BMCH2017-001978-495 CALLE TAMPICO Ct 0. D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0019
Property Address:
79942 AMORA DR
APN:
609640021
Application Description:
YOUSEF / CHANGE OUT (2) SPLIT SYSTEMS
Property Zoning:
Carrier: NORGUARD INSURANCE COMPANY Policy Number: TIWC721117
Application Valuation:
$15,000.00
Applicant:
TIMO'S AIR CONDITIONING & HEATING INC
72232 CORPORATE WAY
THOUSAND PALMS, CA 92276
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
(760)770-4357
Llc. No.: 920062
LICENSED 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. I compensation, as provided for by Section 370C• of the Labor Code, for the performance
License Class: C20 License No.: 920062 of twork for which this permit is issued.
I have and will maintain worker
'
Date:
2/2/2017
Owner:
1 V
is issued. My workers' compensation insuranL- carrier and policy number are:
JACOB YOUSEF
Carrier: NORGUARD INSURANCE COMPANY Policy Number: TIWC721117
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
79942 AMORA CR
License Law for the f40ing reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any'manner so 3s to become subject to the workers'
LA QUINTA, CA 91253
z
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
v n
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
�- -2 -
m
Co
Date: Applicant:
c�
Contractor:
'T, a
tv
TIMO'S AIR CONDITIONING & HE.
(_) I, as owner of the property, or my employees with wages as their sole
C�
72232 CORPORATE WAY
-1I
��
Q
THOUSAND PALMS, CA 92276
apply to an owner of property who builds or improves thereon, and who does the work
v
(760)770-4357
Llc. No.: 920062
LICENSED 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. I compensation, as provided for by Section 370C• of the Labor Code, for the performance
License Class: C20 License No.: 920062 of twork for which this permit is issued.
I have and will maintain worker
'
s' ccmpensation insurance, as required by
Date: L / Contractor I
Section 3700 of the Labor Code, for the performance of the work for which this permit
1 V
is issued. My workers' compensation insuranL- carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: NORGUARD INSURANCE COMPANY Policy Number: TIWC721117
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of :he work for which this permit is issued, I
License Law for the f40ing reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any'manner so 3s 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 thst, 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 the 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
�- -2 -
3 of the Business and Professions Code) or.that he or she is exempt therefrom and the
Date: 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
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
(_) 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 --ity 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. Ariy 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 cancellbtion.
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 Name:
Lender's Address:
I certify that I have read this application and stcte 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 representaives of thisity t nter upon the
above-mentioned property for inspection purposes.
Date:' t--'� -1 Signature (Applicant or Agent):
Application Number:
BMCH2O17-0019
Owner:
Property Address:
79942 AMORA DR
JACOB YOUSEF
APN:
609640021
79942 AMORA CP
Application Description:
YOUSEF / CHANGE OUT (2) SPLIT SYSTEMS
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$15,000.00
Date: 2/2/2017
Applicant: Contractor:
TIMO'S AIR CONDITIONING & HEATING INC TIMO'S AIR CONCITIONING & HEATING INC
72232 CORPORATE WAY 72232 CORPORATE WAY
THOUSAND PALMS, CA 92276 THOUSAND PALfG;S, CA 92276
(760)770-4357
Llc. No.: 920062
---------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - (2)17SEER/80AFUE SPLIT SYSTEM [2016 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2016 CALIFORNIA BUILDING CODES.
Total Paid for PERMIT ISSUANCE: $96.27
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
$152.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$76.00
Total Paid for CHANGEOUT: $228.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3)
Project Name: Jacob Yousef Date Prepared: 2017-02-01
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
Jacob Yousef
02
Date Prepared
2017-02-C1
03
Project Location
79942 Amora Drive
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Jacob Yousef
SC System
SC System
CFA served
Dwelling Unit Conditioned
refrigerant
07
Zip Code
92253
OB
Floor Area (ft2)
2600
by this SC
ducted
containing
system
Number of Space
entirely new i entirely new
'09
Climate Zone
i5
10
Conditioning (SC) Systems in
2
components?
feet of ducts?
duct system? SC system?
Alteration Type
this Dwelling Unit:
Location 1
. ,*-K #
B. Space Conditioning (SC) System Information , It
inr-
• 2.. , kf Xi ,
01
02
03
04
OS
_ 06 _
_ OT
u OS _ _ 09
10
is the SCr'
Install'i'ng a
S
3 -✓f '
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 i entirely new
Name.
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system? SC system?
Alteration Type
System 1
Location 1
1400
Yes
Yes
Yes
No
No " No
Altered space
I
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)1D1ib)
This section does not apply to this project.
Registration Number: 217-A02003617SA-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-02-01 14:50:17
Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CaICERTS
Report Generated: 2017-02-01 14:51:20
r
CERTIFICATE OF COMPLIANCE
CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -IR -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
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
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
80
AC
cooling
SEER
.17
Setback
section is not
section is not
components
components
applicable
applicable
Central gas
All new
Central split
Allpew
This field or
This field or
System 2
furnace
heating
AFUE
80
AC
cooling
SEER
17
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply-airand returnair ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test.iequired when heating or cooling, components are installed in ducted systems, or when more than 40 it of duct length is repleted
-Leakage rate compliance: — 15% or <= 10% leakage to outside, or seal.all aicessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification ` ' ' ' " �
g rg required when contamutg components are installed or.altered'(applicable:in Q 2, 8-15)"Inc:
CF2R and CF3R-MCH-23 Airflow Rate >= 3D0 CFM per ton required n MCH-; is required.
Exceptions: ..
- Duct HERS fmm'MCH-20
systems registered with provider as previously seek dare :exempt Dui[ Le, akage Teessting requ�rem�nts.' ,:
- Heating -only systems and Air Handler Furnace changes do not requrre.verifiwtlon of Air Flow MCH -23, or Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos 6re exempt fr°om:MCHh 0DucMakage.Testing req rerr nt<:
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: 217-A020036175A-000-000-0000000-0000 Registration Date/Time: 201.7-02-01 14:50:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-01 14:51:20
Schema Version: rev 10/16
i
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:
Timo
Documentation Author Signature:
, Joseph
Company:
Signature Date:
TIMO'S AIR CONDITIONING & HEATING INC
2017-02-01 14:50:17
Address:
CEA/ HERS Certification Identification ('dapplicable):
72232 Corporate Way
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-770-4357
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under thejaws 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 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 myanufactured 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 Caldomia Code ofPRvgulatton }� ` +M+au
4. The building design features or system design features identified on•this Certificate of Compliance areconsistent withdhe irdornation,pmvided on other applica'zo empliance documents, worksheets,
r"""t" NS
�wrth
calculations, plans and specifications submitted.to the e*orcemen agency forrapp val this buildrn g permit application. F
" A t +, ttl f'l .6+ 'y a+. N*, 0 - -
S. I will ensure that a registered co
g copy of this Cert cate ofCdympliance shall;•bemade ayadable With:the building permn(s),issued for.the building and made ava bs.to;tfie enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance u required to be included with the documematron the builder provides to the building owner at occupancy.
Responsible Designer Name: f—�! :.
Responsible Designer Signature: V I L. o 1C :—
Timo., Joseph//i17�
Company:
Date Signed:
TIMO'S AIR CONDITIONING & HEATING INC
2017-02-01 14:50:17
Address:
Lkense:
72232 Corporate Way
920062
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-770-4357
Digitally signed by CalCERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider
responsibility for the accuracyof the information.
Registration Number: 217-A020036175A-000-000-0000000-0000 Registration Date/ rime: 2017-02-01 14:50:17 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-01 14:51:20
Schema Version: rev 10/16
II3in #
Crty of LQ Q uin LA
-
Submittal
Building &r Safety Division
heed
p.0. Box 1504, 78-495 Calle Tampico .
Permit #La
Qulnta, CA 92253 • (760) 777-7012
-ZO — ba�j
wilding Permit Application and TrackingS(�eet _.
project Address:
Owner's Name:
49 P-
A. P. Number.
Address:
-
elf
Title 24 Cates.
Legal Description:
city. ST, Zip
_
N
Contractor /
elm e+e �.. Telephone:
Address: `�,
Project Description:
��14'—
City, ST, Zip: EFS•
t �7 66W��
Telephone: Xa6
�
Subeontactor List
State Lic. # ; QQ
City Lie. &
5
I
Arch., Engr., Designer:
Address:
Ii.O.A. ApproVai
City., ST, Zip=
Construction Type. Occupancy:
Telephone:
#:
Project type (circle one): New Add'n
alter Repair Demo
State Lic.
7 Sq. Ft.: # Stories:
#Units:
Contact Person: �" ��'-
Name of
mob/
O , Fstimaud Value of Projc�d
CRO
Telephone # of Contact Person:
R1TE BELOW T141S LINE
Date of permit issue
APPLICANT:
DO TMU W
Tom+ G
Plan Check submitted
t/
Submittal
Rcq'd
heed
Pian Sets
Structural Cala.
Reviewed, ready for corrections
Truss Cales.
Called Contact ?crson
Title 24 Cates.
Plans picked up
Flood plain plan
Plans resubmitted
Grading plan
2°' Review, ready for eorreetionslissue
Subeontactor List
Called Contact Person
Grant Deed
Plans picked up
Ii.O.A. ApproVai
Plans resubmitted
ITi HOUSE;_
;`' Rc.vlew, ready for corrcctlonslissue
Planning Approvid
Called Contact Pcrson
Pub. Wks. Appr
Date of permit issue
Sc11061 Fees
..
FERN= FEES
Item Amount
Plan fficckepositPlan x ance.
Construction
Mechanical
Electrical
Plumbing
S.IVLL
Grading
Developer Imt3act Fee
• p.LP.P.
( Total Permit Fees 1