BMCH2017-019178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0191
Property Address: 44420 FOXTAILCIR CIR
APN: 604081051
Application Description: HULL / (1)20 SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $6,500.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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, C36 License No.: 630503
Date:S Zz t- Contractor: Sc�us7���7
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 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 Na
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
SCOTT HULL
44420 FOXTAIL CIRCLE
LA QUINTA, CA 92253
Contractor:
A - AVIS PLUMBING HEATIN
600 EAST VALLEY BLVD
COLTON, CA 92324
(909)825-3600
Llc. No.: 630503
Date: 5/22/2017
. 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 work for which this permit is issued.
!Z4R�t__ 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9138414
I certify that in the performance of the work for which this permit is issued, 1
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.
Date:S 2.Z S7 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 ($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 1 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.
Date: �� LZ 1� Signature (Applicant or Agent): Z7�_ �'��------
Date: 5/22/2017
.Application Number: BMCH2O17-0191 Owner:
PropePty'Mdress,* 44420 FOXTAIL CIR CIR SCOTT HULL
APN: 604081051 44420 FOXTAIL CIRCLE
Application Description: HULL / (1)20 SEER/80AFUE SPLIT SYSTEM. LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $6,500.00
Applicant: Contractor:
IE INC A - AVIS PLUMBING HEATING & AIR CONDITIO
31225 LA BAYA 600 EAST VALLEY BLVD
WESTLAKE VILLAGE, CA 91362 COLTON, CA 92324
(909)825-3600
Llc. No.: 630503
------------------------------.--------------------------.------------------------------------
Detail: HVAC CHANGE OUT - (1)20SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FiflArICIAL IRFORRIATIOn
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
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
'HVAC CHANGEOUT- SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
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
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: Scott Hull I Date Prepared: 2017705-19
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.
Scott Hull
02
Date.Prepared
2017-05-19
03
Project Location.
44420 Foxtail Circle
04
Building Type -
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Scott.Hull
Dwelling Unit Conditioned
07
Zip Code
92253
08
Floor Area (ft2)
1600
(!"
SC System
Number of Space
CFA served
09
Climate Zone
15 -
30
Conditioning (SC) Systems in
1
Identification or
Location or Area
by this SC
this Dwelling Unit:
containing
• • ��,...�. i' -i �'►�`"".�,� i ,r.'�,` i; C""�a�� �,:-��y €"-`.� rte`-�;� � �'
.
B. Space Conditioning (SC) System Information .Of
.
01
02
03 �°�,
� `� 04
"05'�r-�a..-
rt 066—
F_.
� OT—.
� _ .
08
09
10
'Is the SCS
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
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1600
Yes
Yes
Yes
Yes
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 217-A020168643A-000-000-0000000-0000 Registration Date/Time: 2017-05-19 16:53:07
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005
HERS Provider: CaICFRTS
Report Generated: 2017-05-19 16:53:02
CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -1R -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
Duct Length
R -Value
Central gas
All new
Central split
All new
Greater than
System 1
furnace
heating
AFUE
80
AC
cooling
SEER
20
Setback
40 feet
R 8
components
components
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.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF213 and CF313-MCH-23 Airflow Rate >= 300 CFM per ton,required when MCH -25 is required.
Exceptions: -
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testingequirements.,,
Heating -only systems and Air Handler Furnace changes do not.require verification of Air Flow MCH-23,"o(Refrigerant MCH'25"
-Existing duct systems constructed, insulated or sealed with asbestos -Are exempt,from MCH=20 Duct@Leakage Test;ng requirrreinerits
E. Entirely,New or Complete Replacement Duct•System, with or without1cl ment Changeout (Sections 150.2(b)1Diia and--150.2(b)1E, F)
I e y
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: 217-A020168643A-000-000-0000000-0000 Registration Date/Time: 2017-05-19 16:53:07 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-19 16:53:02
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:
Jan
Jacoby, Ian
dacoiY.
Company:
Signature Date:
i PERMIT E RATERS
2017-05-19 16:53:07
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
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 land Part 6 of the California Code of Regulations'" e
4. The building design features or system design features identified on this Certificate of Compliance are consistent with -the information_provided on other, appyj{licabFl$e,compliance documents, worksheets,
calculations, plans and specifications submitted to enforcement agency forzapprovallwi� this bwld ung perm}t application. �
� l Y �
5: 1 will ensure that a registered copy of this Certificate of Compliance shall be`made,available with the building! peemit(s),issued for the building, and made availible; ci,the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is;requiired to be;included,with the documentation�the. builder provides to -the building owner at occupancy.
Responsible Designer Name: 1f I"
Responsible Designer Signature:" is
�n
Jacoby, Ian
acobJt.
Company:
Date Signed:
i PERMIT E RATERS
2017-05-19 16:53:07
Address:
License: -
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
Easy to Verify RE 10
-
at CalCERTS.com
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
1. L
i.
responsibility for the accuracy of the information.
a
Registration Number: 217-A020168643A-000-000-0000000-0000
Registration Date/Time: 2017-05-19 16:53:07
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-19 16:53:02
�z 4L
Bin.#
City, of La Quints
Building a Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Budding Permit Application and Tracking Sheet
Permit #
20 r]
ProjeccAddress: 44420 Foxtail Circle
Owner'sName:.Scott Hull
A. P. Number.
Address: 44420 Foxtail Circle
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. A -Avis Plumbing Heating & Air
K.
Telephone: 559-593-5216 ;�?,
Address: 600 E Valley Blvd
Project Description: Replace 5 ton A/C, coil, 80,000
City, ST, Zip: Colton, CA 92324
BTU furnace and 9 ducts
Telephone: 909-825-3600
"2 r
State Lic. # : 630503 City Lie. #;
Arch, Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:Project
Name of Contact Person: Steven Schnierer
Construction Type Occupancy:
type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories:
#Units
Telephone # of Contact Person: 818-735-7876
Estimated value of Project: $21,600.90.
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for cortecdons
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction ;
Flood plain. plan
Plans resubmitted .' .
Mechanical
Grading plan
2`d Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.OA. Approval
Plans resubmitted
Grading
IN HOUSE:-
'jd Review; ready for correction&rtwue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit lssue
School Fees
Total Permit Fees