BMCH2017-008878-495 CALLE TAMPICO Ct 0 D ZP
LA CIUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O17-0088
Property Address:
78765 CASTLE PINES DR
APN:
770080029
Application Description:
STOUT/ HVAC CHANGE OUT-(2)21SEER/81AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$23,554.00
Applicant:
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: C20, C4%3 License No.: 276586
'ate: - 21 6 7 GonVactor:
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 ) 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 Na
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/24/2017
Owner:
RODNEY STOUT
21355 ESTEPA CIR
HUNTINGTON BEACH, CA 92253
Contractor:
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
(760)323-3383
Llc. No.: 276586
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 rk for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
Section 3 00 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: BENCHMARK INSURANCE COMPANY Policy Number: CSTS008762
_ 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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
natp-4 — Z Y ✓' / fAnnlirant•
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 building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property
for inspection purposes.
A ---N.
f -
Date: 3/24/2017
Application Number:
BMCH2017-0088
Owner:
Property Address:
78765 CASTLE PINES DR
RODNEY STOUT
APN:
770080029
21355•ESTEPA CIR
Application Description:
STOUT / HVAC CHANGE OUT-(2)21SEER/81AFUE SPLIT SYSTEM
HUNTINGTON BEACH, CA 92253
Property Zoning:
Application Valuation:
$23,554.00
Applicant:
Contractor:
DESERT AIR CONDITIONING INC
DESERT AIR CONDITIONING INC
590 WILLIAMS ROAD
590 WILLIAMS ROAD
PALM SPRINGS, CA 92264
PALM SPRINGS, CA 92264
(760)323-3383
--------------------------------------------------------------------------------------------
Llc. No.: 276586
Detail: (2) HVAC CHANGE OUT - (1-2)21SEER/81AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
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
$152.00
DESCRIPTION '
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$76.00
Total Paid for CHANGEOUT: $228.00
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
. .
i
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 -:(760) 777,7012
Building Permit -Application'and Tracking Sheet
Pennit #
ProjectAddress: 78-765 Castle Pines, Dr. La Quinta, CA
Owner's Name: Rod Stout
A- P.'Number:
Address: 78-765 Castle Pines, Dr.
Legal Description:
Contractor: Desert Air Conditioning, Inc.
City, ST, Zip: La Quinta, CA 92253
Telephone: 714-852-1118 R I ME
Address: 590 Williams Rd -
Project Description: Install (2) 3ton split:systems
City, �T, Zip: Palm Springs, CA 92264
Telephone: 760-323-3383
�YN
city!
Arch, Engr., Designer
StateLic.#:
Name of Contact Person: candiceForsythe
Project type (circle one): New Add'n. Alter Repair Demo
Sq. Ft.: tori�s:
Telephone# of Contact Person: 760-323-8383 Estimated valiie of Project: $23,554.013.
APPLICANT: DO NOT WRITE BELOW THIS LINE
PERMITFEES-
Plan Sets
Plan Check submitted
Item AMGUMt
Structural Cales.
Reviewed, ready for corrections
Plan Check W.posit.
Truss Calcs.
Called Contact Person
Plan Check Wiance.
Title 24 Cales.
Plans pickid up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Giuding plan
21' Rev iew, ready for corrcctions/issue
Electrical
Grant Deed
Plans picked up
S.M.L
ILOA. Approval
Plans resubmitted
Grading
IN HOUSE-.-
Wview, ready for correcdon&/issue
Developer Impact Fee
Planning Approval
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Femes
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
78-765 CASTLE PINES DR Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3)
2017-02-08
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
78-765 CASTLE PINES DR
02
Date Prepared
2017-02-08
03
Project Location
78-765 CASTLE PINES DR
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
78-765 CASTLE PINES DR
SC System
SC System
CFA served
Dwelling Unit Conditioned
refrigerant
07
Zip Code
92253
08
Floor Area (ft2)
2180
Location or Area
by this SC
ducted
containing
Number of Space
more than 40
09
Climate Zone
15
10
Conditioning (SC) Systems in
2
system?
component?
components?
feet of ducts?
this Dwelling Unit:
SC system?
B. Space Conditioning (SC) System Information ii ,
rn)
01
02
03
13 04
05
06 ...
07
08 .�
09
10
,Is the SCS`
Installiga
?
V I'
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
Altered space
System 1
Location 1
1200
Yes
Yes
Yes
No
No
No
conditioning system
Altered space
System 2
Location 2
1,200
Yes
YPs
Yec
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 217-A020042894A-000-000-0000000-0000 Registration Date/Time: 2017-02-08 09:00:19. HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-08 09:00:34
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-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)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 gas
All new
Central split
All new
Less than or
System 1
furnace
heating
AFUE
81
AC
cooling
SEER:
21
Setback
equal to 40
R-8
components
components
feet
Central gas
All new
Central split
All new
Less than or
System 2
furnace
heating
AFUE
81
AC
cooling
SEER
21
• Setback
equal to 40
R-8
components
components
feet
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.
...wwrew fit �^'� �'+"y°!1' r-•�a..,� r+� -.-�
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed orr,altered'(applicable in CZ 2, 8-15). '
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH 25 is required. �4
Exceptions:
,div
Duct systems registered with HERS provider as previously seal d are exempt from MCH -20 Duct Leakage,Testing requirements) . f j�
asks..' e i�£
-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 req ement . 1=' P
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacemnt $pace Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 217-A020042894A-000-000-0000000-0000 Registration Date/Time: 2017-02-08 09:00:19 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-08 09:00:34
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE r' 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. t
Documentation Author Name:
Documentation Author Signature: X /r—j�
Trefun, Michael
tc ae re un
Company:
Signature Date:
Desert Air Conditioning Inc.
2017-02-08 09:00:19
Address:
CEA/ HERS Certification Identification (if applicable):
590 Williams Road
8275622 1
City/State/Zip:
Phone:
Palm Springs CA 92264
760-323-3383
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. ��� '; �Rr
4. The building design features or system design features identified on this Certificate Compliance are consistent with the information provided on other pa plicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approvel'with this building permit application. '`�� 4
t�. . t ti tt tt.'' �.. a, ti
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be,made available with the building permit(s) issued forthe building, and made available -to the,enforcement agency for all applicable
inspections. I understand that a registered copy of thistertificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Deiigner Signature: V �� r / i /r 7
Trefun, Michael
cc ae re un
Company:
Date Signed:
Desert Air Conditioning Inc.
2017-02-08 09:00:19
Address:
License:
590 Williams Road
276586
City/State/Zip:
Phone:
Palm Springs CA 92264
/bU-313-3383
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 for the accuracy of the information.
Registration Number: 217-A020042894A-000-000-0000000-0000
Registration Date/Time: 2017-02-08 09:00:19
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-08 09:00:34
Schema Version: rev 10/16
0