BMCH2017-032578-495 CALLE TAMPICO D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN &DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/31/2017
Application Number:
BMCH2O17-0325
Owner:
Property Address:
49628 MONTANA WAY
ROBERT LANPHEF.E
APN:
602160020
w
1177 SW CATLIN CREST DR
Application Description:
LANPHERE / CHANGE OUT (1)16SEER/81AFUE SPLIT SYSTEM
Cr
PORTLAND, OR 92253 r�
Property Zoning:
¢
L,+ N zt a
Application Valuation:
$7,800.00
o LU
M LL —0
(
Applicant:
Contractor: .J
o
ADAM SIMMONS
P0BOX314 -
ADAM SIMMONS 0 i--
P0BOX 314 ( '
LA QUINTA, CA 92247
LA QUINTA, CA 92247
(760)564-7525
Llc. No.: 780534
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.: 780534
Date 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.).
(_) 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 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:
t
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 thejwork 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 perfornance 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: 9054788
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 than, if I should become subject to the
workers' compensation provisions of Section 3-00 of the Labor Code, I shall forthwith
comply with thoseprovisions.
Date Applicant:'
G
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 performe d 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 th � 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 isuance of such permit, or cessation of
work for 180 days will subject permit to cancell::tion.
I certify that I have read this application and sta:e that the above information is correct.
I agree to comply with all city and county ordin antes and state laws relating to building
construction, and hereby authorize representat ves of this city to enter upon the
above-mentioned property for inspection purposes. O
Date: Signature (Applicant or Agent):
Date: 7/31/2017
Application Number: BMCH2017-0325 Owner:
Property Address: 49628 MONTANA WAY ROBERT LANPHEF E
APN: 602160020 1177 SW CATLIN :REST DR
Application Description: LANPHERE / CHANGE OUT (1)16SEER/81AFUE SPLIT SYSTEM PORTLAND, OR 9:.253
Property Zoning:
Application Valuation: $7,800.00
Applicant:
Contractor:
ADAM SIMMONS
ADAM SIMMONS
PO BOX 314
PO BOX 314
LA QUINTA, CA 92247
LA QUINTA, CA 92247
(760)564-7525
---------------------------------------------------------------------------------------------
Llc. No.: 780534
Detail: CHANGE OUT (1)16SEER/83AfUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(5) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CAiIFORNIA
BUILDING CODES.
FINANCIAL INFO
DESCRIPTION
ACCOUNT
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-42404
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 CHANG =OUT:
$114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION ACCOUNT iQTY AMOUNT
'TECHNOLOGY ENHANCEMENT FEE. 502-0000-43611 0• $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
FA
f
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: Mrs Lanphere Date Prepared: 2017-07-31
A. General Information
CF1R-ALT-02 is applicable to multiple Spa.ce cQnditioning wsterns contained within asingle dwelling unit. When mi tiplp dwelling i!nit,,; must be documented, uce one
CF1R-ALT-02 document for each dwelling unit.
01
Project Name.
Mrs Lanphere
02
Date Prepared
2017-07-31
.03
Project Location
49628 Montana Way
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Mrs Lanphere
'*is the SCS
I�iiallih" -
g'a
-* F"
.7 7 i
Dwelling Unit Conditioned
07
Zip Code
92253
08
Floor Area (W)
1600
Installing new SC
Installing
Installing
Installing
Number of Space
Identification or
09
Climate Zone
15
10
Conditioning (SC) Systems in
1
entirely new
entirely new
.Name
this Dwelling Unit:
System (ft)
B. Space Conditioning (SC) System Information4'1
Kk1 r—
,
01
02
03
04
05
' 69
10
'*is the SCS
I�iiallih" -
g'a
-* F"
.7 7 i
T.
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
Sys -t -ern
more than 40
entirely new
entirely new
.Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System I
WHOLE HOUSE
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Sectlon150.2(b)1Dflb)
This section does not apply to this project.
Registration Number: 217-A020261527A-000-000-0000000-0000 Registration Date/Time: 2017-07-31 11:12:42 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-31 11:12:44
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-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)lE and F)
01
02
03
04
05
06
07
08
09
10
it
12
Heating
Cooling
System
Heating
AIIOVL!d
Heating
Minimum
Altered
Coofing
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
Mew Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Leggth
R -Value
Central gas
All new
Central split
All new
Less than or
System 1
furnace
heating
AFUE
81
AC
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Reouired Documentation: -
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
CF2R and MR -MCH -20-1-1 - Duct Leakage Test required when heating or cooling components are Installed in ducted systems, or when njore than 40 ft of duct length is replaced
-Leakage rate compliance: <= 15% or <= 30% leakage to outside, or seal all accessible leaks.
CF2R and MR -MCH -25-1-1 Refrigerant Charge verification required when refrigerant containing components are Installed or altered (applicable in CZ 2, 8-15).
CF2R and CBR -MCH -23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required.
Exceptions:
Duct systems registered with HERS provider as previously sealed are exempt from,M.CH-20 Duct Leakage Testing egUirements.
Heating -only systems and Air Handler Furnace changes do not require verificatibri of Air Flow MCH'' -23 or Re Agerant Charge MCH -2S E
"1
-Existing duct systems constructed, insulated or sealed with asbestos,are exempt -from MCH 20 Duet Leakage Testing fequiiements. t
r'
.rr . ':-,p er 0 ,t'7 15 \1 11 ft di f ler S1 Pi tx
•E. Entirely New or Complete Replacement Du&System, with or without -Equipment Changeout (Sections.150.2(b)1Diia=and 150.2(b)1E, F)
This section does not apply to this project.
i
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 217-A020261527A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-07-31.11:12:42
Report Version: 2016. 1.006
Schema Version: rev 10/16
HERS Provider: CaICERTS
Report Generated: 2017-07-31 11:12:44
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: ��
Bachus, Tom
Company:
Signature Date:
MLC Building Performance
2017-07-31 11:12:42
Address:
CEA/ HERS Certification Identification (if applicable):
77825 Delaware Place
City/State/Zip:
Phone:
Palm Desert CA 92211
760-836-0066
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 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' �' 8
r , pu n ;p -p- ----ar
4. The building design features or system design features identified on„Shis Certificate of Compliance are consistent with -the mformatio_n provided on;othe� applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcementagentyfor-approval withthis building permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall;be>made.available with -the building permits) issued for4the;tiuildlog, and,made available.tc;the;enforcement agency for all applicable
Inspections. I understand that a registered copy of this,C&tifcate of CompIiance,is,required to be_incIuded with the documentationythe.builder provides to the building owner at occupancy.
t x r.
Responsible Designer Name; a. - a d
P g
p "B^Signature:"
Res onsible Desi ner
Bachus, Tom
Company:
Date Signed:
MLC Building Performance
2017-07-31 11:12:42
Address:
License:
77825 Delaware Place
City/State/Zip:
Phone:
Palm Desert CA 92211
760-836-0066
Easy to Verify
at CaICERTS.com
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility f
the accuracy of the inforimms
Registration Number: 217-A020261527A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-07-31 11:12:42
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CaICERTS
Report Generated: 2017-07-31 11:12:44
#
City. of- La Quinta
Butift ar Safety Duron
P.O. Box 1504,78.495 Cage Tampico
La-Quinta, CA 92253 - (760) 777-7012
Building Pennit Application and Tracking Sheet
Permit #
Project Address: Ll 1 on hG' W
Owner7sN7=e: hA SLA
-
A. P. Number.
Addres
Legal Description:
City, ST, Zip:
Contractor. Sid vu,-GUIs A
Telephone:
Project Descripti
f4—
Address: $ pmt '� (–/ .
City, ST, Zip: IA lX V 1 h (} ao
Y
Telephone: Q'
State Lic. # : 3 City Lic #
Arch. Engr., Designer-
esignerAddress:
Address:
City, ST. Zip.
Telephone:
Statc Lia #:
Construction Type:. Occxpancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Unitp
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project: �7O
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Play Seta
Plan Cheek submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Chock Deposit. .
Truss Calm
Called Contact Person
Plan Cheek fWanee-
Mile 24 Calci.
Plana picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan
'! Review, ready for correctiomAmue
Electrical
Subeoatactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S NLI
H.O.A. Approval
Plans resubmitted
Grading
114 HOUSE:-
''" Review; ready for correcttonsliM4
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. VVI®. Appr
Date of permit issue
School Fees
Total Permft Fees