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
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... ��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-.