`
05 i6-
16W 6-6V j. Amd
07
08
09
10
Is the SC
Installing.a,
''^^ r+ori'
R VStr Ifra@
SC System
SC System
CFA served
system a
refrigerant
Installing neW'SC
Installing
Installing
Installing
Identification or
Location or Area '
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
compon ent?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOUSE
1268
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
SYSTEM 2
WHOLE HOUSE
1268
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020094997A-000-000-0000000-0000 Registration Date/Time: 2017-05-24 08:40:22 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2,016 Residential Compliance Report Version: 2016. 1.005 Report Generated: 2017-05-24 08:40:23
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
11
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
80
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
SYSTEM 2
Central gas
All new
heating
AFUE
80
tra'��+t
Cenl split
1cooling
All new
SEER
14•
Setback
This field or
section is not
This field or
section is not
furnace
AC
+s r r
components,
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- uuu lmuleUu,i rcquiremant for rho new rnrtinn5 of 5ug91y-air and return -air ducts or plenums: W(CZ 1 10; 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed In dbrtt6d Yp5ttrn3, OF whet. mnre than an ft of duct length is replaced
-Leakage rate compliance: <=15% or <=10% leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components "are installed or altered (applicable in CZ 2, 8-15).
CF2R'and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required
Exceptions: , ) r— F,
HERS from Testing '
Duct systems registered with provider as previously sealed are exempt MCH -20 Duct Leakage requirements. .
ion of
Heating -only systems and Air Handler Furnace changes do not require verificatAir Flow MCHt23`or Refrigerant Charge MCH" 25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
'ua a, , %Ga c•c.., EtSka , a,s,.ts +seats. .i3 1-�t�' i fiL17
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia 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: 417-A020094997A-000-000-0000000-0000
Registration Date/Time: 2017-05-24 08:40:22
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-24 08:40:23
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Cara Goldberg
CcwcvQ&1dle4-g'.
Company:
Signature Date:
A#1 Services Heating & Air Conditioning
2017-05-24
Address:
CEA/ HERS Certification Identification (if applicable):
78026 Varner Road #D-189
City/State/Zip: -' W
Phone:
Palm Dessert CA 92211 y
(760) 342-3610
Responsible Person's Declaration statement'rr
I certifythe following under penalty of perjury, under the laws of the State of California:
g P Y P 1 ry.f3!
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 responsibilit 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 man ufactured"devices for the building design or system design identified on this Certificate of.Compliance conform to the
requirements of Title 24, Part rand 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 -appy o6pith this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be;mae available with the building permit(s)-issued for the building, and made available to the enforcement agency for all applicable
'inspections. I understand that a registered copy of this Certificate of ComPIlan& i&a uiredto be included wththe documentation the builder provides to the building owner at occupancy.
N•
Responsible Designer Name:
hiad �P'4'S e
Responsible Designer Signature:
Cara Goldberg "
CUk&;C,'6MBi6'ro,
Company:
Date Signed:
A#1 Services Heating & Air Conditioning
2017-05-24
Address:
License:
78026 Varner Road #D-189
977333
City/State/Zip:
Phone:
Palm Dessert CA 92211
(760) 342-3610
Digitally signed by CHEERS T" 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: 417-A020094997A=000-000-0000000-0000 Registration Date/Time: 2017-05-24 08:40:22 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-24 08:40:23
Schema Version: rev 10/16