BMCH2019-026878-495 CALLE TAMPICO Di+rnI/ VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/8/2019
Permit Type/Subtype: MECHANICAL/ Owner:
Application Number: BMCH2O19-0268 KING FAMILY TRUST
Property Address: 79985 RANCHO LA QUINTA DR 6320 W 24TH ST
APN: 602370016 GREELEY, CO 92253
Application Description: KING /HVAC CHANGEOUT
Property Zoning:
Application Valuation: $8,000.00
Applicant: D Contractor:
AUSTIN SIMMONS DBA SIMMONS AIR CONDITION ��� g 2019 AUSTIN SIMMONS DBA SIMMONS AIR CONDITION
PO BOX314 PO BOX314
LA QUINTA, CA 92247 LA QUINTA, CA 92247
C6, 40pME%T EWMENT (760)863-5254
DESIGN &DEVE Llc. No.: 780534
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.: 780534
.ate: /2rZ4 --
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 th
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:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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.
AqW 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:5TATE FARM FIRE AND CASUALTY COMPANY Policy Number: 90EJU2601
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.
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.
/� C
+ (Applicant or Agent):
Date: 7/8/2019
Application Number:
BMCH2019-0268
Property Address:
79985 RANCHO LA QUINTA DR
APN:
602370016
Application Description:
KING /HVAC CHANGEOUT
Property Zoning:
Application Valuation:
$8,000.00
Applicant:
AUSTIN SIMMONS DBA SIMMONS AIR CONDITION
P 0 BOX 314
LA QUINTA, CA 92247
Owner:
KING FAMILY TRUST
6320 W 24TH ST
GREELEY, CO 92253
Contractor:
AUSTIN SIMMONS DBA SIMMONS AIR CONDITION
P 0 BOX 314
LA QUINTA, CA 92247
(760)863-5254
Llc. No.: 780534
---------------------------------------------------------------------------------------------
Detail HVAC CHANGE OUT- 17 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INS;TALLED 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
tev ���
— k':en•+ fd, DF-SEwr —
PERMIT #
PLAN LOCATION:
Project Address: I �i— n C h0 LC, w ir`tw
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
nq C�
yI +
ii
Z)p
Applicant Name: vn,.e-, o
J
Address: Y d ('a Lp A r•- ?(CC,
City, ST, Zip: &! T _ CAI
Telephone:
Email:
Valuation of Projects o G
Contractor Name: hN-Y\ ` �S_
New SFD Construction:
Address T,D JP)6Y 314
Conditioned Space SF
City, St, Zip i
Garage SF
Telephone: -� G �;� ., i
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: 9.5 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: e X ; n
New Commercial / Tenant Improvements:
Address: 7 Cr of j'
hancko U.- n-�A
Total Building SF
City, ST, Zip �, 6,u1 n � A CA —5
Construction Type: Occupancy:
Telephone: J 70
Email: I-1A
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC) (Page 1 of 3)
Project Name: 79985 Rancho La quinta I Date Prepared: 2019-07-08
A. General Information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF113-ALT-02 document for each dwelling unit.
01 Project Name �— 179985 Rancho La quinta 02 Date Prepared 2019-07-08
03 Project Location J 79985 Rancho La quinta 04 Building Type Single family
05 CA City La Quinta 06 I Dwelling Unit Name 79985 Rancho La quinta
[07 Zip Code 92253 08 Dwelling Unit Conditioned 1600
Floor Area (ft)
Number of Space J
09 Climate Zone 15 10 Conditioning (SC) Systems in 1
this Dwelling Unit:
B. Space Conditioning (SC) System Information
01 02 03 T 04 05 06 07 08 09 10
Is the SC Installing a
SC Systern jI SC System CFA.. served system a refrigerant Installing new SC Installing Installing Installing
Identification or I 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 f Whole House 1600 Yes Yes Yes No No No Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project_
Registration Number: 219-A020152578A-000-000-0000000-0000
Registration Date/Time: 2019-07-08 12:10:57
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-07-08 12:10:52
c�ho veal....• ')nlQnn')r
[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)
CF1R-ALT-02-E
(Page 2 of 3)
01 02 I - 03 04 I 05 I 06 07 — I 08 - 09 - 10 I 11 12
Heating Cooling
System Heating Altered Heating Minimum � Altered Cooling Minimum Required New or
ldentificatior, 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 I Less than or
System 1 Central gast
heating AFUE 80 Central split cooling SEER 14 I Setback equal to 40 R-8
furnaceomponents AC components feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement far 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.
.: !oe t-Du Li: Ty• :;a, -Wife¢ of Without Equliprrient Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F)
J This section does not apply to this project_
I F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
1 This section does not apply to this project. 4
",2gistration Date/Time: 2019-07-08 12:10:57
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-07-08 12:10:52
%1—i.,.,•—,'7r11 Qnn7G
CERTIFICATE OF COMPLIANCE
IteraV ns to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
Foci
mentation Author's Declaration Statement
Certfflliicit- of Ca ipFance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Bachus, Tom -
r: r
CFIR-ALT-02-E
(Page 3 of 3)
Company:
Signature Date:---
MLC Building Performance
2019-07-08 12:10:57
Address:
CEA/ HERS Certification Identification (if applicable):
77825 Delaware Place
City/State/Zip:
Phone:•
Pa Im Desert CA 92211 _ _
760-836-0066
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).
That the energy features and perfor,ii?nce specifications; matey a!s, components, and manufactured devices for the building deSigr 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.
^.. T• _ buildi g dasiCn features er s, st_m d sisr, iear.:res iderti`6ed o, ;his Certificate
of C - m•a!iance are consistent v.,ith the information provided on other applicable compliance documents, worksheets,
Ld:cu:ctio(1s, p:aos alid speciiiiaiiuiis su Lin:eted Lo the emurcemenL agency for approval
with this building permit application.
"U, Lc LL;Id',ig Pci rrkr s) issueu fui L :e Luildiug, and ina c avai:abie Lu the enforccrnent agency for all applicable
Responsible Designer Name;
r;g
Responsible Designer Signature:
Bachus, Tom
A
Company:
Date Signed:
MLC Building Performance
2019-07-08 12:10:57
Address:
License:
77825 Delaware Place
780534
City/State/Zip:
Phone:
Palm Desert CA 92211
760-836-0066
Uigita,'.t 'sly; ec'by Ca!Cr?T.S. T"is uig;ial signature is provided in, order to secure the content ofthis registered document, and in noway implies
Registration Provider responsibility for the accuracy of the information.
2019-G7-v3 2:10.57
Easy to Veri ;, 51 ■❑
at CaICERTS.com k
0_
i-'s Provider: 1:.ER-5
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
c s o.,> Mora ro„ 11"11 sznnor
Report Generated: 2019-07-08 12:10:52
r I �im.4'lrirrql
J31 LA
PO Box 314
U 4uinta. GA 92247
Ph:760-863-5254
License #7H0534
Client: King
Property: RLQ Dr.
Date: June 9, 2019
P_ro O d-Equip-ment-Options:
A. 4TonTrane XR17/SSX1 System -Living Room/Kitchen Unit - $8,358
i) 10 YR Manufacturer Warranty with 3 YR Labor Warranty
i) Includes replacement of Living Room/Kitchen unit (Furnace in attic), XR17 (Two -Stage) condenser, high efficiency
evaporatorcoil, S8X1 (Single -Stage Heating with Fixed -Torque ECM Blower) furnace, new liquid line drier, l"/2" filter
base, T-Series thermostat, secondary drain pan, lineset flushing, and condensate overflow switch
B. 4Ton crane XR16/S8X1- Living Room/Kitchen Unit - $7,385
i) 10 YR Manufacturer Warranty with 2YR LaborWarranty
i) Includes replacement of Living Room/Kitchen unit (Furnace in attic), XR16 (Single -Stage) condenser, high efficiency
evaporator coil, S8X1(Singte-Stage Heating with Fixed -Torque ECM Blower) furnace, new liquid line drier, l"/2" filter
base, T-Series thermostat, secondary drain pan, lineset flushing, and condensate overflow switch
C. 4Ton Trane XR17/S8X1 System - Bedrooms Unit - $7,756
i) 10 YR Manufacturer Warranty with 3YR Labor Warranty
I) Includes replacement of Bedrooms unit (Furnace in garage), XR17 (Two -Stage) condenser, high efficiency
evaporator coil, S8X1(Singte-Stage Heating with Fixed -Torque ECM Blower) furnace, new liquid line drier, 1"/2"fitter
base,T-Series thermostat, lineset flushing, and condensate overflow switch
Q. 4Ton Trane XR16/S8X1 System - Bedrooms Unit- $6,785
i) 10 YR Manufacturer Warranty with 2YR Labor Warranty
j) Includes replacement of Bedrooms unit (Furnace in garage), XR16 (Single -Stage) condenser, high efficiency
evaporator coil, S8?Cl (Sing(e-Stage Heating with fixed -Torque ECM Blower) furnace, new liquid tine drier. 1"/2" fitter
base.T-Series thermostat, lineset flushing, and condensate overflow switch
Note: If both systems are replaced in tandem, $350wit[ betaken off bill.
Optional Accessories;
Price nfaccessoryllsledpersystem
1) Wi-Fi Thermostat - $175
i) HoneywettTb Lyric
2) Honeywell 4" Media Filter - $91
i) 40/8" Whole House Media Filter
3) Compressor Sound Blanket - $89
i) Sound padding wrap for compressor, reducing noise
4) Hard -Start/ Start Booster- Kit - $130
0 Start capacitor providing boost to compressor, reducing in -rush amps and start load
5) iWave-R - $814
IndoQr,Ai- Purifier
Pia=ent• Upon contractor completion.
FEcg4u.9i911c
Any alteration or deviation fram the above specifications involving extra cost of material or tabor will he executed upon written order for same and Will
become an extra charge overthe mentioned in this contract. All agreements must be made in writing, warranties apply to new equipment only.
Expenses/work for patching/repair not inclun ed or covered. this proposal Is valid for 30 days from above date. Oy signing/accepting. the prices,
specifications and conditions are satisfactory and are hersbyaccepted. Authorizing/signing party endorses work to beginas agreed upon and payment wilt
be made as outlined above. prices are subject to change with fluctuation of economy and production.
Options Selected'
Authorized Parity Name:.
Authorized Party Signat
s c immor►s �� �s � 6, �a dam
�eowsr�s
ure:
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