BMCH2018-0383ce;trSep Qalutt
78-495 CALLE TAMPICO
VOICE (760) 777-7125FAX
LA QUINTA, CALIFORNIA 92253
(760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/13/2018
Permit Type/Subtype:
MECHANICAL/
Owner:
Application Number:
PP
BMCH2O18-0383
RICHARD KONDAN
Property Address:
P V
80470 VIA TALAVERA
5645 FOX VALLEY DR �'
2
APN:
777270003
f
DOYLESTOWN, PA 922
Application Description:
KONDAN / HVAC CHANGEOUT (2)14 SEER/80 AFUE SPLIT SYSTEMS
Property Zoning:
_ s CAS
Application Valuation:
$9,600.00
Applicant:
Contractor: i� c i
SABRINA SERVICES INC DBA COACHELLA VALLE
SABRINA. SERVICES INC AC14 A VAS
72216 NORTHSHORE ST#101
72216 NORTHSHORE ST ►� �;� w'„�r
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA922T cn
mom.
(760)343-2121 c*S
LIc. No.: 1042749 Lij
(��)=
Cl
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 oft Business and Professions Code,
and my License is in full force and effect,
License Class- C20, C36 License No.: 1 4 4
Date: Cant raclor: r t
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.).
() 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
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'
cornpen5a on, as provided for by Section 3700 of the Labor Code, for the performance
of For which this permit is issued.
•Ilhave 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: NOVA CASUALTY COMPANY Policy Number: SISWK1000000100
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 s uld become subject to the
workers' compensation provisions of Section 370 o the Labor Code, I shall forthwith
comp) i tho provisions.
Date: plicant: �1
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that t4tawS
rmation is correct,
I agree to comply with all city and county ordinances arelating to building
constructip and hereby authorize representatives of ter upon the
above- Ioned roperty for inspection purposes.
Date; .$nature (Applicant or Agent
Application Number: BMCH2018-0383
Property Address: 80470 VIA TALAVERA
APN: 777270003
Application Description: KONDAN / HVAC CHANGEOUT (2)14 SEER/80 AFUE SPLIT SYSTEMS
Property Zoning:
Application Valuation: $9,600.00
Applicant:
SABRINA SERVICES INC DBA COACHELLA VALLE
72216 NORTHSHORE ST #101
THOUSAND PALMS, CA 92276
Date: 9/13/2018
Owner:
RICHARD KONDAN
5645 FOX VALLEY DR
DOYLESTOWN, PA 92253
Contractor:
SABRINA SERVICES INC DBA COACHELLA VALLE
72216 NORTHSHORE ST #101
THOUSAND PALMS, CA 92276
(760)343-2121
Llc. No.: 1042749
Detail: (2) 4-TON HVAC CHANGE OUTS - 14 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
FINANCIAL
INFORMATION
ACCOUNT
CITY
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
$78.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$156.04
Total Paid for CHANGEOUT: $234.06
DESCRIPTION
ACCOUNT CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404 0
$98.83
Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
R HcWZ011 _ 1030
Bin#
City of La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
Project Address: V ,A-
-r L-w J ex,
Owner's Name: 9 t G{, `� / `-
(/i OA-) D�o
A.P. Number
.Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone: qts 5-115- �.ZZ
.Address:
Project Description: -
City, ST, Zip: 72216 Northshore St #101
'[2-e(A-TjE, Z It-C-o t-)
Telephone: i nousand Palflis, Cd 92
61f Cop 'G C L�, L�
State Lie. #: 1) 4 /; ' L City Lie #:
Arch, Engr., Designer:
Address:
City, ST, Zip:
'Telephone:
Construction Type:
Occupancy:
:State Lic. #;
Proj. Type J New I Add'n
Alter
Repair
Demo
Name of Contact. t Q
SgFt: #Stories
# Units:
Telephone of Contact: ���/a?r -3 )-1'Z/
Estimated Value of Project: ®.�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Req'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Cales
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
2nd Rev, Ready for corrections /
Electrical?
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
Project Name:
B. Space Conditioning (SC) System Information
KONDAN j Date Prepared:
01
02
03
04
1 05
06
Is the SC
Installing a
SC System
SC System
Y
CFA served
system a
refrigerant
Installing new SC
Ins1
Identification or
Location or Area
by this SC
ducted
containing
system
more
Name
Served
System (ft2)
system?
component?
components?
feet o
System 1
Location 1
1600
Yes
Yes
Yes
System 2 I Location 2 I 1600 1 Yes I Yes I Yes
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
CF1R-ALT 02-E
(Page 1 of 3)
2018-09-13
37 108 04 1 10
ailing
Installing
Installing
than 40
entirely new
entirely new
f ducts?
duct system?
SC system?
Alteration Type
Jo
No
No
Altered space
conditioning system
Jo
No
No
Altered space
conditioning system
Registration Number: 218-A020256679A-000-000-0000000-0000 Registration Date/Time: 2018-09-13 08:47:56
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Report Generated: 2018-09-13 08:47:52
Schema Version: rev 20180426
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)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 as Outdoor
System 1 g Indoor coil AFUE 80 Centralsplitsplit condensing SEER 14
furnace
This field or This field or
Setback section is not section is not
unit
applicable applicable
Central as Outdoor
System 2 g Indoor coil AFUE 80 Centralsplitsplit condensing SEER 14
furnace
This field or This field or
Setback section is not section is not
unit
applicable applicable
Required 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 (CZ 11 and 14-16)
CF2R and CF3R-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 percent or <= 10 percent leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed oralteted (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH-2S is required.
Inc
Exc�tions:
- Duct systems registered with HERS provider as previously sealed areexempt from AAGi-20 pact Leakage -Testing requirements. �'
.�
Heating -only systems and Air Handler Furnace changes do not requimveriiication of Air Flow MCH-23, or Refrigerant Charge MCH-25.
_
-Existing duct systems constructed, insulated or sealed with asbestos are exempt fr*m MCM-20 Dud Leakage Testing recuiiements.
I►=- E.
E. Entirely New or Complete Replacement Duct System, with or without 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)1C)
Registration Number: 218-A020256679A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2018-09-13 08:47:56
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-09-13 08:47:52
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Mascarenas, Brannon
Company:
SABRINA SERVICES INC
Address:
72216 NORTHSHORE ST #101
City/State/Zip:
THOUSAND PALMS CA 92276
Responsible Person's Declaration statement
Documentation Author Signature: /-
Signature Date:
2018-09-13 08:47:56
CEA/ HERS Certification Identification (if applicable):
Phone:
760-343-2121 X123
CF1R-ALT 02-E
(Page 3 of 3)
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. 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 Regulatlons.
4. The building design features or system design features Identified on this Certfficatevf Compliance are Consistent w;th the irtformation provided on otherapplicable compliance documents, worksheets,
calculations, plans and specifications submitted to the e4arcementageney forapprovalwith this building permit applicatiarr.
5. 1 will ensure that a registered copy of this Certiflcateaf CoMpiiance sf!'aJl bemadeaWilable with the building permits) issued for the building, and made avagableto the enforcement agency for all applicable
inspections. I understand that a registered copy of this CetWicate of Compliance is required to be Included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Mascarenas, Brannon
Company:
SABRINA SERVICES INC
Address:
72216 NORTHSHORE ST #101
City/State/Zip:
THOUSAND PALMS CA 92276
Responsible Designer Signature:
Date Signed:
2018-09-13 08:47:56
License:
1042749
Phone:
760-343-2121 X123
r .1
Easy to Verify
at CaICERTS.com
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies I
Registration Provider responsibility for the accuracy of the information.
L.
Registration Number: 218-A020256679A-000-000-0000000-0000 Registration Date/Time: 2018-09-13 08:47:56 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-09-13 08:47:52
Schema Version: rev 20180426