BMCH2019-005278-495 CALLE TAMPICO D "'iN�1L1CiJ
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number:
BMCH2O19-0052
Property Address:
51895 AVENIDA RUBIO
APN:'
773161019
Application Description:
AMMERMAN / HVAC CHANGEOUT 18SEER/80AFUE SPLIT
Property Zoning:
Application Valuation:
$12,244.00
Applicant: D
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362 FEB 0 5 2019
CITY OF LA QUINTA
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 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.: 827420
Date: 2151 I ci 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 re.
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/5/2019
Owner:
AIDA & DENVER AMMERMAN
51895 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
ALL SEASONS AIR CONDITIONING PLUMBING &
75-450 GERALD FORD DR STE 303
PALM DESERT, CA 92211
(760)568-2663
LIc. No.: 827420
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
work for 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: SECURITY NATIONAL INSURANCE COMPANY Policy Number:
SWC1188850
_ 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.
c
Date: 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: S 1 Signature (Applicant or Agent): �71
Date: 2/5/2019
Application Number:
BMCH2019-0052
Property Address:
51895 AVENIDA RUBIO
APN:
773161019
Application Description:
AMMERMAN / HVAC CHANGEOUT 18SEER/80AFUE SPLIT
Property Zoning:
Application Valuation:
$12,244.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
Owner:
AIDA & DENVER AMMERMAN
51895 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
ALL SEASONS AIR CONDITIONING PLUMBING &
75-450 GERALD FORD DR STE 303
PALM DESERT, CA 92211
(760)568-2663
Llc. No.: 827420
Detail: HVAC CHANGE OUT - 18SEER/80AFUE SPLIT SYSTEM. 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 QTY
AMOUNT
HVAC CHANGEOUT- SPLIT -SYSTEM PC 101-0000-42600 0
$80.05
Total Paid for CHANGEOUT:
$120.07
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:d 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
PERMIT #
Project Address: 51Sc5
APN #:
Applicant Name;��
Address: 31ZZ5
City, ST,Zip: x���0,[.0O3
Telephone:
Email:
dr
Property Owner's Name: ' cks-
Address: S "R2 Len iaa L1 io
City, ST, Zip � .� ,�� C.A R2z53
Telephone:
Email:
q i 3%z
PLAN LOCATION.
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
VA C: S:vsV& nrm
Valuation of Project $ 12,-21fet. cz-->
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QU I NTA, CA 92253
760-777-7000
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
Project Name:
". `1�nera1 Information -
` CF1R-ALT-02 document for each dwelling unit. u -
01 Project Name AIDA AMMERMAN
,3 :e�. Project LacyL�o
� • - �Y _ ......_ _ .. 5i995 Ad/ENID,4 RJBlU
r's
CA C21i La
07 Zip Code 92253
00 Climate Zone 15
AIDA AMMERMAN I Date Prepared:
1-nulti •!z? 6� eilin.g units r:-,ust be documented,
02 Date Prepared
' 04 + Building Type - —
nC )� Dwelling Unit Name
08 Dwelling Unit Conditioned
Floor Area (W)
Number of Space
1
0 Conditioning (SC) Systems in
this Dwelling Unit:
CF1R-ALT 02-E
(Page 1 of 3)
2019-02-05
2019-02-05
Single family
AIDA AM MERMAN
1621
1
D. Spare Conditioning (SC) System Information
01 02
03 04 05 06 _. - — — --- -- - -- -- i 07 + 08
Is the SC� Installing a
SC Syy'star� � SC S atem � CFA served — __ _- -- .• - _
{ system a refrigerant
�?�_.oi�ieiu•�a�:. CE I E2s^
Installing new SC
hS�� Installing Installin-a63.1 c =cted ing system more than 40 entire)
:u•4 porients? � 'eet of ducts7 � � i e
_ ! f.3�:E Sy�St
_ System 1 Location 1 1621 Yes Yes Yes No No
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
Registration Number: 419-A020011198A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-02-05 07:53:43
-- 09 - - 10
g
Installing
aw
entirely new
m?
SC system?
Alteration Type
f
No
Altered space
conditioning system
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Report Generated: 2019-02-05 07:53:43
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
CFlR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC)
(Page 2 of 3)
M ASte7ed Space Conditioning System (Sections 150.2(b)1E and F)
�1 I 02. C5
06
Of
C`� j _ 09
1
�0 13
12
•.,z,•
I , ry. . , _ p
•
?`;:e'e,q
Cooling I Mini
g mum
! Required New or
'u :f«::'i�G
[ s ! ` ` :•. g � .. I -
r.
`>s
a
rtt•f .. r:,,'
:r..'se�s:� Efr:..FLreey
T
hec•mostat Replaced
New Duct
r
° �• i I
.roc. _..is Tyr Vs. r�, +.. -;, Type
C.,.:;paler xs
Tyae Value
Type Dust Length
R-Value
l:entral pas !', „ .. f
f i•
Central split
I. _ �.
is 3i�iu a
- r
TnisJieiu or
_G
I furnace O
Uts�
AC
a
��", ES
6LL,;Sele secuar, is not
se i o`
L _ I
Required Documentation
- is
c`__ ' n
__J- _ _ -•'
f a,:'11cable
_I ' - —•Y� apr
applicaw!e
( ('2R-idiCH-0!-E - Space Conditioning Systems
++ "::�t �s 'a::;•: rrq�, 5 3,e'.F rgr the r 2:: ;r�#i^ua of supply-tir pay;et n,� air doctS or plenums R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16)
:k ;,; ^r;, ' N 20..; ' .rcr , ,o�- Te: ;Cc :1r +,.,s e. r� }ira o, ter)Yrim .ntnp,: ne; its c. = nstatied in ducted systems, or when more than 40 ft of duct length is replaced
II leolcig :a.s anisllance e= ;5 perier<t or <= 4 percent leakage m o iQe, or seal all accessible leaks..
arm Lei C:ia� rp�utr.r w'leo refrtgc,ant Containing _ofnrorrents are installed or altered (applicable in CZ 2, 8-15).
R;•tx; nO C'M per ',of' re4u!(C,i when MCH•25 is regzxed.
x e tan
F ystcr:s registered tvWt KIRS provider as previously sealed are exempt from MCH•20 Duct Leakage Testing requirements.
sy wrns anti Air Handler Furnace than&sdo not require verlfieation of Air Plow MCH-23, or Refrigerant Charge MCH-25.
t ;fact systems comtr_Cted, Insulated or seated with asbestos are exempt frt+m MCH-20 Duct Leakage Testing requirements.
Chanv?l4rp'a Sections 150.2(b)1Diia and 150.2(b)lE F
This section does not apply to this project.
i-idi'ioring System (Section 150.2(b)1C)
._ This section does not. apply to this project.
Registration Number: 419-A020011198A-000-000-0000000-0000
Registration Date/Time: 2019-02-05 07:53:43
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-02-05 07:53:43
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
CFIR-ALT 02-E
(Page 3 of 3)
N�eorrer:ration Author's Declaration Statement -� �-
- �. � ` ___ �_. R• _
1.5 i'jrnent;;,o, a,-<:horrdame:
�Jo Anne Orona
C:crumrnt=±ionAutho;Sienat.ire:
Jo-AvuwOrarra I
Company:
1 _ - . .,. -_., •,..�_.•-.,.�,. __
l Permit ERaters
� 20191-02-05
- -
131225 La Baya Drive
T w
��-4j ., . .. .. - .,tifirai:i^-1 (iF-..pic,-?hlpl• -.. _�.__. _.. .. ..... ..
! City/State/Zip:
-• y - - - -
V"'^-r!ake Village CA �?1352
i.`.�=:w
8�.$ 73 c_ 7o
�76
Ise rs;,sa'` ^R;:laration statement
c�-rii`y S,e follovding under pena'',y of oerjury, under the laws of the State of California:
+ 'h = information ro„Hfd , ! this Certificate of Compliance is true and correct.
)
.0 Pr 'e s er:_'_cr?_ !o ::.ceai .-espoi. Lai:; `c; he
bui:G!1,,o design or sy.'em design identified on this Certificate of Compliance (responsible designer).
� -,.�, s� ;r,. ,., :� :. ' � �� '
rf:,. ._.._ .... ._ Stara = cur cni_.. • -.-.d :,.c,.u`arr,.::d
y
.."'-eS `.. tl ` building c'c_is,-: a stern design ident ficd cn this Certifi r
"l- s cate of Compliance conform to .he
rec;uirement_s of Title 74, Part 1 and Part 5 of the California Code of Regulations.'
[
r r T
, . "•" .• •. "• d�3 ^n h plicable compliance documents, worksheets,
'inn nr,-lti Ot of applicable P
�.;.-, . ...._, ; ..... ...;,_ .;,::• :. , .�:...:., c = .. _... _:.i a cnc� {pr aPP'-, --Z�: wif i, lhss tPuildIIIg PerIT, it a p pii[3tion.
= - J i'
.... ., . •.. (,j u r _.._ . ,.,.'',i�g, 4nd i± _,de a',ailuble to the enforcement agency for all applicable
- - -. ..
° •i- ,,, din: ok" E—
'Responsible Designer Name:
Responsible Designer Signature: y
David Beale
Company :
Date Signed:
- ; Seasons �i; Conditioning Plumbing & Heating, Inc.
2019-02-05
�Address:
v _ �__�.._...._.._...�.
License:
73605 Dinah Drive #1310M
�827420
City/State/Zip:
Phone:
Palm Desert CA 92211
760-568-2663
Digitally signed by CHEERSTM. 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-A020011198A-000-000-0000000-0000 Registration Date/Time: 2019-02-05 07:53:43
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Schema Version: rev 20180426
HERS Provider: CHEERS
Report Generated: 2019-02-05 07:53:43