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BMCH2019-004978-495 CALLE TAMPICO U7, VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/5/2019 Permit Type/Subtype: MECHANICAL/ Owner: Application Number: BMCH2O19-0049 CAROL PAWLUK Property Address: 81201 VICTORIA LN 81201 VICTORIA LN APN: 764440041 LA QUINTA, CA 92253 Application Description: PAWLUK / HVAC CHANGE OUT - 18SEER/80AFUE SPLIT SYSTEM Property Zoning: Application Valuation: $13,520.00 Applicant: 0 Contractor: CERTIFIED COMFORT SYSTEMS INC DBA HYDEV Q D CERTIFIED COMFORT SYSTEMS INC DBA HYDES 42949 MADIO STREET 42949 MADIO STREET FEB 05 2019 INDIO, CA 92201 INDIO, CA 92201 0 (760)360-2202 CITY OF LA QUINTA Llc. No.: 906115 DESIGN & DEVELOPMENT DEPARTMENT 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: C20. C36. CIO License No.: 906115 Date: 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 Name: Lender's Address: 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 w . for which this permit is issued. have and will maintain workers' compensation insurance, as required by Sectlon 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: E-VFREST NATIONAL INSURANCE COMPANY 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:IZX—.//, Applicant: :Z 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-mentloneg property for Inspection purposes. Date: Signature (Applicant or Agent)t� Date: 2/5/2019 Application Number: BMCH2019-0049 Property Address: 81201 VICTORIA LN APN: 764440041 Application Description: PAWLUK / HVAC CHANGE OUT -18SEER/80AFUE SPLIT SYSTEM Property Zoning: Application Valuation: $13,520.00 Applicant: CERTIFIED COMFORT SYSTEMS INC DBA HYDES 42949 MADIO STREET INDIO, CA 92201 Owner: CAROL PAWLUK 81201 VICTORIA LN LA QUINTA, CA 92253 Contractor: CERTIFIED COMFORT SYSTEMS INC DBA HYDES 42949 MADIO STREET INDIO, CA 92201 (760)360-2202 Llc. No.: 906115 Detail: 5-TON HVAC CHANGE OUT - 18SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT 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 $40.02 DESCRIPTION ACCOUNT CITY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $80.05 Total Paid for CHANGEOUT: $120.07 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT QTY 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 i Qalara q PERMIT # 'Bkc—(4 l (DO — i; E,\d >frle LFSFikC -- PLAN LOCATION: Project Address: �l`a,�` viC-� �.{� Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: S Applicant Name: S t i Address: iJl t City, ST, Zip: Ut, �� Telephone: ,�:N d — �U leu-L Email: }n�lr� ,QS Valuation of Projects Contractor Name: i S ' New SFD Construction: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: U_ ��0 �'Lr7 02 Patio/Porch SF Email: Y `z b aC �VC�, /fin I Fire Sprinklers SF State Lic:9 City Bus Lic: l Arch/Eng Name: Address: City, St, Zip Telephone: Email: State Lic: City Bus Lic: Construction Type: Grading: Bedrooms: Stories: Occupancy: # Units: Property Owner's Name: (ayo\ ��vC� New Commercial / Tenant Improvements: Total Building SF Address: cb � City, ST, Zip 'L Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA CLUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Req'd Ree'd Plan Sets Structural Calcs Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM10) 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-IR-ALT-HVAC) (Page 1 of 3) Project Name: 81201 Victoria Lane Date Prepared: 2019-02-05 A. General Information CHR-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 81201 Victoria Lane 02 Date Prepared 2019-02-05 03 Project Location 81201 Victoria Lane 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name 81201 Victoria Lane 07 ZipCode 92253 Dwelling Unit Conditioned 08 2109 Floor Area (ft) 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 CFA served Y Y 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 2109 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) Registration Number: 219-A020030649A-000-000-0000000-0000 This section does not apply to this project. Registration Date/Time: 2019-02-05 09:38:38 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-02-05 09:38:29 Schema Version: rev 20180426 CF1R-ALT-02-E CERTIFICATE OF COMPLIANCE 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 All new All new This field or This field or Central gas Central split System 1 heating AFUE 80 cooling SEER 18 Setback section is not section is not furnace AC components components applicable applicable Required Documentation: CM-MCH-014 - 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 MR-MCH-25-11 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 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)iDiia 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) Registration Number: 219-A020030649A-000-000-0000000-0000 This section does not apply to this project. Registration Date/Time: 2019-02-05 09:38:38 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-02-05 09:38:29 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: Hyde, Mark Company: CERTIFIED COMFORT SYSTEMS INC Address: 42949 Madio City/State/Zip: Indio CA 92201 Responsible Person's Declaration statement Documentation Author Signature: ozo� 1� Signature Date: 2019-02-05 09:38:38 CEA/ HERS Certification Identification (if applicable): Phone: 760-360-2202 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 buiiding 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 forthe 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 wrth the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Hyde, Mark Company: CERTIFIED COMFORT SYSTEMS INC Address: 42949 Madio City/State/Zip: Indio CA 92201 Responsible Designer Signature: Date Signed: 2019-02-05 09:38:38 License: 906115 Phone: 760-360-2202 Digitally signed by CaICERTS. 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: 219-A020030649A-000-000-0000000-0000 Registration Date/Time: 2019-02-05 09:38:38 Easy to Verify at CaICERTS.com HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Schema Version: rev 20180426 Report Generated: 2019-02-05 09:38:29