BMCH2017-039878-495 CALLS TAMPICO C& 0 D 4 Qum&
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0398
Property Address:
80235 VIA TESORO
APN:
777011034
Application Description:
KEGLEY / CHANGE OUT (1) 14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$9,000.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
p Q �
FSEP0 5 2017
CITYOFLAQUINTA
COMMUNITY DEVELOPMENT 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: C20, C36 License No.: 977333
Date: 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 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).:
(_J 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/5/2017
Owner:
CHARLE KEGLEY
80235 VIA TE.30RO
LA QUINTA, C4 92253
Contractor: .
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189
PALM DESERI, CA 92211
(760)565-2691
Llc. No.: 977333
WORKER'S COMPEMATION DECLARATION
I hereby affirm under penalty of perjury ore 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: FALLS LAKE FIRE AND CASUALTY COMPANY Policy Number: FLA006188
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.
Date: 5 1 –1 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 PROVIDEDTOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made tD the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this a?plication is made, each person at whose
request and for whose benefit work is perfDrmed 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 _o 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 ca icellation.
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.
Date:_ Signature (Applicant or Agent): �_�
Application Number:
BMCH2017-0398
Property Address:
80235 VIA TESORO
APN:
777011034
Application Description:
KEGLEY / CHANGE OUT (1) 14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$9,000.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
Date: 9/5/2017
Owner:
CHARLIE KEGL'EY
80235 VIA TE ORO.
LA QUINTA, CA 92253
Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNE R RD #D-189
PALM DESER—, CA 92211
(760)565-2691
Llc. No.: 9772.33
Detail: HVAC CHANGE'OUT-14SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
" DESCRIPTION
ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0. $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Notal Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin.#
Qty/ Of % QuIf1ta
Building a Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Pemut #
OA�*
Project Address: 80235 Via Tesoro
Owner's Name:. Charle Kegley
A- P. Number.
Address: 80235 Via Tesoro
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. A#1 Services Heating & A/C
sig'•':
Telephone: 442-400-3707
Address: 78206 Varner Road #D-189
Project Description: Replace 5 ton A/C, coil, 8 110,000
City, ST, Zip: palm Desert, CA 92211
BTU furnace.
Telephone: 760-342-3610
State Lic. # : 977333
City Lic, #;
Arch., Engr., Designer
Address:
City., ST. Zip:
Telephone: v r : `� , .:�
State Lic. #: :; .w... _
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair
Demo
Sq. Ft.:
Stones:
# Units:
Telephone # of Contact Person: 818-735-7876
.—T—#
Estimated Value of project: $9,000.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural.Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Pian Check Balance
Tide 24 Cates.
Plans picked up
Const -action
Flood plain plan
Plans resubmitted..
Mech:uikal
Grading plan
2" Review, ready for correctionsfissue
Electneal
Subcontactor List
Called Contact Person
plum"ging
Grant Deed
Plans picked up
S.MA
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'^` Review, ready for correctionsfissne
Dev6oper Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Tota' Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
CHARLE KEGLEY I Date Prepared:
CF111-ALT-02-E
(Page 1of 3)
-2017-09-01
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
CHARLE KEGLEY
02
Date Prepared
2017-09-01
03
Project Location
80235 VIA TESORO
l
04
Building Type
Single family
OS
CA City
La Quinta r
;,'96
Dwelling Unit Name
HOME
Identification or
Location or Area
�,
ducted
containing
system
07
Zip Code
92253`_
, 08
Dwelling Unit Conditioned
Floor Area Z
2254
System (W)
system?
�..
components?
(ft )
duct system?
SC system?
Alteration Type
`
WHOLE HOME
Number of Space
Yes
09
Climate Zone
15 "'
' 10 /
Conditioning (SC) Systems in
1
this Dwelling Unit:
B. Space Conditioning (SC) System Information n n i €
- 01
02—
03
04 �
L1 1105 IL-=: !
L6 # 661),
07
08
09
10
SC System
SC System
CFA served
Is the SC
%- nn
system a
Installing a
atc�'r;6 =-o,'1A
refrigerant
`l wii+� l�9a#4+)
`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 (W)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOME
2254
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-A020113775A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-09-01 14:42:59
Report Version: 2016.1.006
HERS Provider: CHEERS
Report Generated: 2017-09-01 14:42:59
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)lE 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
Componeritf
lype
value
System lype
L6MP0nent5
type
value
type
uuct Length
k=value
Central gas
All new
Central split
All new
This field or
This field or.
SYSTEM 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (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 ducted systems, or when more than 40 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:
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 MCH -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. Erj>)irely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 417-A020113775A-000-000-0000000-0000
Registration Date/Time: 2017-09-01 14:42:59
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-01 14:42:59
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:
Stephanie Shryock
StPPh".Z&Shryock.
company:
Signature bate:
I Permit E Raters
2017-09-01
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip:
Phone:
Westlake Village CA 91362
818-735-7876
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:.
Cara Goldberg s' ,' t
Stpphcw�Shryock-(c ...tiu r4edd
Company:
Date Signed:
A#1 Services Heating & Air Conditioning
2017-09-01
Address:
License:
78026 Varner Road #D-189
977333
City/State/Zip:
Phone:
Palm Dessert CA 92211
(760) 342-3610
Digitally signed by CHEERS TM. 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-A020113775A-000-000-0000000-0000
Registration Date/Time: 2017-09-01 14:42:59
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-01 14:42:59