BMCH2016-001478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0014
Property Address:
51949 ELDORADO DR
APN:
777300010
Application Description:
DELEO / CHANGEOUT CONDENSOR AND COIL
Property Zoning:
`a
Application Valuation:
$5,890.00
Applicant:
ARCHON ENERGY SOLUTIONS
OUTSIDE CITY LIMITS
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.
Licen0se-Class: _ License No.: 765074 ✓ l _ 97
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).:
(1 I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure isnot 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.).
(1 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 I 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:
,7
VOICE (760).777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
(951)276-9744
Llc. No.: 765074
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'
compensat on, as provided for by Section 3700 of the Labor Code, for the performance
of the, kkr which this permit is issued.
�'T ave and will maintain workers' compensation insurance, as required by
Section 3 00 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity 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 C� Applicant:10 A"
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES III 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-mentio ed property for inspection purposes.
icy,
* j f�
Date: Signature (Applicant or Agent): ,
i
Date: 2/8/2016
Owner:
RICHARD DELEO
n
469 INNWOOD RD
`a
SIMI VALLEY, CA 92253
z
o�
o
do
Contractor:
c
A R S AMERICAN RESIDENTIAL
0
S VC
965 RIDGE LAKE BLVD SUITE 20D
rn
MEMPHIS, TN 38120
(951)276-9744
Llc. No.: 765074
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'
compensat on, as provided for by Section 3700 of the Labor Code, for the performance
of the, kkr which this permit is issued.
�'T ave and will maintain workers' compensation insurance, as required by
Section 3 00 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity 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 C� Applicant:10 A"
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES III 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-mentio ed property for inspection purposes.
icy,
* j f�
Date: Signature (Applicant or Agent): ,
i
ALINFORMATo
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DESCRIPTION` ``ti ACCOUNTS, PAIDDATE
..�QTYANIOLINT'�gPAID'
«.. ��•:—,E .9d�� .�. 7 :;moi W ........;.s;;..�. .�„..�.....�_,x
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
4 ( 3F .: d' e fi <'-Yf H -� .iW�XX':y: 'A�. $: #� {R 1C z� R: ”` hn 3 mn`::}1 .., E ,� X. `-h. —v z`E %i :.R " ;;;'i; 'f' 'e ?-(d: f3Y' m''�4$E"kt= : 4: n, <��E J•h'i .::
PAID;BY� `a Y� 4 F: METHOD, �� _RECEIPTS#�aCHECK#E::CL~TD BYE
E _.
r.•a,a?'...`"_,'.:.ra......4``.L.....`A%'"x.axS��4`a.".'.,.�E ...a'
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 " $0.00
t =�' 5'':+f'Y).!..
DES; CRIPTION
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PAID<,
PAID DATE
DY:.
x..
MMOUNT
,�::.sx
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
'$36.26
$0.00.
ds ra`
c t PAID BYE ' & ,(y4 4��4 "
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'l":,idN4T ...✓
t'AMOUNT
'-. I
;PAID
: rrFBs. &7+i6'v7i'?:F
HVAC CHANGEOUT - CONDENSER ONLY PC,
101-000042600
0-
$24.17
$0.00
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f PAID BY
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PAID'>DATE
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a is : .. . � . ,*� .
�ri
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-424020
$12.09'
$0.00
k 4 PAID,BY
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RECEIPTS#�
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,AMOUNTS
,
PAIDDATE
HVAC CHANGEOUT - REPAIR/ALTERATION :
'101-0000-42600 '-
0
$4.83
$0.00
PC
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Az}g� S J+ ,� '4 *F
BYr�4,```�'`*
x:* .'y 5: $;.iL ., £
- `' iaE'METHOD.a� `�.'RECEIP.T#.4i';�CHECK#'
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Total Paid for CHANGEOUT: $17.35, •`
.: 1� _•: 3. 4 •E`E d^.SCS:k.«
€�i;ACCOUNT�pQTY..
s$0.00
r ,t �,+, i f;Y
,:''^
Ea z 3 X,DESCRIPTION
{AMOUNT s�PAIDPAIDiJATE
PERMIT ISSUANCE
.
0
$91.85
1,. $0:00 .
l J ': ', x d i J 5 .e i C� Y -'.i Sit . _ -, d :i `(,C '�?Y`-
PLAID BY
y101-0000-424084
3 1Sj`'^ �4 : ;0$,: �. .. E'idJ" Al
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Totaf Paid for PERMIT ISSUANCE: ;$91.85 $0.00.,
TOTALS:• �0
Description: DELEO / CHANGEOUT CONDENSOR AND COIL
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 2/8/2016 SKH
Approved:
Parcel No: 777300010 Site Address: 51949 EL DORADO DR LA QUINTA,CA 92253
Subdivision: TR 31349 Block: Lot: 160
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,890.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: HVAC CHANGE OUT- 15SEER/78AFUE CONDENSOR 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
ARCHON ENERGY SOLUTIONS
OUTSIDE CITY LIMITS
CONTRACTOR
A R S AMERICAN RESIDENTIAL
SERVICES OF C
965 RIDGE LAKE BLVD
SUITE 201
MEMPHIS
TN
38120
OWNER
RICHARD DELEO
469 INNWOOD RD
SIMI VALLEY
CA
92253
Printed: Monday, February 08, 2016 5:43:58 PM 1 of 2 C
SYSTEMS
PARENT PROJECTS
ATTACHMENTS
Printed:. Monday, February 08, 2016 5:43:58 PM 2 of 2 (rI7
sysrenns
CLTD.
DESCRIPTION
ACCOUNT'
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
CONDENSER ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
CONDENSER ONLY PC
HVAC CHANGEOUT -
101-0000-42402
0
$12.09.
REPAIR/ALTERATION
.$0.00
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: $170.20 00
PARENT PROJECTS
ATTACHMENTS
Printed:. Monday, February 08, 2016 5:43:58 PM 2 of 2 (rI7
sysrenns
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CF1 R -ALT -04-E Revised 06114
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE
CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -1R -ALT -HVAC)
(Page 1 of 1)
Site Address: I
Enforcement Agency:
Date Prepared:
Permit#:
2 l
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
KEvaporator Coil
A %$AFUE
COP
❑ R-6 (CZ2, 8-13) Ducting
Served by system
❑ Setback
❑ Split System
Condensing Unit
❑ R-8' (CZ 11, 14, 15) Ducting
3 qft
(If not already
❑ Mini Split
1115 Compressor
SEER
�ZHSPFpresent,
❑ R-6 (all CZ's) Plenums
must
❑ Furnace
❑Lineset
IL—EER
❑ R-5 or R7.5) Lineset'
be installed)
11 TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF111-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-OS, MECH-20-HERS, MECH-(23 or 24)' -HERS, MECH-25-HERS2
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage (:L15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
111. Duct system registered with -HERS provider as previously sealed, -or ❑ 2. There is less than 40 linear feet of duct in unconditioned space; or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts3 CFSR-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS'
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3 CF111-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (:S_15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
3 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5 -3T -2Y.", 3.5 to 4T-2%", 5T -4Y."
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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.
Responsible Desi finer Name / i '
Responsible Designer Si u ' •
( Date S' ' cl:/& /�
Lice?/:��
Coy : �
S
Aess: O
ity/State/Z
�
Ph0
l—VfM
/
F* assistance or questions regarding the Energy Standafds, contact the Energy Hotline at: 1-800-772-3300
Bin ##
City of La Quinta
Building a Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit ##
Project Address: Lj / / 6
ner's Name: # ��
A. P. Number:
Address: S pyvy/
Legal Description:
City, ST, Zip:
/ �
Contractor:
rl
TelePhone: g
d -Z96
Address:
S 5 'f`
Project Description: Co' {�jQ' ' %I S rPij- /c 1
City, ST, Zip:
74 [
cL G `ems' <Ai
P d]
Tele h ne•
o . I r
/ l
y
o
State Lic. # :
City Lie. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
aneY
Construction Type: Occupancy:
• �?
Lic. #.
Project type (circle one): New Add'n
Demo
Namd•of Contact Person:
Sq. Ft,:
# Stories:
# nits:
U
Telephone # of Contact Person:
Estimated 4a ue of Project:
p
APPLICANT: DO NOT WRITE BELOW THIS LINE
M
Submittal
Req'd
Rec'd
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
2qd Review, ready for correclionstissue
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