BMCH2016-006278-495 CALLE TAMPICO
I have and will maintain a certificate of consent to self -insure for workers'
LA QUINTA, CALIFORNIA 92253
Application Number:
BMCH2O16-0062
Property Address:
793115 TOM FAZIO
APN:
766041012
Application Description:
PLY / HVAC REPLACE
Property Zoning:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
Application Valuation:
$5,350.00
Applicant:
AIR EXPERTS AIR CONDITIONING & HEATING
84-160 MEADOWS LANE
COACHELLA, CA 92236
T4ht 4 XP Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
11111111111111111111
69
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/22/2016
Owner:
PLY TOM
79311 TOM FAZIO
LA QUINTA, CA 92253
Contractor:
AIR EXPERTS AIR CONDITIONING & HEATING
84-160 MEADOWS LANE
COACHELLA, CA 92236
(760)397-3438
LIC. No.: 1008665
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C20 License No.: 1008665
of the work for which this permit is issued.
Date: �ZZ� Contractor:
.SLI 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:
d
OWNER -BUILDER DECLARATION
Carrier:— Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of a Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
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
Date: —22. Applicant:
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compehsation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The. Contractors'
issued as a result of this. application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. . B.&P.C. for this reason
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.
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 Add
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 tot upon the
above-mentioned property for inspection purposes.
Date: -Z2' bi 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 - CONDENSER ONLY
101-0000-42402
0
$36.26
$0.00
-PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
tPAID DATE
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - FURNACE ONLY
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - FURNACE ONLY PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $120.86 $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:00
Description: PLY / HVAC REPLACE
CONDITIONS
Type: MECHANICAL
Subtype: Status: APPROVED
Applied: 3/22/2016 RSE
Approved: 3/22/2016 RSE
Parcel No: 766041012 Site Address: 79311 S TOM FAZIO LA QUINTA,CA 92253
Subdivision:
Block: Lot:
Issued:
J
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:.
Valuation: $5,350.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
FAX.
Details: HVAC CHANGE OUT - 14.OSEER/80AFUE CONDENZER AND COIL [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
AIR EXPERTS AIR CONDITIONING &
HEATING
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX.
EMAIL
APPLICANT
AIR EXPERTS AIR CONDITIONING &
HEATING
84-160 MEADOWS
LANE
COACHELLA
CA
92236
(630)795-9568
CONTRACTOR
AIR EXPERTS AIR CONDITIONING &
HEATING
84-160 MEADOWS
LANE
COACHELLA
CA
92236
(630)795-9568
.
OWNER
PLY TOM
79311 TOM FAZIO
I LA QUINTA
I CA
92253
1 (630)795-9568
Printed: Tuesday, March 22, 2016 12:21:27 PM 1 of 2
SYSTEiviS
INSPECTIONS
Printed: Tuesday, March 22, 2016 12:21:27 PM 2 of 2
srsrrMs
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
$36.26
$0.00
CONDENSER ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$24.17
$0.00
CONDENSER ONLY PC
HVAC CHANGEOUT -
101-0000-42402
0
$36.26
$0.00
FURNACE ONLY
HVAC CHANG.EOUT -
101-0000-42600
0..
$24.17
$0.00
FURNACE ONLY PC
Total Paid for CHANGEOUT: $120.86 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE:' $91.85 •$0.00
TOTAL$: $711,71 00
INSPECTIONS
Printed: Tuesday, March 22, 2016 12:21:27 PM 2 of 2
srsrrMs
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)3E 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 split
All new
This field or
This field or
System 1
furnace
component
section is not
section is not
AC
cooling
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
components
applicable
applicable
Reouired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
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: <_ 15%, 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 t 300 CFM/ton regwred when.MCH-25 is required.
Exceptions: � -�
-Duct systems registered with HERS provider as previously sealed are. exempt -from MCH -20 Duct Leakage. Testing requirements...
Air Handler/Furnace do of Air Flow MCH f23�r'ReffigeranfChaige EM requirements.,,,
-Heating-only systems and changes not require verification
3 ,' +H-20 1 * ° a 4 re P #
duct insulated MCH_2 Dint Testmg7egui0
��
P
Existing systems constructed, or sealed with -asbestos are exempt�from t' ' — nts.
�3 $ ci T f
f I -e Ile FP 9 IF #'+.' $F I& IN IN,
E. Entirely New or Complete Replacement Duct,System, with .or without,Equipment Changeout (Sections 150.2(b)1Diia;and 150.2(b)1E, F)
i 4 w4 it .1 1 4 1 0- 04
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC)
This section does not apply to this project.
Registration Number:-216-A0105680A-000000000-0000 Registration Date/Time: 2016-03-18 18:59:59 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-18 19:00:13
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Lira, Luis M
Company:
Signature Date:
Air Experts Air Conditioning
2016-03-18 18:59:59
Address:
CEA/ HERS Certification Identification (if applicable):
PO Box 94
City/State/Zip:
Phone:
La Quinta CA 92247 h
1760-777-1724
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the` laws of the State of California:
Ir IL
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3`of, he,Businessand Professions Code -to-accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
uilding design_or_system design identified on this Certificate of Compliance conform to the
3. That the energy features and perfor1rriance specifications, materials; components, and manufactured devices for the building.-
requirements of Title 24, Part 1 and Fart ,6 f theifor`nia Code ofd eg lat ons�� / f`^
4. The building design features or system design features'identified on this Certificate of Compliance are consistent with�the information -provided on other,appikabie'compliance documents, worksheets,
calculations, plans and specifications submitted,to the enforcement agency for approval with this building permit application. A�
r
.4 . � i•• -� ..:
5. 1 will ensure that a registered copy ofthis""Certificate of-Cyompliance shall be made.avaJable with the building:permit(s) issuetl forthe building, and:made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this.Certificate of Complyiance ,required to be included with thedocumentation�thetabuilder proves to -the building owner at occupancy.
Responsible Designer Name:.. +rW
Responsible Designer Signature:
Lira, Luis M
Company:
Date Signed:
Air Experts Air Conditioning
2016-03-18 18:59:59
Address:
License:
PO Box 94
1008665
City/State/Zip:
Phone:
La Quinta CA 92247
760-777-1724
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-AO10568OA-000000000-0000 Registration Date/Time: 2016-03-18 18:59:59 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-03-18 19:00:13
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
CF1R-ALT 02-E
(Page 1 of 3 )
IProject Name: Ply I Date Prepared: 2016-03-18 I
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 MR -ALT -02 document for each dwelling unit.
01
Project Name
Ply
02
Date Prepared
2016-03-18
03
Project Location
79-311 Tom Fazio Lane South
04
Building Type-
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Ply
07
Zip Code
9225308
♦
Dwelling Unit Conditioned
1610
Floor Area (ft2)
SCS stem
System
SCS stem
y
CFA served
t
,system a
' ' f
refrigerant
Number of space conditioning
,r
Installing
re
09
Climate Zone
15 F�\��
30
(SC) systems in this dwelling
1
ducted
'—
fE
than 40'
unit.
� entirely new
e�-0
B. Space Conditioning (SC) Systeminffformatn
Ol
02
�3 fig
y 506..11
07
08
iy
10
(f
t�
_09
♦
C"'"-Installi �
FIs the S
.n 4 s 4 # ,.'�. ng a
SCS stem
System
SCS stem
y
CFA served
t
,system a
' ' f
refrigerant
Installing new SC
,r
Installing
re
s
nlnsialling
Installing
Identification or
Location or Area
by this SC
ducted
containing x
system
than 40'
ent ely w
� entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
kitchen
1610
Yes
Yes
Yes
No
No
No
Altered 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: 216-A0105680A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-03-18 18:59:59
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2016-03-18 19:00:13
13in'##
Permit #t
City. of La Qulnta
building K Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's
A. P. Number:
Address:
Legal Description:
City, ST, Zip: l.�c ct1�►�t�.CA CA zzs3
Contractor;
Address: P1-1160 mof w tYS
Project Description: R-e— V_kCV_. Y\
City. ST, Zip- CO("o(�e
c-AC`2-Z_36
1
Telephone:"
Tele p 76o-,Y??-3(43q
,N
` '
v< � � r
:..mow".li.'a'. .u....•u..u�...i..
State Lic. # : - (a V A(�6,5
City Lie.:.
Arch., Engr., Designer:
Y
'
Address: -
City, ST, Zip:
Telephone:
p
>.: f•
'~>.,..:..., z:,::-a:r:mrc>
sy :
Construction Type: C Occupancy: V
State Lic. #:
Project type (circle one New Add'n Ite Repair Demo
Name of Contact Person: �S. ��
Sq. Ft.: \JG \ I
# Stones:
# Units:
Telephone # of Contact Persen:7G (3� 3q?--?4f
F,stimated Value of Proj=t 33S v O
APPLICANT: DO NOT WRITE BELOW THIS LINE -
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Flan Sets
Plan Check submitted ,
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
:
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontaclor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
ReYiew, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P,
Pub. Wks. Appr
Date. of permit issue
-Sch7oi Fees,Ej
Total Permit Fees