BMCH2018-001878-495 CALLE TAMPICO Twit D 4 Qu&z
Q.�•i
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number: BMCH2O18-0018
Property Address: 79670 RANCHO SAN PASCUAL
APN: 602280026
Application Description: BLOMGREN / HVAC CHANGEOUT 14 SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuatiom $7,289.00
Applicant:
IE INC
31225 LA B4OA
WESTLAKE VILLAGE, CA 91362
JAN 2 3 2018
CITY 0FLA QUINTA
COMMUNITY I)EVELOPIJiciIT DEPAI
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20 License No.: 489046
Date: I g Contractor:�� ,
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/23/2018
Owner:
BRUCE BLOMGREN
, 92253
Contractor:
ESSER SERVICES INC DBA ESSER AIR CONDITI
P 0 BOX 1636
CATHEDRAL CITY, CA 92235
(760)324-0550
Llc. No.: 489046
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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' 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:
OWNER -BUILDER DECLARATION
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSDS030167
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 70315, Business and Professions Code: Any
I certify that in the performance of the work for which this permit is issued, I
city or county that requires a permit to construct, alter, improve, demolish, or repair
shall not employ any person in any manner so as to become subject to the workers' .
any structure, prior to its issuance, also requires the applicant for the permit to file a
compensation laws of California, and agree that, if I should become subject to the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
comply with those provisions.
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
) S
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
Date: ` 7=1
Applicant:
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
U I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
compensation, will, do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
he or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
�) I, as owner of the property, am exclusively contracting with licensed contractors
1. Each person upon whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any permit
State License Law does not apply to an owner of property who builds or improves
issued as a result of this application , the owner, and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
shall defend,•indemnify and hold harmless the City of_La Quinta, its officers, agents, and
the Contractors' State License Law.).
employees for any actor omission related to the work being performed under or
(_) I am exempt under Sec. B.&P.C. for this reason
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
Date: Owner
work for 180 days will subject permit to cancellation.
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:
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.
a
Date: 123 ) g Signature (Applicant or Agent): �• c�z
Date: 1/23/2018
ApplicaWn.Number:BMCH2O18-0018
Owner:
Property Address: 79670 RANCHO SAN PASCUAL
BRUCE BLOMGREN
APN: 602280026
Application Description: BLOMGREN / HVAC CHANGEOUT 14 SEER/80AFUE SPLIT SYSTEM
92253
Property Zoning:
Application Valuation: $7,289.00
Applicant:
Contractor:
IE INC
ESSER SERVICES INC DBA ESSER AIR CONDITI
31225 LA BAYA
P O BOX 1636
WESTLAKE VILLAGE, CA 91362
CATHEDRAL CITY, CA 92235
(760)324-0550
-----------------------------------------------------------
Llc. No.: 489046
Detail: HVAC CHANGE OUT - 14SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE
-----------------------------------
INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
• j
FINANCIAL INFORMATION
` "DESCRIPTION ACCOUNTQTY AMOUNT
BSAS SB1473 FEE
201-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00•
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$78.02
Total Paid for CHANGEOUT:. $117.03
'DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$98.83
• Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE.
101-0000-42416.
0
$10.00 .
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00 •
Total Paid for TECHNOLOGY ENHANCEMENT FEE: . $S.00
#
City Of- La Quihta
awkring 8r safety Divirion
P.O. Box 1504,78-495 Calle Tampico
1.a.Quinta, CA 92253 -{760) 777-7012
Building Permit Application and Tracking Sheet
Perritt #
Project Address' 79670 Rancho San Pascual
Owner's Name:. Bruce Blomgren
A- P. Number.
Address: 79670 Rancho San Pascual
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. Esser Services Inc.
Telephone: 760-333-7355` v N.
M4
Address: PO Box 1636
Project Description: Replace 5•ton A/C, coil, & 100,000 BTU
City, ST, Zip: Cathedral City, CA 92235
furnace
Telephone: 760-324-0550 C}'w. _2.
State Lic. # : 489046 (qty Lie. 9
Arch., FaW., Designer
Address..
City' ST, Zip.
Telephone:
_ r
State Lia #:
Name of Contact Person: Steven Schnierer
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Univ:
Telephone # of Contact Person: 818-735-7-876 Estimated Valise of project $7,289.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACICYIVG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Pian Check Deposit.
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted .' .
Mechanical
Grading plan
V Review, ready for correctioushssue
Electrical
Subcontaetor I3st
Called ContactPerson
Plumbing
Grant Deed
Plans picked up
SMI.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE-
'^' Review; ready for correctionsfissue
Developer Impact Fee -
Planning Approval
C411ed Contact Person
AJX.P.
Pub. Wks. Appr
Date of permit issue
Sehodl Fees.
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:. r Bruce Blomgren Date Prepared: 2018-03-19
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
Bruce Blomgren
02
Date Prepared
2018-01-19
03
Project Location
79670 Rancho San Pascual
04
Building Type
Single family
05
CA City
La Quinta .-^'�:�
06
Dwelling Unit Name
HOUSE
SC System
SC System
CFA served
system a
Dwelling Unit Conditioned
Installing new SC
07
Zip Code
92253 }08
Floor Area (ft2)
3854
by this SC
ducted
Al
system
Numberof Space09
entirely new
entirely new
Climate Zone
15 '"
10'
Conditioning (SC) Systems in
11
component?
components?
feet of ducts?
duct system?
this Dwelling Unit:
Alteration Type '
B. Space Conditioning (SC) System Information„,
01
02
03
04
05
06'
07
OS
09
10
Is the SC
Installing a
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
system
more than 40
entirely new
entirely new
Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type '
Altered space
SYSTEM 1
WHOLE HOUSE
3854
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 418-A020003635A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2018-01-19 15:58:22
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Re p o rt,G e n e ra to d: 2018-01-19 15:58:24
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
All new
Central split
All new
This field or
This field or
SYSTEM 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Reouired Documentation:
t Y
CF2R-MCH-01-E - Space Conditioning Systems� y
Duct insulation requirement for the new portions of supply -air and return -air ducts or plenumJRF6 (CZ 1 1 , 12 ah13) 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:66ted systems, or when more than 40 ft of duct Iengt6 is replaced
-leakage rate compliance: <=15% or <= 10% leakage to outside, or seal all accessible leaks. t .'
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components.are ihstalled 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 Dud Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or withoLit �Equipm nt Change ut (Sections 150.2(b)1Diia 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)1C)
This section does not apply to this project.
Registration Number: 418-A020003635A-000-000-0000000-0000 Registration Date/Time: 2018-01-19 15:58:22 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-01-19 15:58:24
Schema Version: rev 10/16
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:
Patty Hernandez
Patty fleyn—dZk
Company:
Signature Date:
I Permit E Raters
2018-01-19
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip:
Phone:
Westlake Village CA 91362)
V.
818 735-7876
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. I am eligible under Division 3 of the Business and Professions Code to accept responslbility,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. v,-
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.
terra ' . A 4 A -
for for
S. I will ensure that a registered copy of this Certificate of Compliance shall be=made available with th- 6uilding permit(s)-issued the building, and made available to the enforcement agency all applicable
�requlPed-to
inspections. I understand that a registered copy of this Certificate of Compliancc i be ihMde'd with -the documentation the builder provides to the building owner at occupancy.
e s-
Responsible Designer Name:
Responsible Designer Signature:
Shantel Faugno
Patty fl--ndvk (aut3—tp-&)
Company:
Date Signed:
Esser Services, Inc.
2018-01-19
Address:
License:
PO Box 1636
489046
City/State/Zip:.
Phone:
Cathedral City CA 92235
760-324-0550
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: 418-A020003635A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2018-01-19 15:58:22
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2018-01-19 15:58:24