BMCH2019-006478-495 CALLE TAMPICO Ct 0 D 4v
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number:
BMCH2O19-0064
Property Address:
50880 MANGO
APN:
776192005
Application Description:
OLSON / [2] HVAC CHANGEOUT 16SEER/80AFUE
Property Zoning:
Application Valuation:
$14,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
Olson Lance & Marie Fam Trust
50880 MANGO
LA QUINTA, CA 92253
Date: 2/28/2019
Applicant: Contractor:
SAN'SAIR CONDITIONING & HEATING DD
SAN'SAIR CONDITIONING & HEATING
51 -530 JACKSON STREET 51 -530 JACKSON STREET
COACHELLA, CA 92236-2737 COACHELLA, CA 92236-2737
FEB 2 8 2019
(760)398-8247
CITY OF LAQUINTA Llc. No.: 522775
_ _ _ _ _ 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 License No.:
Date`- %:e>" y'� 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
Owner:
CONSTRUCTION LENDING AGENCY
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 Na
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 the 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: STATE COMPENSATIQNPolicy Number: 9074503
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 f the Labor Code, I shall forthwith
comply with those provisions.
Date:.' Appli '
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 aws relating to building
construction, and hereby authorize representatives oft ' ci ;err upon t eabove-
mentioned property for inspection purposes, , f 1 Il
Dare Signature (Applican
Date: 2/28/2019
Application Number:
BMCH2O19-0064
Property Address:
50880 MANGO
APN:
776192005
Application Description:
OLSON / [2] HVAC CHANGEOUT 16SEER/80AFUE
Property Zoning:
Application Valuation:
$14,000.00
Applicant:
SAN'S AIR CONDITIONING &-HEATING
51-530 JACKSON STREET
COACHELLA, CA 92236-2737
Owner:
Olson Lance & Marie Fam Trust
50880 MANGO
LA QUINTA, CA 92253
Contractor:
SAN'S AIR-CONDITIONING & HEATING
51 -530 JACKSON STREET
COACHELLA, CA 92236-2737
(760)398-8247
Llc. No.: 522775
i
Detail: (2)HVAC CHANGE OUTS - (1&2)165EER/80AFUE SPLIT SYSTItM$. CARBON MONOXIDc ALARMIS) 10 BE INSTALLED PRIOR TO FINAL INSPECTION,
2016 CALIFORNIA BUILDING CODES.
_',_',`;1`„
FINANCIAL INFORMATION
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
$80.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$160.10
Total Paid for CHANGEOUT: $240.14
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
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
(Page i of 3)
Project Name:
OLSON RES. Date Prepared: 2019-02-18
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
CF111-ALT=02 document for each dwelling unit.
01 Project Name OLSON RES.
02
Date Prepared 2019-02-18
03 Project Location 50880 MANGO DR
04
Building Type Single family
05 CA City La Quinta
06
Dwelling Unit Name OLSON RES.
07 Zip Code 92253
08
Dwelling Unit Conditioned
2800
Floor Area (ft)
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 i
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
LIVING AREA
1600
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
SLEEPING AREA
1200
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 219-A020041610A-000-000-0000000-0000 Registration Datefime: 2019-02-18 14:51:32 HERS Provider: Cs
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-02-18
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
1 03
04
05
Heating
System
Heating
Altered
Heating
Minimum
Identification
System
Heating
Efficiency
Efficiency
or Name
Type
Components
Type
Value
Central gas
All new
System 1
furnace
heating
components
Central gas
All new
System 2
furnace
heating
components
AFUE 80
AFUE 80
06 ) 07
Altered
Cooling
Cooling
System Type
Components
Central split
All new
cooling
AC
components
Central split
All new
cooling
AC
components
08
09
Cooling
Cooling
Minimum
Efficiency
Efficiency
Type
Value
SEER
16
SEER
16
Required
New or
Thermostat
Replaced
New Duct
Type
Duct Length
R-Value
This field or
This field or
Setback
section is not
section is not
applicable
applicable
This field or
This field or
Setback
section is not
section is not
applicable
applicable
Reouired 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 <= 30 percent leakage to outside, or seal all accessible leaks.
CF2R and CBR-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.
Exceotions:
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-A020041610A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-02-18 14:51:32
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-02-18 14:51:25
Schema Version: rev 20180426
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: c+
Johnston, Dave S -ape c� jhnston
Company: Signature Date:
A and R Energy Solutions 2019-02-18 14:51:32
Address: CEA/ HERS Certification Identification (if applicable):
60815 NATOMA TRAIL 2006244
City/State/Zip: Phone:
JOSHUA TREE CA 92252 1760-567-0082
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. ; 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. ; 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: �
Johnston, Dave S 'Dave o nston
Company: Date Signed:
A and R Energy Solutions 2019-02-18 14:51:32
Address: License:
60815 NATOMA TRAIL 522775
City/State/Zip: Phone:
JOSHUA TREE CA 92252 760-567-0082
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 information.
Registration Number: 219-A020041610A-000-000-0000000-0000 Registration Date/Time: 2019-02-18 14:51:32
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: 2019-02-18 14:51:25
u�
-
PERMIT #1U� Gars
PLAN LOCATION:
Project Address:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Address:
City, ST, Zip: (� .
Telephone:
Email:
Valuation of Project $ 4
rlr,r,�1 •:[.A4- i
Contractor Name:
New SFD Construction:
Address:`. ��,s�}�
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:quo
Patio/Porch SF
Fire Sprinklers SF
Email:
State Lic a "�� City Bus Lic:
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:Su app 1
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QU I NTA, 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
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License