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BMCH2016-00134 78;495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&tr 4 4 4" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O16-0013 Property Address: 77222 CALLE FLORA APN: 658210020 Application Description: HOLLFELDER / HVAC CHANGEOUT Property Zoning: Application Valuation: $71,000.00 Applicant: AHP TESTING 74998 COUNTRY CLUB DR STE 220-420 PALM DESERT, CA 92260 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 License No.: 416394 Date: " Q6 & Contractor: z GCJ'1L 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 thv 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.). (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 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 11111111111111111111 16 . VOICE (760) 777-7125 Owner: THOMAS HOL 696 ARROW GR COVINA, CA 92253 Contractor: BREEZE AIR CONDITIONING INC 75-145 ST CHARLES PLACE PALM DESERT, CA 92211 (760)346-0855 Llc. No.: 416394 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 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: _ 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. pie: ( �CJ ! Applicant: F/Pi%e FOJ Sl J1 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 pefformed 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 rel.Vhg to building construction, and hereby authorize representatives of this city to e n the above-mentioned property for inspection purposes. die: (1/2 J % Signature (Applicant or Agent) FINANCIALINFORMATIO DESCRIPTIOON A ACCOUNTS QTY c AMOUNT PAIDPAIUDi4TE y .. BSAS SB1473 FEE 101-0000-20306 0 $3:00 $3.00 2/8/16 PAI D'BY MODu zDFMS M� ,R�PT�#CL^TDrBY AHP TESTING CHECK R12680 8886 MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $3.00 $3.00 DESCRIPTION ACCO NT QTY AMOU T M,PAID PAID DATE �4pry HVAC CHANGEOUT - FURNACE ONLY 101-0000-41402— 0 $72.52 $72.52 2/8/16 PAID BY No WE �M HOD WmREIP�� � =§, CH=ECK #" CLTD BY *sY Y, # ll •' x AHP TESTING CHECK R12680 8886 MFA, . DESCRIPTION :� ke ACCOUNT qs AMOUNT P>,AID ,PAID DATE-, ��,�� �. �, �Y„+,��,n�m:;�'�,� :� s � .�' :�N�x •>. .:�..�x HVAC CHANGEOUT -FURNACE ONLY PC 101-0000-4260.0 ' 0' $48.34 $48.34 2/8/16 M EERCIP#�CHM TDYD "N>�•ta.r;r4 ? x AHP TESTING CHECK R12680 8886 MFA L TDESC PTION "0', ACCO NT N I AMOUNT NOWT P.A D �PAIO DATE ...r• =.,,,A .. Yr. ir.{. "+...�::=�.,,, �n?i::fs Xu� {i ��+ ... ��Y'btx^x4r�n°�. xx�.. '. >.�4>1�� ivy5i w`r S�k„' �r'.� <,�UZM w HVAC CHANGEOUT - SPLIT-SYSTEM 101=0000-02402. 0 $217;56 $217.56 2/8/16 ” �PAID'BY� METHOD RECE PT# CHEC� CLTDuBY`'. ,sF..:. .Lem a s •: x��s AHP TESTING CHECK. R12680 8886 MFA - ' DESCRIPTION ' ,� k �F ACCOUNT'` TAY Q AMOUNT om ' ?P � '9 PAID`>DATE �.r.,a�'p.:wrra>.Us `X9§x,�' ..k, 5..110. HVAC CHANGEOUT - SPLIT-SYSTEM PC 101-0000-42600 0 $108.78 $108.78 2/8%16 PAID B K� HCEI#ic Y AHP TESTING CHECK 1112680 8886 MFA Total Paid.for,CHANGEOUT: $447.20 $447.20 ° ,ADESCRIPTION� ACCOUNT �yS�.. QTY AMOUNT PAID r PAID.DATE=, •Y"v2xrr".%&"+x7di...''+d.+E�,."$Ai'.r4ffi�Y✓rr'e{Wr..G:rP`3 .Mr.Ji*ersd'n zs` . `.S+NzSc'k5"nu ,E+Ygi'ri PERMIT ISSUANCE 101-0000-02404 0 .$91.85 $91:85 2/8/16 ` ''a ``,PAID E AAET O RCEIP # CHC , JCtT� Y BY AHP TESTING CHECK -1112680 8886 MFA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 • a z Cff`y OF'fNF'v Description: HOLLFELDER / HVAC CHANGEOUT Type: MECHANICAL Subtype: Status: ISSUED Applied: 2/8/2016 MFA Approved: 2/8/2016 MFA Parcel No: 658210020 Site Address: 77222 CALLE FLORA LA QUINTA,CA 92253 Subdivision: TR 21120 Block: Lot: 17 Issued: 2/8/2016 MFA Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $71,000.00 Occupancy Type: Construction Type: Expired: 8/6/2016 MFA No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: THREE (3) HVAC CHANGE OUTS - 13 SEER/.078 AFUE SPLIT SYSTEM (2) HEAT PUMPS [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 AHP TESTING 74998 COUNTRY CLUB DR STE 220-420 PALM DESERT. CA 92260 CONTRACTOR BREEZE AIR CONDITIONING INC 75-145 ST CHARLES PLACE PALM DESERT CA 92211 OWNER THOMAS HOLLFELDER 696 ARROW GRAND CIR COVINA CA 92253 Printed: Monday, February 08, 2016 10:11:23 AM 1 of 2 RSYSTEIvt S r" Permit Details PERMIT NUMBER City of La Quinta BMCH2O16-001�` INSPECTIONS PARENT PROJECTS Printed: Monday, February 08, 2016 10:11:23 AM 2 of 2 9?SVS7EMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $3.00 $3.00 2/8/16 R12680 8886 CHECK AHP TESTING MFA Total Paid for BUILDING STANDARDS ADMINISTRATION $3.00 $3.00 BSA: HVAC A - 101-0000-42402 0 $72.52 $72.52 2/8/16 R12680 8886 CHECK AHP TESTING MFA ONLY FURNNACEEONLY HVAC CHANGEOUT - 101-0000-42600 0 $48.34 $48.34 2/8/16 R12680 8886 CHECK AHP TESTING MFA FURNACE ONLY PC HVAC CHANGEOUT - 101-0000-42402 0 $217.56 $217.56 2/8/16 R12680 8886 CHECK AHP TESTING MFA SPLIT -SYSTEM HVAC CHANGEOUT - 101-0000-42600 0 $108.78 $108.78 2/8/16 R12680 8886 CHECK AHP TESTING MFA SPLIT -SYSTEM PC Total Paid for CHANGEOUT: $447.20 $447.20 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 2/8/16 R12680 8886 CHECK AHP TESTING MFA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS:• INSPECTIONS PARENT PROJECTS Printed: Monday, February 08, 2016 10:11:23 AM 2 of 2 9?SVS7EMS I I I I sinh, Qty* Of LQ Quinta Building &T Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit -Application'and Tracking Sheet Pennit # Project Address: AJ LP by[& -owner's Name:. M1461 A. P. Number. Address: Legal Description: City, ST, Zip: La Bluafi Telephone: latp Project Description: Contractor: Address: City, ST, Zip:"7) ffi Telephone: (�Jqllk -ovac, State Lir. #: 'All P'3 City Lic� 9, Arch., Engr., Designer. V� Pak ot i'm P,� Address: City, ST, Zip: Telephone: Construction Construction Type: Occupancy: 9"Lic. #: Project type (circle one): New Add'a. ter Repair Demo WsName of Contact Person: Sq. Ft.: 44 05 1# Stories: 0 Units: Telephone# cfContact Person: _1UQY0VCAU�zW Fztimated Value of Projectl APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Req1d 'Reeld TRACIMG PERMIT FEES Pfau Sets Plan Check submitted item Amount Structural Cafes. ready for Corrections Plan Check Deposit. Truss Cafes. -Reviewed, Called Contact Person Plan Check Balance Tide 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted . Mechafifw Grading plan 2'' R-icw,*rcady for correctionsrasue Electrical Subcontactor List Called Contact Person Plumbing Grout Deed Plans 01clud up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE-, Wylew, ready for correctionsfissuc Developer Impact Fee Planning Approval Called . Contact Person AJ.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees OB/26/2014 15:05 760-566-5966 BREEZE AIR PAGE 01 Aug 20 2094 10:03PM AHP Testing & Nsign 760-772-4656 page 1 FAIR COIMMMMMW NOITIONIFjO I C Palm Desert TOo •,1426.Osss FAX: T60os6 .y98S I, authorize, AHP TESTING (Robert Bachus, Alexandra Winner, and Humberto Torres) to take care of all our City Permit needs, including all submittal and paperwork associated with the process. Thank you. Phil Turner Comfort Advisor Breeze Air Conditioning (760) 409-2121 breezeair@dc.rr.com CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: 77222 Calle Flora I Date Prepared: CFIR-ALT 02-E (Page 1 of 4 ) 2016-02-03 A. General Information CHR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit. 01 Project Name 77222 Calle Flora 02 Date Prepared 2016-02=03 03 Project Location 77222 Calle Flora 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name 77222 Calle Flora 07 Zip Code 92253 08 Dwelling Unit Conditioned 4410 77 ikJt `ru Floor Area (ft2) SC System CFA se e Nsystem a refrige�ra�nt Installing,new�SC Number of space conditioning +Installing 09 Climate Zone 15 10 (SC) systems in this dwelling 5 containing system more than 40 entirely new unit. B. Space Conditioning (SC) System Information 10=* 01 02 03A 0A� '05 k� 1(U6J 07 � �� Q8 ) � 09 10 ti�� �Is the SC i ) -�+Y .l Install�ing a ,; , v...�nA:w( u, 77 ikJt `ru SC System SC System CFA se e Nsystem a refrige�ra�nt Installing,new�SC stallIVg 1 +Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 Location 1 882 Yes Yes Yes No No No Altered spaceconditioning system System 2 Location 2 882 Yes Yes Yes No No No Altered space � conditioning system System 3 Location 3 882 Yes Yes Yes No No No Altered space conditioning system System 4 Location 4 882 Yes Yes Yes No No No Altered space conditioning system. System 5 Location 5 882 Yes Yes Yes No No No Altered space conditioning system . Registration Number: 216-A0044185A-000000000-0000 Registration Date/Time 2016-02-03 10:45:22 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2016-02-03 10:44:55 CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 4 ) C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. D. Altered Space Conditioning System (Sections 150.2(b)lE and F) 01 02 03 04 05 06 07 08 09 10 it 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 Less than or System 1 furnace heating AFUE 0.78 AC cooling SEER 13 Setback equal to 40 R-8 components components feet Central gas All new Central split All new Less than or System 2 furnace heating AFUE 0.78 C cooling SEER 13 Setback equal to 40 R-8 components f y co�mpo.nents , *_�__,,. feet System 3 Central gas All new heating AF4UE 0.78 ( "4A ti f ; Ceritral,split + Wl,new� s cooling; C�. f �� gSEER 13 Setback Less than or equal to 40 R 8 furnace components AC r. components ' `� feet Central split All new "' {MCentspli All e '"` Less than or System 4 HP heating AFUE 0.78 HP cooling SEER 13 Setback equal to 40 R-8 components components feet Central split All new Central split All new Less than or System 5 HP heating AFUE 0.78 HP cooling SEER 13 Setback equal to 40 R-8 components components feet Reauired Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: RE. 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%, or 510% 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. Exce ons: -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: 216-A0044185A-000000000-0000 Registration Date/Time: 2016-02-03 10:45:22 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2016-02-03 10:44:55 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 4 ) E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F) 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-A0044185A-000000000-0000 Registration Date/Time: 2016-02-03 10:45:22 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residehti6l Compliance Report Version: 2013-1.006 Report Generated: 2016-02-03 10:44:55 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 4 of 4 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: White, Butch ���GGlY%�U�GGW Company: Signature Date: BREEZE AIR CONDITIONING INC 2016-02-03 10:45:22 Address: CEA[HERS Certification Identification (if applicable): 75-145 ST CHARLES PLACE City/State/Zip: Phone: PALM DESERT CA 92211 760-346-0855 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 ofR Regulations. f 4. The building design features or system design features identified on this Certificate of Compliance are consisteC1wi*tD1he informatfon.provided on of ' r applicable -compliance documents, worksheets, calculations, plans ands specifications submitted to the enforcemen agency fora proval with this buddin s ' p p g permit a hcation. ff mow. �-•R �i�f.h� 'i':l �L �`k �k � 5. 1 will ensure that a registered copy of this Certificate of�Cpmpliance shall;be.made,ayailable with the buljding permit(s),issued forithe;buil Ji g, and;made available,toYthe enforcement agency for all applicable inspections. I understand that a registered copy of this.Ceftlficate of Co npl anc,,is,requXre�d to be included with the ocumerfl ation�the�buil er prwov des��to�t�he/building owner at occupancy. Responsible Designer Name: . —, J Responsible Designer Signature: ILaf KV White, Butch Company: Date Signed: BREEZE AIR CONDITIONING INC 2016-02-03 10:45:22 Address: License: 75-145 ST CHARLES PLACE 416394 City/State/Zip: Phone: PALM DESERT CA 92211 760-346-0855 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, Registration Number: 216-A0044185A-000000000-0000 Registration Date/Time CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-.