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BMCH2015-0419f 11111111111111111111 78-495 CALLE TAMPICO T D 4 Q94(40 VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/26/2015 Application Number: BMCH2O15-0419 Owner: Property Address: 57.785 SEMINOLE DR TYRONE TRBOVICH APN: 762380014 57785 SEMINOLE DR Application Description: TRBOVICH / HVAC CHANGEOUT LA QUINTA, CA 92253 Property Zoning: Application Valuation: $14,000.00 - Applicant: {I,� Il If l Ip Contractor: COMFORT AIR I��"„.5,� II i COMFORTAIR 0 OUTSIDE CITY LIMITS �_ ,., z”; j p 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)320-5800 Llc. No.: AEC343 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 Professio Code, and my License is in full force and effect. License Class: /Licens o.: AEC343 Date:� !� 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 C 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 hot 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 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 Na Lender's Add 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 a will maintain workers' compensation insurance, as required by Section f tSe Labor Code, for the performance of the work for which this permit is is a orkers' compensation insurance carrier and policy number are: Car ' r: 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 provisiogs. 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 pefson 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 upo the above-mentioned property for inspection purposes. - Date:- 'ature•(Applicant or Agent): DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT . , PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 10/26/15 PAID BYMETHOD ` " RECEIRT # CHECK # CLTD BY COMFORT AIR CHECK R10270 2185 SGU .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 10/26/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY - COMFORT AIR CHECK R10270 2185 SGU DESCRIPTION ACCOUNT ::' CITY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $36.26 10/26/15 PAID BY METHOD RECEIPT # CHECK # CLTD"BY COMFORT AIR CHECK R10270 2185 SGU Total Paid for CHANGEOUT: $108.78 $108.78 DESCRIPTION. ACCOUNT. CITY AMOUNT PAID -PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 10/26/15 PAID BY METHOD RECEIPT #CHECK # CLTD BY COMFORT AIR CHECK R10270 2185 SGU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS:• Description: TRBOVICH / HVAC CHANGEOUT Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 10/26/2015 SGU Parcel No: 762380014 Site Address: 57785 SEMINOLE DR LA QUINTA,CA 92253 Approved: Subdivision: TR 29147-2 Block: Lot: 55 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $14,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC CHANGE OUT - 25SEER/.78AFUE SPLIT SYSTEM [2013. ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. Printed: Monday, October 26, 2015 12:01:57 PM 1 of 2 cirmf MY Svs Trues ADDITIONAL 'CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT COMFORT AIR 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 (760)771-2734 CONTRACTOR COMFORT AIR 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 (760)771-2734 OWNER TYRONE TRBOVICH 57785 SEMINOLE DR LA QUINTA CA 92253 (760)771-2734 Printed: Monday, October 26, 2015 12:01:57 PM 1 of 2 cirmf MY Svs Trues BOND INFORMATION ATTACHMENTS Printed: Monday, October 26, 2015 12:01:57 PM 2 of 2 CYLY SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID.DATE RECEIPT # CHECK # METHOD PAID BY . . BY HVAC CHANGEOUT - 101-0000-42402 0 $72.52 $72.52 10/26/15 R10270 2185 CHECK COMFORT AIR 'SGU SPLIT -SYSTEM HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $36.26 10/26/15 R10270 2185 CHECK COMFORT AIR SGU SPLIT -SYSTEM PC Total Paid for CHANiSEOUT:' $108.78 $108.78 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 10/26/15 R10270 2185 CHECK COMFORT AIR SGU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: BOND INFORMATION ATTACHMENTS Printed: Monday, October 26, 2015 12:01:57 PM 2 of 2 CYLY SYSTEMS CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 ) Project Name: TRBOVICH, TY ( Date Prepared: 2015-10-23 A. General Information MR -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 TRBOVICH, TY 02 Date Prepared 2015-10-23 03 Project Location 57785 SEMINOLE DR 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name TRBOVICH, TY 07 Zip Code 92253 08 Dwelling Unit Conditioned 2501 �! ate09 Floor Area (ft2) SC System f SC System , . CFA served $ systema' +*'A . a�:. refr�geraMInstalling:new Number of space conditioning e . Installing mo 09 Climate Zone 1510 ��, �,.,� Identification or (SC) systems in this dwelling 1 ducted c Mainin g -- _. more than 4o unit. entirely new ' B. Space Conditioning (SC) System''Information f 01 02 f r`�,03% 04"�.. U5 F-66' t Q$ 10 f.. _07)) . -, 1' C ils the SC"""" "Insta.S.>; a+. lling ate09 SC System f SC System , . CFA served $ systema' +*'A . a�:. refr�geraMInstalling:new rem. SC e . Installing mo `Installing Installing e Identification or Location or Area b this SC y ducted c Mainin g s system more than 4o entirely new entirely new ' Name Served System (ft2) system? component? components? feet of ducts? dud system? SC system? Alteration Type Entirely new or 4 TON LENNOX Location 1 2501 No Yes Yes No No Yes complete replacement space conditioning system 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: 215-A6368768A-000000000-0000 Registration Date/Time: 2015-10-23 13:08:54 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-23 13:08:58 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)lE and F) This section does not apply to this project. 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) 01 02 03 04 05 06 07 08 09 30 11 ;t Heating Cooling System Heating Minimum Cooling Minimum Required Identification or Heating System Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct Name , Type`" Component --""Type„. Value System Type Component Type Value Type R -Value 4 TON LENNOX Central gas All new heating, .w s ,, r AFUE 0Central'split 0.78 ® All':new cooling IE € �., �; SEERC25 SetbackTher This field or section furnace /components LAC components mostat is not - ' applicable Reouired Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans" -Duct insulation requirement for new plenums: R6. CF2R & CF3R-MCH-20-H Duct Leakage Verification required. -Leakage rate compliance: 5 6%. - CF211 & CF3R-MCH-22 Fan Efficacy Verification CF211 & CF3R-MCH-23 System Air Flow Rate Verification -Compliance: Fan Efficacy15 0.58 W/cfm and System Airflow z 350 cfm/ton. - Alternative Compliance: CF2R & CF3R-MCH-28 Return Duct Design Verification is an alternative to MCH -22 and MCH -23 verification. CF2R & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). Exceptoonse Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements. ote: An "entirely new or replacement duct system" means 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) if the reused parts are accessible and can be sealed to prevent leakage Registration Number: 215-A6368768A-000000000-0000 Registration Date/Time: 2015-10-23 13:08:54 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-23 13:08:58 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: Documentation Author Signature: /� n y Volta, Paul (J� Company: Signature Date: VOTTA ENTERPRISES INC 2015-10-23 13:08:54 Address: CEA/ HERS Certification Identification (if applicable): 4803 E SUNNY DUNES ROAD City/State/Zip: Phone: PALM SPRINGS CA 92264 A 760-320-5800 Responsible Person's Declaration statement's 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. lam eligible under Division 3 of the, Business and ProfesiionsCo 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, mateiGls; c ponents, 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. R amt 4. The building design features or system tur te design feaes identified on this Certificate of Compliance are consistent` -with the information -provided on other;applicalile.`compliance documents, worksheets, calculations, plans and specifications submitted to -the enforcement agency forapproval with this building permit application. 5. I will ensure that a registered copy of this of,CCompliance shal(be made available with't_he bwlding permit(s),iss ed forkthe buildi^g, and,ma a available to the enforcement agency for all applicable ^Certificate inspections. I understand that a registered copy ofthiszCertifcate of Compliance tobe.included with thea ocume�n tion<the builder provides to�the building owner at occupancy. Responsible Designer Name:. «a.e �.: �. a . Responsible Designer Signature:8` I'/�j Volta, Paul Company: Date Signed: VOTTA ENTERPRISES INC 2015-10-23 13:08:54 Address: License: 4803 E SUNNY DUNES ROAD 763937 City/State/Zip: Phone: PALM SPRINGS CA 92264 760-320-5800 Digitally signed by CaICERTS This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6368768A-000000000-0000 Registration Date/Time: 2015-10-23 13:08:54 HERS Provider. CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-23 13:08:58 Schema Version: 0.555SDD Permit #A o�t 1 N` Project Adders: S City of" La Quinta Building 8t Safety DWon P.O Box 1504,78-49S Calle Tampico 14.Quinta, CA 92233 -:(760) 7774012 Building Permit Application and Tracking Sheet 1 Owner's Name: . A P. Number. Address: t ✓� ��-2 � i . C: -- 1 5 Legal Description: City, ST, Zip: Contractor. C Address: Ll tbS ," S u Telephone: /Zo %-1I - �13y Proje Description: ���� c . V\a n b - City, ST, Zip: q- Telephone: _ $01 22G • tet t7t� 111 I J.r State Lia # : City Lic, #; Arch, Engr., Uasignea Address: City., ST, Zip: Telephone: State Lic. #: Construction Type: , Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: C( V Sq. Ft -:,R50# Stories: # Unit*s: Telephone # of Contact Person: —760 o^s 16, 6-0 i Estimated Value of Project: pp APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Plan Sets Req'd Reed TRACMG Plan Check submitted PERM FEES Item Amount structural Cafes. Reviewed, ready for corrections Plan Cheek Deposit. . Truss Colo. Called Contact Person Plan Check Balance- alance_Tide Tide24 Calci6 Plans picked up Construction Hood plain plan Plans resubmitted.' • Mecharilcal Giadtag plan r! Review, ready for correctionei sue I Electrical Subeoatactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL ILO -A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review; ready for eorreetionslissue Developer Impact Fee Planning Approval. Called Contact Person Ad -P -P. Pub. Wks. Appr Date of permit issue School pees Total Permit Fees CERTIFICATE OF LBLIABILITYINSURANCE DATE (&%VOOIYYYYI7/15/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ` CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT B€1WEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the j certificate holder In lieu of such endorsement(s). PRODUCER Desert Cornerstone Insurance Service, Inc. CA License IrOF15709 81557 Dr. Carreon Blvd. Ste B8 Indio CA 92201 CONTACT Sanae Martin NAME: uc,No E,d. (760) 347-7723 FAC, No: (760)347 7725 DAEss•sane%desertcornerstoneins.com INSURER(S) AFFORDING COVERAGE MAIC* INSURER Rockhill Insurance Company 28053 INSURED Votta Enterprises, Inc. DBA: Comfort Air 4803 E. Sunny Dunes Rd _ Palm Springs CA 92264 INSURERS United Financial Casualty Co. INSURERC:State Compensation Ins. Fund 04028 INSURERD: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:201AWC2015GILAL REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO `WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR TYPE OFWSURANCE A POLICY NISASER POLICY EFF MM/OD 161M10D POLICY EXP LIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CtaIFdS tdUaGiE X❑ OCCUR DAMAREN I Ell PREIA SES Ea ocaurem a 50,000 F:IEDe: (Any one person) $ 5,000 X Y RCOLPGO1751-00 1/25/2015 1/25/2016 PERSORAL a ADV IH,_IRY a 1,000,000 OEtitA:GRE:ATELGrIITAPPLIES PER ac�i �LGi GENERAL AGGREGATE 5 2,000,000 2,000,000POLIC, $ C- HEP AUTOMOBILE LIABILITY C0141811415D 631GLELG.11 S- 1,000,000 Ea actidant BGDIL'r CIJURV (Par parson) $ B X AI•IY AUTO ALL 1-1V�IED SCHEDULED AUTOS AUTOS X 01698174-3 6/29/2015 6/29/2016 BODILY G•IJURY (P?r accident) $ X KION -0V IED HIREDAUTOS X AlrrQc PROP TY DAMA 15 Paracadarlt Undennsurd motonst 5 UMBRBLLA UAB OCCUR EACH O CCURP.E•!CE AC-GRE@ATE EXCESS UAB CIAIF15Ati,DE DED T RETEI•ITIOI•I S I $ C WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN AI•ri PROFRIETORIPAI7TI• ccRrr;EOJTIVE OFFICEPRAFJASER E)!!- a (Mandatory in NH) NIA 9063962-2014 9/1/2014 9/1/2015 PER G� H- % STATUTE E.L. EACH ACCIDEt•IT $ 1,000,000 E.L. DISEASE -EARAPLOY 1 000 000 Iters descrit- under DES'RIPTU)li GF OPERATIONS below E.L. DISEASE- POLICY LR.IIT T 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks SehodulR may be attached if more space Is required) Lowe's Companies Inc. and Lowe's Home Centers LLC are additionally insured as respects general liability per the attached. Primary wording applies per the attached. Waiver of subrogation applies as respects general liability per the attached. Lowe's Companies Inc. and Lowe's Home Centers LLC are additionally insured as respects commercial auto liability. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. .The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Locre's Companies, Inc. and any THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN and all subsidiaries ACCORDANCE WITH THE POLICY PROVISIONS. At.tn : vendor Insurance AUTHORIZED REPRESENTATIVE PO BOX 1111 N. Wilkesboro, NC 28656 [lett List/SAN ACORD 25 (2014101) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. .The ACORD name and logo are registered marks of ACORD