BMCH2017-0040k }
78-495 CALLE TAMPICO T 0 D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0040
Property Address: 78890 BRECKENRIDGE DR
APN: 770110019
Application Description: PATTERSON / HVAC CHANGE OUT
Property Zoning:
Application Valuation: $5,200.00
Applicant:
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
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 oft ie Business and Professions Code,
and my License is in full force and effect.
License Class:
C20, C36 License No�777777, 4
Contracto?`
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 APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application.
(_) I, as owner of the property, am exclusively contracting with licensed contractors 1. Each person upon whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' request and for whose benefit work is performed under or.pursuant to any permit
State License Law does not apply to an owner of property who builds or improves issued as a result of this application , the owner. and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
the Contractors' State License Law.). employees for any act or omission related to th ? work being performed under or
( ) I am exempt under Sec. B.&P.C. for this reason following issuance of this permit.
2. Any permit issued as a result of this applic.tion becomes null and void if work is
not commenced within 180 days from date of isuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
GEORGE PATTERSON
78890 BRECKENR DGE DR
LA QUINTA, CA 92253
D 2017
F --
C
N
Contractor: m
J ANTHONY PLUMBING HEATING IR C PZbITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276
(760)328-8096
Llc. No.: 777794
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WORKER'S COMPENSATDN DECLARATION
I hereby affirm under penalty of perjury one ofthe following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 370Dof the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sect�700 of the Labor Code, for the perfornance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: MIDWEST EMPLOYERS CASUALTY COMPANY Policy Number:
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 Es to become subject to the workers'
compensation laws of California, and agree tha:, if I should become subject to the
workers' compensation provisions of Section 3:0 of the Labor Code, I shall forthwith
comply with those provisions.
Applica t
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 ($100,00[). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
Date:
Owner:
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatves of this city o enter upon the
above me tinned
Lender's Name: property for inspection purpcses.
01
� �� Signature (Applicant c ee`n' ':
Lender's Address: qW
Date: 2/23/2017
Application Number: BMCH2O17-0040 - Owner:
Property Address: 78890 BRECKENRIDGE DR GEORGE PATTER30N
APN: 770110019 78890 BRECKENF.IDGE DR
Application Description: PATTERSON / HVAC CHANGE OUT LA QUINTA, CA 9°2253
Property Zoning:
Application Valuation: $5,200.00
Appncant: Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101 72216 NORTH SHIORE ST #101
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
(760)328-8096
Llc. No.: 777794
7 -----------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT -I4SEER/81AFUE SPLIT SYSTEM [2016 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
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: $9.6.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMELIT FEE: $5.00
L TOTALS: $216.27
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC)
Project Name:
PATTERSON I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2017-02-23 '
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
PATTERSON
02
Date Prepared
2017-02-23
03
Project Location
78890 BRECKENRIDGE DR
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
PATTERSON
07
Zip Code
92253 j
08
Dwelling Unit Conditioned
2000
I stalli g a
�,..
Floor Area (ft)
SC System
SC System
CFA served
system a
Number of Space
Installing new SC
09
Climate Zone ""`""
15d
10
Conditioning (SC) Systems in
1
by this SC
ducted
containing
system
this Dwelling Unit:
entirely new
B. Space Conditioning (SC) System Information I I ti.
01
02"
03
04
bst
_
05 .6
ter« ..
0
07
- OS
x
09
10
.,A.,A
`
"Is the SCrl
I stalli g a
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 (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
I Alteration Type
System 1
Location 1
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)IDiib)
This section does not apply to this project.
Registration Number: 217-A020060136A-000-000-0000000-0000
Registration Date/Time: 2017-02-23 10:05:37
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-23 10:06:18
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)1E 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
Central split
Outdoor
This field or
This field or
System 1
furnace
Indoor coil
AFUE
81
AC
condensing
SEER
14
Setback
section is not
section is not
unit
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 and 13) and R8 (CZ 11 and 14-16)
CF2R and CBR -MCH -20-H - Duct Leakage Test required when_ Heating or cooling components are installed in ducted systems, or when more than 40 it of duct length is replaced
-Leakage rate compliance: <=15% or <=10% leakage to otutside "or seal all accessible leaks.
CF211 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 perton requireh When -MCH -25 is required.
Exceptions:
Duct systems registered with HERS provider ap viously sealed acre exempt fro MCH 20 Duct Lea kage Testing requirements
Heating -only systems and Air Handler Furnace changes do not require'wenfication ofAir Flow MCH=23 ar•Ref�ig�rant Charge NIGH -25a '
C
-Existing duct systems constructed, insulatebestos
d or sealed with as�are exemptbfrom MCH -20 Leakage Testing
41 Duct eyuiremmeents.
+
'.:.:.�J' `yam +. ,� 'u'k-..v�+�' � § 'R!s..tut '!�" '' #& �5� i#,a• ys+f;
E. Entirely New or Complete Replacement Duct*System, with or witu Equipment Changeout (Sections -150 2TJ1Di and 50.2(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-A020060136A-000-000-0000000-0000 Registration Date/Time: 2017-02-23 10:05:37 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-23 10:06:18
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:
Robinson, Kevin
/�P.!/6�(li��C04��GifrCB1U/
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-02-23 10:05:37
Address:
CEA/ HERS Certification Identification (if applicable):
72216 NORTH SHORE ST #101
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the. ws:of the State of California:
4
1. The information provided on;this CerFificate of Compliance.is true and,correct.
<
2. 1 am eligible under Division 3 of the Business and Professio—ns Code�to accept 6pons"ibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications _matenals components, and manufactured devices the building design or system design identified on this Certificate of Compliance conform to the
ifor
requirements of Title 24, Part 1 and Pai.t6 of the CallfOrmaCOde of, . tilat ons.
4. The building design features or system.design features'identified on his Certificate pf Com liance are'cgnsistent withsthe informs oneRrovided on, the appiicakic o`mpliance documents, worksheets,
calculations, plans and specifications submitted.to.the h(orcement.' ency fgfgapprov- with this building permit application. I
£j.. � '
Vile
cate x. 3..} i j' '
5. I will ensure that a registered copy of�ttiis Certificate afCompliance shalt be matte available withtlie:build(ngpermit(s)Issued forthe kwildtng, andmade avaJlable tothe enforcement agency for all applicable
w __. ..
inspections. I understand that a registeredcopy of this. t'iflcate of Compliance s req d to be included. 'th the doacum�enta�tion he b alder provides to the buil ung owner at occupancy.
u$r
Responsible Designer Name: ' � .*a F:r,
Responsible Designer Signature: U '"F
Robinson, Kevin
I�P.!/l.�ffil�G�L4ds(fi
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-02-23 10:05:37
Address:
License:
72216 NORTH SHORE ST #101 1777794
City/State/Zip:
Phone:
THAI ISANn PAI US CA 92376 1780-343-2121
Digitally signed by Ca10ERTS. 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: 217-A020060136A-000-000-0000000-0000 Registration Date/Time: 2017-02-23 10:05:37 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-23 10:06:18
Schema Version: rev 10/16
Bin 1'#
.City of La Quuilita
Building u Safety Division
pit #{ 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: `k,e 0 Rk Owner's Name: �, Pil,a
A. P. Number:,
Address:
Legal Description:
City, ST, Zip:
Contractor:
T elePhon• -17
Address:
City- ST, Zip: 72216 NORTH SHORE ST STE 101lHOUZiANUFALMS0-�
Project Description:
D.ai N 5
Telep hone.:
State Lic. #
,CA9
vn
l
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
t
Sa te Lic. 4:
Project type (circle 1e one)• New Add'n
_]ter Repair r Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ZOD
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrics[
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
M.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
3" Review, ready for corrections/issue
Developer Impact, Fee
Planning Approval
Called Contact Person
A.T.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees