BMCH2017-028578-495 CALLE TAMPICO C` 0 D 'iHMUCl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0285
Property Address: 51660 AVENIDA OBREGON
APN: 773124008
Application Description: DOOLEY / CHANGE OUT (1)22SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $20,271.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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.: 827420
Dater? i 1-1 Contractor: �7.intT�
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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_J 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 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. . 6.&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
VOICE (760) 777-7125
FAX (760) 777-7011
(760)202-3067
Llc. No.: 827420
. 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.
1 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: SECURITY NATIONAL INSURANCE COMPANY Policy Number:
. _ 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, l shall forthwith
comply with those provisions.
Date: 7 li Applicant:' r
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: T 1 i Signature (Applicant orAgent):��1�aT2��
?Date: �/7%}
of
r—
Owner:
r T'
ROBYN DOOLEY
o
„3
51660 AVENIDA OBREGON
f c
LA QUINTA, CA 92253
0 15
N
o
MD
9
M
C
Contractor:
ALL SEASONS AIR CONDITIONING PLUMBING
&
75-450 GERALD FORD DR STE
303
PALM DESERT, CA 92211
(760)202-3067
Llc. No.: 827420
. 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.
1 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: SECURITY NATIONAL INSURANCE COMPANY Policy Number:
. _ 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, l shall forthwith
comply with those provisions.
Date: 7 li Applicant:' r
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: T 1 i Signature (Applicant orAgent):��1�aT2��
Date: 7/7/2017
Application Number: BMCH2O17-0285 Owner:
Property'Address: '51660 AVENIDA OBREGON ROBYN DOOLEY
APN: 773124008 51660 AVENIDA OBREGON
Application Description: DOOLEY / CHANGE OUT (1) 22SE ER/80AFU E SPLIT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $20,271.00
Applicant: Contractor:
IE INC ALL SEASONS AIR CONDITIONING PLUMBING &
31225 LA BAYA 75-450 GERALD FORD DR STE 303
WESTLAKE VILLAGE, CA 91362 PALM DESERT, CA 92211
(760)202-3067
LIC. No.: 827420
-------------------------- ------------------------------------------------------------------
Detail: HVAC CHANGE OUT - 22SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
FINANCIAL FORMATION:
DESCRIPTION ACCOUNT QTY . AMOUNT
BSAS 581473 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
L -
Iain # Qty VI L .a Qui fta
1 Building a Safety Division
Permit #1 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
Project Address: p m. 'C>bVe t7r Owner's Name:�ob
A. P. Number:
Address: 51(,6C>
Legal Description:
City, ST, Zip: L,� C>yk ko, Gp 92253
1'
Contractor: 1 s �l b. Ft�-
1 �easo vrn
r
Telephone: (o �- �l
5 -349
�
Elam
Address:'i5-14SDC-erc,Xa&! , $303
Project Description: a lC.3-foy, A L
City, ST, Zip: �Iclk, Ver,.,t-a GQ
cttZ l\
I;RO OCO RTS.?
Telephone: '1 O _ �p 2- 7
State Lic. # : gV742-•o
City Lic. #•-
Arch., Engr., Designer:
Address:
City, ST, Zip:
e:
Telephone:hon
aneY
Occupancy:
:TYPe: Construction
State Lic. .
n Alter Repair.air DemoPJtYPe �circle oneNew Add
Name of Contact Person: Se�ti�
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: %Q -735--7M
Estimated Value of Project: ZOO 2.71, oa
APPLICANT: DO NOT WRITE BELOW THIS LINE
11 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 Calcs..
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed .
Plans picked up
S.M.I.
II.O:A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'`d 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,
I
Total Permit Fees
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3)
Project Name: ROBYN DOOLEY Date Prepared: 2017-07-06
A. General Information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF1R-ALT-02 document for each dwelling unit.
01
Project Name
ROBYN DOOLEY
02
Date Prepared
2017-07-07
03
Project Location
51660 AVENIDA OBREGON
04
Building Type
Single family
05
CA City
La Quinta � 1:
06
Dwelling Unit Name
HOME
Identification or
Location or Area
by this SC
ducted
containing
07
Zip Code
�? .'�'
92253
08
Dwelling Unit Conditioned
>
1710
Served
System (W)
system?
component?
Floor Area (ft2)
feet of ducts?
duct system?
SC system?
Alteration Type
Number of Space
09
Climate Zone
15 -
10'`
Conditioning (SC) Systems in
1
Yes
No
No
No
this Dwelling Unit:
B. Space Conditioning (SC) System Information
r( � 7 re= €fid
01
02
03
04
U 05
K j 6_6�& 1 401
07
08
09
10
SC System
SC System
CFA served"`��'
Is the SC
system a
Installing -a.
refrigerant
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 (W)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Altered space
SYSTEM 1
WHOLE HOME
1710
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Dii1b)
This section does not apply to this project.
Registration Number: 417-A020101745A-000-000-0000000-0000 Registration Date/Time: 2017-07-07 11:41:12 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-07-07 11:41:12
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)lE and F)
01
02
03
04
05
06
07
08
09
10
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-Va!ue
Central gas
All new
Central split
All new
This field or
This field or
SYSTEM 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
22
Setback
section is not
section is not
components
components
applicable
applicable
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 (C211 and 14-16)
CF2R and CF311-MCH-20-11 - Duct Leakage Test required when heating or cooling components are installed In ducted systems, or when more than 40 ft of duct length is replaced
-Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks.
CF2R and CF311-MCH-25-11 Refrigerant Charge verification required when refrigerant containing components aie installed or altered (applicable in CZ 2, 815).
CF2R and CF3R-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 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. EntirelyNew or Complete Replacement Duct System, with orlwithout E' ui Im nt Chan geo t Sections 150.2 b 1Diia and 150.2 b lE F)
P P Y _ 4 P g ( () ()
This section does not'apply to this•prolect.
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-A020101745A-000-000-0000000-0000 Registration Date/Tirne: 2017-07-07 11:41:12 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017=07-07 11:41:12
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems (formerly C0 -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:
Patty Hernandez
Patty f(eh-nandek
Company:
Signature Date:
All Seasons Air Conditioning Plumbing & Heating, Inc.
2017-07-07
Address:
CEA/ HERS Certification Identification (if applicable):
73605 Dinah Drive #1310M
-<
City/State/Zip: �'.
_
_Phone:
Palm Desert CA 92211
160,-568 2663
Responsible Person's Declaration statement
I certifythe following under penalty of perjury, under the laws of the State of California: 4'
g P Y P 1 rY, �T.
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.
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'for-approval;with this building permit application.
5. I will ensure that a registered copy of this Certificate of Compliance shall be madeiavailable with the building permits) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be'in`cluded with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:Resp�11onsible
i1(?k�1CC)i"VGi
Designed Signature:
PaLty}Eerruav►de%CalurYv�edi
David Beale
Company:
Date Signed:
All Seasons Air Conditioning Plumbing & Heating, Inc.
2017-07-07
Address:
License:
73605 Dinah Drive #1310M
827420
City/State/Zip:
Phone:
Palm Desert CA 92211
760-568-2663
Digitally signed by CHEERS'"'. 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-A020101745A-000-000-0000000-0000
Registration Date/Time: 2017-07-07 11:41:12
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated' 2017-07-07 11:41:12