BMCH2018-0014• F
T , �Q�i a^" '^�
VOICE (760) 777-7125
78 495-CAJ.L.E TAMPICO
0/ D
LA QUINTA, CALIFORNIA 92253
FAX (760) 777=7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/19/2018
Permit Type/Subtype:
MECHANICAL/
Owner:
Application Number:
BMCH2O18-0014
JEFF GRASSBERGER
Property Address:
54530 AVENIDA DIAZ
54530 AVENIDA DIAZ
APN:
774271002
LA QUINTA, CA 92253
Application Description:
GRASSBERGER / HVAC
CHANGEOUT 14 SEER/ 80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$13,150.00
'
Applicant: D /�\ u Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C [rZ1 tJ A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD#201 965 RIDGE LAKE BLVD#201
MEMPHIS, TN 38120 JAN 1 9 , 2018 MEMPHIS, TN 38120
CITY OFLA.OLIINTA .(951)276-9744
COMMUNITY DEb'ELOPMENTDEPARTMENT Llc. No.: 765074
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: C36 C10 C20 License N 074
r
D
ate: IC41 8 Contractor•
OWNER- ER 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).:
(1 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 Name:
Lender's Address:
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
Df 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: LIBERTY INSURANCE CORPORATION Policy Number: WA763DS08631017
_ 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 a Labor C , s o ith
comply with t seprovi S.
Date: '` 8 Applicant:
WARNIN : FAILU E TO SECURE WORK 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 rela buildin
construction, and hereby authorize representatives of this c' o ent up t v -
mentioned roper for inspection purposes.
Date: �' Signature (Applicant or A
ti
Date: 1/19/.2018
Application Number: BMCH2O18-0014
Owner:
Property Address: 54530 AVENIDA DIAZ
JEFF GRASSBERGER
APN: 774271002
54530 AVENIDA DIAZ
Application Description: GRASSBERGER / HVAC CHANGEOUT 14 SEER/ 80AFUE SPLIT SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $13,150.00
Applicant:
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD #201
965 RIDGE LAKE BLVD #201
MEMPHIS, TN 38120
MEMPHIS, TN 38120
(951)276-9744
---------------------
LIc. No.: 765074
------------ ------------------------- --------------------------------
Detail: HVAC CHANGE OUT - 14SEER/80AFUE SPLIT SYSTEM. THIS SYSTEM WILL INCLUDE LESS THAN 40 FEET OF R-8 DUCT WORK REPLACEMENT 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
HVACCHANGEOUT-OTHER EQUIPMENT
101-0000-42402
0
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - OTHER EQUIPMENT PC
101-0000-42600
0
$39.01
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: $195.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$5.58
Total Paid for Credit Card Fee: $5.58
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
E DESCRIPTION.
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
1 U I ALS: 5315.46
Bin. #
City . .
of La Qurnta
Building 8T Safety Division
P.O. Box f 504, '78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: Sys bQ AV1 `
J^i l°X�
Owner's Name:. r PJr�
A. P. Number:
Address: S4 s' �� • G '� 1
City, ST, Zip:
Legal Description:
Contractor:_ �Vt C 4d
Telephone
Address: Y�j�
S o , —%
City, ST, Zip: V 9Z. L)
1P,ro-jecct1Description:
�1C� ►�
Telephon � UUO CLO
1p r' '`
2W%
City Lie. #..-
. G�C�VN-v�i�1
State Lic. #: '7
IeA cp—W IAN)c / I
Arch., Engr., Designer
Address:
City,, ST, Zip:
Telephone:
State Lic. #:'
•:„ .,; � "'
A
Construction Type: � Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person: �5 ` ��
Telephone # of Contact Person: — 3 Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE -
#
Submittal
Req'd
Recd
TRACICIiVG
PERMLTFEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Plan Check Balance
Tide 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
tad Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
34 Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr -
Date of permit Issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC) (Pagel of 3)
Project Name: GRASSBERGER Date Prepared: 2018-01-19
A. General Information
CFiR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CFiR-ALT-02 document for each dwelling unit.
01
Project Name
GRASSBERGER
02
Date Prepared
2018-01-19
03
Project Location
54530 AVENIDA DIAZ
04
Building Type
Single family
05
CA City
La Quinta. `"
06�y
Dwelling Unit Name
HOME
SC System
Code
92253
system a
Dwelling Unit Conditioned
%Floor
1767
07
Zip
„
08
Area (ft2)
Location or Area
by this SC
ducted
`
system
more than 40
entirely new
entirely new
I
TANs
� �
Number of Space
system?
09
Climate Zone
15
10`
Conditioning (SC) Systems in
1
HVAC1
1767
V
Yes
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information
01
02
03
04 *Am*
' ' 05
06% 1 4i0
07
08
09
10
Is the SC
Installing 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
I System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
HVAC1
1767
1767
Yes
Yes
Yes
No
No
No
Altered space
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: 418-A020003455A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2018-01-19 08:27:23
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2018-01-19 08:27:25
11
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)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 split
All new
Central split
All new
Less than or
HVAC1
HP
heating
HSPF
g
HP
cooling
SEER
14
Setback
equal to 40
R-8
components
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems pp�.� F ,
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums:lR6-(CZ 1 10, 32 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.
CF2R and CBR -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 pe'r ton required 'when MCH -25 is required.""� s`� %(
Exceptions:
Duct systems registered with. HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements:
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 requirements.
Ar — t tLAN R FL_ ILL- I W --A y
E. Entirely New or Complete Replacement Duct.System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F) .
This section does not apply to'this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 418-A020003455A-000-000-0000000-0000 Registration Date/Time: 2018-01-19 08:21:23 HE Provider: CHEERS
CA Building Energy Efficiency Standards - 2016.Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-01-19 08:27:25
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:
Christina Calhoun
ChrLWL#LWCalhoury
Company:
Signature Date:
Rightime Home Services
2018-01-19
Address:
CEA/ HERS Certification Identification (if applicable):
965 Ridge lake Blvd, Suite 201
City/State/Zip:
Phone:
s
Memphis TN 38120 I.
951 276-9744
Responsible Person's Declaration statement �e%' '`%,�..,.,i
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. 1
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for-approvaltyith this building permit application.
�.e_
!t -A %.i tl' e t�
S. I will ensure that a registered copy of this Certificate of Compliance shall be mde th�building permit(s�sued for the building, and made available to the enforcement agency for all applicable
Fwailabl+ewith
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible. Designer Signature:
Christina Calhoun
0w4ttina,caihovAv
Company:
Date Signed:
Rightime Home Services
2018-01-19
Address:
License:
965 Ridge lake Blvd, Suite 201
765074 `
City/State/Zip:
Phone:
Memphis TN 38120
951-276-9744
Digitally signed by CHEERS"". 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: 418-A020003455A-000-000-0000000-0000 Registration Date/Time: 2018-01-19 08:27:23
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2018-01-19 08:27:25