BMCH2017-050978-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
1 Permit Type/Subtype: MECHANICAL/
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O17-0509
Property Address:
45065 DESERT VIEW CT CT
APN:
604331027
Application Description:
RUCH / HVAC CHANGEOUT
Property Zoning:
Application Valuation:
$5,000.00
Applicant:
ADAM SIMMONS
P 0 BOX 314,
LA QUINTA, CA 92247
R/81 E SPLITYST
r LDEC29 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.: 780534
Date: ' 1 Contractor '4z!!e--e= Az _
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: 12/29/2017
Owner:
EDWARD RUCH
92253
Contractor:
ADAM SIMMONS
P O BOX 314 .
LA QUINTA, CA 92247
(760)564-7525
Llc. No.: 780534
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 3100 of the Labor Code, for the performance
of the ork for which this permit is issued.
t 1 have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the periiormance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9054788
_ 1 certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner ;o as to become subject tothe 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.
Date: 2 Z7 Applicant:
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 ($100000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACK.40WLEDGEMENT
IMPORTANT: Application is hereby made tc the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this apalication is made, each person at whose
request and for whose benefit work is perfarmed under or pursuant to any permit issued
as a result of this application, the owner, ar.d the applicant, each agrees to, and shall
defend, indemnify and hold harmless the Ciry 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 isuance of such permit, or cessation of work
for 180 days will subject permit to cancellat on.
I certify that I have read this application anc 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 purpose!.
Dje' Signature (Applicaaf or Agengeoe-
F y
Date: 12/29/2017
Application Number:. BMCH2O17-0509
Owner:
•, '�PrvperW..Wldress: DESERT VIEW CT CT
EDWARD RUCH
APN: 604331027
Application Description: RUCH /HVAC CHANGEOUT 16SEER/81AFUE SPLIT SYSTEM
92253
Property Zoning:
Application Valuation: $5,000.00
Applicant:
Contractor:
ADAM SIMMONS
ADAM SIMMONS
P0BOX 314
P0BOX 314
LA QUINTA, CA 92247
LA QUINTA, CA 92247
(760)564-752-
LIc. No.: 780534
Detail: HVAC CHANGE OUT - 16SEER/81AFL)E SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED P1tICM 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 1
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 CHAMGEOUT: $117.03
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
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 ENHANCEM=NT FEE: $5.00
TOTALS: $231.8
r
• .._........... _ GF'.N4afar c)t3..C1'-:R:i' .�................
PERMIT # kL-TC,7-0-506
PLAN LOCATION:
Project Address: ^ 5" �21�1
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Telephone:
Patio/Porch SF
Email: `
Fire Sprinklers SF
Applicant. Name:
Address: P- 6bx Li
City, ST, Zip: Q,6`4=- A
Telephone:
Email: c
fto, t
Valuation of Project $�'�C�
Contractor Name:
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip ���tv�
Garage SF
Telephone:
Patio/Porch SF
Email: `
Fire Sprinklers SF
State Lic: CityBus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic:` City Bus Lic:
i
Property Owner's Name:
New Commercial / Tenant Improvements:
Address: ,�� �.
Total Building SF
City, ST, Zip ba tl--na Ce, . (�
Construction Type: Occupancy:
Telephone: .,
Email:
/8495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
-Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
-
Soils Report
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
r
Grant Deed
'
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
c
f
ti
CERTIFICATE OF COMPLIANCE CF111-ALT-014
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: 45065 Desert View Cir FDate Prepared: 2017-03-06
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 dacumpnt for @ach dwelling unit.
01
Project Name
45065 Desert View Cir
02
Date Prepared
2017-03-06
03
Project Location
45065 Desert View Cir
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
45065 Desert View Cir
07
Zip Code
92253
013
Dwelling Unit Conditioned
2000
I
v
Floor Area (ft)
SC System
SC System
CFA served
system a
refrigerant
Number of Space
Installing
09
Climate Zone
15,'', : ; -
10
Conditioning (SC) Systems'in
1
ducted
containing
., w..: .
.this
Dwelling Unit:
entirely -new
Name
Served
System (ft2)
system?
component?
B. Space Conditioning (SC) System Information y"qj{[
Ri
[p[�;
Pkil". . F
.
Ol
02
'4r L,(ls;`,,4
03 �,
04
' at.^..Q.: .,q `.y
05..
�isxr JR yf t3l, M3 v..'t
06
,..v
07 .,
w;.x. 6-r .pf:
OS
-p@Arv.W *6
09
10
. «
:.
«�
n15 the SCS >
Xstallirtla
I
LA 1
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
System 1
WHOLE HOUSE
--20-00—r
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: 217-A020071616A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-03-06 06:18:58
Report Version: 2016.1.005
Schema Version: rev 10/16 ,
HERS Provider: CalCERTS
Report Generated: 2017-03-06 06:19:59
CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
11
12 %ka
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
16
Setback
equal to 40
R 8
components
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems ,+d
- Duct insulation requirement for the new portions of supplyair 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 wheh 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 <= 101% leakage to oiit'side,.or seal all accessible leaks.
CF2R 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: i
Duct systems registered with HERS provider as previously sealed are exempt from.MCH-20 Duct Leakage Testing requirements
A_ _ ,, _ ""'' ,
Heating -only systems and Air Handler Furnace changes do not require verification of Air FlowMCW23 76r Refrigerant L arge MCH 25
-Existing duct systems constructed, insulated or sealed with.asbestosrare exempt'from MCFfi R0.DuttttLeakage Test g.requi meni .
,..
E. Entirely New or Complete Replacement Duct�System, with or without Equipment Changeout(SectionsAS0.2(b)1Diia..and.ISO .2(b)1E, F)
E " °i, 4 , NJ" v I
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: 2.17-A020071616A-000-000-0000000-0000 Registration Date/Time: 2017-03-06 06:18:58 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report -Version: 2016.1.005 - Report Generated: 2017-03-06 06:19:59
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: �
Simmons, Donna
Z64G.� _IVi4S6~1691'
Company:
Signature Date:
ADAM SIMMONS
2017-03-06 06:18:58
Address:
CEA/ HERS Certification Identification (if applicable):
54440 AVENIDA CARRANZA
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-564-7525 —�
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 trueandcorrect.
2. 1 am eligible under -Division 3 of the Business and Professions Code to.accept;tesponsibility'for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materlals,scomponents, 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. �Re0ul'alons
mpliance
4. The building design features or system design features Identified orl.,this Certlfic'ate bf Compliance are consistent with>'the Inform atlbn,provided onzothef. pphgatilec documents, worksheets,
calculations, plans and specifications submitted,to the e orcement:agency foKApprovilmith this building permit application.
S. I will ensure that a registered copy of this Certificate of Corrhpliance snall�b'e`irtede avails le with'the b4Ulltling;permit(si:issu it forlthe bdlldi)ig, and made available tb'tFie enforcement agency for all applicable
inspections. I understand that a re istefed co of thi Ce�r-�li#icate of Com liance,is re uired to be included wrth the documentation the bi''Ilder ro_uides to,the buildin owner at occupancy.
P g PY P q pi. g
R a r •,. .v �a -
Responsible Designer Name: }:w "iY
Responsible be5igrier SIgnalure:oF.
,G�/�/LB�L4'
Simmons, Donna
.
Company:
Date Signed:
ADAM SIMMONS
2017-03-06 06:18:58
Address:
License:
54440 AVENIDA CARRANZA
780534
City/State/Zip:
Phone:
LA QUINTA CA 92253
760-564-7525
Digitally signed by CaICERTS. 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-A020071616A-000-000-0000000-0000 Registration Date/Time: 2017-03-06 06:18:58 , ' HERS Provider: CaICERTS
CA Building Energy Efficiency Standards -.2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-06 06:19:59
Schema Version: rev 10/16