BMCH2019-033678-495 CALLE TAMPICO TO�D / VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/21/2019
Permit Type/Subtype: MECHANICAL/ Owner:
Application Number: BMCH2O19-0336 KATHLEEN GLADISH
Property Address: 53575 AVENIDA DIAZ 53575 AVENIDA DIAZ
APN: 774111015 LA QUINTA, CA 92253
Application Description: GLADISH / HVAC CHANGE OUT - 14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $9,123.00
Applicant: Q Contractor:
AMBER GERRICK - IE INC F
PREFERRED AIR CONDITIONING HEATING & PLU
31225 LA BAYA 45-311 GOLF CENTER PKWY STE A
WESTLAKE VILLAGE, CA 91362 AUG 21 2019 D
INDIO, CA 92201
CITY OF LA QUINTA (760)863-0832
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 1022645
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 Clap: License No.:
Date: vl 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 Na
Lender's Add
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 th or which this permit is issued.
�fhave and will maintain workers' compensation insurance, as required by
Secti n 3700 of the Labor Cade, for the performance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier: ACE AMERICAN INSURANgE; OMPANY Policy Number: WLRC66055954
_ 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' ensation provisions of le n 3700a the Labor Code, I shall forthwith
comply. 'T
it hose I" vi ions, c
[ [q
Date: 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
constructio ,and hereby authorize representatives of thi city to enter upon t above-
mentione �pJro�p ty for inspection purposes.
Date: l Signature (Applicant orAgen
Date: 8/21/2019
Application Number:
BMCH2019-0336
Property Address:
53575 AVENIDA DIAZ
APN:
774111015
Application Description:
GLADISH / HVAC CHANGE OUT - 14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$9,123.00
Applicant:
AMBER GERRICK - IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
Owner:
KATHLEEN GLADISH
53575 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
PREFERRED AIR CONDITIONING HEATING & PLU
45-311 GOLF CENTER PKWY STE A
I N DIO, CA 92201
(760)863-0832
Llc. No.: 1022645
Detail: 4-TON HVAC CHANGE OUT OF EXISTING MECHANICAL EQUIPMENT - 14SEER/80 AFUE SPLIT SYSTEM & AIR HANDLER IN GARAGE LOCATION,
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 - OTHER EQUIPMENT
101-0000-42402
0
$40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - OTHER EQUIPMENT PC
101-0000-42600
0
$40.02
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: $200.11
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: $S.00
PERMIT H � �C 1� 2 0 f 9 0 13 ►P
Iq�INI�-
PLAN LOCMION
Project AddressG� ,� V� InOcA , Z
_
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN
Applicant Name:,
r.
r i �
h can
Address: ZSVA
�{ 213
City, ST, Zip:
[ 6113 2
Telephone:
lir — 5 _ `-1 K-7 iq
Emil:
Valuation of Project
Contractor Name: i' r ,� I
New SFD Construction:
Address:��'31I�}A-
Conditioned Space SF
City, St, Zip CA 01 2Z� U
r']
Garage — - ` Sp
L[q
Telephone: U - (fob , �t � 1
Patio/Porch SF
Email:
Fire Sprinklers SF
Stale Licl V�Z�k. ; 15 City Bus Lie.
Arch/Eng Name: ' ,�.
Construction Type: Ac ct�iOccupancy:
Address:
Crading:
City, St, 'Lip
Telephone:
Bedrooms: Stories:
# Units:
Email. -
State Lie: City taus Lie:
New Commercial / Tenant Improvements:
Property Owner's Name: W�
C-'� G I
Address:5 �� Z
Tolal Building SF
City, ST, Zip Z
�r
Construction Type: Occupancy:
[ -7 j l
Telephone:1 Q) - J 10 "L 2,
-
Email:
_
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HVAC)
Project Name:
KATHY GLADISH I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2019-08-16
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
CF1R-ALT-02 document for each dwelling unit.
01
Project Name
KATHY GLADISH
02
Date Prepared
2019-08-16
03
Project Location
53575 AVENIDA DIAZ
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
KATHY GLADISH
07
Zip Code
92253
08
Dwelling Unit Conditioned
1610
Floor Area (ftft2)
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
CIA 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
1610
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)
This section does not apply to this project.
Registration Number: 419-A020089096A-000-000-0000000-0000
Registration Date/Time: 2019-08-16 17:19:17
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-08-16 17:19:17
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
CF111-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
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
All new
All new
This field or
This field or
System 1
Central split
heating
AFUE
0.8
Central split
cooling
SEER
14
Setback
section is not
section is not
HP
components
AC
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.
CF213 and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF213 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)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: 419-A020089096A-000-000-0000000-0000 Registration Date/Time: 2019-08-16 17:19:17 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-08-16 17:19:17
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:
Jo Anne Orona
d. AVliie/0ronal
Company:
Signature Date:
I Permit E Raters
2019-08-16
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.
S. I 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:
Octovio Garza
O oyto- 6 ar
Company:
Date Signed:
Preferred Air Conditioning Heating & Plumbing
2019-08-16
Address:
License:
40719 Fortunato Court
1022645
City/State/Zip:
Phone:
Indio CA 92203
760-863-0832
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-A020089096A-000-000-0000000-0000
Registration Date/Time: 2019-08-16 17:19:17
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-08-16 17:19:17
Schema Version: rev 20180426
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