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BMCH2016-005678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 C&tyll 4 40 Q�Mro COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 64 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/18/2016 Application Number: BMCH2O16-0056 Owner: Property Address: 79930 FIESTA DR DAVID MILLER APN: 600060037 Application Description: DAVID MILLER / HVAC CHANGE OUT 92253 Property Zoning: Application Valuation: $8,200.00 Applicant: �� i 9 NIB pp '� ontrador: BURGESONS HEATING AND AIR CONDITIONING I - 'r, URGESONS HEATING AND AIR CONDITIONING I P 0 BOX 7310 REDLANDS, CA 92375 0310 Go�;.�SrS;jvOI 1��1r't`� �'U_,. �Eg-� R O BOX 7310 REDLANDS, CA 92375-0310 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, Cff43 License No.: 26 871 r IkJ Date: g lD 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).: ( ) 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 (909)793-3685 Llc. No.: 263871 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 f the w rk for which this permit is issued. I have and will maintain workers' compensation insurance, as required by . Sectio 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: _ Polity 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: CO _Applicant,=.k).-t�"R at,__ WARNING: FAILURE TO SECURE WORKERS' COMPEN TION 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. a., Date: J 0 v Signature•(ApplicantorAgen FINANCIAL •R • DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE BSAS 561473 FEE 101-0000-20306 0 $1.00 $1.00 3/18/16 PAID BY = METHOD RECEIPT # CHECK # CLTD BY BURGESONS HEATING AND AIR COND CHECK MR280 6393 RSE ,Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $72.52 3/18/16 PAID BY METHOD RECEIPT # ' CHECK # ;, CLTD BY- BURGESONS HEATING AND AIR COND CHECK MR280 6393 RSE DESCRIPTION ACCOUNT QTY. AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $36.26 3/18/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY BURGESONS HEATING AND AIR COND CHECK MR280 6393 RSE Total Paid for CHANGEOUT: $108.78 $108.78 DESCRIPTION ACCOUNTQTY AMOUNT PAID PAlD DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/18/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY BURGESONS HEATING AND AIR COND CHECK MR280 6393 RSE Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: Description: DAVID MILLER / HVAC CHANGE OUT Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 3/18/2016 RSE Approved: Parcel No: 600060037 Site Address: 79930 FIESTA DR LA QUINTA,CA 92253 Subdivision: TR 2180 Block:. Lot: 54 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $8,200.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0. BURGESONS HEATING AND AIR CONDITIONING 1 Details: HVAC CHANGE OUT-18.OSEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES CONDITIONS NAME TYPE NAME ADDRESSI CITY STATE ZIP ` PHONE FAX ,EMAIL APPLICANT BURGESONS HEATING AND AIR CONDITIONING 1 P O BOX 7310 REDLANDS CA 92375 - 0310 CONTRACTOR BURGESONS HEATING AND AIR CONDITIONING 1 P 0 BOX 7310 REDLANDS CA 92375 - 0310 OWNER DAVID MILLER 92253 FINANCIAL INFORMATION Printed: Friday, March 18, 2016 12:39:53 PM 1 of 2 SYSTEMS INSPECTIONS PARENT PROJECTS BOND INFORMATION Printed: Friday, March 18, 2016 12:39:53 PM 2 of 2 1r9?LJ L.J �.�s(lIJ' SYSTEIv1S CLTD DESCRIPTION ACCOUNT QTY . AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSA$ SB1473 FEE 101-0000-20306 0 $1.00 $1.00 3/18/16 MR280 6393 CHECK BURGESONS HEATING RSE AND AIR COND Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $72.52 $72.52 3/18/16 MR280 6393 CHECK BURGESONS HEATING .RSE SPLIT -SYSTEM AND AIR COND HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $36.26 3/18/16 MR280 6393 CHECK BURGESONS HEATING RSE SPLIT -SYSTEM PC AND AIR COND Total Paid for CHANGEOUT: $108.78 $108.78 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/18/16 MR280 6393 CHECK BURGESONS HEATING RSE AND AIR COND Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: INSPECTIONS PARENT PROJECTS BOND INFORMATION Printed: Friday, March 18, 2016 12:39:53 PM 2 of 2 1r9?LJ L.J �.�s(lIJ' SYSTEIv1S Bin # City of La Quinta 'Building 8i' Safety Division ` Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 OBuilding Permit Application and Tracking Sheet Project Address: —+qq3v f:71,esk-c, Owner's Name: cAv�c �.er A. P. Number. Address: Legal Description: City, ST, Zip: Contractor: lf� ur Telephone: Address: Zv mv,e SS e 2 Project Description: City, ST, Zipa:� l Telephone: I 0 I Z ` ZZZZ State Lic. # : 2(0 3 City Lie. #; S�gli Arch., Engr., Designer: Address: 10IL City., ST, Zip: Telephone: p k < . rte' X �y? { s, ', ... fir.. yx Construction Type N vj Occupancy State Lic. #: > r Project type (circle one): New Add'n Altei Repair Demo Name of Contact Person: uQ� ,. Si,,Sq. Ft.: #Stories: # Units: Telephone #,of Contact Person: pcj 3Z,Z - 3 3 S Estimated Value of Project: g12—CTL-) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIONG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit Truss Coles. 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 corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Pians resubmitted Grading IN I10USE:- s^' Reylew, ready for correctlonsAssue Developer Impact Fee Piarming Appr9xA:1_ _Called C.ontact.1erson Pub. Wks. Appr Date of permit issue Scho61 Fees �. ) Total Permit Fees 620 Tennessee Street • Redlands, CA 92374 _ (909) 793-3685 • Fax (909) 792-2149 HEAT/NG & AIR CONDITIONING. /NC. www.burgesons.com • info@burgesons.com -*4m e• w'A 66 Lk. 259671 Sh- 1949 March 171h, 2016 I, Dianne A:Burgeson, President/CEO of Burgeson's Heating & Air Conditioning, Inc., do authorize Kathryn R. Cochran, personal assistant and employee of Burgeson's Heating & Air Conditioning, Inc. to sign as an authorized agent on any city or county permit forms and CF -IR -ALT -HVAC forms as required for the Building and Safety Departments in all cities within San Bernardino, Riverside and Los Angeles counties. 620 Tennessee St. Burgeson's Heating & Air Conditioning, Inc. Redlands, Ca 92374 CA Lic.# 263871 LENNOX CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: MILLER I Date Prepared: CF1R-ALT-02-E (Page 1 of 3 ) 2016-03-16 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 CF1R-ALT-02 document for each dwelling unit. 01 Project Name MILLER 02 Date Prepared 2016-03-16 03 Project Location 79930 FIESTA DR 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name HOUSE 07 Zip Code 92253 08 Dwelling Unit Conditioned 1828 No No No Altered space conditioning system Floor Area (ft2) Number of space conditioning 09 Climate Zone 15 10 (SC) systems in this dwelling 1 unit. B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 SC System Identification or Name SC System Location or Area y Sery eMd CFA served d by this SC+� RSy`stemu(ft2) r 'Is the SC system a ducted system? Installing a refrigerant containing component?— Installing new SC system components? r� Installing more�than 40 -feet ofducts? Installing entirely new duct system? Installing entirely new SC system? Alteration Type System 1HOU_SE.,„1828� - Yes - Yes., �, � Yes, No No No Altered space conditioning system U.a7, CI 11=f 114Y rICILCI� IA IVU 142LIVll 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: 316-A1021818A-000000000-0000 Registration Date/Time: 2016-03-16 09:23:15 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-16 09:24:54 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)lE and F) , O1 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 Components Type Value System Type Components Type Value Type Duct Length R -Value Central gas All new Central split All new Greater than System 1 furnace heating AFUE .78 AC cooling SEER 14 Setback 40 feet R-8 components components Required Documentation: CF2R-MCH-01-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: 515%, 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 2 300 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. Registration Number: 316-A1021818A-000000000-0000 Registration Date/Time: 2016-03-16 09:23:15 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-16 09:24:54 Schema Version: 0.555SDD 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: Kevin Burgeson �� , /117 Documentation Author Signature: y Signature Date: Company: Burgeson's Heating and Air Conditioning, Inc. 2016-03-16 Address: CEA/ HERS Certification Identification (if applicable): 620 Tennessee St 263871 City/State/Zip: Phone: Redlands CA 92374 909-793-3685 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 Cerfi Compliance-shall•be,mad`e available'with'the,building permit(s)iissu�for the building, and made available to the enforcement agency for all applicable inspectioluunderstand thak t a,!regist red,eopy of 4_zi tCertificat-erof-Compliance;is required to be -included with the docu� mentation the builder provides to the building owner at occupancy. Responsible Designer Name:r Kevin Burgeson Respo sible Desig'Me'rig a ure: „� `v�JD/V Company :1 ` D' YeSigned: r Burgeson's Heatingtiand AirConditioning, Inc: - 2016103-16 Address:U.S.t 620 Tennessee St SEnergy Ra License: A W3367Asso cation City/State/Zip: Phone: Redlands CA 92374 909-793-3685 TM "This digital signatureis provided in order to secure the content of this registered document, and in no allay implies Registration Provider responsibility for U.S. Enemy Raters Association the accuracy of the informaiion." Registration Number: 316-A1021818A-000000000-0000 Registration Date/Time: 2016-03-16 09:23:15 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-16 09:24:54 Schema Version: 0.555SDD "� �S-44S Cj�Tj� �6 'LA-�;,�a gzes3 0