BMCH2019-011678-495 CALLE TAMP ICO 4 4P
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
MECHANICAL/
Application Number:
BMCH2O19-0116
Property Address:
78109 CALLE NORTE
APN:
770011053
Application Description:
YOUNG / HANGE OUT (1)14 SEER CONDENSOR
Property Zoning:
Application Valuation:
$1,950.00
Applicant:
AIR QUALITY SPECIALIST INC
P 0 BOX 105
SAN JACINTO, CA 92583
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 myLicense is in full force and t9
License Class:
Class: C20 License No.:o.:9Z 41
Date:—Y-10 . 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'
-Le nder's.AddMs:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/10/2019
Owner:
BEMIS MERRILEE T / YOUNG JOHN D
78109 CALLE NORTE t:J
M
LA QUINTA, CA 92253
Contractor: cm
AIR QUALITY SPECIALIST INC z
P 0 BOX 105 p 3
SAN JACINTO, CA 92583 a
(951)487-6700 M
Llc. No.: 929419 s
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
Tithe work f .Which this permit is issued,
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: FALLS LAKE FIRE AND CASUALTY 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 LaborC ,Rall forthwith
comply with those provisions. /J
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 co"":
I agree to comply with all city and county ordinances and state I lating to buildi
construction, and hereby authorize representatives of this city o er upon t
above-mentioned property for inspection purposes.
Date: r7�� Signature (Applicant or Agent
Application Number:
BMCH2019-0116
Property Address:
78109 CALLE NORTE
APN:
770011053
Application Description.
YOUNG / HANGE OUT (1)14 SEER CONDENSOR
Property Zoning:
Application Valuation:
$1,950.00
Applicant:
AIR QUALITY SPECI4IST INC
P 0 BOX 105
SAN JACINTO, CA 92583
Date:
Owner:
BEMIS MERRILEE T / YOUNG JOHN D
78109 CALLE NORTE
LA QUINTA, CA 92253
Contractor:
AIR QUALITY SPECIALIST INC
P 0 BOX 105
SAN JACINTO, CA 92583
(951)487-6700
Llc. No.: 929419
4/10/2019
Detail: CHANE OUT (1)145EER/CONDENSOR. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING
CODES.
FINANCIAL INFORMATION
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 - CONDENSER ONLY
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$26.68
Total Paid for CHANGEOUT: $66.70
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
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -SR -ALT HVAC)
Project Name:
CF1R-ALT 02-E
(Page 1 of 3)
Bemis & John Young Date Prepared: 2019-0410
A. General Information
CF111-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
Bemis & John Young
02 Date Prepared
2019-04-10
03 Project Location
78109 Calle Norte
04 Building Type
Single family
05 CA City
La Quinta
06 Dwelling Unit Name
Bemis & John Young
07 Zip Code
92253
08 Dwelling Unit Conditioned
Floor Area (ft2)
2121
09 Climate Zone
15
Number of Space
1
10 Conditioning (SC) Systems in
1
this Dwelling Unit:
B. Space Conditioning (SC) System
Information
01 02
03
04
05
06 07
08 09
Is the SC
Installing a
SC System SC System
Identification or Location or Area
CFA served
by this SC
system a
refrigerant
Installing new SC Installing
Installing Installing
Name Served
System (ft2)
ducted
system?
containing
system more than 40
entirely new entirely new
component?
components? feet of ducts?
duct system? SC system?
System 1 Location 1
2121
Yes
Yes
Yes No7
No No
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
10
Alteration Type
Altered space
conditioning system
Registration Number: 219-A020081612A-000-000-0000000-0000 Registration Date/Time: 2019-04-10 06:30:05
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Report Generated: 2019-04-10 06:30:00
CERTIFICATE OF COMPLIANCE
CFZR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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 09 110
11 12
Heating Cooling
System Heating Altered Heating Minimum Altered Cooling Minimum Required
Identification System Heating Efficiency Efficiency
New or
Cooling Cooling Efficiency Efficiency Thermostat
or Name Type Components Type Value System Type I Components Type Value
Replaced New Duct
Type
Duct Length R -Value
Central gas No Heating This field or This field or Outdoor
System 1 Component section Is not section is not Central split
furnace condensing SEER
This field or This field or
AC 14 Setback
Altered applicable applicable unit
section is not section is not
Reuuired ntatiow
applicable applicable
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)
CFZR and CBR -MCH -20-1-1 - 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 r= 10 percent leakage to outside,
or seal all accessible leaks,
CFZR and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are Installed or altered (applicable in CZ 2, 8-15).
CFZR and CF3R-MCH-23 Airflow Rate a- 300 CFM per ton required when MCH is
-25 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)1DIta 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-A020081612A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-04-10 06:30:05
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Report Generated: 2019-04-10 06:30:00
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:
Smith, Michael
Company:
Air Quality Specialist Inc
Address:
1000 N State St Unit 119
City/State/Zip:
hemet CA 92543
Responsible Person's Declaration statement
Documentation Author Signature;
Signature Date:
2019-04-10 06:30:05
CEA/ HERS Certification Identification (If applicable):
Phone;
714-476-0522
CFIR-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 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 perm}t application.
S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permlt(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 occuaancv.
Responsible Designer Name:
Smith, Michael
Company:
Air Quality Specialist Inc
Address:
1000 N State St Unit 119
City/State/Zip;
hemet CA 92543
Responsible Designer Signature;
Date Signed:
2019-04-10 06:30:05
License:
929419
Phone:
714-476-0522
Digitally signed by CaICERTS. This digital signature Isprovidedin 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-A020081612A-000-000-0000000-0000 Registration Date/Time: 2019-04-10 06:30:05
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Easy to Verify
at CaICERTS,com
HERS Provider: CaICERTS
Report Generated: 2019-04-10 06:30:00
�' QazKACU
PERMIT # � Ito
PLAN LOCATION:
Project Address:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mcch
APN #:
IZA t)
Applicant Name: � �
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Address: � s• �,. � � ���
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City, ST, Zip:
3
Telephone: � 7
Email:
Valuation of Project $ C
Contractor Name:
New SFD Construction:
Address:
i S
Conditioned Space SF
City, St, Zip
� C � �
�-�
Garage
SF
Telephone: ^r `r -7 DG
/ r /
Patio/Porch
SF
Email: lA.— } ', �
Fire Sprinklers SF
State Lic• ity Bus Lic;
ng Name:
FAddress:
Construction Type: Occupancy:
Grading:
, Zip
Telephone:
Bedrooms: Stories: # Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address: y
Total Building SF
City, ST, Zip C_,4- 2
Construction Type: Occupancy:
Telephone:
!J
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000