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BMCH2015-037278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tity 4 4 Quiftro COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT i Application Number. __' BMCH2O15-0372 Property Address: 79895 FIESTA DR APN: 600061001 Application Description: FALLUER / (1) 5 TON 16 SEER / 0.8 AFUE SPLIT SYSTEM Property Zoning: Application Valuation: $6,800.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: SHANE FALLEUR 79896 FIESTA DR. LA QUINTA, CA 91253 Date: 9/29/2015 Applicant:I I Contractor: A#1 SERVICES HEATING & AIR CONDITIONING SEP 2 2015) A#1 SERVICES HL'-1TING & AIR CONDITIONING 78206 VARNER ROAD #D-189 78206 VARNER ROAD #D-189 PALM DESERT, CA 92211 CIlYOFLAQUINTA PALM DESERT, CA 92211 COMMUNITY DEVELOPMENT DEPARTMENT (760)342-3610 Llc. No.: 977333 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am llicpeed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 e Business and Professions Code, and my License is in full force and effect. License Class: C200. C36 cLicense No.' 77 Date /+ /� Contra, ofr W 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).: (1 1, 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: 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 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one ot the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 370C of the Labor Code, for the performance ofth or for which this permit is issued. ave 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 insuranc-2 carrier and policy number are: Carrier: _ Policy Number: _ I certify that in the performance of -he work for which this permit is issued, I shall not employ any person in any manner so.as to b me subject to the workers' compensation laws of California, and agree that, ' should become subject to the workers' compensation provisions of Section 37 0 of the L bon CoI forthwith comply with ?those provisions. Date: /T Applicant: WARNING: AI LURE TO SECURE WORKERS' COLA PENSATION 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 appli®tion is made, each person at whose request and for whose benefit work is perform =d under or pursuant to any permit issued as a result of this application, the ownea, 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 applic: tion becomes null and void if work is not commenced within 180 days from date of i .suance 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 ci er up above-mentioned property for inspection purposes. Dat dP`�4W� Signature (Applicant or AgenA G 1 1• FINANCIAL ? <:DESCRIPTION . ` p `' f��'ACCOUNT_; t .QTY - ., i AMOUNT �•� �::; PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY+ "° ' f METHOD RECEIPT ,#.:,,, .; .CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 ' :DESCRIPTION y }, -, `ACCOUNT QTY AMOUNT,', �_ PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $0.00 aPAID BY' METHOD RECEIPT # CHECK #a , , CLTDtBY:;f ''bESCRIPTION•�;. ACCOUNT , `QTY;.� AMOUNT, PAID 'PAIDDATE' HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $36.26 $0.00 PAID BYe:a' a _ .,k .METHOD M _ RECEIPT #:< a CHECK # s CLTD BY . Total Paid for CHANGEOUT: $108.78 $0.00 'DESCRIPTION. , "ACCOUNT s _ QTY. ° .r ;. AMOUNT PAID , � ' PAID,DATE, PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY `'; 4" METHOD" f RECEIPT #;. CHECK # #., CLTD BY ' Total Paid foe PERMIT ISSUANCE: $91.85 $0.00 1 00 TOTALS:' Description: FALLUER / (1) 5 TON 16 SEER / 0.8 AFUE SPLIT SYSTEM Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 9/29/2015 SGU Approved: Parcel No: 600061001 Site Address: 79895 FIESTA DR LA QUINTA,CA 92253 Subdivision: TR 2180 Block: Lot: 60 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $6,800.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ZIP - PHONE:. FAX EMAIL. Details: HVAC CHANGE OUT- 16SEER/8AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES Printed: Tuesday, September 29, 2015 2:30:57 PM 1 of 2 c„ "` SYSTEMS NAME TYPE NAME , ADDRESS1. CITY STATE ZIP - PHONE:. FAX EMAIL. APPLICANT A#1 SERVICES HEATING & AIR 78206 VARNER ROAD PALM DESERT CA 92211 CONDITIONING #D-189 CONTRACTOR A#1 SERVICES HEATING & AIR 78206 VARNER ROAD PALM DESERT CA 92211 Co NnITIONING #D-199 OWNER SHANE FALLEUR 79896 FIESTA DR LA QUINTA CA 92253 Printed: Tuesday, September 29, 2015 2:30:57 PM 1 of 2 c„ "` SYSTEMS 7777�_. { :CLT DESCRIPTION ACCOUNT " " QTY AMOUNT If) "PAu PAID DATE RECEIPT # CHECK # METHOD , PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00. BSA: HVAC CHANGEOUT - 101-0000-42402 0 $72.52 $0.00 SPLIT -SYSTEM HVAC CHANGEOUT - 101-0000-42600 0 $36.26 $0.00 SPLIT -SYSTEM PC Total Paid for CHANGEOUT: $108.78 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 00 INSPECTIONS """"'" PARENT PROJECTS _. BOND INFORMATION..... „ ATTACHMENTS,,, Printed: Tuesday, September 29, 2015 2:30:57 PM 2 of 2 • srs•renns CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: Shane Falleur I Date Prepared: CF1R-ALT 02-E (Page 1 of 3 ) 2015-09-29 _ 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 MR -ALT -02 document for each dwelling unit. 01 Project Name Shane Falleur 02 Date.Prepared 2015-09-29 ' 03 Project Location 79895 Fiesta Dr 04 Building Type Single family OS CA City La Quinta 06 Dwelling Unit Name Shane Falleur 07 Zip Code 92253 t 08 Dwelling Unit Conditioned 1953 nstalling= ew.SC Installing }Installingr installing Floor Area (ft2) Identification or . location or Asea by this SC ducted containing Number of space conditioning more than 40 09 Climate Zone 15 10 (SC) systems in this dwelling 1 system? component? components? feet of ducts? unit. SC system? B. Space Conditioning (SC) System Information,`" 01 02 a F` 03 .. ; 04' ; 06r _07 f1 08 ' i 09 10 .IS the SC in a Installing a SC System SC System x 0CFA served ' ystem al refrigerant f %.,w7fC' nstalling= ew.SC Installing }Installingr installing Identification or . location or Asea 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 Whole House 1953 Yes Yes Yes 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: 215-A634125OA-000000000-0000 Registration Date/Time; 2015-09-29 11:56:01 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-29 11:56:00 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-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)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 _ Dud Length R -Value All new All new This field or This field or System 1 Central gas heating AFUE 0.8 Central split cooling SEER 16 Setback section is not section is not furnace components AC components applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans. -Duct insulation requirement for new plenums: R6. + >- ° . CF2R-MCH-20-H &'CF3R-MCH-20-H —Duct Leakage testing 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: :5 15%, ors 10% leakage to ouf' ide;'or seal all accessible leaks. CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow:;2;300'CF,NI/ton regi ired,when MCH -25 is required. Exceptions:y"9 -Duct systems registered with HERS provider as previously sealed are exe"mpt.fro MCH -20 Duct Leakage Testing requirements " -Heating-only systems and Air Handler/Furnace changes do not requirevenficatiomof Air Flow MCW=23, or'Refrigerant Charge MECH 25 Existing duct systems constructed, insulated ofsealed with esbestoNsare exempt from MCH 0 DuLakage Test g�requirements. •YL 9rk' .'O41 wv. W�ft . �° r.. N" E. Entirely New or Complete Replacement Du Sy tem, with or without;Equipment Changeo.ut (,Sections 1-50 2(b)1Dua and 150.2(b)lE, F) r k i This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)19 This section does not apply to this project. Registration Number: 215-A6341250A-000000000-0000 Registration Date/Time: 2015-09-29 11:56:01 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-29 11:56:00 Schema Version: 0.555SDD 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: Castillo, Daniel Company: Signature Date: A 1 SERVICES 2015-09-29 11:56:01 Address: CEA/ HERS Certification Identification (if applicable): 74866 Lennon PI City/State/Zip: Phone: Palm Desert CA 92260 760-565-2269 1 Responsible Person's Declaration staterneltnt I certify the following under penalty of perjury, under the law of the State of California: 1. The information provided on this CertificateCo fiance is true and correct. 'PR ; 2. I am eligible under Division 3 of the Business and Professions Code to accept-iesponsibility for the building design or system design identified on this Certificate of Compliance (responsible designer ,_bap, , 3. That the energy features and performance specifications, materials co'mponents, and manufactured devices for the building, design or system design identified on this Certificate of Compliance conform to the ti6`of Code requirements of Title 24, Part 1 and Pa the CaITia ofgulations.,y w 4. The building design features or system des gn features identified on=this Certifii ante bf Comp lance areCnsis,ent wgitthh,the information.provided orcother applicatile'compliance documents, worksheets, calculations, plans and specifications s b itted the enforcement gency for.-app ova ith.this building permit application. * *10 � � for v" �... ' k fil FES . all applicable 5. I will ensure that a registered copy of;this'Certificate of Compliance shall be made available wrth'the building;pecmit(s),issu d for.'.ih�uild g, and ade available to tfie enforcement agency •rx.A,i,.�. bu�ild�in404 at occupancy. ha...-� g owner inspections: I understand that a registered copy of this C�fficate of Coumpl ance s�requ�ire,� �d to be included kwith the clocumentation�thexbuild�er p�ro�es to the Responsible Desigher Name: �N - Responsible ble Des g er Signature: V PLOW Castillo, Daniel Company : Date Signed: A 1 SERVICES 2015=09-29 11:56:01 Address: License: 74866 Lennon PI 977333 Phone: 760-565-2269 1 Cl ly/S La Le/EI p. Palm Desert CA 92260 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: 215-A6341250A-000000000-0000 Registration Date/Time: 2015-09-29 11:56:01 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-29 11:56:00 - Schema Version: 0.5555DD Bin.# CItj/ Of %c7 Quinta Building 8T Safety Division P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 -:(760) 777-7012 Building Permit -Application and Tracking Sheet Permit # Project Address: —Owner's ` Name:.ne A. P. Number. Address: — Legal Description: City, ST, Zip: Contractor. oL Telephone: — — Lr-5% Address: Project Description: City, ST, Zip. Tele hone: P �, �. State Lie. # : City Lie. #!,qV77nA Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person: V Y ' a / h 'i.: i�N•'G vNJ �; t nh�U Construction Type:VAC Occupancy: Project type (circle one): New Add' Alter Repair Demo Sq. Ft.:#Stories: #Units: Telephone # of Contact Person: Q— — Estimated Value of Project: �p exi APPLICANT: DO NOT WRITE BELOW THIS LINE M Submittal Req'd Recd TRACKING PERMrr FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Chect Deposit. . 'Fuss Calcs. Called Contact Person Plan Check Balance. Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted.'. MechafikLI Grading plan 2" Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing, Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading N HOUSE-.- '"` Review; ready for correctionstissue Develope:- Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Pe.-mit Fees