BMCH2017-027278-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
`%
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O17-0272
Property Address:
54430 AVENIDA ALVARADO
APN:
774241009
Application Description:
DIAZ / HVAC CHANGE OUT
- 14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$4,229.00
A
D
Applicant:
JOHN BORDEN HEATING
AND AIR CONDITIONING
P 0 BOX 459
JUN 3 0 2017
YUCAIPA, CA 92399
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/29/2017
Owner:
DIAZ, ADRIAN & AMY
54430 AVENIDA ALVARADO
LA QUINTA, CA 92253
Contractor:
JOHN BORDEN HEATING AND AIR CONDITIONING
P 0 BOX 459
YUCAIPA, CA 92399
CITY OF LA QUINTA (951)797-5669
DESIGN AND DEVELOPMENT DEPARTMENT Lic. No.: 719570
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 License No.: 719570
<,Date: � 1 90 Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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).:
(1 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.).
(J 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. Q. . .
Lender's Na
Lender's Address:
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'
compensateri, as provided for by Section 3700 of the Labor Code, for the performance
of thewo 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031288
_ I certify that in the performance of the work for which this permit is issued, 1
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: 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 Ming
construction, and hereby. authorize representatives of this city to enter upon a ove-
mentioned property for inspection purposes.
Date: AA7ngnature (Applicant or Agent):
Date: 6/29/2017
Application Number: BMCH2017-0272 Owner:
Property Address: 54430 AVENIDA ALVARADO DIAZ, ADRIAN & AMY
APN:774241009 54430 AVENIDA ALVARADO e
Application Description: DIAZ / HVAC CHANGE OUT 14SEER/80AFUE SPLIT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $4,229.00
Applicant:
Contractor:
JOHN BORDEN HEATING AND AIR CONDITIONING
JOHN BORDEN HEATING AND AIR CONDITIONING
P 0 BOX 459
P 0 BOX 459
YUCAIPA, CA 92399
YUCAIPA, CA 92399
.(951)797-5669
--------------------------------------------------------------------------------------------
Llc. No.': 719570
Detail: 14SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING
CODES.
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:. $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT- SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION.
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101=0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT.ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bln. #
City Of *La Q[Ii[1�
BtdW 9 8r Safety DhMon
Permit #
P.O. Box 1504,78-495 C211e Tampico
1a.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: S `7 Owner's Name:. 3
A. P. Number.
Address: S y
LO XV
Legal Description:
City, ST, Zip.
(
Contractor.
n• 1
g WriCI Telephone: 7
Address: I [ (S
U(4 Pmject Description:
City, ST, Zip:
Ot 7[ I
c� ?CLQ rl d ,
Telephone:
�a
'
�n
State Lic. #: —
City Lie'. fk- 7 �S
Arefi., Engr., Designer.
Address:
City, ST, zi .
Telephone:
ConstructionType:. V O�p�y;
to -•
Project type (Owe one Ne Add'n Alter Repair Demo
Sq. # Stories:
Univ:
Name of Contact Person:
n
Telephone # of Contact Person: Q—
=Sip Oq
Estimated Value of Pmjeck ,aa(?
APPLICANT; DO NOT WRITE
BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACENG
• PERMtF FEES
Plan Sets
Plan Check submitted
Item •
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit, .
'Russ Cala.
Caged Contact Person
Plan Check Balance -
Title 24 Coles.
•
Plans picked up
Construction '
Flood plain plan
Pians resubmitted '
Mechanical
Giading plan
2'! Review, ready for correctioWme
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
S bLL
H.O.A. Approval
Plans resubmitted
Grading
DV HOUSE-,
1i8 Review; ready for correc@onslissae
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
DIAZ, ADRIAN I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2017-05-15
A. General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF111-ALT-02 document for each dwelling unit.
01
Project Name
DIAZ, ADRIAN
02
Date Prepared
2017-05-15
03
Project Location
54430 AVENIDA ALVARADO
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
HOUSE
SC System
SC System
CFA served
system a
Dwelling Unit Conditioned
Installing new SC
07
Zip Code
92253
108
Floor Area (ft2)
1318
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
r
Number of Space
system? .
09
Climate Zone
15 --`
30'
Conditioning (SC) Systems in
1
SYSTEM
HOUSE
1318
f
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information r n__1I 1`771 I7- i iF�\ �c�`
01
02
03
04'\`
� U 05 L=
07
08
09
10
Is the SC
1LJA y
Installin
�e�r�k ci 5g.a,vi
;to,4 Ah Inzwi�ritN
SC System
SC System
CFA served
system a
refrigerant
Installing new 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
HOUSE
1318
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.21b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020093764A-000-000-0000000-0000 Registration Date/Time: 2017-05-15 15:12:24 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-15 15:12:24
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF111-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 split
All new
Central split
All new
Less than or
SYSTEM
HP
heating
AFUE
0.8
HP
cooling
SEER
14
Setback
equal to 40
R-8
components
components
feet
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 1-10,13 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test 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 <= 30% leakage to outside, or seal all accessible leaks.1 -" �_ `4 r
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed 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.
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 sectio d s not ap ly to th s 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-A020093764A-000-000-0000000-0000 Registration Date/Time: 2017-05-15 15:12:24 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-15 15:12:24
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:
Connie Goe
CcvwU&gael
Company:
Signature Date:
Russells Heating & Air Conditioning
2017-05-15
Address:
CEA/ HERS Certification Identification (if applicable):
33145 Yucaipa Boulevard
City/State/Zip:
Phone:
Yucaipa CA 92399 �R ` "
90_9 797-5669
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. � x
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 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 forapproval with this building permit application.
,,. I� _I. i �.
S. I will ensure that a registered copy of this Certificate of Compliance' shall be madeiavailableiwith the buildingp"ermit(s) issued for the building, and made available to the enforcement agency for all applicable
.1-11
inspections. I understand that a registered copy of this Certificate of ompliance is requiredto be included witt the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Unryfatched Ser+viot
Responsible Designer Signature:
;c, % N ;,i P, , , r y
Connie Goe
Con:vu:� Goer
Company:
Date Signed:
Russells Heating & Air Conditioning
2017-05-15
Address:
License:
33145 Yucaipa Boulevard
719570
City/State/Zip:
Phone: "
Yucaipa CA 92399
909-797-5669
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-A020093764A-000-000-0000000-0000 Registration Date/Time: 2017-05-15 15:12:24
CA Building Energy Efficiency Standards - 2016 Residential Compliance" Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-05-15 15:12:24