BMCH2017-030778-495 CALLE TAMPICO Twit4.4.0"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0307
Property Address: 49360 MISSION DR WEST
APN: 602150004
Application Description: TOPOR / CHANGE OUT (1) 14SEER CONDENSOR AND COIL
Property Zoning:
Application Valuation: $3,277.00
Applicant:
JOHN BORDEN HEATING AND AIR CONDITIONING
P 0 BOX 459
YUCAIPA, CA 92399
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: C(2200 License No.: 719570
O___�",4��___
Data e: / • 1 ` ' Contractorf
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 Cade: 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.).
a
Lender's Name:
Lender's Address:
Owner:
ROBERTTOPOR
5714 W VIEW DR'
ORANGE, CA 92869
Contractor:
JOHN BORDEN HEA
P 0 BOX 459
YUCAIPA, CA 92399
(951)797-5669
Llc. No.: 719570
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
7
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'
compensate as Pro"
rovided for by Section 3700 of the Labor Code, for the performance
of thew for which this permit is issued.
iI'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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031288
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 I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
atey'. kok-a
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 state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date// • kig ture (Applicant or Agent):`
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7
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'
compensate as Pro"
rovided for by Section 3700 of the Labor Code, for the performance
of thew for which this permit is issued.
iI'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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031288
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 I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
atey'. kok-a
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 state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date// • kig ture (Applicant or Agent):`
Date: 7/19/2017
Applicant:*
Contractor:
JOHN BORDEN HEATING AND AIR CONDITIONING
Application.Alumber:
BMCH2017-0307
Owner:
Property Address:
49360 MISSION DR WEST
ROBERTTOPOR
APN:
602150004
5714 W VIEW DR
Application Description:
TOPOR / CHANGE OUT (1) 14SEER CONDENSOR AND COIL
ORANGE, CA 92869
Property Zoning:
Application Valuation:
$3,277.00
Date: 7/19/2017
Applicant:*
Contractor:
JOHN BORDEN HEATING AND AIR CONDITIONING
JOHN BORDEN HEATING AND AIR CONDITIONING
P O BOX 459
P 0 BOX 459
YUCAIPA, CA 92399
YUCAIPA, CA 92399
(951)797-5669
------------------------=-------------------,-------------------------------------------------
Llc. No.: 719570.
Detail: HVAC CHANGE OUT - (1)14SEER CONOENSOR AND COIL. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
FINANCIAL •• •
DESCRIPTIONACCOUNT' 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 - CONDENSER ONLY
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC"
101-0000-42600
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - OTHER EQUIPMENT
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - OTHER EQUIPMENT PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT:. $139.33
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: $5.00
Oty of* La Quina
Bugftg ar Safety DF fibs
P.O. Box 1504,•78-49S Cage Tampko Bui! 4.Q`hn�, ca 9223 - (760) 777-7012.
ding Pem* A0plicadon' and Tracking Sheet
Peritnt #n�
PmjedAddress: q3toQUisSio
1
•owner's Name:. 0
A P. Number
Addrm: 5 y Lk) • VleL,t3 Or.
Legal Description+
Contractor. VJ
JHeafimA
k6mk
��.ST. r q2�c�
elephone: • 2$D . 8
Project Description: in 3 T 5
Address: 06
c*' n. zip: U
Tehsphoao:q
State iia # :
0 3 9_LqStcrCo
< cty Li ' sJ.
S
1
Awl' EW' Designer:
b
Address:
City, ST, Tap:
Telephone:
�o Lia #:
Construction Type:.1tV 4C Occupancy:
Ptojcot type (*do one): Now Add'n Alter Repair Demo
Name of Contact Penson
0
Sq• pt : ' 9 2
Storibs:
# Uaitg: 2
TdWhonc # of Contact Person
e.4 i � I
Estimated Value of Pmjecx 3.) .-7 .
APPLICANT: DO NOT WRITE BELOW TIM UNE
p
Submittal
RWd
Reed
TBAQMG
Pl'sRlliTi FEFS
Pip Sete
Plan Cher: submitted •
Deal
Amount
S"ctutal Gine.
Reviewed, ready for wrrxcdoas
Plan Chcck Deposit. .
Truuas Cala.
Called Contact Penn
Pian Check Balance
Title 24 Calm
Plane picked up
Construction
Flood plain plan
Plans resubmitted.' •
Mechatikal
Ginding plan
2' Review, ready for correctlonerasue
Electrical
Sabeontactor List
Called Contact Person
Plumbing
Groat Deed
Pians pidmd up
S.M L
E.O.A. Approval
Plaus resubmitted
Grading
HOUSES
''' Review, ready for corrudoaermue
Developer Impact Fee
Planning Appy •
Called Contact Person
A,Lp p. '
Pub. Wks. Appr "
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
ROBERT TOPOR I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2017-07-18
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
CF111-ALT 02 document for each dwelling unit.
01
Project Name
ROBERT TOPOR
02
Date Prepared
2017-07-18
03
Project Location
49360 MISSION DR W
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
SYSTEM
07
Zip Code
92253 /`'
-0812924
Dwelling Unit Conditioned
2924
system
more than 40
entirely new
entirely new
Floor Area (ft )
Name
Served
System (ft2)
.y
component?
Number of Space
feet of ducts?
09
Climate Zone
.15
10
,
Conditioning (SC) Systems in
1
f
this Dwelling Unit:
B. Space Conditioning (SC) System Information
'. TIL -J). ice'
01
02
03
04
if 05
06 S ' '-
07
08
09
10
SC System
SC System
CFA served
Is the SC
system a
Installing a -
Vi
refrigerant
-?nWi lntearlf
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
Altered space
SYSTEM
HOUSE
2924
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 417-A020103902A-000-000-0000000-0000
Registration Date/Time: 2017-07-18 19:33:56
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-18 19:33:56
Schema Version: rev 10/16
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
30
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
No heating
This field or
This field or
Central split
All new
Less than or
SYSTEM
furnace
component
section is not
section is not
AC
cooling
SEER
14
Setback
equal to 40
R-8
altered
applicable
applicable
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems cg "
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6.(CZ 1 10 12'a4 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 inducted systems, or when more than 40 ft of duct length is replaced
-Leakage rate compliance: <=1S% or <=10% leakage to outside, or seal all accessible leaks.
CF211 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 ton required when MCH 25 is required. f
Exceptions:.
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or w thoutE'quiPpment Changgeot (Sections 150.2 b lDiia and 150.2 b lE, F)
otlent ttprThssection saply o hisoject.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 417-A020103902A-000-000-0000000-0000
Registration Date/Time: 2017-07-18 19:33:56
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-18 19:33:56
Schema Version: rev 10/16
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:
Connie Goe
C0nAz ,Qoe,
Company:
Signature Date:
Russells Heating & Air Conditioning
2017-07-18
Address:
CEA/ HERS Certification Identification (if applicable):
33145 Yucaipa Boulevard
City/State/Zip: ,r
Phone:
Yucaipa CA 92399,909;797-5669
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. f
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 1 and Part 6 of the California Code of Regulations.
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 enforcement agency ford -approval -with this building permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with tt a building�permit(spissued for the building, and made available to the enforcement agency for all applicable
�., A# �f k +t\,,. . a... t!. dr
inspections. I understand that a registered copy of this Certificate of Compliance is'required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: , nResponsible
[1"sCi1%f's i �Tz. +.:Cowiue
Designer Signature:
Goeir(
Connie Goe
Company:
Date Signed:
Russells Heating & Air Conditioning
2017-07-18
Address:
License:
33145 Yucaipa Boulevard
719570
City/State/Zip:
Phone:
Yucaipa CA 92399
909-797-5669
Digitally signed by CHEERSTm. 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:417-A020303902A-000-000-0000000-0000
Registration Date/Time: 2017-07-18 19:33:56
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-18 19:33:56
Schema Version: rev 10/16