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BMCH2017-0466
1$-495 641LE TAMPICO lA QUINTA, CALIFORNIA 92253 c&i�t 4 4 Qu&& DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/1/2017 Permit Type/Subtype: MECHANICAL/ Owner: Application Number: BMCH2O17-0466 KEN HERICH Property Address: 50480 CYPRESS POINT DR P 0 BOX 2112 APN: 770110041 KETCHUM, ID 32253 Application Description: HERICH / HVAC CHANGEOUT Property Zoning: Application Valuation: $4,900.00 n n n n Applicant:NOV 01 Zp�� U Contractor: J ANTHONY PLUMBING HEATING & AIR CONDITI J ANTHONY PLUMBING HEATING & AIR CONDITI 72216 NORTH SHORE ST #101 CITyOF(A 72216 NORTH SHORE ST #101 THOUSAND PALMS, CA 92276 LU MMUNITYOEVELOPMENT EPARTMENT THOUSAND PALMS, CA 92276 . (760)343-2121 Llc. No.: 777794 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 ofthe Business and Professions Code, and my License is in full force and effect. License Class: C20, C36 License No.: 7777 4 Dam(, ContraC ct': 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).: LJ 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.). dl ' I, as owner of the property, y, am exclusively contracting with.liciMsed 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: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one if 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 tor which this permit is issued. nFI 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: MIDWEST EMPLOYERS CASUALTY CCMPANY Policy Number: _ I certify that in the performance oll 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, l shall forthwith comply with those provisions. l—� Datgi f1Applicant: q 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 FCR 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 th s application. 1. Each person upon whose behalf this appl cation is made, each person at whose request and for whose benefit work is perforrhed under or pursuant to any permit issued as a result of this application, the owner, andlthe 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 fie work being performed under or following issuance of this permit. 2. Any permit issued as a result of this applie_ation 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 cancellatioh. I certify that I have read this application and rate that the above information is correct. I agree to comply with all city and county ordi,hances and state ws relating to building construction, and hereby authorize representatives of this city o enter upon the/above- mentioned property for inspection purposes. Date �� ( Signaa pplicant xAgent) 1 0 a, Date: 11/1/2017 Application Number: BMCH2O17-0466 Owner: Property Address:. `-50480 CYPRESS POINT DR KEN HERICH APN: 770110041 P 0 BOX 2112 Application Description: HERICH / HVAC CHANGEOUT KETCHUM, ID 92253 Property Zoning: ` Application Valuation: $4,900.00 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)343-2121 LIc. No.: 777744 -- ---- -- -- - - - - -- Detail: HVAC CHANGE OUT - 14 SEER/ 81 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. 1 0 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 $39.01 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $78.02 Total Paid for CHANGEOUT: $117.03 DESCRIPTION ACCOUNT AMOUNT PERMIT ISSUANCE 101-0000-42404 !QTY 0 . $98.83 Total Paid for PERMIT ISSUANCE: $98.83 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 a Bin# City of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Skeet Permit-# Project Address:Ilt (1 f7 � L ✓J O l� J7 Bk� Owner's Name: l� 1" A. P. Number Address: Legal Description: City, ST, Zip: Contractor: Telephone: Address: . 72216 NORTH SHORE ST STE 101 Project Description: City, ST, Zip: THOUS I 2 s TB Telephone: C&u r— State Lic. #:1--0 1 City Lic #:���� Arch, Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type:. Prej. Type 1 New Add'n Occupan y: State Lic. #: Alter Repair Demo Name of Contact: SgFt: #Stories # Units: Telephone of Contact: Estimated Value of Project: ©0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Ree'd TRACKING PERMIT FEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Che:k Deposit: Truss Calcs Called Contact Person Plan Che;k Balance: Title 24 Calcs Plans Picked Up Construc-:ion: . Flood Plain Plan Plans Resubmitted Mechanical: Grading Plan 2nd Rev, Ready for corrections / Electrical Subcontractor List Called Contact Person Plumbing Grant Deed Plans Picked Up S.M.I. HOA Approval Plans Resubmitted Grading IN-HOUSE 3rd Rev, Ready for corrections / Develope_ Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Apps Date of permit issue School Fees Total Pernit Fees CERTIFICATE OF Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: ARLENE HERICH I Date Prepared: MR -ALT 02-E (Page 1 o 3) 2017-11-03 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 ARLENE HERICH 02 Date Prepared 2017-11-01 03 Project Location 50480 CYPRESS POINT DR 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name ARLENE HERICH Dwelling Unit Conditioned 07 Zip Code 92253 .;7�'>>;:. 08 Floor Area (fitZ ) 1350 SC System SC System CFA served Number of Space refrigerant 09 Climate Zone 1S=' i'` _ 10 Conditioning SC Systems in 1 Location or Area by this SC ducted containing this Dwelling Unit: imore than 40 „-.. I .-,° "N. B. Space Conditioning (SC) System Information a� Aft Nq 01 02 03 04 05 06 07 , ' 08 09 10 mow. Ni the SC's""" InstaIIiga rllVN �.p . I o :, , f1% 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 imore than 40 entirely new entirely new Name Served System (ft) system? component? components? feet of ducts? duct system? SC system? Alteration Type Altered space System 1 Location 1 1350 Yes Yes Yes No No No •conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)Mib) This section does not apply to this project. Registration Number: 217-A020377187.A-000-000-0000000-0000 Registration Date/Time 2017-11-0106:30:44 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-11-01 09:31:01 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)3E 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 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 a-10, 12 and 13) and R8 (CZ 11 and 14-16) CF2R and CF3!R-MCH-20-H - Duct Leakage Test required w"*K%eating 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%lleakage to outside;:or seal all accessible leaks. CF2R and CF3!R-MCH-25-H Refrigerant Charge verificatio .fequired when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2R and CF31R-MCH-23 Airflow Rate > - 300 CFM per tin required when:MCH:25.is required. s, ..:.... .......-.:. ...,.... . ...:.::,:::::;:..: Exceptions: Duct systems registered with HERS provider as previously sealed are exempt' romm MCH 20 Duct Leakage Testing reequi ements� 5 rge MC.141 Heating -only systems and Air Handler Furnace chariges do not requre venfication of Air Flow MCH=23, or RefngeranfCha{ � Existing duct systems constructed, insulated or sealed with asbestos -are exempt from MCH2ODuctle'kage Test ng<regw}ements. Mk,_ ..: 'mj,.:•'$.� ''=fie ``�+'r':,�'p STS vo$Ys.�" eexx2aS+a�S?7 1peY L.y� �gy .'+%z`p]$r' .+�,i" ;w': +ibW "Aa9ltfi?'?-h, °' E. Entirely New or Complete Replacement DuctISystem, with or without,Equwpment Changeo.ut XSections�1550 2(b)1Dua,and,5.150.2(b)lE, F) 44 This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC) This section does not apply to this project. Registration Number: 217-A020377187A-000-000-0000000-0000 Registration Date/Time: 2017-11-0106:30:44 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-11-01 09:31:01 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: ef4hC�LdBX/ Robinson, Kevin "''� Company: Signature Date: J ANTHONY ]PLUMBING HEATING & AIR CONDITIONING 2017-11-01 06:30:44 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 thejlawsof the State of California: 1. The information provided o..n; this Certificate`of Compliance is truq and correct. 2. 1 am eligible under Division 1—e' the Bu if ss`and Professions Code to. accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). performance specifications materials tomponents, and manufactured devices for the building design or.system design identified on this Certificate of Compliance conform to the 3. That the energy features and_ txa rte:.. requirements of Title 24, Part 1 and Part'6 of the Calrforma,Code of Regulations.'• $ � 4. The building design features or system design featiaresidentified on this CertifcaY lof Compliance are consiste^Y wtth the lnformaUon:provided 0n;other applicable compliance documents, worksheets, calculations, plans and specifications submitted tthe enforcementgency forapprvwiththis bwldng permt applcatio�: b"uilding 5. I will ensure that a registered copy of this Gertficate of Compliance shallbe.made a ailable with tti'e permit(sj;;issued for -,the; bu'ildi^g, and=„made availableto"sth enforcementagency for all applicable inspections. I understand that a registered copy of this C rt ficate of Compliance �s required to be included with the documentation the,builder provides to. the building owner at occupancy. Responsible Designer Name: :_:< Responsible Designer Sjgnaturev"w Robinson, Kevin Company: Date Signed: J ANTHONY PLUMBING HEATING & AIR CONDITIONING 2017-11-01 06:30:44 Address: License: 72216 NORTH SHORE ST #101 777794 City/State/Zip: Phone: THOUSAND PALMS CA 92276 760-343-2121 Easy to Verify a� 0 at CaICERTS.com 416. Digitally signed by CaICERTS. 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. n Registration:JNumber: 217-A020377187.A-000-000-0000000-0000 Y Registration Date/Time: 2017-11-01 06:30:44 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-11-01 09:31:01 Schema Version: rev 10/16