BMCH2014-1039T� 4
-----------------------------------------------------------
I CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 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, C38 License No.: 967982 of the for which this permit is issued.
ve and will maintain workers' compensation insurance, as required by
Date: - Contractor: 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:
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 t abor 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: 7 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
(_) 1, 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
compensation, 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
(_) 1, 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.
78 495 CALLE TAMPICO VOICE (760) 777-7125
LA gUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/7/2014
Application Number: BMCH2O14-1039 Owner:
Property Address: 80416 PEBBLE BEACH UNIT B83 MARYLS ALLEN P�V—
APN: 77513104480416 PEBBLE BEACHApplication Description: CHAGE OUT COMPRESSORLA QUINTA, CA 92253Propert
(760)343-1002
Llc. No.: 967982
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
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•
mentionK property for inspection purposes.
Date: f Signature (Applicant or Agentf�o
y Zoning:cl
Application Valuation: $80.00
Applicant:Contractor:
BEST IN THE WEST AIR CONDITIONBEST
IN THE WEST AIR CON255
N ELCIELO ROAD #140125255
N ELCIELO ROAD #140 -PALM
SPRINGS, CA 92262PALM
SPRINGS, CA 92262
(760)343-1002
Llc. No.: 967982
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
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•
mentionK property for inspection purposes.
Date: f Signature (Applicant or Agentf�o
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 forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION -
ACCOUNT
CITY'
AMOUNT
PAID ` `
PAID DATE
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
$35.75
$0.00
PAID BY`'
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION `' ` _ ' -
ACCOUNT,,r,
=QTY
AMOUNT
PAID.
PAID DATE
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0'.
$23.83
$0.00
J. - `.PAID BY ' • .
"' ' ` METHOD a = `
:: ;RECEIPT # '
CHECK # " _
"CLTD BY
Total Paid forCHANGEOUT: $59.58 $0.00
DESCRIPTION'• ,.
ACCOUNT - .=
QTY'
AMOUNT
=. _PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
" 'PAID BY
METH D. '
RECEIPT #
CHECK #-
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:• •-
Description: CHAGE OUT COMPRESSOR
Type: MECHANICAL Subtype: Status: ISSUED
Applied: 8/7/2014 SKH
Approved:
Parcel No: 775131044 Site Address: 80416 PEBBLE BEACH UNIT B83 LA QUINTA,CA 92253
Subdivision: TR 20717-2 SEE ASSR MB 769 PGS 3134 Block: Lot: 35
Issued:
3536
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $80.00, Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
� ' ADDRESSI1
Details: HVAC CHANGE OUT- 13SEER COMPRESSOR [2008 ENERGY] CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES. - ,
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE ,.
L ` - NAME r
� ' ADDRESSI1
. • � CITY '"
STATE
ZIP
PHONE, "
FAX
� EMAIL x'
APPLICANT
BEST IN THE WEST AIR CONDITION
255 N ELCIELO ROAD
#140-125
PALM SPRINGS
CA
92262
(760)564-7030
CONTRACTOR
BEST IN THE WEST AIR CONDITION
_
255 N ELCIELO ROAD
#140-125
PALM SPRINGS
CA
92262
(760)564-7030
OWNER
MARYLS ALLEN
80416 PEBBLE BEACH
LA QUINTA
CA
92253
(760)564-7030
Printed: Thursday, August 07, 2014 8:40:01 AM 1 of 2 CR .
SYSTEMS
~
-
CLTD
` DESCRIPTION
•- ACCOUNT
QTY
- AMOUNT
PAID
PAID DATE
RECEIPT,#
CHECK #
METHOD
PAID BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$35.75
$0.00
CONDENSER ONLY
HVAC CHANGEOUT -
101-0000-42600
0
$23.83
$0.00
CONDENSER ONLY PC
Total Paid forCHANGEOUT: $59.58 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00"
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
INSPECTIONS
SEQID •' "INSPECTION TYPE INSPECTOR, SCHEDULED :COMPLETED
RESULT, „REMARKS . NOTES
DATE DATE
MECHANICAL FINAL"
ATTACHMENTS
Printed: Thursday, August 07, 2014 8:40:01 AM 2 of 2
B?SY57EM5
-'2_5 � 4-
Bin #
City of La Quinta-z..-
-Building &r Safety 'Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:' o 41
&Cicil
Owner's Name: jft!t
A. P. Number:
Address: 50 q-1 (a RalZP 65?--cA
R64 we
Legal Description:
City, ST, Zip: Ila
Contractor:Telephone:
Z�;4-f�i- 7030-
Address: -
2,6,e7i 'Al. et? c
,
el, PNg 1/';�5
Project Descr iption: 74-
e—
City, ST, Zip: a Ion Sg15—ta
ou./c/oor- V kv Y!5 efe fe,550,1"
Telephone:
716a -3 4t3 _/ 0 dz
t
State Lic. # of6 7 q 5:-Z
Arch., Engr., Designer:
City Lie. #.-.
Address:
City., ST, Zip:
Telephone:
Construction type: Occupancy:
State Lic'e-11,
Projecttype (circle one): New Add'n pa'
Sq. Ft.: # Stories: # Units:
Demo
Name of �2k_ Contact Person:
. _. P
Telephone .4,of Contact Person: 76,15,1��-
t902:
Estimated Value of Project: Mroo-_
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Rec1d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount'
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance.
Title 24 CaIcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3rd Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE Z' ` ' CFiR-ALT 02-E-
Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) '.:' - a = ' r• �y�. _ )y ' .+ (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this^ Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: -
Documentation Author Signature:
Stewart, Wendy
Company:
Signature Date:
Best in the West Air Conditioning & Heating Inc -
2014-07-17 16:36:35
Address: _
CEA/ HERS Certification Identification (if applicable):
31225 Plantation Dr
City/State/Zip:
Phone:
Thousand Palms CA 92276
(760) 343-1002 _.
Responsible Person's Declaration statement
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. 1 am eligible under Division 3 of the Busine s and_Professions Code to acc pt-_respo�nsibility.for�the building.desiign oar system -design on this Certificate of Compliance (responsible designer). '
�id�entified
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. .:
• - . ,�'... ,rrYR-
4. The building design features or system design featu es identified on this. Certificate ofCompliance are consistent with the information provided,N othet applicable compliance documents, worksheets,
calculations, plans and specifications submitted.tothe enforcement, agency for approval with this bullding permit application
5. 1 will ensure that a registered copy of this Certificate of{amphance shall'be made available with the building.permit(s) issued for th_e building, and made available to the enforcement agency for all applicable
Inspections. I understand that a registered copy of this Certificate of Compllance is'required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: -
Responsible Designer Signature:
Stewart, Wendy:-
Company: . '
Date Signed:
Best in the West Air Conditioning &Heating Inc
2014-07-17 16:36:35 _
Address: ,
License:
31225 Plantation Dr
967982
City/State/Zip:
Phone:
Thousand Palms CA 92276 _
(760) 343-1002
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the
?.7 information.
Registration Number: 21440058037A-000000000-0000 - • • Registration Date/Time: 2014-07-1716:36:35 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance • ; ..• : _ Report Version: 2014-03-31
-Report Generated: 2014-07-17 16:36:42
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 4 )
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC)
This section does not apply to this project.
Registration Number: 214-A0058037A-000000000-0000
Registration Date/Time: 2014-07-17 16:36:35
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-07-17 16:36:42
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E?
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 4 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
.. _
01
02
03
04
05
06
07
08
09
30
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
This field or
1
furnace
component
section is not
section is not
AC
Compressor
SEER
13
Setback
section is not
R-8
altered
applicable
applicable
applicable
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Duds and Fans
-Duct insulation requirement for new plenums: R6.
CF211-MCH-20-H & CF311-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: 5 15%, or 5 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF311-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 requirecl.v. �r.�-
I
Exceptions:.'`,'r. ?
HERS from MCH Duct Leakagefestmg'requirements.
'
-Duct systems registered with provider as previously sealed are exempt -20
-Heating-only systems and Air Handler/Furnace' changes do not require verification of Air Flow MCH=23, or Refrigerant Charge MECH-25 '
~
H-
-Existing duct systems constructed, insulated or sealed with-aseestos.are exempt from MCH -20 Duct Leakage Testing requirements..
itF
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. ,
Registration Number: 214-A0058037A-000000000-0000 Registration Date/Time: 2014-07-17 16:36:35 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-07-17 16:36:42
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name: Marlys Allen Date Prepared: 2014-07-17
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 CHR -ALT 02 document for each dwelling unit.:
01
Project Name:
Marlys Allen
02
Date Prepared:
2014-07-17
03
Project Location:
80416.1 Pebble Beach
04
Building Type:
Single family
O5
CA City:
La Quinta
06
Dwelling Unit Name:
Marlys Allen
07
Zip Code:
92253
08
Dwelling Unit Conditioned
1600
Installing new
4 '
Is the entire
Floor Area (ft2):
Number of space conditioning
09
Climate Zone:
15
10
(SC) systems being altered in
1
(packaged unit, or
this dwelling unit.:
Are all of the
B. Space Conditioning (SC) System Information
01
02 }
03
' 04,
05
' 06 1
07
08/-
09
10
f/�
Installing new
4 '
Is the entire
components?
duct system
(packaged unit, or
accessible
Are all of the
condensing unit,
Installing
for sealing,
system's
Is the altered
Altering or
- or
more than 40
and is more
components
or installed
installing a
cooling/heating
linear feet of
than 75% of
and duds new
SC System
SC System
CFA served
system a
refrigerant
coil, or
new or
the duct
or replaced?
Identification or
Location or Area
by this SC
ducted
containing
air -handling unit,
replacement
system new
(entirely new
Name
Served
System (ft2)
system?
component?
etc)
duds?
or replaced?
system)
Alteration Type
1
Living Zone
1600
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: 214-A0058037A-000000000-0000 Registration Date/Time: 2014-07-17 16:36:35 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-07-17 16:36:42