BMCH2015-039078-49.5 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tjht 4 4� Qumro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/12/2015
Application Number:
BMCH2O15-0390
Owner:
Property Address:
51933 AVENIDA NAVARRO
JOHN PROUT
APN:
773183025
51933 AVENIDA NAVAR
Application Description:
PROUT / 14SEER/80AFUE SPLIT SYSTEM
LA QUINTA, CA 92253
Property Zoning:
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Application Valuation:
$5,000.00
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Applicant:
Contractor:
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PERFECT AIR
PERFECT AIR t—
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P O BOX 8056
P O BOX 8056 U
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MORENO VALLEY, CA 92552
MORENO VALLEY, CA 9 552 C:
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(951)442-4825
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 usiness and Professions Code,
and my License is in full force and effect.
License Class: C20 License No.: 972661
Date: /10-�10'IS- 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, 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 contractorls) licensed pursuant to
the Contractors' State License Law.).
(� I am exempt under Sec. . B.&P.C. for this reason
I
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
Llc. No.: 972661
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 Ae yvork for which this permit is issued.
=-Y 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 37 of the Labor Code, I shall forthwith
comply with those provisions.
Date:®—%�-7'S Applica
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 I ws relating to building
construction, and.hereby authorize representatives of this city t ntec-U on the
above-mentioned property for inspection purposes. Ir
Date:. IVIS Signature (Applicant or Agent
FINANCIAL INFORMATION
DESCRIPTION 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 CHANGEOLIT - 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:0•
Description: PROUT / 14SEER/80AFUE SPLIT SYSTEM
CONDITIONS
Type: MECHANICAL Subtype:
Status: UNDER REVIEW
Applied: 10/12/2015 SKH
Approved: 10/12/2015 SKH
Parcel No: 773183025 Site Address: 51933 AVENIDA NAVARRO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 120
Lot: 9
Issued:
NO 12
NAME
ADDRESSI
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $5,000.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
MORENO CA
VALLEY
Details: HVAC CHANGE OUT-14SEER/80AFUE SPLIT SYSTEM [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
,_g Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
PERFECT AIR
P 0 BOX 8056
MORENO CA
VALLEY
92552
CONTRACTOR
PERFECT AIR
P 0 BOX 8056
MORENO CA
VALLEY
92552
OWNER
JOHN PROUT
51933 AVENIDA
NAVARRO
LA QUINTA CA
92253
Printed: Monday, October 12, 2015 10:29:01 AM 1 of 2
.� /7SYSTEti1S
Printed: Monday, October 12, 2015 10:29:01 AM 2 of 2 r .
SYS7Eti1S
-#
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
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 00
Printed: Monday, October 12, 2015 10:29:01 AM 2 of 2 r .
SYS7Eti1S
Bin
Permit
Project Address:vc�r
Qty of. La Quinta
Building &• Safety Division
ox Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:
Address:.J
�" No
Legal Description:
City, ST, Zip; LQ4mq e
Contra Gt or.
t
Te h o e:
le P 1
Address:o,5/
Project Description: VA
city, ST, Zi rPJ10
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State Lic. # :
City Lie. #:cold,
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Arch., Engr., Designer:
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Address:
City, ST, Zip:
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ne:
Tele hone:
Construction YP Occupancy:ancY
to
Ste Lic.X.
Project type (circle one): Add'n Repair Demo
Name of Contact Person:
Sq. Ft.: )D(00 # Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 57CX=K3
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
2"' Review, ready for correctionsrissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
I-I.O.A. Approval
Plans resubmitted
Grading '
IN HOUSE:-
Review, 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
STATE OF CALIFORNIA r
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 I
-" CALIFORNIA ENERGY EG`��i1MISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04 E
Alterations-,IiVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) CLIMATE ZONE 10 (Page 1 of 1)
Site Address:
Enforcement Agency:
Date Prepared:
Permit#:
3 idC4 10C4 rM UCC, .
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
floor Area (sq ft)
❑ Packaged System
XEvaporitor Coil
AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
❑ Setback
'Split System
_OCondensing Unit
❑ R-8' (CZ 11, 14, 15) Ducting
2000 -sgft
(if not olreody
❑ Mini Split
❑ Compressor
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
JJ Furnace
0 Uneset
EER
❑ R-5 or R7.5) Uneset'
be installed) .
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.
❑ 1. 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-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS:
Compressor, TXV, Uneset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS=
Air Handler/Furnace= (Can include new ducting)
Installer Requirement: Duct leakage (:S.15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. 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. Ducts'
CF111-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-2S-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CF111-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow t 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 CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Uneset, Furnace2 CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 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 I Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3-,., I CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (515% or,, -:S.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 handier, 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-2'/.", 3.5 to 4T-2/.", 5T -4y."
Contractor (Documentation Author's /Responsible Designer's Declaration Statement) "
1 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, orksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit applicati
Responsible Designer Name:
Responsible Desig r Signature:
Date Signed:
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license:
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Address:Ci
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tate/Zip:
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Phone:
19s, 30_1 3 o b -
W, doors.
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For assistance or questions regarding the Energy.5 ndards, contact the Energy Hotline at: 1-800-772-3300
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