BMCH2019-027578-495 CALLE TAMPICO T-ititV VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT D ARTMEJWL 10 2019 PECTIONS (760) 777-7153
BUILDING PER
CITY OF LA QUINTA Date: 7/10/2019
Permit Type/Subtype: MECHANICAL/ DESIGN & DEVROPMENT DEPARTMENT
Application Number: BMCH2O19-0275 JELSTORM, GREG
Property Address: 57598 BARRISTO CIR 57598 BARRISTO CIR
APN: 762500025 LA QUINTA, CA 92253
Application Description: JEL5TORM/HVAC CHANGEOUT- 14SEER / 80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $15,659.00
Applicant: Contractor:
KENNY PERRY RIGHTIME HOME SERVICES INC.
3030 MEYERS ST OUTSIDE CITY LIMITS
RIVERSIDE, CA 92503 ,
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: License No.: •Li - 105373
OWNER -BUILDER / , ARATIO
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 they
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for al
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
() 1, 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:
(951)276-9740
Llc. No.::LIC-0105373
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
oft A for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
sectio 3700 of the Labor Code, for the performance of the work for which this permit
Crrie �y wnrlcers omp n "ns�ranc carrier [f policynumberare:
Carrier; �� umb �- �084,3101
1 certify that in the performance of the Work forwhlch this ermit 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 3760 of the Labor Code, I shall forthwith
comply with those provisions. f
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 ofthis 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 nt h
above -mentioned property for inspection purposes.
W__7 J vg/ Signature (App I I can L o r Agen t
Date: 7/10/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
KENNY PERRY
3030 MEYERS ST
RIVERSIDE, CA 92503
BMCH2019-0275
57598 BARRISTO CIR
762500025
JELSTORM/HVAC CHANGEOUT- 14SEER / 80AFUE SPLIT SYSTEM
$15,659.00
Owner:
JELSTORM, GREG
57598 BARRISTO CIR
LA QUINTA, CA 92253
Contractor:
RIGHTIME HOME SERVICES INC.
OUTSIDE CITY LIMITS
(951)276-9740
Llc. No.::LIC-0105373
Detail: HVAC CHANGE OUT - 5 TON 14 SEER/80 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES
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
ta Qw�tra
PERMIT #
CALIFORNIA -
PLAN LOCATION:
Project Address: • .V cSC �} � i�� Project Description:
APN #: r �-
Applicant Nam ve
Address:;'
City, ST,
Telephone:,�� '
Email: Valuation of Project $
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Required Received
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
DocuSign Envelope ID: 2FDD058A-64A6-4E61-gCOC-A75D3A837FOC
costco
999 lake Drive
Issaquah, WA 98027
1-877-483-6226
California Contractor's License No. 858087
(Class B General Contractor)
WORK ORDER
Dealer Name: American Residential Services of California, Inc.
dba RighTime Home Services, Lic. #765074
Proposal Submitted To: EA>�L.�cM Item #: Date: 7L9 P
Street (Billing): 5 5_7$ Street (Job Location- If Different):
City, State, Zip Code:/ - u7Nt4 a 1�5,3 City, State, Zip Code:
(�
Phone:
Email:
-\
lip
EXISTING EQUIPMENT
SYSTEM PIPING AND MISC.
Remove X Outdoor Unit
Indoor Coil
`
Wall Furnace
X Emergency Overflow Drain Pan
X Furnace
_` Ductwork
Floor Furnace
X Condensate Drain Hook-up Primary Secondary
x Thermostat
Package Unit
, Air Handler —
Swamp Cooler
_ _
Refrigerant Piping Liquid Line Suction Line
^ Condensate Pump
Explain
Lineset Wall Cover
EXISTING LOCATION: 5kAT
❑ CLS ❑ GRG
111 3GRD
Gas Piping—
NEW LOCATION: A AT
❑ CLS ❑ GRG
❑ RF N GIRD
Vent Pipe ___
NEW EQUIPMENT
X Outdoor Unit kAox _o -j XG 2
)< Evaporative Coil X I 0
_ Ductwork
_X_ Furnace N
_ Package Unit
_ Air Handler
Equipment
_ Water Heater-309al. 40 af.-50gol. •NGos -LPGos -MH
SEER EER AFUE
AIR DISTRIBUTION- DUCTWORK
New Flex Duct System ❑ Standard E7 Premium
# Of New Supply Ducts
# Of New Return Ducts
# Supply Grills
Ceiling _ Sidewall _ Floor
_ # New Return Air G
Ceiling tdewall _ Floor
existing system:
Roof Flashing
Other
Roof Curb
CONTROLS AND ELECTRICAL
_ NON Prog. H/C Thermostat Model
X Programmable Thermostat ModelL4ffii%jNciK MIp
_ Breakers to Existing Service Model
Install New amp Electrical Service & Panel
X New 220V disconnect switch box w/fuses, weather proof conduct and
connectors at condensing unit.
_ New Power Circuit Reconnect power circuit _ 1 10V
New Power Circuit — Reconnect power circuit _ 220V
RIGHTIME WARRANTIES
?� Parts Warronlies
Labor Warranties
One Year Worronty on all Roof Preparations.
ADDITIONAL PRODUCTS & SERVICES
K Precast reinforced condenser slab size
Other
INDOOR AIR QUALITY -- — -- 5e— Subconlrocior Needed
New Fillrolion SystemUltraviolet Air Air Clea ystem
Filler Sixe
All products, services and/or representations of performance cued/or outcome promised to me (verbally or
in writing) are listed in this Work Order, Member initial
Print
Registered
Effective Date: _710 /[ 5
Form # RTSVC•RV01 C) 2018 American Residential Services LLC- All rights reserved.
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
(Page 1 of 3)
Project Name:
ITEN, TRACY Date Prepared:
2019-07-09
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
CF1R-ALT-02 document for each dwelling unit.
01 Project Name ITEN, TRACY
02 Date Prepared
2019-07-09
03 Project Location 57598 BARRISTO CIRCLE
04 Building Type
Single family
05 CA City La Quinta
06 Dwelling Unit Name
ITEN, TRACY
07 Zip Code 92Z53
Dwelling Unit Conditioned
08
2867
Floor Area (ft)
Number of Space
09 Climate Zone 15
10 Conditioning (SC) Systems in
1
this Dwelling Unit:
B. Space Conditioning (SC) System Information
01 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 (ft) system? component?
components? feet of ducts?
duct system? SC system?
Alteration Type
System 1 Location 1 2867 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-A020070270A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2019-07-09 08:13:41
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-07-09 08:13:41
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC) (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)IE and F)
01
02
03
04
05
06
07
08
09
10
11
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
Central gas
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
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)1Diia 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)iC)
This section does not apply to this project.
Registration Number: 419-A020070270A-000-000-0000000-0000
Registration Date/Time: 2019-07-09 08:13:41
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-07-09 08:13:41
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
I. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Diana McGinnis
Company:
ARS American Residential Services of CA dba Rightime Home Services
Address:
965 Ridge lake Blvd, Suite 201
City/State/Zip:
Memphis TN 38120
Responsible Person's Declaration statement
Documentation Author Signature:
Diana, McGauiLk
Signature Date:
2019-07-09
CEA/ HERS Certification Identification (if applicable):
Phone:
951-276-9744
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 I 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:
Diana McGinnis
Responsible Designer Signature:
'DLa,na,Mc45Ln^n k
Company:
ARS American Residential Services of CA dba Rightime home Services
Date Signed:
2019-07-09
Address:
965 Ridge lake Blvd, Suite 201
License:
765074
City/State/Zip:
Memphis TN 38120
Phone:
951-276-9744
Digitally signed by CNEERSTM This digital signature is provided in order to secure the content of this registered
document, and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 419-A020070270A-000-000-0000000-0000
Registration Date/Time: 2019-07-09 08:13:41 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001
Report Generated:2019-07-09 08:13:41
Schema Version: rev 20180426