BMCH2016-006578-495 CALLE TAMPICO Ct 0 D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0065 Owner:
Property Address: 54675 SOUTHERN HILLS RONNIE
APN: 775101068 54675S
Application Description: MARAVICH / HVAC CHANGE OUT LA QUIN
Property Zoning:
Application Valuation: $5,500.00
Applicant:
AIR QUALITY SPECIALIST, INC.
OUTSIDE CITY LIMITS
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 ProfessipKs5tode,
and my License is in full force and effect.
License Class: License No.::LIC-0111035
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
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
($500).:
( 11, as owner of the property, or my employees with wages as their sole
compensation,'will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
( ) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(� I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
.CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). -
Lender's Name
Lender's Address:
Cor
11111111111111111111
72
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/24/2016
IN. HIL Q
�2253A
MAR 2 4 2019
AIR QU ILITY SPECI`r fA QUINTA
OUTBID$��I'rllS'DEVElOPMENTDEPAarMEM
0
Llc. No.: :LIC -0111035
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 ubject to the
workers' compensation provisions of Section 3700 of the Labor e, I shall fo wi
comply with those provisions.
Date: Jh 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.
1 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 ofthis city to enter upon e
above-mentioned roperty for inspection purposes.
Date: C% Signature (Applicant or Agen
ap
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT:
QTY' AMOUNT.
PAID PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$1.00 3/24/16
PAID BY
METHOD
RECEIPT #
°:CHECK # CLTD BY
AIR QUALITY SPECIALIST, INC.
DEBIT
MR286
RSE
Total Paid for. BUILDING STANDARDS ADMINISTRATION BSA: $1.00. $1.00
DESCRIPTION
_ ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - PACKAGED UNIT
101-0000-42402
0
$36.26
$36.26
3/24/16
PAID BY
-METHOD
RECEIPT #
CHECK #
CLTD BY
AIR QUALITY SPECIALIST, INC.
DEBIT
MR286
RSE
DESCRIPTION
ACCOUNT.
QTY
- :' : AMOUNT,,
PAID
PAID DATE
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
0
$24.17
$24.17
3/24/16
PAID BY
METHOD
. RECEIPT.# ..
CHECK #
CLTD BY .
AIR QUALITY SPECIALIST, INC.
DEBIT
MR286
RSE
Total Paid for CHANGEOUT: $60.43 $60.43
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
3/24/16
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
AIR QUALITY SPECIALIST, INC.
DEBIT
MR286
RSE
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
• 1
Description: MARAVICH / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 3/24/2016 RSE
Approved:
Parcel No: 775101068 Site Address: 54675 SOUTHERN HILLS LA QUINTA,CA 92253
Subdivision: TR 22432-4 CM 75/098 Block: Lot: 3
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $5,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
BSAS SB1473 FEE 101-0000-20306 0
Details: HVAC CHANGE OUT - 16.5SEER/80AFUE PACKAGE UNIT [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO '
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Thursday, March 24, 2016 1:08:06 PM 1 of 2. V?
SYSTEMS
FINANCIAL
ADDITIONAL
DESCRIPTION ACCOUNT QTY
AMOUNT
PAID
CHRONOLOGY
CONDITIONS
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$1.00
CONTACTS
NAME TYPE
NAME
ADDRESSI CITY
STATE . ZIP PHONE FAX EMAIL
APPLICANT
AIR QUALITY SPECIALIST, INC.
OUTSIDE CITY LIMITS
(760)771-8358
CONTRACTOR
AIR QUALITY SPECIALIST, INC.
OUTSIDE CITY LIMITS
(760)771-8358
OWNER
RONNIE MARAVICH
54675 SOUTHERN HILLS LA QUINTA
CA 92253 (760)771-8358
Printed: Thursday, March 24, 2016 1:08:06 PM 1 of 2. V?
SYSTEMS
FINANCIAL
INFORMATION
DESCRIPTION ACCOUNT QTY
AMOUNT
PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
BY
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$1.00
3/24/16 MR286 DEBIT AIR QUALITY ASE
SPECIALIST, INC.
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
BSA:
Printed: Thursday, March 24, 2016 1:08:06 PM 1 of 2. V?
SYSTEMS
INSPECTIONS
BOND INFORMATION
ATTACHMENTS
Printed:. Thursday, March 24, 2016 1:08:06 PM 2 of 2 OF
SYSTEAAS
CLTD
DESCRIPTION
ACCOUNT '
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$36.26
3/24/16
MR286
DEBIT
'AIR QUALITY
RSE
PACKAGED UNIT
SPECIALIST, INC.
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$24.17
3/24/16
MR286
DEBIT
AIR QUALITY
RSE
PACKAGED UNIT PC
SPECIALIST, INC.
Total Paid for CHANGEOUT: $60.43 $60.43
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
3/24/16
MR286
DEBIT
AIR QUALITY
RSE
SPECIALIST, INC.
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
TOTALS:
INSPECTIONS
BOND INFORMATION
ATTACHMENTS
Printed:. Thursday, March 24, 2016 1:08:06 PM 2 of 2 OF
SYSTEAAS
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 )
Project Name: Ronnie Maravich Date Prepared: 2016-03-23
A. General Information
CF111-ALT-07 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
Ronnie Maravich
02
Date Prepared
2016-03-23
03
Project Location
54675 southern his
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Ronnie Maravich
07
Zip Code
92253
08
Dwelling Unit Conditioned
2598
)nstalling=nevi SC
Instai�ifig
Installing
Installing
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted
containing
Number of space conditioning
more than 40
09
Climate Zone
15
30
(SC) systems in this dwelling
2
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SC) System Information , `
��%= ._ Ir�
03
02
03
k 04.
05:xT"66r
4� +�
071 i
i OS f
09
10
X
:FIs the SC _
Installing a
SC System
SC System
CFA served
+`ystem al �
refrigerant
)nstalling=nevi SC
Instai�ifig
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
1300
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
1300
No
No
No
No
No
No
No alteration
performed
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 216-A0111554A-000000000-0000 Registration Date/Time: 2016-03-2314:46:12 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-23 14:46:00
Schema Version: 0.5555DD
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:
Smith, Michael .
Company:
Signature Date:
Michael Smith
2016-03-23 14:46:12
Address:
CEA/ HERS Certification Identification (if applicable):
975 Cypress Drive
City/State/Zip:
Phone:
San Jacinto CA 92583
714-476-0522
Responsible Person's Declaration statement
I certify the following under penaltyof perjury, under the laws of the State of Californla:
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 wlth the Information provided on other applicable compliance documents, worksheets,
i
calculations, plans and specifications submitted to the enforcement, agency for approval `with this building perrnit application. } f,'
+ I
-011. �+ ti t ,... r s s
S. I will ensure that a registered copy of this Certificate of Compliance' shall be;made:ayailable with the building permit(s),issued for,the'builcl& and,maIde ava11able.to the enforcement agency for all applicable
Inspections. I understand that a registered copy of this Certificate of Compliance,is,regyired to be Included with the docum,�ntation the builder provides to. the building owner at occupancy.
Responsible Designer Name: Y i
Responsible Designer signature: `V 'I
Smith, Michael
Company:
Date Signed:
Michael Smith
2016-03-23 14:46:12
Address:
License:
975 Cypress Drive
929419
City/State/Zip:
Phone:
San Jacinto CA 92583
714-476-0522
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: 216-A0111554A-000000000-0000 Registration Date/Time: 2016-03-23 14:46:12 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-23 14:46:00
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)
01
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
No heating
This field or
This field or
Central
All new
This field or
This field or
System 1
furnace
component
n is not
sectio
section is not
packaged
ackaed AC
cooling
SEER
13
Setback
section is not
section is not
altered
applicable
applicable
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF211-MCH-20-11 & 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: s 15%, or:s 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.
Exceotlons: '
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. � s
-Heating -only - `_'
systems and Air Handler/Furnace changes do not require verlfication`of Air Flow MCH 23, Refrigerant Charge NtECH 25.:
g y or ;"
-Existing duct systems constructed, Insulated or sealed with asbestos are exempt'from MCH Z6DWt ,Leakage Testingreguiremerits.
t
11 V1... {s [t 41 tt Jr . t.# 71 Ib ILA
E. Entirely New or Complete Replacement Duct System, with or Without, Equipment Changeout (Sections,150 2(b)lDiia-andr150.2(b)lE, F)
•at. l ---t 4r•'' r -+t '�,. 14•-•* � 4t t `L ..� t t # ,� � ,;,,,F
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 216-A0111554A-000000000.0000 Registration Date/Time: 2016-03-2314:46:12 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-23 14:46:00
Schema Version: 0.555SDD
Iain #
Permit #
Project Address: �j
City of La Quinta
Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Su ' h (5 ' Owner's Name:
A. P. Number:
Address: 57Y (o -7
15 -
Legal Description:
City, ST, Zip: (,� a2
Contractor: P4 aoc, f (2—
Telephone: '"7 &Q 77 (-193 W
Address: `(XXjNt,
S S'
Project Description:
City, ST, Zip
fi
ele h ne:
T o –
P %
O O
State Lic. # : ?
(
City Lie. #z
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
cu aneY
C truction Occupancy:
Type: :
State Lic
Project type citcle one): : Ne w Add'n Iter Repaira'u Demo
Name of Contact Person:
1' "\k lk s'm t �} (-�
Sq. Ft.:
# Stories:
# Units: /
Telephone # of Contact Person: (00— O
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Clieck Balance.
Title 24 Cates.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2",Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
3r! Reyieiv, 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