BMCH2019-031778-495 CALLE TAMPICO D "'ifAJ
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number: BMCH2O19-0317
Property Address: 80523 PEBBLE BEACH
APN: 775131023
Application Description: PETERSON / 2 HVAC CHANGE OUTS-16 /17SEER/80AFUE SPLIT SYS.
Property Zoning:
Application Valuation: $8,000.00 � n
Applicant: D
CLAIRE BACHUS AUG 0 6 2019
77825 DELAWARE PLACE
PALM DESERT, CA 92211 CITY OF IAOUINTA
DESIGN & DEVELOPMENT DEPARTMENT
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:.Q& License No.: 756658
Date. , 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. Q.
Lender's
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/6/2019
Owner:
ROBERT PETERSON
80523 PEBBLE BEACH DR
LA QUINTA, CA 92253
Contractor:
VIC'S AIR CONDITIONING INC
P 0 BOX 215
THOUSAND PALMS, CA 92276
(760)343-5033
LIc. No.: 756658
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 thre.� rk for which this permit is issued.
?f 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: EVEREST NATIONAL-IR,i,JjM6NCE 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 Labor Code, I shall forthwith
comply wf h i ose provislons.
Date Ze2&T 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 prop ty for inspection purposes.
Date- I Signature (Applicant or Agent)
Date: � 8/6/2019
Application Number:
Property Address:
APN:
Application Description -
Property Zoning:
Application Valuation:
Applicant:
CLAIRE BACHUS
77825 DELAWARE PLACE
PALM DESERT, CA 92211
BMCH2019-0317
80523 PEBBLE BEACH
775131023
PETERSON / 2 HVAC CHANGE OUTS-16 /17SEER/80AFUE SPLIT SYS.
$8,000.00
Owner:
ROBERT PETERSON
80523 PEBBLE BEACH DR
LA QUINTA, CA 92253
Contractor:
VIC'S AIR CONDITIONING INC
P 0 BOX 215
THOUSAND PALMS, CA 92276
(760)343-5033
Llc. No.: 756658
Detail: (1) 4-TON 17 SEER/80AFUE AND (1) 5-TON 16 SEER/80AFUE HVAC SPLIT SYSTEM CHANGE OUTS. CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES.
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$80.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$160.10
Total Paid for CHANGEOUT: $240.14
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
ter Qa&ra
PERMIT # [ C ti L• O / —+
PLAN LOCATION:
Project Address:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
k 5 P Yrl
loin
Applicant Name:
�1
4-o n 7 p, r
Address:
0ye')awl' ca-
City, ST, Zip:
Telephone:
66
2
Email:
I /
Valuation of Project $4. On
Contractor Name: Vi�� A G
New SFD Construction:
Address: Q
Conditioned Space SF
City, St, Zipsouspqnd •. -7 C
Garage SF
Telephone: - n
Patio/Porch SF
Email: ���
Fire Sprinklers SF
State Lie: 7� 6 6 srg City Bus Lie: ,
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Bedrooms: Stories: 1 # Units:
Telephone:
Email:
State Lie: City Bus Lie:
Property Owner's Name: &,B
r o 2
New Commercial / Tenant Improvements:
Address: U��S ` BG a t f
Total Building SF
City, ST, Zip s•
Construction Type: Occupancy:
Telephon G _ so-? �J
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
CF1R-ALT 02-E
CERTIFICATE OF COMPLIANCE
(Page i of 3)
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
2019-08-06
Project Name: 80-23 Pebble Beach Drive Date Prepared:
A. General Information
CF111-ALT 02 is applicable to multiple space conditioning systems contained Wthin a singledwelling urit. When multiple dwelling units must be documente ,use o
ne
CF1R-ALT-02 document for each dwelling unit.
Ol Project Name 80-523 Pebble Beach Drive
12 Date Prepared 2019-08-06
03 Project Location 80-523 Pebble Beach Drive
14 Building Type Single family
05 CA City
La Quinta 16 Dwelling Unit Name 90-523 Pebble Beach Drive
Dwelling Unit Conditioned
3000
07 Zip Code
92253
08 Floor Area (ft2)
Numbei of Space
10 Conditioning (SC) Systems in
Z
09 Climate Zone 15
this Dwelling Unit:
1
i
B. Space Conditioning (SC) System Information
01
02
03
04
05
06 01
08
09
SC System
SC System
CFA servedInstalling
Is the SC
system a
Installing a
refrigerant
Installing new SC Installing
new
Installing
entirely new
Identification or
Location or Area
by this SC
ducted
containing
system more than 40
feet of ducts?
entirely
duct system?
Sc system.
Alteraton Type
Name
Served
System (ft)
system?
component?
components7
No
No
NO
46*mad space
c�riditioning system
System 1
Living Area
2000
Yes
Yes
Yes
Altered space
No
NO
NO
conditioning system
System 2
Bedrooms
2000
Yes
Yes
Yes
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1DIik))
This section does not apply to this p roject.
HERS Provider: CaICERTS
Registration Number: 219-A020174665A-000-000-0000000-0000 Registration Date/Time: 2019-08-06 11:16:14
Report Generated: 2019-08-06 11:08:36
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.C101
--- Ana onn7G
CERTIFICATE OF COMPLIANCE CFiR-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)1E 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 as
g
All new
CentrAaCsplit
All new
Less than or
System 1
furnace
heating
AFUE
80
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Central gas
All new
CentrAaC split
All new
Less than or
System 2
furnace
heating
AFUE
80
cooling
SEER
17
Setback
equal to 40
R-8
components
components
feet
Reauired 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.
CF211 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 CF311-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)lDiia and 150.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 219-A020174665A-000-000-0000000-0000 Registration Date/Time: 2019-08-06 11:16:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-08-06 11:08:36
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
CF111-ALT 02-E
(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:
Bachus, Tom
//��Gsy
Company:
Signature Date:
MLC Building Performance
2019-08-06 11:16:14
Address:
CEA/ HERS Certification Identification (if applicable):
77825 Delaware Place
City/State/Zip:
Phone:
Palm Desert CA 92211
1760-836-0066
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).
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:
Bachus, Tom
///�GQ'
Company :
Date Signed:
MLC Building Performance
2019-08-06 11:16:14
Address:
License:
77825 Delaware Place
756658
City/State/Zip: Phone:
Palm Desert CA 92211 760-836-0066
Easy to Verify
at CaICERTS.com
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies 0-0Registration
Provider responsibility for the accuracy of the information.
Registration Number: 219-A020174665A-000-000-0000000-0000
Registration Date/Time: 2019-08-06 11:16:14
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-08-06 11:08:36
Schema Version: rev 20180426
U
city or 4a Quinva
Depaftment of bufldi4 and';
78495 Cajt� Tampico
La Quin taa ca, 92301
ntgr Permit Office:
I hereby authorize MLC Test
mechanical hermit for any PP
Addrss: 80523 Pebble'Beac
Fame of property Qwnel•:
Property owner signature:
Date
�' Vi , Air Conditioning
PO BOX 215Thousand Palms, CA 92276
United States
A?wcCl.vq .4,r Zr.rr.I Owe r"'t'dauoe aC =,t 'r::-,:
(760)343-5033
Billing Address
JANE AND BOB PETERSON
80-523 PEBBLE BEACH DRIVE
LA QUINTA, CA 92253
Estimate Details
XR17 SPLIT SYSTEM
Task # Description
5 TON XR17
5 TON XR17, SEER: 16.00,
1= CONDENSER: 16 SEER STIR COOL 2 STAGE COND UNIT
1= FURNACE: 5 TON XV80 2 STG VAR SPD FURNACE
1= COIL: COOLING COIL YES (HORIZONTAL)
4 TON XR17, SEER: 17.00,
1=CONDENSER: 17 SEER STR COOL 2 STAGE COND UNIT
1=FURNACE:4 TON XV80 2 STG VAR SPD FURNACE
COIL:
1= COOLING COIL YES (HORIZONTAL)
T-STAT • 2= XL824 T-STAT
CONDENSER PAD: NO
NEW REFRIGERANT LINES: NO
WARRANTY:
CONDENSER: 10 YEARS PARTS, 10YEARS COMPRESSOR
COILS: 10 YEARS PARTS
FURNACE: 10 YEARS PARTS AND LIFETIME HEAT EXCHANGE
LABOR: ONE YEAR
COMFORT/HEALTH ENHANCEMENT:
AIR SCRUBBER: NO
CLEAN EFFECTS: NO
FILTER RACK.5" OR 2": NO
DUCT CLEANING: NO
EQUIPMENT AND PERMITS
CRANE- LARGE: YES
CITY PERMIT: YES
HERS TESTER: YES
ELECTRICAL
DISCONNECT: YES
POWER CORD: YES
ELECTRICAL WHIP: YES
NEW LOW VOLTAGE WIRING: NO
NEW FUSES: YES
CONDENSATE
NEW DRAIN PAN 36X36: YES
NEW 3/4 P-TRAP: YES
NEW CONDENSATION SAFETY-T-SW ITCH: YES
NEW PVC FITTINGS AT THE COIL AND DRAIN PAN: YES
NEW DBLWL FLEX FLUE PIPE: YES
NEW FLUE PIPE CONNECTOR: YES
NEW GAS SEDIMENT TRAP: YES
Estimate 5193741
Job 5195631
Estimate Date 8/1/2019
Customer PO
Job Address
JANE AND BOB PETERSON
80-523 PEBBLE BEACH DRIVE
LAQUINTA, CA 92253
Quantity Your Price Your Total
1.00 $21,215.00 $21,215:00
Ails DISTRIBUTION
REPLACED SUPPLY AIR REGISTERS: NO.
REPLACED RETURN AIR REGISTERS: NO
BALANCED AIR FLOW THROUGHOUT SYSTEM: NO
INSTALLED MANUAL BALANCING DAMPERS: NO
DUCT WORK, PLENUMS, AND SEALING
NEW INSULATED RETURN AIR PLENUM: YES
DUCT SEALANT: YES
INSTALLED DUCT -WORK: NO
INSTALLERS ARRIVE ON TIME
INSTALLERS ARE COURTEOUS & PROFESSIONAL
MAINTAIN CLEAN WORK AREAS
REMOVE EXISTING EQUIPMENT
RECYCLE EXISTING EQUIPMENT
COMPLETE SYSTEM START-UP
A COMPLETE SYSTEM PERFORMANCE CHECK: YES
OUR WORKERS ARE FULLY COVERED BY WORKMAN'S COMPENSATION
INSURANCE
COMPLETE WORK PERFORMED IN A WORKMAN LIKE MANNER ACCORDING TO
INDUSTRY STANDARDS
S_qOPE OF WORK: REMOVE TWO EXISTING COMPLETE AC AND HEATING SYSTEM.
CONDENSERS ARE ON ROOF AND FURNACE ACCESS IS ALSO ON ROOF. WE WILL
USE A CRANE REMOVE OLD EQUIPMENT AND INSTALL NEW SYSTEMS,
WE WILL REPLACE 25' OF 10" DUCT IN ATTIC.
CITY PERMITS AND HERS TESTER IS INCLUDED.
EIS
Alteration or deviation from the above specifications involving extra costs will be
executed only upon written work order
Note: This proposal may be withdrawn by us if not accepted within 30 days
Acceptance of proposal for the above price, specifications and conditions are
satisfactory and are hereby accepted. You are authorized to do the work as specified.
Payment will be made in full upon completion. YOU WAIVE YOUR THREE DAY RIGHT
TO CANCEL.
TOTAL: $23,461.00
VICS DISCOUNT: $2,246.00
NEW TOTAL: $21,215.00
IID REBATE: $2,200.00
WHEN REBATE IS RECEIVED YOUR COST WILL BE $19,015.00
Sub -Total $21,215.00
Tax $0.00
Total $21,215.00
Thank you for choosing Vic's Air Conditioning
THIS IS AN ESTIMATE, NOT A CONTRACT FOR SERVICES. The summary [above] is Furnished by Vicfs Air Conditioning as a good faith
estimate of work to be. per formed at JANE AND 606 PETCRSQN[Vie location described above] and is based on our evaluation and does
not include material price increases or additional labor and materials which may be required should unforeseen problems arise after the
work has started. I understand that the final cost of the work may differ from the estimate, perhaps materially. THIS IS NOT A
GUARANTEE OF THE FINAL PRICE OF WORK TO BE PERFORMED. I agree to the estimate and authorize [the contractor] to perform the
work as summarized and on these estimated terms, and I agree to pay the full amount for all work performed. Not Responsible for any
stucco , drywall, paint or floor repairs.