BMCH2015-04474t!t 4 4 Qum& 22
78-495 CALLE TAMPICO VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
at 12/1/2015
Application Number: BMCH2O15-0447 Owner: Q 9I y
Property Address: 57065 MOUNTAIN VIEW JOHN KOTIS m � It
APN: 762350011 57065 MOUNTAIN VIEW o'� �=
Application Description: KOTIS / HVAC CHANGE OUT (2) 13 SEER/ 78AFU SPLIT SYSTEMS LA QUINTA, CA 92253 ° o
Property Zoning: `—_ r.1
C=
Application Valuation: $25,981.00
Applicant: Contractor:
DESERT AIR CONDITIONING INC DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD 590 WILLIAMS ROAD
PALM SPRINGS, CA 92264 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, 0431 License No.: 27658
Yate: ! '� / L tractor:
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.).
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.).
(_J 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
(760)323-3383
Llc. No.: 276586
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.
� 1 have and will maintain workers' compensation insurance, as required by
Section3700 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.
D / 4 " ` App�t:
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. • n n
Date: SiOEM
gnre (Applicant or Agent)
FINANCIAL •
DESCRIPTION _ ACCOUNT-,..
a.
QTY. ; AMOUNT
PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $2.00
$0.00
PAID BY METHOD
RECEIPT.#
CHECK # CLTD BY
Total'Paid for BUILDING STANDARDS ADMINISTRATION BSA:. $2.00 $0.00
DESCRIPTION
ACCOUNT.
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT.
QTY.
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT # -
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $217.56 $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:a 00
Description: KOTIS / HVAC CHANGE OUT (2) 13 SEER/ 78AFU SPLIT SYSTEMS
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 12/1/2015 SGU
Approved: 12/1/2015 SGU
Parcel No: 762350011 Site Address: 57065 MOUNTAIN VIEW LA QUINTA,CA 92253
Subdivision: TR 29147-2 Block: Lot: 22
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $25,981.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0. No. Unites: 0
Details: HVAC CHANGE OUTS - (2)13SEER/78AFUE.SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONUITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE ZIP
PHONE FAX
EMAIL
APPLICANT
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS
CA 92264
CONTRACTOR
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS
CA 92264
OWNER
JOHN KOTIS
57065 MOUNTAIN
VIEW
LA QUINTA
CA 92253
Printed: Tuesday, December 01, 2015 4:11:03 PM 1 of 2 C9?w
SYSTPrAS
DESCRIPTION
ACCOUNT.
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK # -]
METHOD
PAID BY
CLTD
BY
HVAC CHANGEOUT -
101-0000-42402
0
$145.04
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$72.52
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 0•
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Tuesday, December 01, 2015 4:11:03 PM 2 of 2 0r
SYSTEMS
12/01/2015 TUE 14:53 FAX 760 323 8983 Desert.Air Conditioning
0002/005
Girl #City
Of La QUifltd
Building 8i' Sarety Division
"i P.O. Box 1504, 78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012 —� cry `�► '"�"�l ` ` \\
Building Permit Application and Tracking Sheet
Permit #
BMC
Project Address:G
1 -_,,� •C:�'4.JN • < - „_ �' .
Owner's Nannc: , l- '-
A. P. Number:
Address: P:31 .O , .:J '�Ae V %Pi x'
Legal Description:
City, ST, Zip`_._ r ! r. -✓L--
Contractor: Desert Air Conditioning, Inc.
'lblephonc: .�i�i-
Address: 590 Williams Rd.
Project Deseriptioi - '\ X
City, ST, Lip: Palm Springs, CA 92264
Telephone: 760-323-3383
„,NP"C
U. NC -
State Lic. #: 276586
City Lic. iE; 363
<..-•
Areh., Lrngr., Designer: N/A
Address:
City, ST, zip:
Telephone:
State Lic. #:
a r`�1� `�<
u �`
. � s '" -f
'1�:.:,�t;�
ConstructionType:. Occupancy:
Pro -e t i e ne . New Add'n Ale lie air Dem
j c type (circle one),. e Alter p o
Name of Contact Person: Keri Skov
Sq. Ft.��:~ r
#Stories:
#'Units:
Telephone # of Contact Person: 760-323-3383
Estimated Value of Project: �c
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates,
Called Contact Person
Plan Check Balance
Title 24 Cates,
Plans picked up
Construction
Flood plain plan
Plans resubmit(ed .
Mechanical
Grading plan
2" Review, ready for correclions/issue
Electrical
Subcontactor List
Called ContactPerson
Plumbing
Grant Deed
Plans picked up
S.ALI.
MOA. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for correctionsAssue
Developer Irupact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
I Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name:
57065 MOUNTAIN VIEW I Date Prepared:
2015-12-01
A. General Information
CF1R-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
57065 MOUNTAIN VIEW
02
Date Prepared
2015-12-01
03
Project Location
57065 MOUNTAIN VIEW
04
Building Type
Single family
OS
CA City
La Quinta
06
Dwelling Unit Name
57065 MOUNTAIN VIEW
07
Zip Code
92253
08
Dwelling Unit Conditioned
2501
Installing
Installing
,Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
i5
10
(SC) systems in this dwelling
2
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information '
01
02
03
04 >:.
06 %::
07 ° `:
0$
09
10
Is the SC
Installing a
SC System
SC System
CFA served
".system a
refrigerant
Anstalling flew SC
Installing
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
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
1200
Yes
Yes
•Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A6411549A-000000000-0000
- Registration Date/Time: 2015-12-01 12:20:48
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-01 12:20:47
Schema Version: O.SSSSDD
ru
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)1E 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
all new.
—
Central split
All new
This field or
This field or
System 1
;ornate
heating
AFUE
0.78
AC
cooling
SEER
13
Setback
section is not
section is not
components
components
applicable
applicable
All new
All new
This field or
This field or
System 2
Central gas
heating
AFUE
0.78
Central split
cooling
SEER
13
Setback
section is not
section is not
furnace
components
AC
components
applicable
applicable
Recuired Documentation:
U2R :MCH -0_-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & C=3R-MCS-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: 5 1551., or S 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-2S-FI & CF3R-MAC:-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 _> 300 CFM/ton required when MCH -25 is required. ;
_xceoti^ns:
-Duct systems registered with HERS provider as previously sealed, are exempt from MCH-20.Dua Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, 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: 215-A6411549A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-12-01 12:20:48
Report Version: 2013-1.006
Schema Version: 0.5S5SDD
HERS Provider: CalCERTS
Report Generated: 2015-12-01 12:20:47
CERTIFICATE OF COMPLIANCE CFIR-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 Acs.::^.er Name:
Documentation Author Signature:
Trefun, Michael
rc tae Ye LUt
Co npary:
Signature Date:
Desert Air Conditioning Inc.
2015-12-01 12:20:48
Address:
CEA/.HERS Certification Identification (if applicable):
590 Williams Road
Phone:
Palm Springs CA 92264
760-323-3383
Responsible Person's Declaration statement
I cer•.ify the following under penalty or perjury, under the laws of the State of California:
_. 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 orp system designidentified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of fhe California Code of Regulations.
4. The building design features or system design features identified on this Certificzte:of Compliance are consistent with the information provided on`other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for;approval with this building permit application.
5. I wi!I ensure that a registered copy of this Certificate: of.Compliance shall be made'avail.: with the building permits) issued for the building, and made available to theenforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the.documentation,the.buitder provides to.the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature: / � �
Trefun, Michael
C/(,icftae✓re [[n
Company :
Date Signed:
Desert Air Conditioning Inc.
2015-12-01 12:20:48
Address:
License:
590 Williams Road
276586
City/State/Zip:
Phone:
Palm Springs -CA 92264
760-323-3383
Digitally signed by Ca10ERTS. rids 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-A6411549A-000000000-0000 Registration Date/Time: 2015-12-01 12:20:48 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-01 12:20:47
Schema Version: 0.555SDD