BMCH2017-040978-495 CALLE TAMPICO D �iNI1ICl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0409
Property Address: 81867 RANCHO SANTANA DR
APN: 767740024
Application Description: FARLEY / (1) 20SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $14,799.00
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.: 977333
Date: C4 1`1 1 17 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).:
( 11, 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
MARY FARLEY
81867 RANCHO SANTANA DR
LA QUINTA, CA 92253
Date9 14/2017
Z
R
N
Contractor: '~
A#1 SERVICES HEATING & AIR Z. DITI*G
78206.VARNER RD #D-189 c
PALM DESERT, CA 92211
(760)565-2691
Llc. No.: 977333
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one :)f 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' 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: FALLS LAKE FIRE AND CASUALTY COMPANY Policy Number: FLA006188
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner s•) 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.
r
Date: qILI.1 1-7 �
Applicant— curt
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIM NAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,00). 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 tlis application.
1. Each person upon whose behalf this appication is made, each person at whose
request and for whose benefit work is perfor°ned 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 th> 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.
_ v
Date:' --L i`i t—) Signature (Applicant or Agent):
Date: 9/14/2017
Application Number: BMCH2017-0409
Owner:
Property Address: 81867 RANCHO SANTANA DR
MARY FARLEY
APN: 767740024
81867 RANCHO SANTANA DR
Application Description: PARLEY / (1) 20SEER/80AFUE SPLIT SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $14,799.00
Applicant:
Contractor:
IE INC
A#1 SERVICES HEATING & AIR CONDITIONING
31225 LA BAYA
78206 VARNER ED #D-189 '
WESTLAKE VILLAGE, CA 91362
-PALM DESERT, C4 92211
(760)565-2691
Llc. No.: 977333
Detail: HVAC CHANGE OUT - (1) 20SEER/80AFUE 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 ADMINISTRATICN 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.-
38.00.-Total
TotalPaid 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 # 1 ^{
Qty* of LA Quinta
Building 81' Saky Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application• and Tracking Sheet
Permit #
Project Address: 81867 Rancho Santana Drive
Owner'sName:.Mary Farley
A. P. Number.
Address: 81867 Rancho Santana Drive
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. A#1 Services Heating & A/C
Telephone: 760-398-8209
Address: 78206 Varner Road #D-189
Project Description: Replace 4 ton / 90K BTU complete
Clty, ST, Zip: Palm Desert, CA 92211
HVAC system
rTelePhone: 760-342-3610
State Lic. 4: 977333 City Lie. #;
Arch., Engr.; Designer
Address:
City., ST, Zip:
Telephone:" Y
State Lic. #:y ��".
s.y4� . ,r
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo .
Sq. FL: #Stories: #Units:
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person: 818-73577876
Estimated Value of Project: $14,799.00. .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMrP FEES
Plan Sets
Plan Check submitted
Item Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Pians picked up
Construction
Flood plain plan,
Plans resubmitted' .
Mechanical
Grading plan
rReview, ready'for correctionsAssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
3d Review; ready for corrections/issuc
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.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 -IR -ALT -HVAC) �' ; (Page 1 of 3)
Project Name: _ MARY FARLEY. Date Prepared: 2017-09-13
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
MARY FARLEY
02
Date Prepared
2017-09-13
03
Project Location
81867 RANCHO SANTANA DRIVE
04
Building Type
Single family ,
05
CA City
La Quinta b
X06
Dwelling Unit Name
HOME
Identification or
Location or Area
by this SC
ducted
containing
07
Zip Code
P
92253 +
08
Dwelling Unit Conditioned
2905
Served
System (ft)
system?
component?
Z
Floor Area (ft )
feet of ducts?
duct system?
SC system?
-�
SYSTEM 1
WHOLE HOME •.
2905•
.�.'f
Yes
Yes
No
Number of Space
No
09
Climate Zone
15 .K
Conditioning (SC) Systems in
1
this Dwelling Unit:
NIMH
B. Space, Conditioning (SC) System Information q
r.*
01
02
03
.04 �
U 05 b
0611 .
07
08
09
10
'
SC System
SC System
CFA served
Is the S�Cy, nry
system a
Installing _ya
�YF
refrigerant
"lnsfalling 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?
4 Alteration Type
SYSTEM 1
WHOLE HOME •.
2905•
Yes
Yes
Yes
No
No
No
- Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib) `
rAli- This section does not apply to this project. i
� I do • - , - - � - .'' � • � .
Registration Number: 417-A020116060A-000-000-0000000-0000 Registration Date/Time: 2017-09-13 14:40:11 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 ' Report Generated: 2017-09-13 14:40:12
CERTIFICATE OF COMPLIANCE CF111-ALT-02=E .
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)..- l J (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03
04
0S
06
07
08
09
10
11
12'
Heating
Cooling
System
Heating
Altered
Heating
Minimum
y
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
20
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation: w
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 CF311-MCH-20-H - 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 CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components areinstalledor altered (applicable in'CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. ' t- ^4z �•='
.
Exceptions: '^'4
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.
14, ' 1. ISF Iw 1 st. 1 " ! ''.1W i *+,
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F)
�„t�*v'rsic�'x�t* �'•i',��s!'~+s uti'f� I;•�r.�;�
This section doestnot'apply to this -project.
F. Enjirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) '
This section does not apply to this project.
Registration Number: 417-A020116060A-000-000-0000000-0000 Registration Date/Time: 2017-09-13 14:40:11 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 , Report Generated: 2017=09-13 14:40:12
CERTIFICATE OF COMPLIANCE - CF111=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:
imbYny C2auSii -
i1 vnac3wy i "U14W '
Company:
Signature Date:
I Permit E Raters
2017-09-13
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive -
RCN13063
City/State/Zip:r,�^ 9
Phone:
Westlake Village CA 91362 ' '' .�fi�
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. _r"{
f
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 bn other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency,for:approval�with this building permit application.
it : pt bl �, Ai •- y``
5. I will ensure that a registered copy of this Certificate of Compliance'shallbe made f'vallabl�e with thbwlding permyt(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 requirred io be'included withthe documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
.Cara Goldberg - Unmatched `` ed SeI'�"
ResponsibleDesignerSignature:
� rt C�ea i%w(autYwr'
Company:
Date Signed:
4#1 Services Heating & Air Conditioning
2017-09=13
Address:
License: ,
78026 Varner Road #D-189`
977333
City/State/Zip:
Phone:
Palm pessert CA 92211
(760) 342-3610
f
`. 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-A020116060A-000-000-0000000-0000 Registration Date/Time: 2017-09-13 '14:40:11 HERS Provider: CHEERS
CA Building Energy Efficiency Standards 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-13 14:40:12