BMCH2018-042478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description.
Property Zoning:
Application Valuation:
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
MECHANICAL/
BMCH2O18-0424
`A^*y, 4 lW QU4&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
81895 PRISM DR
764360044
HOELTJE / HVAC AND CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM
$6,900.00
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 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C20, C36 License No.: 977333
Date: I U 1 5 8 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).:
(_) 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/15/2018
Owner:
DONALD HOELTJE
81895 PRISM DRIVE
LA QUINTA, CA 92253
Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189
PALM DESERT, CA 92211
(760)565-2691
Llc. No.: 977333
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.
2E�� 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: INSURANCE COMPANY OF THE WEST Policy Number: WPL5041680
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: LYr Applicant' _
WARNING: FAILURE TO SECURE WORKERS' CQMPENSATION 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: 10 IS 1 S Signature (Applicant or Agent)., __ls�—�
Date: 10/15/2018
Application Number:
BMCH2O18-0424
Property Address:
81895 PRISM DR
APN:
764360044
Application Description-
HOELTJE / HVAC AND CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$6,900.00
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
Owner:
DONALD HOELTJE
81895 PRISM DRIVE
LA QUINTA, CA 92253
Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189
PALM DESERT, CA 92211
(760)565-2691
Llc. No.: 977333
Detail: HVAC AND (2) TON CONDENSER CHANGE OUT - SYSTEM (1)16 SEER/80 AFUE SPLIT SYSTEM. SYSTEM (2) 14SEER CONDENSER. CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 2016 CALIFORNIA BUILDING CODES.
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$80.05
Total Paid for CHANGEOUT: $186.77
DESCRIPTION
ACCOUNT
CITY
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
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Za i.!'LIW
- =sFrrr -
PERMIT # OWCwo 701 01Zi
PLAN LOCATION:
Project Address: 81895 Prism Drive
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Replace 5 ton / 60,000 BTU complete HVAC system
Replace 2 ton condenser
Applicant Name: Steven Schnierer
Address: 31225 La Baya Drive Suite 213
City, ST, Zip: Westlake Village, CA 91362
Telephone: 818-735-7876
Email: swschnierer@roadrunner.com
Valuation of Project $ 6.900.00
Contractor Name: A#1 Services Heating & A/C
Address: 78206 Varner Road #D-189
City, St, Zip Palm Desert, CA 92211
Telephone: 760-342-3610
Email:
State Lic:977333 City Bus Lic:
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
SF
SF
SF
SF
Arch/Eng Name: Construction Type: Occupancy:
Address: Grading:
City, St, Zip
Telephone: Bedrooms: Stories: F#Units:
i
Email:
State Lic: City Bus Lic:
Property Owner's Name: Hoeltje, Don
Address: 81895 Prism Drive
City, ST, Zip La Quinta, CA 92253
Telephone: 949-646-0129
Email:
New Commercial / Tenant Improvements:
Total Building
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
SF
�,V, IfT
1�0
OFFICE USE ONLY
#
Submittal
Req'd
Rec'd 4
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan-(PM1-0)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-SR-ALT-HVAC) (Page 1 of 3)
Project Name: DON HOELTJE I Date Prepared: 2018-10-10
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 DON HOELTJE
02 Date Prepared
2018-10-10
03 Project Location 81895 PRISM DR
04 Building Type
Single family
05 CA City La Quinta
06 Dwelling Unit Name
DON HOELTJE
07 Zip Code 92253
Dwelling Unit Conditioned
08
2460
Floor Area (ft2)
Number of Space
09 Climate Zone 15
10 Conditioning (SC) Systems in
2
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 CFA 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 1230
Yes
Yes
Yes No
No No
Altered space
conditioning system
System 2 Location 2 1230
Yes
Yes
Yes No
No No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section
150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 418-A020079688A-000-000-0000000-0000 Registration Date/Time: 2018-10-10 12:56:58 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-10-10 12:56:59
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
CF1R-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)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 All new All new
System 1 g heating AFUE 0 g CentrAaCl split cooling SEER 16 Setback
This field or This field or
furnace
section is not section is not
components components
applicable applicable
This field or No Heating This field or This field or All new
Central splitAC
This field or This field or
System 2 section is not Component section is not section is not 14 cooling SEER Setback
section is not section is not
applicable Altered applicable applicable components
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 or altered (applicable in CZ 2, 8-15).
CF2R and CF313-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 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.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia 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: 418-A020079688A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2018-10-10 12:56:58
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-10-10 12:56:59
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE CF1R-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:
Drew Queen Drew Queew
Company: Signature Date:
I Permit E Raters 2018-10-10
Address: CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip: Phone:
Westlake Village CA 91362 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.
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 on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(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 required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
Cara Goldberg Cara.Goidbes-g,
Company: Date Signed:
A#1 Services Heating & Air Conditioning 2018-10-10
Address:
License:
78026 Varner Road #D-189 977333
City/State/Zip: Phone:
Palm Dessert CA 92211 (760) 342-3610
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: 418-A020079688A-000-000-0000000-0000 Registration Date/Time: 2018-10-10 12:56:58 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2018-10-10 12:56:59
Schema Version: rev 20180426