BMCH2015-038078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 Qu&Z
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0380
Property Address:
54667 TANGLEWOOD
APN:
775050003
Application Description:
TEIXEIRA / REPLACE 5 TON SPLIT SYSTEM ON GROUND
Property Zoning:
Application Valuation:
$8,985.00
Applicant:
DESERT AIR CONDITIONING
INC
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
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, C43 License No.: 2765861
J
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).:
(_) 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.).
(_) 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 N
Lender's Address:
51
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
STEVE TEIXEIRA
54667 TANGLEWOOD
LA QUINTA, CA 92253
Contractor:
DESERT AIR CONDITIONING 1
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
(760)323-3383
Llc. No.: 276586
Date: 10/6/2015
n
0
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 ork 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.
Date: v' `) Applicant:
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 laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: l �'Signature (Applicant or Agent):
FINANCIAL • 1.
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
CITY
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
CITY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $108.78 L. $0.00
DESCRIPTION
ACCOUNT
CITY
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
•TALS: $201.63 $0.00
Description: TEIXEIRA / REPLACE 5 TON SPLIT SYSTEM ON GROUND
ADDITIONAL D
Type: MECHANICAL Subtype:
Status: UNDER REVIEW
Applied: 10/6/2015 SGU
Approved:
Parcel No: 775050003 Site Address: 54667 TANGLEWOOD LA QUINTA,CA 92253
Subdivision: TR 21640 Block: 999
Lot: 9999
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $8,985.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: HVAC CHANGE OUT - 14SEER/8AFUE SPLIT SYSTEM [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
NAME
ADDRESSI
Printed: Tuesday, October 06, 2015 5:18:07 PM 1 of 2
RWYS TEMS
ADDITIONAL D
CHRONOLOGY
CONDITIONS
CONTACTS
NAMETYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS
CA
92264
(619)948-7917
CONTRACTOR
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS
CA
92264
(619)948-7917
OWNER
STEVE TEIXEIRA
54667 TANGLEWOOD
LA QUINTA
CA
92253
(619)948-7917
Printed: Tuesday, October 06, 2015 5:18:07 PM 1 of 2
RWYS TEMS
PARENT=PROJECTS
B 4
OND'INFORMATION
w�
Printed: Tuesday, October 06, 2015 5:18:07 PM 2 of 2
Ll 1..1 IJ 1..I SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
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
0 1
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
PARENT=PROJECTS
B 4
OND'INFORMATION
w�
Printed: Tuesday, October 06, 2015 5:18:07 PM 2 of 2
Ll 1..1 IJ 1..I SYSTEMS
REQUEST FOR PERMIT
5.90, Williams Rd:
Palin Springs; CA 922.64
760_323-3383,
760-3234983
City ity of La Quinta
Phone Number . 760-777-7050
Fax Number: 760-777-7011.
Date: 10/6/7015
Pages: 5
Re: Permit application — 54667 Tanglewood
Notes/ Comments:
Replace one 5 ton. split: system on. ground like. for
like.
Thank You.,
Ken- Skov
! Bin g Clay Q;Lel Qutnia
i
Btlfl&pg a Safety Divwon
Perirdt P.Q. Box 1504, 78-49S Calle Tampico
l.a.QWnta, CA 92253 - (760) 777-7012
ane, Building Permit Application and Tracking Sheet
Project Address: 54667 TANGLEWOOD Owner's Name:. STEVE TEIXEIRA.
t
A.P.Numbtr.. Address: SAME
I _
J,
i
Legal Description:
City, ST, Zap: LA QUINTA, CA 92253
Contractor. Desert Air Conditioning; Inca
Telophoae: 619-948.-7917
Address: 590 Williams Rd.
Proje4Description: Replace one 5 tons lits sten
City, ST, Zip: Palm Springs, CA 92264
ground like for like.
Telephone: 760-323-3383
j
I
State Lic. N : 276586
City Lis. #, 363
Ard , Engr., Designer. - N/A
Addren:
City. ST. zip:
Telephone.:
Statc Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alta Repair
1
i
'
F-
I
i
..
Name of Contact Person: Keri Skov
Sq. Ft.: d Stories:
#Units-,
Telephone p of Contact Person: 760-323-3383
Estimated Value of Project: $8,985.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
9
Submittal
Rt'd'
Reed
TRACKING PERMIT FEES-
Man Sets
Plan Check submitted
Itcon
structural Cates
RevitMved, ready for corrections
Pian Check Deposit
Trust Cake.
Called Contact Person
Plan Chests Balance
Title 24 plea.
Plane picked up
Construction
Flood plata plan
Plans resubmitted
Mechanical
Grading plan
r Review, ready for correctionsffssue
Electrical
Subeontaetor List
Called Contact Pemn
Plumbing
Gnat Deed
Plans picked up
S.M.L
H O.A. Approval
Plans resubmitted
Grading
IN UOUSBp- B.evtew, ready for correcdou7Jissuo Developer Impact Fee
Planning Approval Called Contact Person A.I.P.P.
1 Pub. Wks. Appr ' Date or permit ime
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
54667 TANGLEWOOD ) Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2015-10-06
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 CFSR-ALT-02 document for each dwelling unit.
01
Project Name
54667 TANGLEWOOD
02
Date Prepared
2015-10-06
03
Project Location
54667 TANGLEWOOD
04
Building Type
Siiigle.family
05
CA City
La Quinta
06
Dwelling Unit Name
54667 TANGLEWOOD
07
Zip Code
92253
OS
Dwelling Unit Conditioned
1620
Floor.Area (ft2)
SC System
SC System
CFA servedystem
a`
refrigerant
Number of space conditioning
Installwng
09.
Climate Zone
15
10
(SC) systems In this dwelling
'I -
ducted
containing
system
more than 40
unit.
entirely new.
S. Space Conditioning (SC) System Information
01
02
03
04 [t
05`
�Q6' {"-'�
; 071�t
ja 08 i
09
10
.
,r'
Is the SIC
'Instilling a
SC System
SC System
CFA servedystem
a`
refrigerant
[nstalling new S:C
Installwng
Installing
.Installinj;
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 systern?
SC system?
Alteration Type
System 1
location 1
2000
'Yes
Yes
Yes.
No
'No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)ZDiib)
This. section does not apply. to this project.
Registration Number: 215-A6348831A-000000000-0000
Registration Date/Time: 2015-10-06 11;23:03
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10.06 11:231:02
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFiR-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)1E and F)
OS
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
All new
Central split
All new
This field or.
This field or
System 1
furnace
heating
AF UE
0.6
AC
cooling,
SEER
14
Setback
section is not
section`is not
components
components
applicable
applicable
Required Documentation:
MR -MCH -01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF211-MCH-20-H & MR -MCH -20-H — Duct Leakage testing required when heating or cooling components are installed in ducted.syste.ms,
orwhen more than 40 ft of duct length is replaced.
-Leakage rate compiiance: s 15961 or 510%leakage to outside,.or seal all accessible leaks.
CF2R-MCH-25-H & COR -MCH -25-1-1 Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, g-15)..
CF211CF311-MCH-23 & CF3R-MCH-23 Air Flow a 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Dust systenis registered with HERS provider as.previously sealed are exemptfrom MCH -20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23 orRefrl `lit t iai•ge MECH•2� 5
y
Existing duct systems constructed, insulated or sealed with asbestos are exempti from MCH=20 Duct Leakage Testing requirements.
_
t 1 r s f f 1A. $S I f 11 1. 1,
E. Entirely New or Complete Replacement Dud System, with or without Equipment Changeout.(Sections,150.2(b)iDiia and.150.2(b)IE, 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 Plumber: 215-A6348831A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Oate/Time
Report Version: 2013-1.006
Schema Version: 0.555SDD
2015-10-0611:23:03 HERS Provider: CaICERTS
Report Generated: 2015-30-06 11:23:02
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:-.
Skov,- Keri
Company:
Signature Date:
Desert Air Conditioning Inc.
2015-10-06 11:23:03
Address:
CEA/ HERS Certification Identification (if.appiicable):
590 Williams Road
City/State/Zip:
Phone:
Palm Springs CA 92264
760-323-3383
Responsible Person's Declaration statement.
I certify the following under penaltyof perjury, under the laws of the State of California:
i. The information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3.ofthe 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 fol the building design or system design identified on this Certificate of Compliance. conform to the
requirements of Title z4, Part land part 6 of the California Code of Regulations.�}}
ri L€ a€ 91 ft �
4. The building design features orsystem design features Identified on this Certificateiof fonipliance are,consiste'nt with the information provided on othera.pp.licable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement�agency forapp;rovelwwi with this bullding permit application. 4
S. 1 will ensure that a registered copy of this Certificate of corimpliance shall be made,available with the building pe�mit(s) Issued forthetiuilding, and made available to,the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is.required to be.mcluded with the documentation the ;builder provides.to. the building.owner atoccupancy.
Responsible Designer Name: "` ! IE - ! N
Responsible Deslgnersignature:. V t�,�r ✓"' r f t
Skov, Keri
Company:
Date: Signed:
Desert Air Conditioning Inc.
2015-10-06 11:23:03
Address:
License:
590 Williams Road
276586
City/State/Lip:
Phone:
Palm Springs CA 92264
760-323-3383
Digitally signed by Ca10ERTS 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-A6348831A-000000000.0000 Registration Date/Time: 2015-10-06 11:23:03 HERS Provider: CaICERTS
CA Building Energy.Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-10-06 11:23:02
Schema Version:0.555SDD