BMCH2018-048078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
MECHANICAL/
BMCH2O18-0480
43780 GENOA DR
609521012
MIKAELIAN /REPLACE FURNACE
$2,800.00
Applicant:
SABRINA SERVICES INC DBA COACHELLA VALLE
72216 NORTHSHORE ST#101
THOUSAND PALMS, CA 92276
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DEC f 5 ?01
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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: Cj2,0,, C�36 License No.: 110442,749
r r~ GU:
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
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 Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/5/2018
Owner:
MAY MIKAELIAN
43780 GENOA DR
LA QUINTA, CA 92253
Contractor:
SABRINA SERVICES INC DBA COACHELLA VALLE
72216 NORTHSHORE ST#101
THOUSAND PALMS, CA 92276
(760)343-2121
Llc. No.: 1042749
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 wor or 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: 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 shoedbecome subject to the
workers' compensation provisions of Section 3700 of t Labor Code, I shall forthwith
comply with those provisions.
Dales, Cs Apj�
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.
certify that I have read this application and state that the ab a information is correct.
I agree to comply with all city and county ordinances and st a laws relating to building
:onstruction, and hereby authorize representatives thi ity to enter upon the
above-mentf ne property for inspection pur
III . � 5 e (Applicant or ge 0:
Date', 311(2018
Application Number: BMCH2018-0480
Property Address: 43780 GENOA DR
APN: 609521012
Application Description: MIKAELIAN /REPLACE FURNACE
Property Zoning:
Application Valuation: $2,800.00
Applicant:
SABRINA SERVICES INC DBA COACHELLA VALLE
72216 NORTHSHORE ST#101
THOUSAND PALMS, CA 92276
Detail: REPLACE FURNACE 80 AFUE FURNACE ONLY. PER 2016 CALIFORNIA BUILDING CODES
Owner:
MAY MIKAELIAN
43780 GENOA DR
LA QUINTA, CA 92253
Contractor:
SABRINA SERVICES INC DBA COACHELLA VALLE
72216 NORTHSHORE ST #101
THOUSAND PALMS, CA 92276
(760)343-2121
Llc. No.: 1042749
FINANCIAL
DESCRIPTION
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 - FURNACE ONLY
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - FURNACE ONLY PC
101-0000-42600
0
$26.68
Total Paid for CHANGEOUT: $66.70
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
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: $5.00
TOTALS::4
-- c e &+ f,l,, D LS ER F —
PERMIT #
PLAN LOCATION:
Project Address:
°0
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
C-
0 e 7-0�
Applicant Name: 1/
4 L—Q-r 3
Address:
City, ST, Zip:
Telephone:
Email:
Valuation of Project S f9
Contractor Name: I New SFD Construction:
Address: Conditioned Space SF
City, St, Zip Plumbing "rvi
72216 North.c more St #101 Garage SF
Telephone: Thousand Palms, (.a a221U
Patio/Porch SF
Email: Fire Sprinklers _ _ SF
State Lic: 10q OL? 1�1 City Bus Lic:'I�� J
Arch/Eng Name: Construction Type: Occupancy:
Address: Grading:
City, St, Zip
Telephone: Bedrooms: Stories: # Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: %�J 1L� -A) New Commercial / Tenant Improvements:
Address: Total Building SF
City, ST, Zip Construction Type: Occupancy:
Telephone: �D
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
i
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
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 MIKAELIAN
02
Date Prepared
2018-12-05
03 Project Location 43780 GENOA DR
04
Building Type
Single family
05 CA City La Quinta
06
Dwelling Unit Name
MIKAELIAN
07
Zip Code
92253
08
Dwelling Unit Conditioned
2000
Floor Area (ftZ)
Number of Space
09
Climate Zone
15
10
Conditioning (SC) Systems in
1
this Dwelling Unit:
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
Is the SC
Installing a
SC System
SC System
CIA 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
System 1
Location 1
2000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Dud System, Greater Than 40 Feet (Section15O.2(b)1Diib)
Registration Number: 218-A020322114A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2018-12-05 09:42:11
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-12-05 09:42:03
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
CFlR-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)lE 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
Gas furnace
Central split
No Cooling
This field or
This field or
This field or
This field or
System 1
furnace
AHU
AFUE
80
AC
Component
section is not
section is not
Setback
section is not
section is not
Altered
applicable
applicable
applicable
applicable
Reauired 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 MR-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 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 regUi'erients.
Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH•23, or Refrigerant Charge iACH-2.5.
-Existing duct systems constructed, insulated or sealed with ashestos are exempt from MCH-2D putt Leakage Testing requiremarrta.
E. Entirely New or Complete Replacement Du&SVztem, with or without -Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, 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: 218-A020322114A-000-000-0000000-0000 Registration Date/Time: 2018-12-05 09:42:11 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-12-05 09:42:03
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:
2018-12-05 09:42:11
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 RejulaHons.
4. The building design features or system design features identified og4his Certifl[at4iv dompliance are ocrosisteit with the iW' rmatlaaprovided on otl.tr1py)icabie compliance documents, worksheets,
calculations, plans and specifications submitted to the ellforcement*gency forappmval wEtA this building perrrdt appiiratil*
5. 1 will ensure that a registered copy of this Certifrcawof Compliance sh*bemulamitable with the building permit(s) issuM for the building, and made avaHab*vD theanforcement agency for all applicable
inspections. I understand that a registered copy of this CeRPficate of Compliance is required to be included with the emumentatiort 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:
2018-12-05 09:42:11
License:
1042749
Phone:
760-343-2121 X123
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies
Registration Provider responsibility for the accuracy of the mfom)atron.
Registration Number: 218-A020322114A-000-000-0000000-0000 Registration Date/Time: 2018-12-05 09:42:11
Easy to Verify
at CaICERTS.com
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Schema Version: rev 20180426
Report Generated: 2018-12-05 09:42:03