BMCH2014-1156s
78-495 CALLE TANi4�ICO � A�
LA QUINTAs'CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
, 1 BUILDING PERMIT
application Number BMCH2014 1156
Property Address: 80545 VIA TERRACINA
APN: 777260006
Application Description: HVAC CHANGE OUT
Property Zoning:
Application Valuation: $9,760.00
Applicant:
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
A
DEC 2 2 2014
CITY OF LA QUINTA
COMMUNITY DEVELOP t72NT DEPARTMENT
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: Lice se NO.::LIC-0004822
ate: + Contract
OWNER-BUILDERLARATION
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 Divisio
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 f 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.). i
Lender's Name:,
Lender's Addre<
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/2014
Owner:
JOHN SHEPANlEK
5905 SE COLUMBIA UNIT 201
VANCOUVER, ,NA 92253
Contractor:
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA, CF. 92253
(760)360-220C
Llc. No.: :LIC -0004822
WORKER'S COMPEN!ATION 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 3'00 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 insuraice carrier and policy number are:
Carrier:_ Polity Number: •
_ I certify that in the performance :)f the work for which this permit is issued, I
shall not employ any person in any manner :o as to become subject to the workers'
compensation laws of California, and agree - hat, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall fo ith
comply with those provisions.
�te: ' !/i Appli
WARNING: FAILURE TO SECURE WORKERS'OOMPENSAT16irCOVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,900). 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 fie Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this aplJlication 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 owr.:er, 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 a 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 Mate that the above information is correct.
I agree to comply with all city and county orcinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the ve-
mentionned pro erty for inspection purposes.
Date: I Signature (Applicant or
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: 80-545 Via Terracina Date Prepared: 2014-12-16
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 CF111-ALT 02 document for each dwelling unit.
01
Project Name
80-545 Via Terracina
02
Date Prepared
2014-12-16
03
Project Location
80-545 Via Terracina
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
80-545 Via Terracina
07
Zip Code
92253
08
Dwelling Unit Conditioned
2976
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
15
30
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
O1
02
03
04
05
06
07
08
09
10
Is the SC
Installing a
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?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Living Area
2100
Yes
Yes
Yes
No
No
No
Altered space
conditioning 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: 214-A0160734A-000000000-0000 Registration Date/Time: 2014-12-16 15:17:27 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-16 15:18:32
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
05
06
07
08
09
10
it
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
f'nnling
Minimum
Roquirod
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
All new
Less than or
System 1
furnace
heating
AFUE
0.78
ackaAC
pged
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Renuired Documentation:
CQR-MCH-03-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: <- 15%, or15 10% 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 > 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 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)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.
Reiistration Number: 214-A0160734A-000000000-0000 Registration Date/Time: 2014-12-16 15:17:27 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-16 15:18:32
Schema Version: 0.551SDD
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:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2014-12-16 15:17:27
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
(760) 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 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) 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:
Responsible Designer Signature:
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2014-12-16 15:17:27
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
1(760) 360-2202
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 214-A0160734A-000000000-0000 Registration Date/Time: 2014-12-16 15:17:27 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-16 15:18:32
Schema Version: 0.551SDD
Description: HVAC CHANGE OUT
CONDITIONS
NAME TYPE
Type: MECHANICAL
Subtype: Status: APPROVED
Applied: 12/19/2014 MFA
Approved:
Parcel No: 777260006 Site Address: 80545 VIA TERRACINA LA QUINTA,CA 92253
Subdivision: TR 30357
Block: Lot: 82
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $9,760.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 5 TON, 16 SEER/78 AFUE SPLIT SYSTEM [2010 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR
TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
HYDES
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESS1
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(760)360-2200
CONTRACTOR
HYDES
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(760)360-2200
OWNER
JOHN SHEPANEK
5905 SE COLUMBIA
UNIT 201
VANCOUVER
WA
92253
(760)360-2200
Printed: Monday, December 22, 2014 8:59:14 AM 1 of 2 sysiEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
-]
MECHANICAL FINAL**
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
HVAC CHANGEOUT -
101-0000-42402
0.
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERM1T ISSUANCE: $91.85 $0.00
TOTALS:
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL**
PARENT PROJECTS
ATTACHMENTS
Printed: Monday, December 22, 2014 8:59:14 AM 2 of 2
SYSTEMS
DESCRIPTION
FINANCIAL INFORMATION
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 - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$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
$36.26
$0.00
PAID BY
METHOD
RECEIPT # =
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $108.78 $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 forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Bin #
City of La Quints
Building .& Safety Division
Permit P.O. Box 1504, 78-495 Calle Tam co
t/
I La Quinta, CA 92253 - (760) 777-7012
`f Building Permit Application and Tracking Sheet
Project Address:( --
Q Owner's Name:
A P. Number:
Address: — i
Legal Description:
City, ST, Zip. �2
Contractor: l .o,ol Fo ^ �. Y e
5' A Telephone: 6 0-- —�
Address: %'Z K
/ " lc( Project Description:
City, ST, Zip: �O C A • .Cf ZZ d I
Telephone: 3Gd
State Lie. #':
City Lic. #: Ll k Z: -4L
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #: str
Conanuction Type: Occupancy:
cy:
Project type (circle one): New Acd'n Alter Repair' Demo
Name of Contact Person:
Sq. Ft : 975
Telephone # of Contact Person: # Stories: # Units:
# Submittal
Plan Sets
Structural Calcs.
Truss Cafes.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. APpr
School Fees
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS
LINE
TRACkMG
PERMIT FEES
Plan Check submitted
Item Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Checc Balance
Plans picked up
Constructhn
resubmitted
•
Plans
•
Mechanics!
' Review, ready for correctionsrusue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M L
Plans resubmitted
Grading
Review, ready for corrections/issue
DeveloperLnpaM Fee
Called Contact Person
A.LP.P.
Date of permit issue
Total Permit Fees