BMCH2017-049778-495 CALLE TAM PICCI
LA CIUINTA, CALIFORNIA 92253
:Permit Type/Subtype:
Application Number:
Property Address:.
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
AIR CONTROL SYSTEMS INC
1940 S GROVE AVE -
ONTARIO, CA 91761
�w �l 1wQ�«rw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
MECHANICAL/
BMCH2O17-0497
54.120 AVENIDA VALLEJO
774213026
LEOTAUD / HVAC CHANGEOUT
$3,500.00
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: C_20. �C-2 License No.: 639003
Date:;- J1_Contractor: '
OWNER -BU RDECLARATION
I hereby affirm under penalty of perjury that 1 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 thepurpose of sale.).
(1 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/12/2017
Owner:
ROBERT LEOTAUD
1940 SOUTH GROVE.AVE
ONTARIO, CA.91761
Contractor:.
AIR CONTROL SYSTEMS INC
1940 S GROVE AVE -
ONTARIO, CA 91761
(909)786-4230
Llc. No.: 639003
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 3100 of the Labor Code, for the performance
of L, work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
S n 3700 of the Labor Code, for the penormance'of the work for which this permit is
issued.. My workers' compensation insuran:e carrier and policy number are:
Carrier: TRAVELERS PROPERTY CASUALTY CDMPANY OF AMERICA 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 1 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith
comply with those provisions.
Date: %i y Applicant:
WARNING: FAILURE TO SECURE WORK e-OMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOY CRIIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($1001000). 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 fiis 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 isauance of such permit, or cessation of work
for 180 days will subject permit to cancellat',on.
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 oriinances and state laws relating to building
construction, and hereby authorize represer tatives of this city to enter upon the above-
mentioned property for inspection purposes. �\
Date: 1 Signature.(Applicart or Agent):
%+
Date: 12/12/2017
J-
Application Number:
BMCH2017-0497
Owner:
Propeilt* Address:
54120 AVE NIDA VALLEJ0
ROBERT LEOTWD
APN:
774213026"
1940 SOUTH GROVE AVE
Application Description:
LEOTAUD / HVAC CHANGEOUT
ONTARIO, CA 31761
Property Zoning:
Application Valuation:
$3,500.00
Applicant:
Contractor:
AIR CONTROL SYSTEMS INC
AIR CONTROL:SYSTEMS INC r
1940 S GROVE AVE
1940 S GROVE AVE
ONTARIO, CA.91761
ONTARIO, CA 91761
(909)786-4230
Llc. No.: 639003
Detail: HVAC CHANGE OUT - 14SEER SPLIT SYSTEM. CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA
BUILDING CODES.
FINANCIAL INFORMATION
sr .DESCRIPTION ACCOUNT I QTY AMOUNT
BSAS SB1473 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
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$78.02
Total Paid for CHAMGEOUT: $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 MANAGEME=NT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00•
Total Paid for TECHNOLOGY ENHANCEME=NT FEE: $5.00
TOTALS:
4
STATE OF CALIFORNIA
ALTEF`tATIONS - HVAC
CEC-CFIR-ALT-04=E Revised 01/16 CALIFORNIA ENERGY COMMISSION
-:CERTIFICATEDF COMPLIANCE CFIR=ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (Page 1 of 1)
Site Address:V ! V ��' !
Enforcement Agency:
Date Prepared:
Permitil:
Equipment Type
Equipment Efficiency
New Ducting or Lineset:
Required R -value
Cor:ditioned 2
Flo it Area (ft )
Thermostat
❑ Packaged
❑ Evaporator Coil
AFUE
COP
❑ R-6 (CZ 1-10, 12&13) Ducts
Ser./ed by system
❑ Setback
System
❑ Condensing Unit
❑ R-8' (CZ 11, 14-16) Ducts
ft
(If not already
JKSplit System
❑ Compressor
SEER
HSPF
❑ 2 R-2.8 Lineset'
present, must
❑ Mini Split
❑ Lineset
be installed)
❑ Furnace
❑ TXV
EER
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site. .
❑ 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CFIR-ALT-02-E
Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)'-H, MCH -25-H'
Compressor, TXV, Lineset, CF3R-MCH-20-H, MCH -(23 or 24)-H2, MCH -25-H'
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (<_15%, or <_10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/toy, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final`.
All new equipment and All New Ducts' CFIR-ALT-02-E
including Mini Split CF2R-MCH-01-E, MCH -20-H, MCH -22-H, MCH -(23 or 24)-H2, MCF -25-H2
CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H2, MCH -25-H'
Mini Splits require CFIR-ALT-02-E, CF2R-MCH-01-E, and (CF2R-CF3R) MCH -2S -H
lnstailer Requirement: Duct leakage < 5%, Fan Efficacy (O.S8W/CFM), Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CF1R-ALT-02-£
replaced: Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)-H, MCH -25-H
Compressor, TXV, Lineset, Furnace' CF311-MCH-20-0, MCH -(23 or 24)-H, MCH -25-H
Installer Requirement: Dud leakage < 5%, Air Flow 2: 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from dud leakage testing if: ❑ 1. Existing dud systems are constructed, insulated or sealed'with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Duds' CFIR-ALT-02-E, CF2R-MCH-20-H, CF3R-MCH-20-H
Installer Required to: Duct leakage L15% or, 510% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
'All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10, 12 &:13, and R-6 insulation when less
than 40 ft installed. This includes in walls, between floors etc.
' Heating only systems and Air Handler/Furnace changes do riot require Air Flow MCH -(23 or 24), or Refrigerant ChE rge verification MCH=25
' All New Ducts is when.at least 75%of the duct system is new duct material, and up to 25%may consist of reused parts from the dwelling unit's
existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-2.8 (1" thick insulation) for linesets 1" and less..
Contractor (Documentation Author's /Responsible Designer'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. • lam eligible under Division 3 of the California Business and Professions Code to accept responsibility for the incormation on this document:
–3—Tttat-the-energy-features and -performance specifications -for -the -design -identified -on -this -Certificate -of -Compliance-conform-to-the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR). '
4. 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 CCR.
5. 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 submi-ted to the enforcement
agency for approval with -this building permit application.
Responsible Designer Name:
Responsible Designer Signature:
OSigned:
ate
License:
Company:
Address:
City/State/Zip:
Phone: .
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-8310-772-3300
�- PERMIT ## ,QNtc�l2c17- o�F7
PLAN LOCATION
Project Address: i.� (� veN 1 1`+✓` �. Project Description: Pool, Remodel, Add't, Elect, Plumb, 4ech
l
New SFD Construction:
Address:S
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Conditioned Space SF
Applicant Name: t (�J� Vj -tJ
Bedrooms:
Address: 5
City, St, Zip �,'V�
City, ST, Zip:
Garage - _ SF
Telephone:
_ s 0
Email:, nn "
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Valuation of Project
Contractor Name:
l
New SFD Construction:
Address:S
` J Jv'
Conditioned Space SF
Telephone:
Bedrooms:
Stories:
City, St, Zip �,'V�
)-� 1
Garage - _ SF
State Lic: City Bus Lic:
_ s 0
Telephone: �� _
/ _sJ 0
l•/�
Patio/Porch SF .
Email:
Fire Sprinklers _ SF
t? , J
State Lic: `3 ��
City Bus Lic:
Areli/Eng Name:
Construction Type: Occupancy:
Address:,
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories:
F# Units:
Email:
Telephone:
State Lic: City Bus Lic:
_ s 0
Property Owner's Name:
. L�
New Commercial /Tenant Improvements:
Address:
M*)
Total Building SF
City, ST, Zip
a a
- -�
Construction Type: Occupancy:
Telephone:
_ s 0
Email: �I
TA .i
AVLLt� S
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000