BMCH2017-040478-495 CA LLE TAMPICO = <� V
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: . BMCH2O17-0404
Property Address: 53585 AVENIDA BERMUDAS
APNi 774135016
Application Description: VENEMA / CHANGE OUT (1)16SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $11,175.00
Applicant:
IE INC FF!SEP
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362 3 2017
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: 920062`
Date: Cy ct
3 11 Contraor•���—
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.).
(� 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. C.).
Lender's
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/13/2017
Owner:
ERIC VENEMA
53585 AVENIDA 3ERMUDAS
LA QUINTA, CA 92253
Contractor:
TIMO'S AIR CONDITIONING & HEATING INC
72232 CORPORATE WAY
THOUSAND PALMS, CA 92276
(760)770-4357
LIC: No.: 920062
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.
` � 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: NORGUARD INSURANCE COMPANY Policy Number: TIWC8S1602
I certify that in the performance ofthe 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 _700 of the Labor Code, I shall. forthwith
comply with those provisions.
Date: 9 1 1% Applicant:mac
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIMAL 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 :ssuance of such permit, or cessation of
work for 180 days will subject permit to cancelation.
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 ordi-iances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
a
Date: q t3 t� Signature (Applicant-or Agent)
�
Date: 9/13/2017
Application Number:' BMCH2O17-0404
Owner: .
Property Address: 53585 AVENIDA BERMUDAS
ERIC VENEMA
APN: 774135016
53585 AVENIDA BERMUDAS
Application Description: VENEMA / CHANGE OUT (1)16SEER/804FUE SPLIT SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $11,175.00
Applicant:
Contractor:
IE INC
TIMO'S AIR CONDITIONING & HEATING INC
31225 LA BAYA
72232 CORPORATE WAY
WESTLAKE VILLAGE, CA 91362
THOUSAND PALMS, CA 92276
(760)770-4357
------------------------------------ ----------------------------------------------------------
LIc. No.: 920062
Detail: HVAC CHANGE OUT - 165EER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
s
FINANCIAL INFORMATION
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 CHAN.CEOUT:. $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: $S.00
11.0TALS: $216.27
r
0
ern.# .
City Of is Quintd
Building U Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 7777012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 53585 Avenida Bermudas
Owner's Name:. Eric Venema
A. P. Number.
Address: 53585 Avenida Bermudas .
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. Timo's Air Conditioning & Heating
Telephone: .-.:x
Address: 72232 Cor orate Way
Project Description: Replace 3.5 ton Neat pump & air handler
City, ST, Zip: Thousand Palms, CA 92276 '
Telephone: a c!'C:�: -�
P • s,�.;,�;�•:• -
760-770-4357
State Lic. # : 920062 City Lie'. #•:
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:V .Y `� .:�
State Lic.
Name of Contact Person: Steven SchniererSq.
Construction Type:. Occupancy:
Project type (circle one): New Ad0n Alter Repair Demo
Ft.:
#Stories:
# Units:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project: $11,175100 .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKIING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Che& Deposit.
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cities.
Plans picked up
Construction
Flood plain plan
Plans resubmitted'
Mechanical
Grading plan
2" Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. ApprovalPlans
resubmitted
Grading
IN ROUSE:-
'^` Review, ready for correctianslissue
Developrx Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total P'_rmit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: ERIC VENEMA Date Prepared: 2017-09-12
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
CF1 R -AI -T--02 document for each dwelling unit:
01
Project Name
ERIC VENEMA
02
Date Prepared
2017-09-12
03
Project Location
53585 AVENIDA Bermudas
04
Building Type
Single family
05
CA City
LA QUINTA ;rte
06
Dwelling Unit Name
ERIC VENEMA
Identification or
Location or Area
lk-
ducted,
Dwelling Unit Conditioned
system
07
Zip Code
92253 ° 3•"
08i
Floor Area (ft)
1400
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
j
P
Number of Space
Yes
09
Climate Zone
15 ;�.�
10
Conditioning (SC) Systems in
1
this Dwelling Unit:
B. Space Conditioning (SC) System Information /
dY i a t n I,..., � 7 ���5 s[..,-' .
01
02
03
04
05
06N
07
08
09
10 ..
SC System
SC System
CFA served
Is the SC
system a
Installing,a
refrigerant
Installing new SO
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
WHOLEHOUSE.
1400
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: 417-A020115830A-000-000-0000000-0000 Registration Date/Time: 2017-09-12 18:33:34 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance- . Report Version: 2016.1.006 Report Generated: 2017-09-12 18:33:35
CERTIFICATE OF COMPLIANCE CF111-ALT-.024
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
Etticiency
Cooling
U66ling
Efficiency
Efficiency
Therrnustal.
Repidced
New DULL
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R -Value
Central split
All new
Central split
All new
This field or
This field or
SYSTEM 1
HP
heating
AFUE
80
HP
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:"
CF2R-MCH-01-E - Space Conditioning Systemsj
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenumA�6 (CZ 1 10, 12 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 <= 10% leakage to outside, or seal all accessible leaks. l t
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing co�_ponents 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)iDiia and 150.2(b)lE, F) .
'This section d s n app y tothis p o ect.
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-A020115830A-000-000-0000000-0000
CA Building Energy Efficiency Standards 2016 Residential Compliance
Registration Date/Time: 2017-09-12 .18:33:34
Report Version: 2016.1.006
HERS Provider: CHEERS
Report Generated: 2017-09-12 18:33:35
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:
Joey Thio
T r4mo-
Company:
Signature Date:
Timo's Air Conditioning & Heating
2017-09-12
Address:
CEA/ HERS Certification Identification (if applicable):
72232 Corporate Way
City/State/Zip: -'.
_Phone:
Thousand Palms CA 92276
760-770-4357
};'"�
Responsible Person's Declaration statement l '
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 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 for -approval with this building permit application.
it YL iP IC —
5. 1 will ensure that a registered copy of this Certificate of Compliance shah} be made iavailable with the-buildirig permit(s) issued for the building,.and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of C&inpliance is required'to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Utlt`t" i` i �'t' ' %
Responsible Designer_ Signature:
jo , r,,mo ;# i ►G
Joey Timo
Company:
Date Signed:
Timo's Air Conditioning & Heating
2017-09-12
Address:
License:
72232 Corporate Way
920062
City/State/Zip:
Phone: .
Thousand Palms CA 92276
760-770-4357
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-A020115830A-000-000-0000000-0000
Registration' Date/Time: 2017-09-12 18:33:34
HERS Provider: CHEERS
CA Building.Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-12 18:33:35
I•_L _.__-\/---.-�. __..1n/fir •