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BMCH2017-0484LICENSED 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. C36 License No.: 1022645 .Dail 21 _1 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.). ( 11, 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 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 Lender's (760)863-0832 Llc. No.: 1022645 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. 9Z � 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: WESCO INSURANCE COMPANY Policy Number: WWC3295958 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:t1 2•t 17 Applicant:. L_ 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. Dates" 21 \i Signator— a (Applicant or Agent): 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 U VOICE (760) 777-7125 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/21/2017 Permit Type/Subtype: MECHANICAL/ Owner: Application Number: BMCH2O17-0484 _ DON BIGLER Property Address: qjbi 49805;ADELITO DR APN: 646240015 Q 49803 ADELITO CIR LA QUINTA, CA 92253 Application Description: - BIGLER RESIDENCE / HVAC Property Zoning: Application Valuation: $6,077.00 N�'� '9• `• Applicant: CIlY0FiA0WwNTA CANiPAUN1TYDEVELOPMENTDEPRRTMUOT Contractor: IE INC PREFERRED AIR CONDITIONING HEATING & PLU 31225 LA BAYA 45-311 GOLF CENTER PKWY STE A WESTLAKE VILLAGE, CA 91362 INDIO, CA 92201 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. C36 License No.: 1022645 .Dail 21 _1 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.). ( 11, 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 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 Lender's (760)863-0832 Llc. No.: 1022645 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. 9Z � 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: WESCO INSURANCE COMPANY Policy Number: WWC3295958 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:t1 2•t 17 Applicant:. L_ 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. Dates" 21 \i Signator— a (Applicant or Agent): Date: 11/21/2017 Application Number: BMCH2O17-0484 Owner: Property Address: 49805 ADELITO DR DON BIGLER APN: 646240015 49803 ADELITO CIR Application Description: BIGLER RESIDENCE / HVAC CHANGE OUT LA QUINTA, CA 92253 Property Zoning: Application Valuation: $6,077.00 Applicant: Contractor: IE INC PREFERRED AIR CONDITIONING HEATING & PLU 31225 LA BAYA 45-311 GOLF CENTER PKWY STE A WESTLAKE VILLAGE, CA 91362 INDIO, CA 92201 (760)863-0832 • --------------------=------------------------------------------------------------------------- LIc. No.: 1022645 Detail: HVAC CHANGE OUT - 16.5SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION. ACCOUNT CITY AMOUNT ' BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT CITY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $39.01 DESCRIPTION ACCOUNT CITY. -AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $78.02 Total Paid for CHANG=OUT: $117.03 DESCRIPTION ACCOUNT CITY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $98.83 Total Paid for PERMIT ISSUANCE: $98.83 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 ''✓ PLAN LOCATION Project Address: L)rq. $OJ C, e- Project Description: Pool, Remodel,.Add't, Elect, Plumb, Mech APN New SFD Construction: Address: tiS - 3})�� y` r �k" it A Conditioned Space SF Applicant Name: . aevgY, Garage SF Address: 31225 (-��y��e. ick: 2-%- t3City, Patio/Porch SF C ity,ST, Zip: Ue-A44e- V, a e �' A Ci 13(0z Fire Sprinklers SF Telephone: 81$'-735- X7.(0 tate Lic: City Bus Lic: Email: Valuation.of Project $ (9 0-1 7. CEJ Contractor Name: Construction Type: Occupancy: New SFD Construction: Address: tiS - 3})�� y` r �k" it A Conditioned Space SF City, St, Zip �..c� CA quo I Garage SF Telephone: -7(,0- Ric3- c�a--,,sZ Patio/Porch SF Email: Fire Sprinklers SF State Lic: • 1022-4.45 City Bus Lic: tate Lic: City Bus Lic: 4rch/Eng Name: Construction Type: Occupancy: Address: Grading: :ity, St, Zip ` telephone: Bedrooms: Stories: F#Units: :mail: tate Lic: City Bus Lic: s 'roperty Owner's Name: �h �r New Commercial /Tenant Improv events: address: ya $ 03 /��'� (ter- Total Building SF :ity, ST, Zip ( �� GD 92253 Construction Type: Occupancy: elephone: maii: 78495 CALLE TAMPICO LA QLIINTA, CA 92253 760-777-7000 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Pagel of 3) Project Name: DON BIGLER I Date Prepared: 2017-11-21 A. General Information CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. WhPn multirle rhe/Piling units must be documented, use one CFIR-ALT-02 document for each dwelling unit. 01 Project Name DON BIGLER 02 Date Prepared 2017-11-21 03 Project Location 49803 ADELITO CIRCLE 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name HOUSE 07 Zip Code ,; 92253 by this SC Dwelling Unit Conditioned 2257 system more than 40 (' X08 2 FloorArea(ft ) Name Served System (ft) T� component? components? feet of ducts? duct system? SC system? ' ( SYSTEM #1 Number of Space 2257 09 Climate Zone 15 10' Conditioning (SC) Systems in 1 Altered space this Dwelling Unit: B. Space Conditioning (SC) System Information / y" . 01 02 03 04 ` 0Sf 06 ' 07 08 09 10 SC System SC System CFA served Is the SC system a rtrl Installing,a, refrigerant V "Installing new SCS Installing Installing Installing Identification or Location or -Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft) system? component? components? feet of ducts? duct system? SC system? Alteration Type SYSTEM #1 WHOLE HOUSE 2257 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: 417-A020129754A-000-000-0000000-0000 Registration Date/Time: 2017-11-21 12:54:27 - HERS Provider: CHEERS CA Building Energy. Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-11-21 12:54:29 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-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)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 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 Reauired Documentation: CF2R-MCH-01-E - Space Conditioning Systems - Duct insulation requirement for the new portions of supply -air and return=air ducts or plenums R6 -(CZ 1 10, 12 ind�13) and R8 (CZ 11 and 14-16) CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are insta'IIA n.d'ucted systems, or when more than 40 ft of duct length is replaced -Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks. �— .}• j CF2R and CF311-MCH-25-11 Refrigerant Charge verification required when refrigerant containing components arerinstalled or altered (applicable In CZ 2, 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. Exceptions: Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. RlJJ : 31.... ?L_ )(."-)1 : irfi E. Entirely New or Complete Replacement Duct System; with or without Equipm9t....e ent Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F) M.�rrs�t�t7?�� '�E?rVt srv►'rF� l�txr��v' 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: 417-A020129754A-000-000-0000000-0000 Registration Date/Time: 2017-11-21 12:54:27 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-11-21 12:54:29 Schema Version: rev 10/16 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: Octovio Garza Dctvvto-Ga• Company: Signature Date: Preferred Air Conditioning Heating & Plumbing 2017-11-21 Address: CEA/HERS Certification Identification (if applicable): 40719 Fortunato Court City/State/Zip: :Phone: Indio CA 92203 f ' 760=863-0832 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. ff . 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 iresponsible 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 with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for -approval appwith this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall�bbe ma,de��roval:vailable with the building:permit(s)-sued for the building, 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 included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name:Responsible Ll3�t°r At hed t of Designer Signature: '�etbvto Gave. Lir Octovio Garza Company: Date Signed: Preferred Air Conditioning Heating & Plumbing 2017-11-21 Address: License: 40719 Fortunato Court 1022645 City/State/Zip: Phone: Indio CA 92203 760-863-0832 Digitally signed by CHEERS". 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 information. Registration Number: 417-A020129754A-000-000-0000000-0000 Registration Date/Time: 2017-11-21 12:54:27 HERS Provide r:•CHEEIRS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-11-21 12:54:29 Schema Version: rev 10/16