BMCH2019-019378-495 CHLLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
ARNOLDS A / C SERVICE
76987 OKLAHOMA AVE
PALM DESERT, CA 92211
ceit4t 4 si� Qaba
DESIGN & DEVELOPMENT DEPARTMENT
MECHANICAL/
BMCH2O19-0193
53160 AVENIDAJUAREZ
774041027
HIGGINS / HVAC CHA T
$9,400.00 D
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
2�1 a
MAY 2 0 2019
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 License No.: 86068
Date: J ;��' — l ] _ Contra
i 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/20/2019
Owner:
Higgins Jeffrey M & Sydney F
53160 AVENIDA JUAREZ
LA QUINTA, CA 92253
Contractor:
ARNOLDS A / C SERVICE
76987 OKLAHOMA AVE
PALM DESERT, CA 92211
(760)409-6696
Llc. No.: 860682
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 w rk for which this permit is issued.
ave 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 FUN❑FUN❑ Policy Number: 9246,899
_
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.
Date: %� Applican
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALLSUBJECTAN 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 ci to ent on the
above -mention d pro erty for inspection purposes.
date: 'Signature (Applicant or Ag
Date: 5/20/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
ARNO,LDS A / C SERVICE
76987 OKLAHOMA AVE
PALM DESERT, CA 92211
BMCH2O19-0193
53160 AVENIDA JUAREZ
774041027
HIGGINS / HVAC CHANGEOUT
$9,400.00
Owner:
Higgins Jeffrey M & Sydney F
53160 AVENIDA JUAREZ
LA QUINTA, CA 92253
Contractor:
ARNOLDS A / C SERVICE
76987 OKLAHOMA AVE
l ,r' PALM DESERT, CA 92211
i
(760)409-6696
L(c. No.: 860682
---------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT- 14 SEER/81 AFUE PACKAGE UNIT SYSTt M�. 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- PACKAGED UNIT
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - PACKAGED UNIT 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
TOTALS: $184.10
W
Project Address: 53160 auare,
APN #: Vt &-e--
Applicant Name: `] � I
Address: 5-� 166) `
City, ST, Zip:
Telephone:�
Email:
Name:
Address: r ' V�
City, St, Zip�,�
Telephone ,�� -- [
Email:&ACAD t4eiNo 0 6 n,
State City Bus Lic: '� I ,�,
Architect/Engineer Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Na
Address:
City, ST, Zip
Telephone: 603
�
CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CF1R•ALT-04-E Revised 01/16
CERTIFICATE OF COMPLIANCE
Alterations - HVAC CZ 2, and 8-15
Equipment Type
Equipment Efficiency
Wackaged
❑ Evaporator
System
❑ Condensing
�Xp
❑ Split System
❑ Compressor
❑ Mini Split
❑Lineset
❑ Furnace
❑ TXV
ER
ENERGY COMMISSION As
CF1R-ALT-04-E
(Page 1 of 1)
Enforcement Agency:
New Ducting or Lineset:
Required R-value
Date Prepared:
Permit#:
Conditioned
Floor Area (ft7)
Thermostat
❑ R-6 (CZ1-10, 12&13) Ducts
❑ R 8' (CZ 11, 14 16) Ducts
❑ >_ R-2.8 Lineset"
Served by system
(�� ft2
tback
(If not already
present must
be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below, At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
❑ 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
All Equipment, CF1R-ALT-02-E
Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH-20-H, MCH-(23 or 24 )2 MCH-25 HZ
Compressor, TXV,, Lineset, CF3R-MCH-20-H, MCH-(23 or 24)-H2, MCH-25-H2
Air Handler/FUrnacez (Can include new ducting)
Installer Requirement: -Duct leakage (< 15%, or <10% to outside, or seal all accessible leaks), Air flow 300 CFM/ton, Refrigerant Charge.
Ex pted from duct leakage testing if:
Ef %. Duct system registered with HERS provider as previously seated, or 112. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, Insulated or sealed with asbestos (list manufacture date of building I
❑ 2. New HVAC System
All new equipment and All New Ducts3
including Mini Split
Installer Requirement: Duct leakage < 5%, Fan
Required Compliance Documents to be left on site for Final:
CF1R-ALT-02-E
CF2R-MCH-01-E, MCH-20-H, MCH-22-H, MCH-(23 or 24)-H2, MCH-25-H2
CF3R-MCH-20-H, MCH-22-H, MCH-(23 or 24)-Hz, MCH-25-H2
Mini Splits require CF113-ALT-02-E, CF2R-MCH-01-E, and (CF2R-CF3R) MCH-25-H
„ Air Flow >_ 350 CFM/ton a,«, r+airve�, nerng
113. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CF113-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH-20-H, MCH-(23 or 24)-H, MCH-25-H
Compressor, TXV Lineset, Furnace CF3R-MCH-20-H, MCH-(23 or 24)-H, MCH-25-H
Installer Requirement: Duct leakage < 5%, Air Flow > 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3 CF1R-ALT-02-E, CF2R-MCH-20-H CF3R-MCH-20-H
nt
Installer Required to: Duct leakage (< 15% or, 5_10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10, 12 &13, and R-6 insulation when less
than 40 ft installed. This includes in walls, between floors etc.
i Heating only systems and Air Handler/Furnace changes do not require Air Flow MCH-(23 or 24), or Refrigerant Charge verification MCFI-25
a All New Ducts is when at least 75%of the duct system is new duct material, and up to 25%may consist of reused parts from the dwelling unit',., existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
` R-2.8 (1" thick insulation) for linesets 1" and less.
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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.
Responsible Designer Name: Responsible Designer Signature: Date $IAned: _ r�aue•
-1 aC,k Ph7(vLj _
ce or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300