BMCH2017-037078-495 CALLE TAMPICO D VOICE (760) 777-7125
LA CiUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/23/2017
Application Number: BMCH2O17-0370 Owner:
Property Address: 49110 RANCHO POINTED EL PEDICIIJI
APN: 602320013 ® 0 ANCHO POINTE
Application Description: PEDICINI RESIDENCE / HVAC CHANGE I TA, C 92253
Property Zoning:. AUG
Application Valuation: $5,760.00 G 2011
Applicant: DESIGN C'TYO'LAQUINTA
AND p l HARRISON
tor:
IE INC /ELOPMEWDEFARTM TO RESERVE ENTERPRISES INC DBA GENERAL AIR
31225 LA BAYA 'rtpl:y'
WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276
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.: 686310
ca
Date: Z6 Z3 1 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.).
(__j 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 Address:
(760)343-7488
Lic. No.: 686310
WORKER'S COMPENSA70N DECLARATION
I hereby affirm under penalty of perjury one o 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.
�I have and will maintain workers' cc mpensation 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 insurancR carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031658
I certify that in the performance of :he 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.
e
Date: ? --'�1-7 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 ($100,00)). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOF 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 owne-, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the =ity 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 applic:,tion 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 cancelFstion.
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 ordirances 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: �1 Signature (Applicant or Agent):
°
Date: 8/23/2017,
Application Number: BMCH2O17-0370
Owner:
Property Address: 49110 RANCHO POINTE
MICHAEL PEDICI NI
APN: 602320013
49110 RANCHO POINTE
Application Description: PEDICINI RESIDENCE / HVAC CHANGE OUT
LA QUINTA, C 92253
Property Zoning:
Application Valuation: $5,760.00
Applicant:
Contractor:
IE INC
HARRISON ENTEIPRISES INC DBA GENERAL AIR
31225 LA BAYA
31170 RESERVE DRIVE
" WESTLAKE VILLAGE, CA 91362.
THOUSAND PALMS, CA 92276
(760)343-7488
---------------------------------------------------------------------------------------------
Llc. No.: 686310
Detail: HVAC CHANGE OUT - 14 SEER/80 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR T7 FINAL INSPECTION. PER 2016
CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
0
Total Paid for BUILDING STANDARDS ADMINISTRATIO4 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
101-0000-426000
$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
Bin.#
Qty. of LA QuInta
Building 8L Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Pennit Application and Tracking Sheet
Permit #
Project Address: 49110 Rancho Pointe
Owner's Name: .Mike Pedicini
A. P. Number.
Address: 49110 Rancho Pointe
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone: <<�
.��x,..a
Address: 31170 Reserve Drive
Project Description: Replace 3.5 ton A/-
CRY, ST, Zip: Thousand Palms, CA 92276 .
Telephone: 760-343-7488;:.,�,�
City Lia M.
State Lic. # : 686310
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone: `� ` .
State Lia #:j•>-^�"`
Construction Type: . Oa:upancy.
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: Units:
Name of Contact Person: Steven Schmierer
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project; $5,760.00
APPLICANT:'DO NOT WRITE BELOW THIS UNE
of
Submittal
Req'd
Recd
TRACIQNG
PERbW FEES
Plan Sets
Plan Check submitted.
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
F
Called Contact Person
Pian Check Balance
Title 24 Calm.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Greding plan
2'! Review, ready for correctionsrrssue
Electrical
Subcortactor 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 Icrpset Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3)
Project Name: MIKE PEDICINI Date Prepared: 2017-08-22
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
MIKE PEDICINI
02
Date Prepared
2017-08-22
03
Project Location
49110 RANCHO POINTE
04
Building Type p
Single family
05
CA City
La Ctuinta X
06
Dwelling Unit Name
HOME
07
Zip Code
92253
"08
Dwelling Unit Conditioned
4243
more than 40 .
entirely new
entirely new
Floor Area (ft)
Served
System (ftz)
system?
L
I components?
Number of Space
duct system?
09
Climate Zone
15 -
"' 10
Conditioning (SC) Systems in
1
Yes
Yes
No
'No
this Dwelling Unit:
Altered space
B. Space Conditioning (SC) System Information
r 01
02
03
04
05 `
1 t 06 '=K'
07
OS
09
10
SC System
SC System
CFA served
Is the SC
system a
Installing_a
refrigerant
-installing new SCS
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40 .
entirely new
entirely new
Name
Served
System (ftz)
system?
component?
I components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOME
4243
Yes
Yes
Yes
No
'No
No
Altered space
conditioning system
C. Extension of Existing Duct System; Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020111495A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-08-22 15:22:28'
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-08-22 15:22:29
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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
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 -Value
Central gas
No heating
This field or
This field or
Central split
All new.
This field. or
This field or
SYSTEM 1
furnace
component
section is not
section is not
AC
cooling
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems-
- Duct insulation requirement for the new portions of supply -ale and return -air ducts or plenums. N6 (CZ 1 10,12.and13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are ihstalled,in.ducte0''stems, 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. s ��
'i
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing comporients 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.
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.
fr " I kE__!f .: 1 !l✓... I I K7
*-p �1. ,fit 4i_--, J.L ,, I *A*. -'4
E. Entirely New or Complete Replacement Duct System, with or wlthout.Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F)
This section does not apply to this°project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 417-A020111495A-000-000-0000000-0000 Registration Date/Time: 2017-08-22 15:22:28 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-22 15:22:29
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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:
Stephanie Shryock
Stephanie,Shryoc*,
Company: •
Signature Date: `
I Permit E Raters
2017-08-22
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive.
City/State/Zip:
Phone:
Westlake Village CA 91362
7
x818 735-7876
'Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California: r
1. The information provided on this Certificate of Compliance is true and correct.-
orrect.
2.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility,forthe 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, Part1 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 budding permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building=permrt(s)_: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 included with°the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:frilll
Patrick Somers
Respons gble Designer. Signature:
stdi'a.;.Sl:.yock.(aut3wred.)
Company:
Date Signed:
General Air Conditioning
2017-08-22
Address:
License:
31170 Reserve Drive
686310
City/State/Zip:
Phone:
Thousand Palms CA 92276
760-343-7488
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-A020111495A-000-000-0000000-0000 Registration Date/Time: 2017-08-22 15:22:28
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-08-22 15:22:29