BMCH2015-032878-495 CALLS TAMPICO Twit 4"'i_ 0"cu VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
�- INSPECTiQNS (760) 777-7153
BUILDING PERMIT
Date: 9/2/2015
Application Number: BMCH2O15-0328 Owner: L�
Property Address: 53035 AVENIDA HERRERA RYAN MARSDEN "
APN: 774053013 53035 AVENIDA HERRERA rr,
Application Description: MARSDEN / CAHNGE OUT (1)17SEER/78AFUE SPLIT SYSTEM LA QUINTA, CA 92233
Property Zoning
Application Valuation: $6,000.00 " Q
r >L�
Applicant: Contractor. o
CERTIFIED COMFORT SYSTEMS INC CERTIFIED COMFORlr5y.mm vt
42-949 MADIO STREET 42-949 MADIO STREET _
INDIO, CA 92201 INDIO, CA 92201"
(760)360-2202
Llc. No.: 906115
-
---------------------- ----------- --------------- ------- ------------------------
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 Licence Is in full force and effect
License Class: C20, Q6 License No.: 906115
�ti� E�c��
Date. S Contractor:
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. 70315, 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).:
(_ j 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 site did not build or improve for the purpose of sale.).
(_J 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 contractors) licensed pursuant to
the Contractors' State License Law.).
(_J 1 am exempt under Sec. " B.&P.0 for this reasah
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 fol lowing declarations:
_ I have and will maintain a certificate & consent to seff-insure for workers'
campensatt n, as provided for by Section 3700 o -1 -the Labor Code, for the performance
of the wgfk for which this permit is issued.
.
-#0' 1 have and will maintain workers' com �ensatlon insurance, as required by
tion 3700 of the Labor Code, for the performance of the work for which this permit
is imsued. My workers' compensation insypnce orrier anclAoicyriumber are:
Carrier— Policy Number._ &;yLAC—t ,,f7-
I certify that in the performance df the work for which this permit is issued, I
shall not employ any person in any manner so as :o become subject to the workers'
compensation laws of California, and agree that, F I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Co , i II forthwith
comply with Pose provisions.
Date: �A � Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMFENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
DNE HUNDRED THOUSAND DOLLARS ($100,000).. IN ADDITION TO THE COST OF
-OMPENSATION, DAMAGES AS PROVIDED FOR IN SECrION 3706 OF THE LABOR CODE,
NTEREST, AND ATTORNEYS FEES.
APPLICANT ACKNOWI=DG EN03VT
IMPORTANT:Appiication is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this ag.plication.
1. Each person upon whose behalf this applicaton is made, each person at whose
request and for whose benefit work is performer under or pursuant to any permit
issued as a result of this application , the owner, End the applicant, each agrees to, and
shall defend, indemnify and hold harmless the CAV 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 applicatian 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 cenceilathn.
I certify that I have read this application and state -that the above informtlon is correct.
I agree to comply with all city and county ordinances and state laws relating to buildi
construction, and hereby authorize representatives of this city I enter upon t a
mentioned property for inspection purposes. �-
Date: Pv/( A" Signature (Applicant or Agent
FINANCIAL INFORMATION
QTY_ NT-PUAID `i, *,:PAID DATE
i`ACCOm
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
x
'' PAID BY,"METHOD r. RECEIP:T,# `CHECK# ',$; ;. CLTD BY
ar _.t_..t
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA* $1'.00 $0.00.
'.'DESCRIPTION
,'ACCOUNT
QTY
T,-_, AMOUNT'....
ri I if
(PAID DATE::
.PAID
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
q PAID BY r, ;
* METHOD '
s
` �, RECEIPT Ji.
x' CHE# i. �
CK.
CLTD BY
_v ,
;DESCRIPTION >
ACCOUNT .'
QTY
' : AMOUNT,
';4� PAID -�
""PAID DATE:'
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
~`METHOD
PAID BY
z•, .
g`.RECEIPT# x4 r
CHECK# `°
CLTD BY
,
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIPTION, ' °
' s ' >A00OUNT,
QTY*AMOUNT
.:
`PAID.
PAID DATE'.
_.
PERMIT ISSUANCE
101-0000-42404,
0
$91.85
$0.00
g 'PAID BY ' �` * `_
w
"METHODRECEIPT
#;"
"CHECK # '
:+ CLTD BY
•'
>� .
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
0
v
Description: MARS,DEN / CAHNGE OUT (1)17SEER/78AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 8/20/2015 SKH
Approved: 8/20/2015 SKH
Parcel'No: 774053013 Site Address: 53035 AVENIDA HERRERA LA QUINTA,CA 92253
Subdivision:'SANTA CARMELITA VALE LA QUINTA Block: 218 Lot: 1
Issued:
UNIT 21
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $6,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 17SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CONDITIONS
Printed: -Wednesday, September 02, 2015 3:51:33 PM 1 of 2
• SYS TEti1S
DESCRIPTION,
`a ACCOUNT
QTY't,
AMOUNT µ •
PAID
PAID DATE'
> RECEIPT W.
. CHECK #:)'
METHOD
PAID BY 1;,
CL YD;
Permit Details PERMIT NUMBER
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
City of La-Quinta BMCH26115'"0328
SPLIT -SYSTEM
DESCRIPTION,
`a ACCOUNT
QTY't,
AMOUNT µ •
PAID
PAID DATE'
> RECEIPT W.
. CHECK #:)'
METHOD
PAID BY 1;,
CL YD;
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 forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
07
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
100MON111MMI 1111 IN III 1111 1 � I'll 1, �!
Printed: Wednesday, September 02, 2015 3:51:33 PM 2 of 2
SYSTEMS
Bin. #
City of La Quinta
Building 8L Safety Division
Permit #
P.O. Box 1504,78-495 Calle Tampico
'14.QWnta, CA 92233 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's Name:.
A. P. Number.
Address:
City, ST, Zip: a ��
Telepho ne. > ><>-' •�
Legal Description:
Contractor:
Address:
Project Description:
City, ST, Zip: + C �1 z
Telephone: Z p. "'i:. :i
S
State Lic. # : 1. L City Lic. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: Construction Type:. Oacu an
' P cY=
State Lic. #:
Project type (oircle one)- New Add'r. Alter Repair Demo
Name of Contact Person: Sq. Ft : #Stories: #Units:
Telephone # of Contact Person: Estimated Value of Project.
APPLICANT: DO NOT WRITE BELOW THIS LINE
0
Submittal
Req'd
Recd
TRACKIIVG
PERMIT FEES
Ylan Sets
Plan Check submitted
Item
Amount
Structural Calks.
Reviewed, ready for corrections
Plan Check Deposit. .
Pian Check 3alance _
Truss Calks.
Called Contact Person
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
tad Review, ready for correctionsriissue
Electrical
5ubconmctor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O A Approval
Plans resubmitted
Grading
IN HOUSE-
Review, ready for correctionsfissuc
Developer rnpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Perm_t Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC)
CFiR-ALT 02-E
IProject Name: 53-035 Avenida Herrera I Date Prepared: 2015-08-11 I
A. General Information
CHR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CRR -ALT -02 document for each dwelling unit.
01
Project Name
53-035 Avenida Herrera
02
Date Prepared
2015-08-11
03
Project Location
53-035 Avenida Herrera
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
53-035 Avenida Herrera
07
Zip Code
92253
08
Dwelling Unit Conditioned
1618
Installing
Installing
installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
enn elyen w
09
Climate Zone
15
10
(SC) systems in this dwelling
1
component?
components?
I feet of ducts?
I duct -system?.
unit.
Alteration -Type -
B. Space Conditioning (SC) System Information
01
02
03 h
04,V
'0S J tll�
f 061 M
J1 07`i)
OS
(, 09
10
�,Is the SC"
' Installing a
SC System
SC System
CFA served
'ti system a�---
refrige nt "
_
Installing new SC
Installing
Installing
installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
enn elyen w
entirely new
Name
Served
System (ft2)
system?
component?
components?
I feet of ducts?
I duct -system?.
SC system?
Alteration -Type -
System 1
Location 1
1600
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: 215-A0223569A-000000000-0000 Registration Date/Time: 2015-08-11 18:36:24 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-08-11 18:36:28
Schema Version: 0.555SDD
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)1E and F)
01
02
03
04
05
06
07
08
09
10
it
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
This field or
This field or
System -1
HP... .•
- heating
AFUE
0.78 ...•
AC
... cooling -
SEER
17
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF211-MCH-20-11 & MR -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: < 15%, or <_ 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-2S-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-1v1CH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from -MCH -20 Leakage -Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Fliiw MCH -'23, or Refrigerant Chayg MECH-251
-Existing duct systems insulated from MCH -20 Duct'Leakage Testing
constructed, or sealed with asbestos are exempt requirements. i f
E. Entirely New or Complete Replacement Duct System, with`or withou Equipment C ng out ( ections 150.2ODii andjS0.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC)
This section does not apply to this project.
Registration Number: 215-A0223569A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-08-11 18:36:24 HERS Provider: CalCERTS
Report Version: 2014-03-31 Report Generated: 2015-08-11 18:36:28
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-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:
Hyde, Mark
Company:
Signature Date:
CERTIFIED COMFORT SYSTEMS INC
2015-08-11 18:36:24
Address:
CEA/ HERS Certification Identification (if applicable):
42949 Madio
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
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'arid Professions Code to accept responsibility for.the building design or system.design identified on this Certificateof 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 i t , # I ---t 1 r) C--� --2 (7E i I
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 enforcemeni agency foraa pr6al with this building application.
permit
�i - � as
5. 1 will ensure that a registered copy of this Certificate of Compliance shallav
be made ailable�with the building permi1rts) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the document ationthe builder provides to the building owner at occupancy.
Responsible Designer Name: 1 I IL— t A .,i
Responsible Designer Signature:
Hyde, Mark
Company:
Date Signed:
CERTIFIED COMFORT SYSTEMS INC
2015-08-11 18:36:24
Address:
License:
42949 Madio
906115
City/State/Zip:
Phone:
Indio CA 92201
(760) 360-2202
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-A0223569A-000000000-0000 Registration Date/Time: 2015-08-11 18:36:24 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-08-11 18:36:28
Schema Version: 0.555SDD