BMCH2017-021478-495 CALLE TAMPICO C� 0 D �NMIACl/ VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/6/2017
Application Number:
BMCH2O17-0214
Owner:
Property Address:
79934 EMISSION DR
GERALD & SHIRLEY CLIFFORD
APN:
602380007
79934 E MISSION DR
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Application Description:
CLIFFORD / EVAP COIL CHANGEOUT 14 SEER
LA QUINTA, CA 92253
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Property Zoning:
Application Valuation:
$1,082.00
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Applicant:
Contractor:
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PREC H & A INCe�
PREC H & A INC
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P O BOX 10991
P O BOX 10991
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PALM DESERT, CA 92255
PALM DESERT, CA 92255
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(760)776-1550
Llc. No.: 818759
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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, C36 License No.: 818
Da 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
. 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 th ork for which this permit is issued.
nsLve and will maintain workers' compensation insurance, as required by
Se on 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: TRUCK INSURANCE EXCHANGE Policy Number: N20087119
_ 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.
Date:je 14,117 LApplican
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 cit ter upon the above-
mentioned property for inspection purposes.
Dale:7-//, Signature(ApplicanforAgen
Date: 6/6/2017
Application Number: BMCH2017-0214 Owner:
Property Address: 79934 E MISSION DR GERALD & SHIRLEY CLIFFORD
APN:. 602380007 79934 E MISSION DR
Application Description:, CLIFFORD / EVAP COIL CHANGEOUT 14 SEER LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,082.00
Applicant: Contractor:
PREC H & A INC PREC H & A INC
'P 0 BOX 10991 P 0 BOX 10991
PALM DESERT, CA 92255 PALM DESERT, CA 92255
(760)776-1550
Llc. No.: 818759
-------------------------------------------------------------------------------------------- -
Detail: EVAP COIL CHANGEOUT ONLY- 14SEER SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED 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 - REPAIR/ALTERATION
101-0000-42402
0
$12.67
.DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION PC
101-0000-42600
0
$5.07
Total Paid for CHANGEOUT: $17.74
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
pin #
Cit/ Of La Quint
'a
8r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701.2
Building Permit Application and Tracking Sheet
Permit #
Project Address: 3 G�
Owner's Name:
A. P. Number:
Address:
'Legal Description:
City, ST, Zip: S-3
Contractor:P e s /�!�a
Tel ePh one: 7277— O 7
Address: P �% /�' p l p ylj
Project Description: Z--
City, ST, Zip:4' 0 U�
Telephone:
State Lic. # : �l87,�
City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #•
Con structi onYP Type: Occupancy:
an cy:
Project • New Add' n Alter r
tYP(circle one) Repair Demo
Name of Contact Person:
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: Fra
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked up.
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issueElectrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A: Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVAC
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CEC-CFIR-ALT-04-E Revised 01/16 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (Pagel of 1)
Site Address: f
Enforcement Agency:
Date rep red:
Permit#:
7 3y/ L .
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Equipment Type
Equipment Efficiency
New Ducting or Lineset:
Required R -value
Co diti ned
Floor Area (ft)
Thermostat
❑ Packaged
®-Evaporator Coil
AFUE
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
EJ -Split System
❑ Compressor
ELS EER
HSPF
❑ z 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 allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
21-1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CFIR-ALT-02-E
Condenser Unit, Evaporator Coil, CF2R-MCH-03-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: Duct leakage (05%, or <_10% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct 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 Ducts3
CFIR-ALT-02-E
including Mini Split
CF2R-MCH-01-E, MCH -20-H, MCH -22-H, MCH -(23 or 24)-H2, MCH -25 -HZ
CF3R-MCH-20-H, MCH -22-1-1, MCH -(23 or 24)-H2, MCH -25-H2
Mini Splits require CFIR-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 2 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts3 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 z 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 Ducts3 CFIR-ALT-02-E, CF2R-MCH-20-H, CF3R-MCH-20-H
Installer Required to: Duct leakage (< 15% or, 1530% 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 1-50, 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 duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
R-2.8 (1" thick insulation) for linesets 1" 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.
S. 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
gency for approval with this building permit application.
p ible Designer e:
Responsible Designer Signature:
Datg Sig d:
License:
ompany:
,eol -5/ on 6, 7- e
Address:
[� o l v 9 0
/S te/Zi ��
Phone: N
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300