BMCH2017-0250_ O�i
78 495 CALLE TAMPICO V
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH254410A ENID 0
Property Address: 54410 AVENIDA 1UAREZ
APN: 774233008
Application Description: ABLON RESIDENCE/ HVn7_-,,L4AEOUT
Property Zoning: JUN 2 ® 2017
Application Valuation: $6,800.00 U ID)
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
JEANNE ABLON
54410 AVENIDA JUAREZ
LA QUINTA, CA 92253
Date: 6/20/2017
Applicant: DESIGNANDD �CITY OFLAQIJINTA Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI LDPMENTDEPARTMENT J ANTHONY PLUMBING
SHORE ST (EATING & AIR CONDITI
72216 NORTH SHORE ST #101
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
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 oLeBusiness and Professions Code,
and my License is in full force and effect.
License/Class: C20 C36 License No.: 777
( Date: -t0 f% I 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. 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 Name:
Lender's Address:
(760)328-8096.
Lic. No.: 777794
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.
_ 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: MIDWEST EMPLOYERS CASUALTY COMPANY Policy Number:
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 should become subject to the
workers' compensation provisions of Section 370 of the Labor Code, I shall forthwith
complgit hos provisions.
Date: 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 I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and stat aws relating to building
construction, and hereby authorize representatives //thi to enter upon theabovegen coned property for inspection. purpose s.
Date: Signature (Applicant or Ag
Date: 6/20/2017
Application Number: BMCH2O17-02SO
Owner:
Property Address: S4410 AVENIDA JUAREZ
JEANNE ABLON
APN: 774233008
S4410 AVENIDA JUAREZ
Application Description: ABLON RESIDENCE / HVAC CHANGE OUT
LA QUINTA, CA 922S3
. Property Zoning:
Application Valuation: $6,800.00
Applicant:
Contractor:
J ANTHONY PLUMBING HEATING & AIR CONDITI
J ANTHONY PLUMBING HEATING & AIR CONDITI
72216 NORTH SHORE ST #101
72216 NORTH SHORE ST #101'
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92276
(760)328-8096
---------------------------------------------------------------------------------------------
Llc. No.: 777794'
Detail: HVAC CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
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
Total Paid for TECHNOLOGY ENHANCEMENT FEE: • $5.00
Bin #
city. of La Quinta
Building 8i Safety Division
Permit # 78-495 .Calle Tampico
La Quinta, CA 92253'- (760) 777-701,2
Building Permit Application and Tracking Sheet
Project Address: "'//0 4(IVAIIC A � Owner's'NameJ
A. P. Number:
Address'
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address:
...........
Project Description:
City, ST, Zip: 12216 NORTH SHORE ST STE 101
Telephone:
State Lic. # : 77?G
City Lie. #.:/0 Fo
Arch.,;Engr., Designer:
Address:
City, ST, Zip:
Telephone:
h one:
Con structi n TYPe- Occupancy:cY
,
State L .
' ic.%
Project tYPa (circle one): New Add'n Alter Repair-ar Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: '
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT TEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections. '
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked•up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2°" Revicw, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d. Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Dale of permit issue
School Fees,
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-iR-ALT HVAC)
Project Name:
ABLON I Date Prepared:
CFiR-ALT 02-E
(Pagel of 3) 1
2017-06-20 I
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
CF1R-ALT 02 document for each dwelling unit.
01
Project Name
ABLON
02
Date Prepared
2017-06-20
03
Project Location
54410 AVENIDA JUAREZ
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
ABLON
X08
'
Dwelling Unit Conditioned
07
Zip Code
92253 ; ti
::.
r„
OS
Floor Area (ft)
1600
SC System
SC System
CFA served
Number of Space
refrigerant
09
Climate Zone ; _' `
15
10
Conditioning (SC) Systems in
1
Location or Area
by this SC
ducted
containing
this Dwelling Unit:
more than 40
B. Space Conditioning (SC) System InformationH in
r
y. r
01
02
03
0405"
06..,
07
09
10
X08
'Is,the SC ?
I stallinj �a
' f
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
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-A020209491A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-06-20 10:49:31
Report Version: 2016.1.005
Schema Version: rev 10/16
HERS Provider: CaICERTS
Report Generated: 2017-06-20 10:49:27
CERTIFICATE OF COMPLIANCE CFiR-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
30
31
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
Outdoor
This field or
This field or
System 1
Central gas
Gas furnace
AFUE
81
Central split
condensing
SEER
14
Setback
section is not
section is not
furnace
AHU
AC
unit
applicable
applicable
Reauired Documentation:
Space Conditioning Systems
CF2R-MCH-01-E - ,
- 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 wleri Heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced
;r -y.
-Leakage rate compliance: <= 15% or <= 10% leakage to outsideyxor 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).
CF2R and CF3R-MCH-23 Airflow Rate >=:300 CFM per tonfrequired when MCH-25.is required... .
:. .:
Exceptions: "'+ -„,F°F ,�-. X;_
Duct systems registered with HERS provider as prev'ously sealed are exempt from MCH 20 Duct Leakage Testing,req�uiremle #
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH=23 or Refrigerant Charge MCH 25
.�.� r
,
-Existing duct systems constructed, insulated or sealed with :asbestoare exemptfrom MCW20 DuC�tiLeakage Test nigequireme�tts.
it :.,'�'14?4 9*;-. ,Gy. .. in, Z4! W WN. 11 W *11. If: ;. X,;V .rlfyi :R SVA Y «ti:
k -r: e`�y =�• '.� .rs �r}3: tew'»..�,,:�+r• a',; !:?:«�'h:' ""
E. Entirely New or Complete Replacement Duct System, with or withou Equipment Changeout (Sectiony150 2(b)1Dna :and 150.2(b)lE, 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: 217-A020209491A-000-000-0000000-0000
Registration Date/Time: 2017-06-20 10:49:31
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-06-20 10:49:27
Schema Version: rev 10/16
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:
Robinson, Kevin
Company:
Signature Date:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-06-20 10:49:31
Address:
CEA/ HERS Certification Identification (if applicable):
72216 NORTH SHORE ST #101
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
Responsible Person's Declaration statement:
1 certify the following under penalty of perjury, under thelaws"if the State of California:
1. The information provided on this Certificate of Compliance.is true and correct.
s to acceptresponsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
2. I am eligible under Division 3 'iif the Bustn'esssand ProfessionCode
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
Ilk
requirements of Title 24, Part 1 and Part:6W the California Code of Regulations
4. The building design features or system design features identified onhis Certifrpt of Co°rriptiance are:consistent with the information,provided on,othelappticalite compliance documents, worksheets,
calculations, plans and specifications submitted,to the enforcemeAgency fo ad pp oval.,wit� this building permit application;.
`; ` - 'w.. $ s _.
.rte`
S. I will ensure that a registered copy of thisCertificate ofCompliance shall bg_ made,available with the;buitding€p ermit(s)alssued for=#hebwld�ing and'made ava(lable to the ehforcement agency for all applicable
inspections. I understand that a registeredcopyof thiiWeitificate of Com pliance�ls.requ�i %d tob eincluded0th the documentation theWbuilderprovides too.0e bu)d ng owner at occupancy.
Responsible Designer Name: " —' i
at'�e..�. � .pg. ice.
Responsible Designer 5ignature: ` f �'
Robinson, Kevin
K
Company:
Date Signed:
J ANTHONY PLUMBING HEATING & AIR CONDITIONING
2017-06-20 10:49:31
Address:
License:
72216 NORTH SHORE ST #101
777794
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-2121
Easy to Verify
at CaICERTS.com
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility tc
r the accuracy of the info ri '
Registration Number: 217-A020209491A-000-000-0000000-0000
Registration Date/Time: 2017-06-20 10:49:31
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-06-20 10:49:27
Schema Version: rev 10/16