BMCH2017-028878-495 CALLE TAMPICO
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LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0288
Property Address: 44300 CAMINO LAVAND�
APN: 604193023
Application Description: PRIESTLY RESIDENCE. HVA C.M NG OUT
Property Zoning:
Application Valuation: $3,500.00 JUL 12 2017
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
R PRIESTLY
44300 CAMINO LAVANDA
LA QUINTA, CA 92253
Date: 7/12/2017
Applicant: CITY OF LA QUINTA Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101 DESIGN AND DEVELOPMENT DEPARTMENT 72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276 THOUSAND PALM, 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 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20. C36 License No.: 7777
ate' �rgsitor:
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.).
(_) 1, 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: qOwner:
(760)328-8096
LIC. No.: 777794
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificateof 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.
_ 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:
re:Carrier: MIDWEST EMPLOYERS CASUALTY COMPANY Policy Number:
BNU WC0135300
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 3 of the Labor Code, I shall forthwith
comply
ywitr�fthose provisions.
Da -`tem" Lry t l App' nt:•y `� �
WARNING: FAILURE TO SECURE WORKERS' COIVPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,00D',. IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR SN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOMEDGEMENT
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 Cty 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 applica-ion 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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and stat that the' bove 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 tate lawsrelating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives is ity to ter upon the
above-�droperty for inspection purposes.
Lender's Name:
D Si •• ce Applicant o Age
Lender's Address:
Date. 7/12/2017
Application Number: BMCH2O17-0288 Owner:
Property Address: 44300 CAMINO LAVANDA R PRIESTLY
APN`. 604193023 44300 CAMINO LAVANDA
Application Description: PRIESTLY RESIDENCE. HVAC CHANGE OUT LA QUINTA; CA 9253
Property Zoning:
Application Valuation: $3,500.00
Applicant: Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101 72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
(760)328-8096
Llc. No.: 777794
7 ---------------------------------------------------------------------------------------
Detail: CONDENSER ONLY CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
1 .• 1.
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
CONDENSER/COMPRESSOR
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$25.33
Total Paid for MECHAMCAL: $63.33
DESCRIPTION
ACCOUNT
IQTY
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
Din ##
Permit #;
Project Address: 410
City Of La Quinto
Building 8T Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Skeet
lk IN e L4470 10cr4c4— Owner's Name: /U M_ T,I e l e
A. P. Number:
Address: `
Legal Description:
City, ST, Zip:
Contractor:
Telephone: (06 -.360 a279'
Address: ,J ANTHONY SERVICES
Project Description:
City, ST • ; Zip: 72216 NORT
----__--- --TH01 JSANn EALMS.
u I
CA 92270
2 TO � .
e
Tleh 2.
Pone: L0 �2 t
3
::.City
-
Ca Q •-s
State Lic. # : '7'7
Lie. #:..0S`0Sr&f
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: P
o • .
Construction TY Pe: Occupancy:
cY•
t a
Sto Lie. Ir •
Project type (circle one)• New Add'n Alter Repair. De m 0
Name of Contact Person:Sq.
Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Bala:ace.
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'`d Review, ready for corrections/issue
Developer Impac: Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. A PPr
Date Of permit issue
•
School Fees,
I
-
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
PRIESTLY I Date Prepared:
CFIR-ALT-02-E
(Page 1 of 3)
2017-07-12
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
PRIESTLY
02
Date Prepared
2017-07-12
03
Project Location
44300 CAMINO LAVANDA
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
PRIESTLY
Dwelling Unit Conditioned
07
Zip Code
92253
08
Floor Area (ft)
1200
SC System
SC System
CFA served
Number of Space
refrigerant
09
Climate Zone
15 -
10
Conditioning (SC) Systems in
1
Location or Area
by this SC
ducted
containing
this Dwelling Unit:
more than 40
B. Space Conditioning (SC) System Information`P
01
02
03 '"•
:4 04
> 05..
a .. 06 r w
„,: "07'-
,.X lib
.... `09
10
""Is the St;7�
I'A'stalling•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?
Alteration Type
System 1
Location 1
1200
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: 217-A020236565A-000-000-0000000-0000
Registration Date/Time
2017-07-12 09:28:28
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-07-12 09:28:56
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)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
TXV or EXV
AFUE
81
AC
condensing
SEER
14
Setback
section is not
section is not
unit
applicable
applicable
Required 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 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.
CF211 and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF211 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. m f tV
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23; or Refrigerant Charge MCH -25.(,'
t
-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 150Z(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-A020236565A-000-000-0000000-0000 Registration Date/Time: 2017-07-12 09:28:28 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-07-12 09:28:56
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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: U
Ke!/G�IiNL4Bfv
Robinson, Kevin
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-07-12 09:28:28
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 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 ori this Certificate of Compliance are consistent with the information provided on otherapplicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for roval with this buildin " '
P P g Y PP g permit application. {,) 4 .E
�
S. I will ensure that a registered copy of this Certificate of Compliance shall be"made'available'with the building permit(s)tissued 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 beincludedwith the documentation the, builder provides to the building owner at occupancy.
Responsible Designer Name: ` ; 1 i .. v a r..
Responsible Designer Signature: GY, L,J' %' u
Robinson, Kevin
KP.dGsY/G�tG4dki
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-07-12 09:28:28
Address:
license:
72216 NORTH SHORE ST #101
777794
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
Easy to Verify �� 0
at CaICERTS.com
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility f
the accuracy of the infory ,
Registration Number: 217-A020236565A-000-000-0000000-0000
Registration Date/Time
2017-07-12 09:28:28
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-07-12 09:28:56
Schema Version: rev 10/16