BMCH2017-006778-495 CALLS TAMPICO D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/23/2017
Application Number: BMCH2O17-0067®! �� ner:
Property Address: 49971 AVENIDA VISTA BONITA 1 ARD KWER
APN: 773340072 O BOX 529
Application Description: KIPPER RESIDENCE / HVAC CHANGE 0 MAR 2 3 2017 v ODY CREEK, CO 92253
Property Zoning:
Application Valuation: $7,000.00
- CITY OF LA QUINTA
Applicant: DESIGN AND DEVELOPMENT DEPARTMUtractor:
CERTIFIED COMFORT SYSTEMS INC DBA HYDES CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET 42-949 MA010 STREET
INDIO, CA 92201 INDIO, CA 92201
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.: 906115
'� !Date: Contractor•
.OWNER -BUILDS CLARAT
I hereby affirm under penalty of perjury t I am exe from the Contractor's State
License Law for the following reason (Se . 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 fora 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.).
(_j 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 Na
Lender's Address:_
s
(760)360-2202
Llc. No.: 906115
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certficate of consent to self -insure for workers'
compensation, as provided for by Sectior. 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 prformance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier: EVEREST NATIONAL INSURANCE ZOMPANY Polity Number: 7600015264
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 agrae that, if I should become subject to the
workers' compensation provisions of Sec -.ion 3700 of the Code, I shall forthwith
comply with those pr visions.
Date: Applican .
WARNING: FAILURE TO SECURE WORKS -' MPENSA ON COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER T IMINAL 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 --ity 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 cancelfstion.
I certify that I have read this application a id state that the above information is correct.
I agree to comply with all city and county xdinances 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: '4 ►7. Signature (Applicant or Agent):
Date: 3/23/2017
Application Number: BMCH2O17-0067 Owner:
Property Address: :49971 AVENIDA VISTA BONITA RICHARD F:IPPER
APN: 773340072 P 0 BOX 5119
Application Description: KIPPER RESIDENCE / HVAC CHANGE OUT WOODY CREEK, CO 92253
Property Zoning:
Application Valuation: $7,000.00 _
Applicant: Contractor.
CERTIFIED COMFORT SYSTEMS INC DBA HYDES CERTIFIED COMFORT SYSTEMS INC DBA HYDES
42-949 MADIO STREET 42-949 MA.DIO STREET
INDIO, CA 92201 INDIO, CA`32201
(760)360-2202
Llc. No.: 906115
Detail• HVAC CHANGE OUT - 16 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
DESCRIPTION ACCOUNT QTY
AMOUNT
BSAS 561473 FEE 101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
7. 101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT •'
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
t DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
F
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3)
Project Name: 49971 Avenue Vista Bonita Date Prepared: 2017-03-14
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
49971 Avenue Vista Bonita
02
Date Prepared
2017-03-14
03
Project Location
49971 Avenue Vista Bonita
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
49971 Avenue Vista Bonita
SC System
SC System
CFA served
Dwelling UnitConditioned
refrigerant
07
Zip Code
92253
08
Floor Area (ft)
1922
Location or Area
by this SC
ducted
containing
Number of Space
,
09
Climate Zone
15
10
Conditioning (SC) Systems in
1
system?
component?
components?
feet of ducts?
this Dwelling Unit:
SC system?
B. Space Conditioning (SC) System Information
01
02
03
" 04
05.
06
_ 07
08
09
10
'Is theSCl'
Installing'a
�-•� t!Y `'
--?
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 (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
whole house
1600
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: 217-A020081740A-000-000-0000000-0000 Registration Date/Time: 2017-03-14 15:28:32
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005
Schema Version: rev 10/16 .
r
HERS Provider: CalCERTS
Report Generated: 2017-03-14 15:28:47
CERTIFICATE OF COMPLIANCE _ CFMALT--024
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) _ _ , . s, (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
Efficiencv
Cooling
Cooling
Fffir.ienry
Ffficienry
Thermostm
Roplaced
Now 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
heating
AFUE
81
AC.,
cooling
SEER
16
Setback
section is not
section is not
HP
componentscomponents
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 CBR -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 CF311-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and MR -MCH -23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required.
c
-
Exceptions:
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
or Refrigerant Charge MCH
Heating -only systems and Air Handler Furnace changes do not require verification'of Air Flow MCH -23 -25. ;
-Existingducts stems constructed, insulated or sealed with asbestos.are exem tfrom MCH 20 DuctLeaka a Testin requirements. F
I r
F. Entirely New or Complete Replacement Space Conditioning System (Section
This section does not apply to this project.
Registration Number: 217-A020081740A-000-000-0000000-0000 , Registration Date/Time: 2017-03-14 15:28:32 HERS Provider: CalCERTS•.
- 'CA Building Energy Efficiency Standards - 2016 Residential Compliance . • Report Version: 2016.1.005 _ Report Generated: 2017-03-14 15:28:47
Schema Version: rev 10/16 -
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
�jOjlLPi
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2017-03-14 15:28:32
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. ; r ' ' , r ` , h ! J r
V. t ` x _
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 applicatiori. 4 I
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building per'mit(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: •xr
Hyde, Mark
Company:
Date Signed: '
CERTIFIED COMFORT SYSTEMS INC
2017-03-14 15:28:32
Address:
License:
42949 Madio
906115 `
City/State/Zip: r
Phone:
Indio CA 92201
760-360-2202
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: 217-A020081740A-000-000-0000000-0000 Registration Date/Time: 2017-03-14 15:28:32 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance - Report Version: 2016.1.005 Report Generated: 2017-03-14 15:28:47
Schema Version: rev 10/16
Bin #
Permit.#
Project Address:'
A P. Number:
Legal Description:
_
Contractor: r �
J
1?� City of La Quinta
Building.& Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
Address:
City, ST, Zip: t /1
� � ^ _/ y e' 2
�� 5 �{ /c Telephone:
Address: %'Z
/11cr Project Description:
City, ST, Zip:
,
C ACI Z Z d I G G
Telephone: 6a _ ZZd
State Lic. # : q 0C
City Lic. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
p cy'
State Lic. #:
Name of Contact Person:
Project type (circle one): New Add'n Alter Repair Demo
F
Telephone # of Contact Person:
Sq. Ft: # Stories: # Units:
7
Estimated Value of Project: 7, o0o
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Recd TRACKING
Plan Sets
. PERMIT FEES
S
Plan Check submitted Item
Structural Calcs.
Amount
Reviewed, ready for corrections
Truss Cales.
Plan Check Deposit
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Flood plain plan
. Construction
Plans resubmitted
Mechanical
Grading plan'
21 Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O-A. Approval
Plans resubmitted
Grading
IN HOUSE:-
34 Review, ready for eorrections/issue Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
A-LP.P.
Date of permit issue
School Fees
Total Permit Fees