BMCH2018-040478-495 CALLE TAMPICO C& 0 DVOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/ Owner: Date: 9/25/2018
Application Number: BMCH2O18-0404 IRENE HASTINGS
Property Address: 53325 AVENIDA VILLA P 0 BOX 1024
APN: 774093016 LA QUINTA, CA 92253
Application Description: HASTINGS / HVAC CHANGE OUT 16SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $5,100.00
Applicant: I�
IE INC ` D� Contractor:
�'� A#1 SERVICES HEATING & AIR CONDITIONING
31225 LA BAYA 78206 VARNER RD #D 189
WESTLAKE VILLAGE, CA 91362 i SAP 2fl18
I I PALM DESERT, CA 92211
I ryC �l ■�n 1 (760)565-2691
V1111J`�QV�1Y1Ct f^ LIc. No.: 977333
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commenting with Section 7000) of Division 3 of the Business and Professions Code, and
my license is In full force and effect.
License Class: _ License No.: 977333
Date: 1 > Contractor: —�A4cs ' `
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 (Chapter9 (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 1<
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 Address: 4144
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 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
`-a 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: MUR8NCECOMRANY OF THE WEST Policy Number: MXJ5041§$0_
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 should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: `� a Applicants�r � J
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 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.
Date: 9 1� Signature {Applicant or Agent}: <s
Application Number:
BMCH2018-0404
Property Address:
53325 AVENIDA VILLA
APN:
774093016
Application Description:
HASTINGS / HVAC CHANGE OUT 16SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$5,100.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
Date: 9/25/2018
Owner:
IRENE HASTINGS
P 0 BOX 1024
LA QUINTA, CA 92253
Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189
PALM DESERT, CA 92211
(760)565-2691
LIc. No.: 977333
.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L _ r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Detail: HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
Project Address: 9 33ZS AV'e— .vF v 11 a
APN #:
Applicant Name:
Address: Izz5 Lz, D
City, ST, Zip: -, �)I
Telephone: R1g-7--1r5--757L
EmaiI:
•#� Z1�
Contractor Name:
Address: 7gZ� Vc-rinerit b �
City, St, Zip Oe ; } CA
Telephone: -�60- 347- 34,12
]✓mail:
State Lie: City Bus Lie:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lie:
City Bus Lie:
Property Owner's Name: �. ,
Address: 5330J ANC 0(- V
City, ST; Zip
Telephone: ••70D--4i oT-002-z-=
Email:
PERMIT 4
PLAN LOCATION:
Project Description. Pool, Remodel, Add't, Elect, Plumb, Mech
Valuation of Project
New SFD Construction:
------------
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms:
SF
SF
SF
SF
Occupancy:
Stories: i # Units:
New Commercial 1 Tenant improvements:
SF
Total Building
Construction Type: Occupancy:
784� LLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
CF1R-ALT-02-E
CERTIFICATE ATE OF COMPLIANCE (Page 1 of 3)
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC) 2018-09-25
:1RE:N:EH:AS�TINGS�DatePrepared:
Project Name:
General information
within a single dwellin
g unit. When multiple dwelling units must be documented, use one
A.
CF1R-ALT-02 is applicable to multipleP
space conditioning systems contained
CF111-ALT-02 document for each dwelling unit.
Date Prepared
2018-09-25
01 Project Name
IRENE HASTINGS
02
04
Building Type
Single family
03 Project Location
53325 AVENUE VILLA
Unit Name
IRENE HASTINGS
06
Dwelling
05 CA City
La Quinta
Dwelling Unit Conditioned
4791
92253
08
Floor Area (ft2)
07 Zip Code
Number of Space
10
Conditioning (SC) Systems in
1
09 Climate Zone
15
this Dwelling Unit:
Conditioning onditioning (SC) System Information
B. Sp
04
05
01
02
03
Is the SC
Installing a
CIA served
system a
refrigerant
SC System
SC System
by this SC
ducted
containing
Identification or
Location or Area
System (ftZ)
system?
component?
Name
Served
System 1
Location 1
4791
Yes
Yes
OS 09 10
06 07
Installing new SC
Installing
Installing
new
Installing
entirely new
system
more than 40
feet of ducts?
entirely
duct system?
SC system • Alteration Type
components?
Altered space
No
No
No conditioning system
Yes
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
HERS Provider: CHEERS
Registration Date/Time: 2018-09-25 08:31:06
Registration Number: 418-A020074466A-000-000-0000000-0000 Report Generated: 2018-09-25 08:31:06
Report Vers'on: 2018.0.001
CA Building Energy Efficiency Standards - 2016 Residential Compliance Schema Vcrsion: rev 20180426
CF1R-ALT-02-E
(Page 2 of 3)
CERTIFICATE OF COMPLIANCE
ing Systems (formerly CF-IR-ALT-HVAC)
Alterations to Space Condition
D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 07 OS 09
10 11 12
06
02 03 04 05 Cooling
01 Heating Minimum Required New or
Altered Cooling New Duct
Heating Minimum Efficiency Efficiency Thermostat Replaced R-Value
System Heating Altered Cooling Cooling Type
Duct Length
Heating Efficiency Efficiency Components Type Value yp
Identification System Value System Type Comp This field or This field or
or Name Type Components Type All new
Central split SEER 16 Setback section is not sectit
All new 80 cooling applicable applicable
Central gas heating AFUE AC components
System 1 furnace
components
Renuir ntatipn:
I air and return-alr ducts or plenums: R5 (� 1-1D, 12 and 131 and RS (CZ 11 and 14 16)
CF2R-MCH-Dl-E -Space Conditioning Systems
Duct insulation requirement for the new portions of suPP y
re than
CF2R and G Ftion re luiM-H - Duct Leakage Test required when heating or cooling seal all accessibleleaks.I� duffed systemsoaltered (applicable nCZ 40 f208f duct length is replaced
_Leakage rate COmpliance: <-15 perrxnt yr <=10 percent leakage to
CF2R and CF3R MCH-ZS-H Refrigerant Charge verificatign requi fed when MCH75 s required,
�rnnenCs are Installed o
Cf2R and CF3R-MCH-23 Alfflow Rate r- 300 CFM per ton requ
rn E& o revIou Duct Systems registered
HERS Hand r Fumace changessly
not require ve ({cation of Al Flow MCH-23go Refnlamnt Charge MCH-25.
Heating -only systems a d
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH-20 fl�� Leakage Testing requirements. 0 2 b 1Diia and 150.2(b)1E, F)
E. Entirely New or Complete Replacement Duct System, with or with�does
�notapply
t Changeout (Sections 15 ( )
This sectito this project.
ning System (Section 150.2(b)iC)
Entirely New or Complete Replacement Space Conditioproject.
This section does not apply to this proi J
HERS Provider: CHEERS
Registration Date/Time: 2018-09-25 08:31:06
Registration Number: 418-A020074466A-000-000-0000000-0000
Report Generated: 2018-09-25 08:31:06
Repot Vernon: 2018.0.001
CA Building Energy Efficiency Standards - 2016 Residential Compliance Sc}1ema Version: rev 20180426
CF1R-ALT-02-E
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 co Documentation lion Author signature:
Documentation Author Name:
Jo Anne Crona
Company:
I Permit E Raters
Address:
31225 La Baya Drive
City/State/Zip:
Westlake Village CA 91362
jo-A n+-w, 0rona1
Signature Date:
2018-09-25
CEA/ HERS Certification Identification (if applicable):
Phone:
$18-735-7876
(Page 3 of 3)
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 Certiizcate of Compliance is true and correct . nsihllit far the building design or system design identified on this Certificate of Compliance (responsible designert
2• 1 am ellgible under omsion 3 of the business and Professions Lode to accept respo Y
features and erformance specifications, materials, components, and manufactured devlcesfvr the building design or system design identified on this Certificate of Compliance conform to the
3. That the energy P licable compliance documents, worksheets,
requirements of Title 24, Part 1 and Fart 6 of the Cal dom1a Cade of Regulations,
with
a info
f rovaI with this buiidIng permit application. f licable
q. The building design features or sVs specifications submittedat the enforcement on agency ath is tepof Compliance are consistent}rmit(s}issued forathe bu} di g and made available to the enforcement agency or ail app
calculations, plans and d co
5, I will ensure that a registered copy of this Certificate is Compliance Shall pl mach available with rile boil ng PC th
inspections. i understand that a registered copy of this CerYrficate of Compliance is required to be included with the documentation the builder provides to the building owner a o
Responsible Designer Signature:
Responsible Designer Name
Cara Goldberg
company:
A#1 Services Heating & Air Conditioning
rAddress:
Varner Road #D-189
atel•Cip:
Dessert CA 92211
C0Wa,Go '*
Date Signed:
2018-09-25
License:
977333
phone:
(760) 342-3610
Digitally signed by CHEERS'".
This
Registration Provider pe provided
in order r t e accuracy of the nformationntent of this 9istered
document, and in y
Registration Number: 418-A020074466A-000-000-0000000-0000
Registration Date/Time: 2018-09-25 08:31:06
Report Version: 2018.0.001
CA Building Energy Efficiency Standards 2016 Residential Compliance Schema Version: rev 20180426
HERS Provider: CHEERS
Report Generated: 2018-09-25 08:31:06