BMCH2016-0069-
75
� auc�cicv _
78-495 CABLE TAMPICO 4 VOICE (760) 7774125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
f COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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: j�l eScea�GC^S
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).:
U 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:
(760)342-3610
Llc. No.: 977333
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
Se ion 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 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 3�'7 < 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 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):
Date:
3/29/2016
Application Number:
BMCH2O16-0069
Owner:
Property Address:
51641 ELDORADO DR
MICHELLE SMITH
APN:
777350009
51641 ELDORADO DR
o
Application Description:
SMITH / HVAC CHANGE OUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$7,500.00
n f
Ito
Applicant:
Contractor:
m p)
cs0
A#1 SERVICES HEATING &
AIR CONDITIONING
A#1 SERVICES HEATING & AIR CpOK 140No
0
78206 VARNER ROAD #D-189
78206 VARNER ROAD #D-189
1 9 >
PALM DESERT, CA 92211
PALM DESERT, CA 92211
S'
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: j�l eScea�GC^S
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).:
U 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:
(760)342-3610
Llc. No.: 977333
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
Se ion 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 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 3�'7 < 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 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):
FINANCIAL INFORMATION
DESCRIPTION F 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 for CHANGEOUT: $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 for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Description: SMITH / HVAC CHANGE OUT
CONDITIONS
Type: MECHANICAL Subtype:
Status: UNDER REVIEW
Applied: 3/29/2016 SKH
Approved:
Parcel No: 777350009 Site Address: 51641 EL DORADO DR LA QUINTA,CA 92253
Subdivision: TR 31349 Block:
Lot: 171
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $7,500.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 -
No. Unites: 0
A#1 SERVICES HEATING & AIR
CONDITIONING
Details: HVAC CHANGE OUT - 14SEER/8AFUE SPLIT SYSTEM [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
92211
(201)694-0278
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY STATE
ZIP
PHONE.
FAX EMAIL
APPLICANT
A#1 SERVICES HEATING & AIR
CONDITIONING
78206 VARNER ROAD
#D-189
PALM DESERT CA
92211
(201)694-0278
CONTRACTOR
A#1 SERVICES HEATING & AIR
CONDITIONING
78206 VARNER ROAD
#D-189
PALM DESERT CA
92211
(201)694-0278
OWNER
MICHELLE SMITH
51641 EL DORADO DR
LA QUINTA CA
92253
(201)694-0278
FINANCIAL INFORMATION
Printed: Tuesday, March 29, 2016 10:47:24 AM 1 of 2 c7
SYSTEMS
Permit Details PERMIT NUMBER
City of la Quinta BMCH2O16,0069,"
PARENT PROJECTS
ATTACHMENTS
Printed: Tuesday, March 29, 2016 10:47:24 AM 2 of 2
' CN?SYS7Eh1S
CLTD
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
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0.
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:i 00
PARENT PROJECTS
ATTACHMENTS
Printed: Tuesday, March 29, 2016 10:47:24 AM 2 of 2
' CN?SYS7Eh1S
Bin #
City of La Quinta
Building 8i' Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: s O '
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: ,
Contractor.
T h n
ele o e.
P 7�
Address:
Project Description:
City, ST, Zip: A 110114Q2
Telephone: 7 � C
-F
State Lic. #
City Lic. #.�f�a
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
=
ancY:
Construction Type: Occupancy:
P
State is #
Pecit le one) New A dd'n Alter Repairair Demo
oProJecttY
Name of Contact Person:�¢
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
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 correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN I10USE:-
'`° Review, ready for correctionsfissuc
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
CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Michelle Smith I Date Prepared: 2016-03-21 1
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
Michelle Smith
02
Date Prepared
2016-03-21
03
Project Location
51641 EI Dorado Dr
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Michelle Smith
07
Zip Code
9225308
`CFA served
Dwelling Unit Conditioned
3612
Installing new SC
v
Installing
+yr
qlx nstalli' gInstalling
ham+
Floor Area (ft2)
Identification or
location or Area
by this SC
ducted
U% q
containing
Number of space conditioning
more than 40
09
Climate Zone
15
10
(SC) systems in this dwelling
1
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SC) System info,rmation�-aw
.' t d' awl iMilia
Ol
02
03
040
in
09
10
"
Is the SC
Installing a
SC System
SC System
`CFA served
system a
re Iger' ant
Installing new SC
v
Installing
+yr
qlx nstalli' gInstalling
ham+
Identification or
location or Area
by this SC
ducted
U% q
containing
m
system
more than 40
new
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Area 1
1800
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Dud System, Greater Than 40 Feet (Section15O.2(b)iDiib)
This section does not apply to this project.
Registration Number: 216-A0107143A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-03-21 13:40:26
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CaICERT!�
Report Generated: 2016-03-21 13:40:50
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
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 Dud
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Dud Length
R -Value
Central split
All new
Central split
All new
This field or
This field or
System 1
HP
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 Ducts and Fans,
-Dud insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H — Dud Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of dud length is replaced.
-Leakage rate compliance: <_ 15%, or15 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-2S-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 z 300 CFM/ton required when:MCH-25 is required.
Exceptions: �.. -
-Dud systems registered with HERS provider aspreviously sealed are exempt -from MCH -20 Dud Leakage Testing requirements.
Q i G .. '. as s ..� a t 9 w n :�.
-Heating-only systems and Air Handler/Furnace changes do notregwre verification of Air Flow MCH -23 or'Refr`igerant`Charge MEC '!25.,,
Ji eExisting duct systems constructed, insulated or sealed with-asbesto,.are exempt from MCH=20 DuctLeakage Test ng eSu 4emen�s.
A rI /4^1 1 t N.'►.,__ _:C .,2U It I ,IV is a — px 04 R; vt 10
/r � +" `tee m* �a ..�+ • � � %& Alf K,r *`V
E. Entirely New or Complete Replacement DuctSystem, with or without Equipment Changeout (Sections 1�50.2(b),lDiia=and 150.2(b)lE, F)
r,. a�
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: 216-A0107143A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-03-21 13:40:26
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2016-03-21 13:40:50
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:
Castillo, Daniel
Company:
Signature Date:
A 1 SERVICES
2016-03-21 13:40:26
Address:
CEA/ HERS Certification Identification (if applicable):
74866 Lennon PI
City/State/Zip:
Phone:
Palm Desert CA 92260 A
760-565-22691
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under t e laws oftthe State of California:
1. The information provided on 'this Certificate of Compliance -is -true and correct.
2. 1 am eligible under Division 3 ofRthe siness and Professions -Codecc2pt 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,designnrorr syystem desig,,n identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of theCalifornia Code o Cg lat ons ��
'
.1^�P4. The building design features or system design features'identified on this Certificate of Compliance areconststent-with.the i11nformn=provided on other applicable•minpliance documents, worksheets,
fi r . . 4 . 9
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
Y : ,¢•'�. h '! _.�.' 4 ,di ► .3 "4., $' µt._. ,,.�.
for -buil for
5. I will ensure that a registered copy of this Certificate of ompliance shall 6e_made,available with the,buildijh% ermit(s),issued the ding, and made available to�tfie enforcement agency all applicable
inspections. I understand that a registered copy of this=C�ertifcate of Co�mplance,is -.required toncluded wi �h thud acum�enttionhe builder provides to the building owner at occupancy.
Responsible Designer Name: "F'� �, M
:_- arc,
Responsible Oesigner5ignature: `,/� �i�
Z�GG�itia &&-
Castillo, Daniel
Company :
Date Signed:
A 1 SERVICES
2016-03-21 13:40:26
Address:
License:
74866 Lennon PI
977333
City/State/Zip:
Phone:
Palm Desert CA 92260
760-565-22691
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: 216-A0107143A-000000000-0000 Registration Date/Time: 2016-03-21 13:40:26 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-21 13:40:50
Schema Version: 0.5555DD