BMCH2019-009178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
°ter 4 a 4w4"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
MECHANICAL/
BMCH2O19-0091
79675 MANDARINA
776191007
JONES / SPLIT SYSTEM HVAC CHANGEOUT
$12,000.00
Applicant:
SAN'S AIR CONDITIONING & HEATING
51 -530 JACKSON STREET
COACHELLA, CA 92236-2737
MAR 2 9 19::?
CREAM
4 EtM
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: C220 License No.: 522775
Date: \�6� 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 ofthe 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 Na
Lender's Address:
1
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/27/2019
Owner:
Jones 0 & E Living Trust
79675 MANDARINA
LA QUINTA, CA 92253
Contractor:
SAN'S AIR CONDITIONING & HEATING
51 -530 JACKSON STREET
COACHELLA, CA 92236-2737
(760)398-8247
Llc. No.: 522775
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.
1 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 -COMPENSATION INSURANCE FUND Policy 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 Sec o 37 hel abor Code, I shall forthwith
comply with those`` provisions.
Date:S- L - Applican
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AIVD 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 ATTORNEYS 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 ard sta� la s relating to building
construction, and hereby authorize representatives nfkhjs Qt tl a ter upgn the above -
mentioned property for inspection purposes
�' %Tk—��
Date: Signature (Applicant orAg J
Application Number:
BMCH2019-0091
Property Address:
79675 MANDARINA
APN:
776191007
Application Description.
JONES / SPLIT SYSTEM HVAC CHANGEOUT
Property Zoning:
Application Valuation:
$12,000.00
Applicant:
SAN'S AIR CONDITIONING
& HEATING
51 -530 JACKSON STREET
COACHELLA, CA 92236-2737
Date: 3/27/2019
Owner:
Jones O & E Living Trust
79675 MANDARINA
LA QUINTA, CA 92253
Contractor:
SAN'S AIR CONDITIONING & HEATING
51 -530 JACKSON STREET
COACHELLA, CA 92236-2737
(760)398-8247
Llc. No.: 522775
Detail: HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
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
$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
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
Property Owner's Name:
Address:
City, ST, Zip
Telephone:
Email:
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
Simplified Prescriptive Certificate of Compliance; 2008 Residential HVACAlterations CF-IR-ALT-HVAC
Climate Zones 10 to 15
Site Address:` , l Enforcement Agency: Date: Permit#:
Equipment T t List Minimum Ef'ficienc 2 Duct insulation requirement I
Conditioned FloorArea Thermostat
Packaged Unit
Furnace ❑ AFUL� COP Over 40 ft of ducts added or Q Setback
Indoor Coil SEER Flo HSPF -re laced in unconditioned space Served by system (Ifnotalready
Condensing Unit ® 'SE
1 �' ® Resistance {..1 R 6 1a13j sf present, must be
Pother LLuLIi R 8 (CZ 14-15) installed)
I. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-ALT-HVACfor each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 77HSAFfor typical residential systems.
HERS VERIFICATION SUMMARY Listed below are four HVAC alteration Options. The installer decides what work is being done and
picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall be left on site for final
inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the
installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and
signed. Beginning October 1 2010, a registered copy of the CF-1R and CF-6R shall also be on site for fmal inspection.
1. HVAC C)hangeout Required Forms:
• All HVAC Equipment replaced CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
CF-4R forms: MECH-21 and fors lit systems) MECH-25
Condenser Coil and/or
■ Indoor Coil and/or CF-6R forms: MECH-2I-HERS and (for split systems) MECH-25-HERS
Furnace CF-4R forms: MECH-21 and (for split systems) MECH-25
■
For Split Systems: Duct leakage < 15 percent; RC, CCA > 300 CFM/ton(Minimum Air Flow Requirement), TMAH
For Packaged Units: Duct leakage < 15 percent
Exempted from duct leakage testing if:
1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
2. Duct systems with less than 40 linear feet in unconditioned space, or
Fl 3. Existink duct systems are constructed, insulated or sealed with asbestos
New HVAC System I Required Forms:
• Cut in or Changeout with new CF-6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-22-HERS, and MECH-25-HERS
ducts: (all new ducting and all CF-4R forms: MECH-20, and (for split systems) MECH-22, and MECH-25
new ui merit
For Split Systems: Duct leakage < 6 percent; RC, CCA > 350 CFM/ton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakap-e < 6 nercent
3. New Ducts with
Required Forms:
■ includes replacing or installing all new ducting I CF-6R forms: MECH-04, MECH-20-HERS,and (for split systems) MECH-25-HERS
and/or outdoor condensing unit and/or indoorj CF-4R forms: MECH-20 and (for split systems) MECH-25
coil and/or furnace. Not all equipment chanced_ I
For Split Systems: Duct leakage < 6 percent, RC, CCA> 300 CFM/ton, TMAH
For Packaged Units: Duct leaks e < 6 percent
LJ 4. New Ducting over 40 feet Required Forms:
■ Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS CF-4R forms: MECH-21
linear feet of duct in unconditioned space.
For split system or packaged units: Duct leakage < 15 percent
El EXCEPTION: Existing duct s stems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
■ I certify that this Certificate of Compliance documentation is accurate and complete.
■ I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance.
• 1 certify that the energy features and performane specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,
Parts I and 6 of the California Code of Regulations.
■ The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets,
calculations, plans andspecifications submitted to the enforcement agency fora roval with the it , lication.
'4ame: 5i
. D A.nr. L .1 i gnafar _ �. nil .:. A ki
Compan
Address: ��•
City/State/Zip: h 5 �t
Date:
License:
Phone:
2008 Residential Comnliance Forms
July 2010