BMCH2017-0164T 0"�Y' °F 40*&
78-495 CALLE TAMPICO
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/2/2017
Application Number: BMCH2O17-0164 j
Owner:
Property Address: 79095 W W MISSION DR (
CRAIG HOLZFASTER
APN: 646330073
P O BOX 28185 �
Application Description: HOLZFASTER / LAST NAME / HVAC CHANGE OUT - 16SEER/80AFUE S
SCOTTSDALE, AZ 92253
Property Zoning:
FrI
Application Valuation: $10,000.00Applicant:
Contractor:
SAN'S AIR CONDITIONING &HEATING
SAN'S AIR CONDITIONING &crtHE—ATIN�
51-530 JACKSON STREET
51-530 JACKSON STREET ! 9 n) - e
COACHELLA, CA 92236-2737
COACHELLA, CA 92236-2737
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commenting 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.: 522775
Date: 6 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 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 contractors) 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)398-4287
Llc. No.: 522775
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.
QI 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9074503
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 f the Labor Code, I shall forthwith
comply with those 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 state laws relating to building
construction, and hereby authorize representatives of this city to enter upon n
above-mentioned property for inspection purposes. 1,
Date: �� Signature (Applicant or Agent)
Date: 5/2/2017
Application Number: BMCH2017-0164
Owner:
Property Address: 79095 W W MISSION DR
CRAIG HOLZFASTER
APN: 1 646330073
P 0 BOX 28185
Application Description: HOLZFASTER / LAST NAME / HVAC CHANGE OUT - 16SEER/80AFUE S
SCOTTSDALE, AZ 92253
Property Zoning:
Applicatiori.Valuation: $10,000.00
Applicant:
Contractor:
SAN'S AIR CONDITIONING & HEATING
SAN'S AIR CONDITIONING & HEATING
51-530 JACKSON STREET
51-530 JACKSON STREET
COACHELLA, CA 92236-2737
COACHELLA, CA 92236-2737
(760)398-4287
----------------------------------------------------------------------------------------------
Llc. No.: 522775
Detail: HVAC CHANGE OUT-16SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT•FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $216.27
j
ALTERATIONS - HVAC
F
CEC-CFI1R-ALT-04-E Revised 01/16 CALIFORNIA ENERGY COMMISSION wwW-
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (Page 1 of 1)
Site Adt�dress: 1 -
Enforcement Agency:
Date Prepared:
Permit#:
E
Equipment Type
Equipment Efficiency
New Ducting or Lineset:
Required R -value
Conditioned 2.
Floor Area (ft )
Thermostat
❑ Packaged
❑ Evaporator Coll�FUE
COP
❑ R-6 (CZ 1-10, 12&13) Ducts
Served by system
❑ Setback
System
❑ Condensing Unit
❑ R-8' (CZ 11, 14-16) Ducts
ft
(If not already
Split System
❑Compressor
SEER
HSPF
❑ > R-2.8 Lineset°
present, must
❑ Mini Split
❑ Lineset!)
be installed)
❑ Furnace
❑ TXV
EER
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is 02=we, a filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
Ct31. AC Cha ut/Repair Required Compliance Documents to be left on site for Final:
All uipment, CFIR-ALT-02-E
Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)2-H, MCH -25-H2
Compressor, TXV, Lineset, CF3R-MCH-20-H, MCH -(23 or 24)-H2, MCH -25-H2
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Dud leakage (s 15%, or <_10% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
12171. Dud system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of dud in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2: New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Duds; CFIR-ALT-02-E
including Mini Split CF2R-MCH-01-E, MCH -20-H, MCH -22-H, MCH -(23 or 24)-H2, MCH -25-H2
CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H2, MCH -25-H2
Mini Splits require CF1R-ALT-02-E, CF2R-MCH-01-E, and (CF2R-CF3R) MCH -25-H
Installer Requirement: Duct leakage < 5%, Fan Efficacy (0.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Duds' and one or more of the following CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)-H, MCH -25-H
Compressor, TXV, Lineset, Furnace CF3R-MCH-20-H, MCH -(23 or 24)-H, MCH -25-H
Installer Requirement: Duct leakage :< 5%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge.
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Duds' CF1R-ALT-02-E, CF2R-MCH-20-H, CF3R-MCH-20-H
Installer Required to: Duct leakage (:-S_15% or, s10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs,1-10, 12 &13, and R-6 insulation when less
than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MCH -(23 or 24), or Refrigerant Charge verification MCH -25
3 All New Ducts is when at least 75%of the duct system is new duct material,. and up to 25%may consist of reused parts from the dwelling unit's
existing dud system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
R-2.8 (1" thick insulation) for linesets I" and less.
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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 for approval with this building permit appKicitJ06Q.
Responsible Designer Name:
s er i atur
`�
Date So ned:
ALL
Licennsee,.^��
rig d�d-1
Company n
Ait�sys^ D SWAB 80
City
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
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Permit #t +
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Project Address: "\NEp� +\
City" of L .Quin to
Building u Safety Division
-� 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2 "
Building Permit Application and.Tracking Sheet
Owner's Name:
A. P. Number:'
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Legal Description:
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Project Description: ,
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State Lic. #
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Arch.; Engr., Designer:
Address: y
City, ST, Zip:
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Telephone:n
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Con miction Type: Occupancy:
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Lic" #
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Name of Contact Person:
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#Stories:
# Units:
Telephone # of Contact Person: �� ��
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Estimated Value of Proje
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rcc'd TRACKING PERMIT FEES
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 vMechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
J
Grant Dced -
Plans picked up
S.M.I.
I4.0.A. Approval
Plans resubmitted
Grading -
IN IIOUSE:-
Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.T.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Perniit Fees
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