BMCH2017-0107rr
78-495 CALLE TAMPICO
Twit 4 4 Q"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O17-0107
Property Address:
78800 LIMA ST ST
APN:
776080015
Application Description:
ZUZACK / HVAC CHANGEOUT 16SEER/82AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$6,000.00
Applicant:
ALBERT CLALDE DBA A AND G AIR SERVICES
81891 SANDY COURT
INDIO, CA 92201
NE
APR 01 2017
-CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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.: 743185
Date: 3' ` ( Contractor:
t
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 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.).
( 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 I 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/3/2017
Owner:
RONALD ZUZACK
Contractor:
ALBERT OLALCE DBA A AND G AIR SERVICES
81891 SANDY COURT
INDIO, CA 92201
(760)342-010D.
Llc. No.: 743185
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificace of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of�jie wor 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: NORGUARD INSURANCE COMPANY Policy Number: ALWC700545
_ I certify that in the performance of3he work for which this permit is issued, I
shall not employ any person in any manner sc as to become subject to the workers'
compensation laws of California, and agree tF at, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
41-
^�
Date: S- \71 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 thi: 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 `he 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 tke 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 state laws relating to building
construction, and hereby authorize representa-:ives of this city to enter upon the above-
mentioned property for inspection purposes.
Date:—'4'- Signature (Applicant ar Agen
f Y
Application Number:
BMCH2017-0107
Property Address:
78800 LIMA ST ST
APN:
776080015
Application Description:
ZUZACK / HVAC CHANGEOUT 16SEER/82AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$6,000.00
Applicant:
ALBERT OLALDE DBA A AND G AIR SERVICES
81891 SANDY COURT
INDIO, CA 92201
Date: 4/3/2017
Owner:
RONALD ZUZ<.CK
Contractor:
ALBERT OLALDE DBA A AND G AIR SERVICES
81891 SANDY COURT
INDIO, CA 922101
(760)342-0100
Llc. No.: 743185
--------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - 16SEER/82AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
vd 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 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 #
Permit ;;
Project Address: v
J C600
City of L a QUhlta
BuifdinD 8z- Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701.2
Building Permit Application and Tracking Sleet
Owner's Name:
A. P. Number:
Address: o fk 0,
Legal Description:
City, ST, Zip: C,
t r V'4�i iv iN �
e:Cantra
Telephone:hon
Address: l gG'�
er
Project Description:
_City, ST,Zip: ^. 0K•5��
Telephone
P one: v �O l u
r -
State Lic.
City Lic. #.-
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
..C—?Ae.......
n Type: e -
Constructiontracti Occupancy:
.
State Lic- #
New Add'n Alter Repairai
Project ect tYPe (circle ne • r Demo
'Name of Contact Person:�
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: k--.,
Estimated Value of Project: �pvO v
tl Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rcc'd TRACKING P ZRMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Tit!e 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
SubeontactorList
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
M.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"! Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
I'ub. Wks- Appr
Date of permit issue
School Fees,
Total Pcrmit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -1R -ALT -HVAC
Climate Zones 10 to 15
Sitr
e�
Enforcement Agency:
Date:t
Permit At:
CC77 o L.
4 • "7 ^�_i
Conditioned Flour
Equipment T et List Minimum Efficiency
Duct insulation requirement
Area
Thermostat
❑ Packaged Unit
amore
❑ COP
Over 40 ft of ducts added or
,
aback
yli3:AFl1Eo
tJuor Coil �SEER1�
❑ HSPF _
replaced in unconditioned space
p p
Served h system
Y
(lfnot atlreotle
condensing Unit BEER 1,jL
❑ Resistance
❑ R 6 (CZ 10-1.3)
❑ R R (CZ 14-15)
I(� sf
present. must he
installed)
❑ Other
1. Equipme►ht Type: Choose the eyaipnen being installed: if store than one ststenh, rase another CF -1 R -ALT -HMC for earls SYSI,em.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPFfor spiral residential ststents.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final
inspection and a copy given to the homeowner. At final, the inspector verifies that (he work listed on this form was in fact the work completed by the
installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF4Rs allowed) are tilled out and
signed. Beginning October 1, 2010, a registered copy of the CF -IR and CF -6R shall also be on site for final inspection.
1. HVAC Changeout
Required Forms:
• All HVAC Equipment replaced
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH- 25 -HERS
CF -4I1 forms: MECH- 21 and (fors lits stems) MECH-25
• Condenser Coil and/or
CF -6R forms: MECH-2I-HERS and (for split systems) MECH- 25 -HERS
• Indoor Coil and /or
CF -411 forms: MECH- 21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA >_ 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
❑ I. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing ducts stems are constructed, insulated or sealed with asbestos
❑ 2. New HVAC System
Required Forms:
• Cut in or Changeout with new
CF -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (a11 new ducting and all
CF -411 forms: MECH 20-, and (for split systems)MECH-22, and MECH 25
new equipment)
For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with Replacement Required Forms:
• Includes replacing or installing all new ducting CF -611 forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoor CF -411 forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment changed.
For Split Systems: Duct leakage < 6 percent, RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
• Includes adding or replacing more than 40
CF -61Z forms: MECH-04, MECH-2I -HERS CF -4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duet leakage < 15 percent
❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's/Responsible Designer's Declaration Statement)
• 1 certify that this Certificate of Compliance documentation is accurate and complete.
• l am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24.
Pars I and 6 of the California Coale of Regulations.
• The design features identified on this Cenifrcate of Compliance are consistent with the information documented on other applicable compliance forms, worksheem
calculations, plans andspecifications submitted to the enforcement a encfora royal with the permit application.
Name:
r
Signature:
Compa \ `
Date- J _ `
'l
�� 1-1�
^
Address:\ LIN
License: /
City/State/Zip:
Phone. - 10