BMCH2016-005178-495 CALLE TAMPICO
aw
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
. BUILDING PERMIT
Application Number:
BMCH2O16-0051
Owner:
Property Address:
48336 BIG HORN DR
SIOBHAN DOHERTY
APN:
623480006
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 f& 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 I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code I shall forthwith .
comply with those / rovisions.
Date: lb . l � Applicant.
., ,v, —, a„cgc. —..y vwwuun u, —u—, iwi vy ...y — a
permit subjects the applicant to a civil penalty of not more than five hundred dollars WARNING: FAILURE TO SECURE WORKERS' C PENeALTIES
COVERAGE IS UNLAWFUL,
($500).: AND SHALL SUBJECT AN EMPLOYER TO CRI NAL P 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 PROVIDED 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
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 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 Address:
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 ter upon
above-mentioned property for inspection purposes.
Date: LO �� Signature (Applicant or Ago -t):
FINANCIAL •
!
DESCRIPTION
ACCOUNT*
QTY_ .r .AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $217.56 $0.00
DESCRIPTION
ACCOUNT
CITY.
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• ! • 00
Description: DOHERTY / CHANGE OUT (2) HVAC SYSTEMS
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 3/10/2016 SKH
Approved:
Parcel No: 623480006 Site Address: 48336 BIG HORN DR LA QUINTA,CA 92253
Subdivision: TR 29436 Block: Lot: 9
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $8,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: HVAC CHANGE OUT - (1)16SEER/78AFUE SPLIT SYSTEM AND (1)18SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
'PHONE
FAX
EMAIL
APPLICANT
CERTIFIED COMFORT SYSTEMS INC
42-949 MADIO STREET
INDIO
CA
92201
DBA HYDES
CONTRACTOR
CERTIFIED COMFORT SYSTEMS INC
42-949 MADIO STREET
INDIO
CA
92201
DBA HYDES
OWNER
SIOBHAN DOHERTY
69 STRATFORD PL SW
CALGARY AB
H7
92253
CANADAT31-1
Printed: Thursday, March 10, 2016 2:29:10 PM 1 of 2 CR
SYS7EAAS
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Thursday, March 10, 2016 2:29:10 PM 2 of 2
RWYSTfti1S
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306.
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT -
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 for CHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:0.40.00
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Thursday, March 10, 2016 2:29:10 PM 2 of 2
RWYSTfti1S
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project,Name:
48-336 Big Horn Dr. I Date Prepared:
2016-03-08
A. General Information
MR -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
48-336 Big Horn Dr.
02
Date Prepared
2016-03-08
03
Project Location
48-336 Big Horn Dr.
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
48-336 Big Horn Dr.
07
Zip Code
92253
08
Dwelling Unit Conditioned
3031
Install4,ng
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system -
Number of space conditioning
entirely new
09
Climate Zone
15
10
(SC) systems in this dwelling
2
component?
components?
feet of"ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information'''
01
02
03
' 04",_
-.05':
E 06r
07 '?
08
09
10
Is the SC "
Installirig a
SC System.
SC System
CFA served
system a
refrigeiant
J Installing new S..0
Install4,ng
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?
component?
components?
feet of"ducts?
duct system?
SC system?
Alteration Type
System 1
Bedrooms
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Living Area
2000
Yes
Yes
Yes
No
No
No
Altered spaceconditioning
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: 216-A0090143A-000000000-0000
Registration Date/Time: 2016-03-08 13:12:23
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-08 13:09:58
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-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)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 split
All new
Central split
All new
This field or
This field or
System 1
HP
heating
AFUE
0.78
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Central split
All new
Central split
All new
This field or
This field or
System 2
HP
heating
AFUE
0.78
cooling
SEER
18
Setback
section is not
section is not
components
AC
components
applicable
applicable
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
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.
-Leakage rate compliance: s 15%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required_ .
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH720 Duct Leakage Testing requirements. ,
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E... Entirely New or Complete Replacement Duct System, with or without Equipment Changeout.(Sections'150.2(b)iDiia and 150.2(b)1E, 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: 216-A0090143A-000000000-0000 Registration Date/Time: 2016-03-08 13:12:23 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-08 13:09:58
Schema Version: 0.555SDD
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:
Hyde, Mark,
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2016-03-08 13:12:23
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
1760-360-2202
Responsible Person'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 Business 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 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'cbinpliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement -agency for aoprbva(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), 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 Compliance_ is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: a t " 4 -
Responsible Designer Signature: `f K
Hyde, Mark
Company:,
Date'Signed
CERTIFIED COMFORT SYSTEMS INC
2016-03-08 13:12:23
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
1760-360-2202
Digitally signed by CaICERTS. 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: 216-A0090143A-000000000-0000 Registration Date/Time: 2016-03-08 13:12:23 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-08 13:09:58
Schema Version: 0.555SDD
Bin. #
Permit #
Project Address: ..
� a
A. P. Number.
Legal Description:
Contractor:
i
Address:
City, ST, Zip:
i Telephone• —3�'-
State Lie. 4: R
Arch., Engr., Designer.
j Address:
City., ST, Zip:
City of La Quinta
Buiiding 8L Safety bldsion
P.O. Box 1504,"78-495 Calle Tampico
La.QLdnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:It b LA
Address: Hery
City, ST, Zip:
Telephone:
Project Description:
Tele hone:
P aER
State Lic. #:
Name of Contact Person:
Construction Type:Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project.
APPLICANT: DO NOT WRITE BELOW THIS UNE
It
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Pian Sets
Plan Cheek submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Pian Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Pians resubmitted-'.
Mechanical .
Giading plan
tad Review, ready for correefionsrmue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.-
''d Review; ready for correcdons/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees