BMCH2019-011878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
MECHANICAL/
BMCH2O19-0118
cNp 4 4v QuiA&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
78914 BRECKENRIDGE DR
770320050
GOODMAN / HVAC CHANGE OUT - 16SEER/80AFUE SPLIT SYSTEM
$14,000.00
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, C36 License No.: 977.333_
Date: rtl I _... 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 Address:
VOICE (760) 777-7125
FAX(760)777-7011
INSPECTIONS (760) 777-7153
Date: 4/11/2019
Owner:
CD
JEFFREY GOODMAN
79814 BREKENRIDGE
�
LA QUINTA, CA 92253
szc
ca �
n
a �°
C) D
Contractor:
A#1 SERVICES HEATING &AIRC"DIT@yING®
78206 VARNER RD #D-189
y
PALM DESERT, CA 92211
rn
(760)565-2691
Llc. No.: 977333
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
action 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: INSURANCE COMPANY OF THE WEST Policy Number: WPL5041680
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.
t
Date: �f' �� 1 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 (Applicant or Agent):
Application Number:
BMCH2019-0118
Property Address:
78914 BRECKENRIDGE DR
APN:
770320050
Application Description:
GOODMAN / HVAC CHANGE OUT- 16SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$14,000.00
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
Date: 4/11/2019
Owner:
JEFFREY GOODMAN
79814 BREKENRIDGE
LA QUINTA, CA 92253
Contractor:
A#1 SERVICES HEATING & AIR CONDITIONING
78206 VARNER RD #D-189
PALM DESERT, CA 92211
(760)565-2691
Llc. No.: 977333
Detail: 5 -TON HVAC CHANGE OUT- 16 SEER/80 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER
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 - 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
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
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT
502-0000-43611
QTY AMOUNT
0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
Jeff Goodman J Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3)
2019-04-09
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
CF111-ALT-02 document for each dwelling unit.
01 Project Name Jeff Goodman
02 Date Prepared
2019-04-09
03 Project Location 78914 Breckenridge Drive
04 Building Type
Single family
05 CA City La Quinta
06 Dwelling Unit Name
Jeff Goodman
07 Zip Code 92253
Dwelling Unit Conditioned
08
2013
Floor Area (ft2)
Number of Space
09 Climate Zone 15
10 Conditioning (SC) Systems in
1
this Dwelling Unit:
B. Space Conditioning (SC) System Information
O1 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 2013 Yes
Yes Yes No
No No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
Registration Number: 419-A020034098A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-04-09 15:04:45
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-04-09 15:04:45
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
CF1R-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 10
it 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
p cooling SEER 16 Setback
System 1 Central gas heating AFUE 0.8
section is not section is not
AC
furnace components components
applicable applicable
Renulred Docum—entation,
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 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: 419-A020034098A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-04-09 15:04:45
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-04-09 15:04:45
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (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:
Cassidy Snow
Ca4*i4 snow
Company:
Signature Date:
Permit E Raters
2019-04-09
Address: CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip: Phone
Westlake Village CA 91362 818-735-7876
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:
Cara Goldberg cora coidbes�
Company: Date Signed:
A#1 Services Heating & Air Conditioning 2019-04-09
Address: License:
78026 Varner Road #D-189
City/State/Zip: Phone:
Palm Dessert CA 92211 (760) 342-3610
Digitally signed by CHEERSTM. Thrs digital signature is provided in order to secure the content of this registered
document, and in no way implies Registration Provider responsibility for the accu;acy of the information.
Registration Number: 419-A020034098A-000-000-0000000-0000
Registration Date/Time: 2019-04-09 15:04:45
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-04-09 15:04:45
Schema Version: rev 20180426
Qu.L!'LfW��r�PERMIT
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- -GEM of?Ic DESF
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PLAN LOCATION:
Project Address: 78914 Breckenridge Drive
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Replace 5 ton / 60,000 BTU complete HVAC system
Fire Sprinklers SF
State Lic: 977333 City Bus Lic:
Applicant Name: Steven Schnierer
State Lic: City Bus Lic:
Address: 31225 La Baya Drive Suite 213
City, ST, Zip: Westlake Village, CA 91362
Telephone: 818-735-7876
Email: swschnierer@roadrunner com
Valuation of Project S 14,000.00
Contractor Name: A#1 Services Heating & A/C
New SFD Construction:
Address: 78206 Varner Road #D-189
Conditioned Space SF
.... ......
+ Garage _ SF
Patio/Porch SF
City, St, Zip Palm Desert, CA 92211
Telephone: 760-565-2691
Email:
Fire Sprinklers SF
State Lic: 977333 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: Jeff Goodman
New Commercial / Tenant Improvements:
Address: 78914 Breckenridge Drive
Total Building SF
City, ST, Zip La Quinta, CA 92253
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
Ree'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