BMCH2015-040978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tjht 4 4 Qu !A rcu
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0409
Property Address: 79140 CINDY CT CT
APN: 604361033
Application Description: RICHARDS / CHANGE OUT 5TON FURNACE AND COIL
Property Zoning:
Application Valuation: $6,500.00
Applicant:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
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 a siness and Professions Code,
and my License Is in full force and effect.
License Class: C20, Q6 License No.: V77779
05—ate: Contracto
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).:
(_) 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.).
(_) 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 Address:
11111111111111111111
78
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/22/2015
Owner:
JODI RICHARDS
79140 CINDY
LA QUINTA, CA 92253
Contractor: `N z—' Z -i
J ANTHONY PLUMBING HEATING &AIR COND)ITI i -R,
72216 NORTH SHORE ST #W
THOUSAND PALMS, CA 92276
(760)343-2121
Llc. No.: 777794
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 which this permit is issued.
Q 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 I should become subject to the
workers' compensation provisions of Section 3700 the Labor Code, I shall forthwith
comply with those provisions.
Dat�`t* ZZ ( Applicant:
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 infor tion is correct.
I agree to comply with all city and county ordinances and state laws elating to building
construction, and hereby authorize representatives of this city to ter upon the
above-mentioned property for inspection purposes.
Date/ z /J Signature (Applicant or Agent):
FINANCIAL •• 1•
DESCRIPTION ACCOUNT QTY 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 - FURNACE ONLY
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #.
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - FURNACE ONLY PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
t CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY.
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
PC
101-0000-42600
0
$4.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $77.35 $0.00
DESCRIPTION
ACCOUNT
QTY
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:• • $0.00
Description: RICHARDS / CHANGE OUT STON FURNACE AND COIL
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 10/22/2015 SKH
Approved:
Parcel No: 604361033 Site Address: 79140 CINDY CT CT LA QUINTA,CA 92253
Subdivision: TR 27899 Block: Lot: 81
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $6,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0'
NAME TYPE
Details: CHANGE OUT - (1) STON FURNACE AND COIL (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
J ANTHONY PLUMBING HEATING &
AIR CONDITI
72216 NORTH SHORE
ST #101
THOUSAND
PALMS
CA
92276
(760)835-5752
CONTRACTOR
J ANTHONY PLUMBING HEATING &
AIR CONDITI
72216 NORTH SHORE
ST #101
THOUSAND
PALMS
CA
92276
(760)835-5752
OWNER
JODI RICHARDS
79140 CINDY
LA QUINTA
CA
92253
(760)835-5752
FINANLIAL INFORMATION
Printed: Thursday, October 22, 2015 1:20:47 PM 1 of 2
SYSTEMS
INSPECTIONS
Printed: Thursday, October 22, 2015 1:20:47 PM 2 of 2 CR
SYSTEMS
CL
DESCRIPTION
ACCOUNT
QTY
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
$36.26
$0.00
FURNACE ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
FURNACE ONLY PC
HVAC CHANGEOUT -
101-0000-42402
0
$12.09
$0.00
REPAIR/ALTERATION
HVAC CHANGEOUT -
101-0000-42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid for CHANGEOUT: $77.35 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
INSPECTIONS
Printed: Thursday, October 22, 2015 1:20:47 PM 2 of 2 CR
SYSTEMS
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: 0 C.
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip:
honer�Oc7 � TeleP 3
ES
Address: 72216 NORTH qT IQ,
Project Description:
THOUSAND PALMS, CA 92276
City, ST, zip:
,� % ��ro
ne•
TeleP ho .
:
l
State Lic. # : 7 %?
City Lic. 9,
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:Construction
State Lic. #:
Name of Contact Person: �{ ��
Type: Occu ancy:
circle one): New Addn Alter
J) Repair
type Project'
Sq. Ft.: # Sto ' s:,/ # Units:
Demo
Telephone # of Contact Person:
Estimated Value of Projectqp
:
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 Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
.Grading plan
2°" Review,.ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Reyiew, 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
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
RICHARDS I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2015-30-22
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
RICHARDS
02
Date Prepared
2015-10-22
03
Project Location
79140 CINDY CT
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
RICHARDS
Dwelling Unit Conditioned
Installing a
07
Zip Code
92253
08
Floor Area (ft2)
1800
SC System
CFA served
system a -
refrigerant
Number of space conditioning
pstalliing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing.
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information""
O3
02
03'
04�k
��056�
07
08
09
10
.IIs the SC
Installing a
SC System
SC System
CFA served
system a -
refrigerant
dnstalling new SC
pstalliing
jnstalling
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
Location 1
1600
No
No
No
No
No
No
No alteration
performed
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
D. Altered Space Conditioning System (Sections 150.2(b)IE and F)
This section does not apply to this project.
Registration Number: 215-A6367115A-000000000-0000
Registration Date/Time: 2015-10-22 12:19:41
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-22 12:19:42
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
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)lC),
This section does not apply to this project.
Registration Number: 215-A6367115A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-10-22 12:19:41
Report Version: 2013-1.006
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2015-10-22 12:19:42
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:
Robinson, Kevin
,(!
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2015-10-22 12:19:41
Address:
CEA/ HERS Certification Identification (if applicable):
72216 NORTH SHORE ST #101
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
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 Ft�gulatio
1 � � l
1-
4. The building design features or system design features identified on this Certific tea of Compliance are, consistent.with the information provided on other.- pa plicable' ompliance documents, worksheets,
F i —n'g p .tgp'i . > �°�.{ t t
calculations, plans and specifications submitted to the enforcement agency for approval with this buildmg permit application. j{z1[
": d s ice,
i t.{ me
5. I will ensure that a registered copy of this Certifica e f Compliance shall be made available with the building permit�s);issued loathe 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: L. fi N —0
Responsible Designer Signature:
Robinson, Kevin
KP.!/G!f/ i�0GB11/
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2015-10-22 12:19:41
Address:
License:
72216 NORTH SHORE ST #101
777794
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
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-A6367115A-000000000-0000 Registration Date/Time: 2015-10-22 12:19:41 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-22 12:19:42
Schema Version: 0.555SDD