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BMCH2017-0045LICENSED 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 License No.: 857079 Date: — 24' l 7 Contractor. L /dJ( C2 dTl 1� OWNER -BUILDER DECLARATION 1 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 Seca . 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 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certifica•:e 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. JA�'I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfarmance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: STATE COMPENSATION INSURANCE FUND Polity Number: 9080831 _ 1 certify that in the performance olthe work for which this permit is issued, l shall not employ any person in any manner s• 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: c;2— 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, ane 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 =he 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 ordnances and state laws relating to building construction, and hereby authorize representatives of this city to r upon the abo mentioned property for inspection purposes. Date: / Signature (Applicantor Agent . / Q�i a� VOICE (760) 777-7125 78-495 CALLE TAMPICO U FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/28/2017 Application Number: BMCH2O17-0045 Owner: Property Address: 79875 LIGA DAVE GOURLE" APN: 776230041 79875 LIGA Application Description: GOURLEY / HVAC CHANGEOUT LA QUI NTA, CA 92253 G� z W Property Zoning: ,= Application Valuation: $7,500.00 ^_ • a a o C= C7 z Applicant: Contractor: 09 icy a ALDCOAIR ALDCOAIR w i 50100 VISTA MONTANA.CT 50100 VISTA MONTANA CT UJ d "'I i j-INDIO, �' CA 92201 INDIO; CA 922C1 (760)564-9963 Llc. No.: 857079 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 License No.: 857079 Date: — 24' l 7 Contractor. L /dJ( C2 dTl 1� OWNER -BUILDER DECLARATION 1 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 Seca . 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 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certifica•:e 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. JA�'I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfarmance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: STATE COMPENSATION INSURANCE FUND Polity Number: 9080831 _ 1 certify that in the performance olthe work for which this permit is issued, l shall not employ any person in any manner s• 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: c;2— 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, ane 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 =he 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 ordnances and state laws relating to building construction, and hereby authorize representatives of this city to r upon the abo mentioned property for inspection purposes. Date: / Signature (Applicantor Agent . / Date: 2/28/2017 Application Number: BMCH2017-0045 Owner: Property Address: 79875 LIGA DAVE GOURLEt - APN: 776230041 79875LIGA Application Description: GOURLEY / HVAC CHANGEOUT LA QUINTA, CA:92253 Property Zoning: Application Valuation: $7,500.00 Applicant: Contractor: ALDCOAIR ALDCOAIR 50100 VISTA MONTANA CT 50100 VISTA MONTANA CT INDIO, CA 92201 INDIO, CA 92201 (760)56479963 Llc. No.: 857079 Detail: HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM [2016 ENERGY] CARBON MONOXIDE ALARMS) TO BE IA`STALLED 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 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 CHANBEOUT: $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 Qin # Permit #t Project Address:. 22 Ze arty of b Quinta Buitding 8£ Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sheet Owner's Name: G y A. P. Number: Address:CN Legal Description: City, ST, Zip: Q V ZZ 3 r: Contracto ' Pr L I Te e Phone 7 2- �y Address: :!so Jcv Project Description:' ( G a� ) City_. ST, Zip: Tele hone: . p on 3 bjo��6V_996 State Lie. # : S 70 7q City Lie. #- Arch., Engr., Designer: Address: City, ST, Zip: Telephone: cY a3Con traction TYP State Lie. #. Project (circle one):: New Add 'n Auer Repairm Demo Name of Contact Person: Ot 'L Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: y p 7 Op�� (� (% Z Estimated Value of Project: S .APPLICANT: DO. NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PEZMIT FEES Plan Sets Plan Check submitted Item. Amount Structural Calcs. Reviewed, ready for corrections Plan Check Depos`t Truss Calcs. Called Contact Person Plan Check Balan_e. . Title 24 Cates. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical . Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval flans resubmitted Grading IN ROUSE:- '"' Review, ready for corrections/issuc Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr Dale of permit issue. School Fees, . I . Total Permit Fees CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E I Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3) Project Name: Dave Gourley I Date Prepared: 2017-02-27 I A. General Information CF111-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 Dave Gourley 02 Date Prepared 2017-02-27 03 Project Location 79875 Liga 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name Dave Gourley SC System SC System . CFA served Dwelling Unit Conditioned refrigerant 07 Zip Code 92253 08 Floor Area (W) 4000 Location or Area by this SC ducted containing Number of Space more than 40 09 Climate Zone 15 10 Conditioning (SC) Systems in 1 system? component? components? feet of ducts? this Dwelling Unit: SC system? d-7, t r ) r Y B. Space Conditioning (SC) System Information �k 01 02 03 `` 04 K : 05:, +•'i ter -06 =w d+ p p"n. w: 07a> , � S -t. 08 .� iYwrc < 09 y.'A�` 10 v...u; FIs the SCS 'h .,.n. i. 2 Installing =a l J 1�' i. $�+lr. g qII.. •�...w �cJ C $3./'.W..F,,-�. �xri- 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 (ftz) system? component? components? feet of ducts? duct system? SC system? Alteration Type system 1 Living Area 2000. Yes" Yes Yes No 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-A020064728A-000-000-0000000-0000 CA Building Energy Efficiency. Standards - 2016 Residential Compliance Registration Date/Time: Report Version: 2016.1.005 c..4.nr.., %1 -:nn. —, In/9C 2017-02-27 15:17:10 HERS Provider: CalCERTS Report Generated: 2017-02-27 15:17:58 CERTIFICATE OF COMPLIANCE CFlR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1g -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 it 12 Hpating 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 This field or This field or system 1 furnace heating AFUE 80, AC cooling SEER 16 Setback section is not section is not components components applicable applicable Required Documentation: CF2R-MCH-01-E -Space Conditioning Systems - Duct insulation requirementfor the new portions of supply -air and return -air ducts or plenums: R5 (CZ 1-50, 12 and 13) and R8 (CZ 11'and 14-16) CF211 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.requ[red when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF211 and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. Exceptions: Dud systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct Leakage�Testing requirements. ,,. 6, Charge Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH;23 or Refrigerant MCH 25 �a++;..+ iB ry 'A tG i� k� ':.'15 -Existing duct systems constructed, insulated or sealed with asbestos are exempt:from MCH- Du Testing -requirements. $t, , �Rl ._ �R,.._.. {dfi N11 R 4 P., %4 tT s; _ =;n `4bYavfi A..rtu..:yY.'.Y.. K• :rc. }: fi+i tT n.r '-::d'i� ''Rk' E. Entirely New or Complete Replacement ZN Duct Sy,A�,tem, wi h or withoUt,Equipment Changeout .(Secti ns -15 F) 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-A020064728A-000-000-0000000-0000 CA Building Energy Efficiency Standards —2016 Residential Compliance Registration Date/Time: 2017-02-27 15:17:10 Report Version: 2016.1.005 HERS Provider: Ca10ERTS Report Generated: 2017-02-27 15:17:58 CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) (Page 3 of 3) Documentation Author's Declaration Statement l..1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Aldaz, Rafael Company: Signature Date: A L D C O Air 2017-02-27 15:17:10 Address: CEA/ HERS Certification Identification (if applicable): 50100 Vista, Montana Ct. City/State/Zip: Phone: Indio CA 92201 760-564-9963 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 energyfeatures and performance specifications, materials,' components,and anufactu �ed devices four th*tUMIK4e buildingilgdesig system design identified on this Certificate of Compliance conform to the P P P f �onents requirements of Title 24, Part 1 and Part6 of the California Code of Re ulations. $ ,�..�. . 4. The building design features or system design features l�dgntified o� his Certific of CpmpIlance are'cgMistewith the information provided onsotherapplicable=compliance documents, worksheets, calculations, plans and specifications submitted to the enf rcement�agency for approv I Wit this buil n p j g PerrtfJt aR�ication. f '* yi w ?+S Aol;� S. I will ensure that a registered copy of:this.Certificate of,CCQmpliance s`heli gg;inade available witojhe bulldijig;pgtmit("s),Issued for thebuilding and%made availab el to;the enforcement agency for all applicable inspections. I understand that a registered copy ofthis.-AZ rtificate of Compqance,-.,requited to 4g included,with the4aocumr tatfon the builder pwovides to the building owner at occupancy. Responsible Designer Name: Aldaz, Rafael Responsible Deflgher signature: y `N Company: Date Signed: A L D C C Air . 2017-02-27 15:17:10 Address: License: 50100 Vista Montana Ct. 857079 City/State/Zip: Phone: Indio CA 92201 1760-564-9963 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: 217-A020064728A-000-000-0000000-0000 Registration Date/Time: 2017-02-27 15:17:10 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-02-27 15:17:58