BMCH2019-0066-!� VOICE (760) 777-7125
78-495 CALLE TAMPICO T4tyl U FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/1/2019
Permit Type/Subtype: MECHANICAL/ Owner:
Application Number: BMCH2O19-0066 KARL BATZLER
Property Address: 54420 EISENHOWER DR 54420 EISENHOWER DR
APN: 774253007 LA QUINTA, CA 92253
Application Description. BATZIER / HVAC CHANGEOUT 14SEER/80 AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $15,093.00
Applicant: Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C L.I V A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201 P
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120 MAR 01 2019 MEMPHIS, TN 38120
0 (951)276-9744
CITY OF LAQUINTA Llc. No.: 765074
DESIGN & DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 fcommencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C366, C100, CC20 License No.: 765074
Fte;, i"3_ ` J ` 1 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 Add
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 th ork for which this permit is issued.
I have and will maintain workers' eampensation insurance, as required by
Sect n 700 p{ the Labor Code, for the performance of the work for which this permit
s sued. My workers' compensation insurance carrier and policy numberare:
arrler: LIBERTY INSURANCE CORPORATION Pallcy Humber:
WA763D508631018
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 F'6 itft
comply with those provisions.
Date: Ak S3 Applicant:
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: Signature (Appli11 or Agent)-
Date: 3/1/2019
Application Number:
BMCH2O19-0066
Property Address:
54420 EISENHOWER DR
APN:
774253007
Application Description
BATZIER / HVAC CHANGEOUT 14SEER/80 AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$15,093.00
Applicant:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
Owner:
KARLBATZLER
54420 EISENHOWER DR
LA QUINTA, CA 92253
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
(951)276-9744
S 1 r Llc. No.: 765074
------------------------------------- ------ ------t-----------------------------------
Detail: HEAT PUMP AND AIR HANDLER - HVAC CHANGE OUT- 14SEER/80AFUE SPLITSYSTEM, CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
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
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
Bin. #
.c1w Of La QuInta
Rulldirig 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
la.Qulnta, CA 92253 - (760) 777-70I2
Building Permit Application and Tracking Sheet
Permit #
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PrqjvAAdd.rass5
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Owner's Name:.
A. P. Number:
Legal Description:
Contractor: F1 kD ftM,, 2 i -
Address: ac-,� e 1 :5�,
City' ST T' T
' 9 ,9 ;z!Et'7
Telephonc: 7W'%7* ,w,
Address: 3paQ "jz� T
Project �
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City, ST,7ip:'� 16� i; F's� t7"QS
4�
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Telephone:
State Lie. # : —76507 4 City Lie. #: Q + 113
Arch., Engr., Designer:
r
--
Address:
City., ST, Zip:
Telephone:
State Lie. #:
Construction Type: E. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: 1!� C=i5TL# Stories: # Units:
Name of Contact Person: (�� cSAc 1
Telephone # of Contact Person: .
p `�G�' �'O(�%�
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
'Fuss Cales.
Called Contact Person
Plan Check ]Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'a Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"` Review; ready for corrections/issue
Developer Impact Fee
pproval
Called Contact Person
A.LP.P.
ApprDate
of permitissue
LPub.Wks.
s
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
Project Name:
BATZLER, KARL I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3)
2019-03-01
A. General Information
CFIR-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
BATZLER, KARL
02
Date Prepared
2019-03-01
03
Project Location
54420 EISENHOWER DR
04
Building Type
Single family
05
CA City
La quinta
06
Dwelling Unit Name
BATZLER, KARL
07
Zip Code
92253
08
Dwelling Unit Conditioned
1495
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
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 (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1495
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 419-A020019570A-000-000-0000000-0000
Registration Date/Time: 2019-03-01 07:48:04
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-03-01 07:48:04
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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
All new All new
This field or This field or
Centrals lit
System 1 Centp cooling SEER 14 Setback
Systemsplit heating AFUE 0.8
section is not section is not
HP
components 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 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 Ducat System, 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)
Registration Number: 419-A020019570A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-03-01 07:48:04
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-03-01 07:48:04
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CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
CF1R-ALT 02-E
(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
Christina Calhoun 0w6Wma CaUwu.ry
Company: Signature Date:
Rightime Home Services 2019-03-01
Address: CEA/ HERS Certification Identification (if applicable):
965 Ridge lake Blvd, Suite 201
City/State/Zip: Phone:
Memphis TN 38120 951-276-9744
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:
Christina Calhoun
C1u-6W"u.Cathou4v
Company:
Date Signed:
Rightime Home Services
2019-03-01
Address:
License:
965 Ridge lake Blvd, Suite 201
765074
City/State/Zip:
Phone:
Memphis TN 38120
951-276-9744
Digitally signed by CFIEERST". 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: 419-A020019570A-000-000-0000000-0000
Registration Date/Time: 2019-03-01 07:48:04
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-03-01 07:48:04
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