BMCH2019-043378-495 CAL LE TAMPICO D 4-
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number:
BMCH2O19-0433
Property Address:
77711 LOS ARBOLES
APN:
658260010
Application Description:
DEVEREAUX / CONDENSER AND COIL
Property Zoning:
Application Valuation:
$9,335.00
Applicant:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS,TN 38120 OCT 2 9 2019
D 0
CITY OF LA QUINTA
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 7000) of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: C36. C10y, C20 License No.:
7�,__
Date: � 7 Contractor:
OWNER -BUILDER DECLARA ION
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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/29/2019
Owner:
Devereaux Asha
77711 LOS ARBOLES
LA QUINTA, CA 92253
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
(951)276-9744
Llc. No.: 765074
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 rk for which this permit is issued.
I have and will maintaln workers' compensation insurance, as required by
Secti❑ 3700 of the Labor Code, for the performance of the work for which this permit is
issue . My workers' compensation insurance carrier and policy number are:
Carrier: LWERTY INSURANCE CORPORATION Policy Number: WA763D508631019
I certify that in the performance of the work for which this permit is issued,
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. z .7 �r
Date:. JQ-Aq- /2_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 subjectto
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.
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.
Date: `vSignature (Applicant or Agent):
Date: 10/29f2019
Application Number: BMCH2O19-0433
Property Address: 77711 LOS ARBOLES
APN: 658260010
Application Description: DEVEREAUX / CONDENSER AND COIL
Property Zoning:
Application Valuation: $9,335.00
Applicant:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
Owner:
Devereaux Asha
77711 LOS ARBOLES
LA QUINTA, CA 92253
Contractor:
A R S AMERICAN RESIDENTIAL SERVICES OF C
965 RIDGE LAKE BLVD. #201
MEMPHIS, TN 38120
(951)276-9744
Llc. No.: 765074
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ # - _ - - - - - - __ _ _ _ _ _ a - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ - _ _ _ _ _ _ _ _ _ _ _ _
Detail: REPLACE CONDENSER AND INDOOR COIL ONLY 144ER%80 AFYA.SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. PER 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 - CONDENSER ONLY
101-0000-42402
0
$40.25
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$26.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$13.42
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION PC
101-0000-42600
0
$5.37
Total Paid for MECHANICAL CHANGEOUT 2019: $85.87
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.97
Total Paid for PERMIT ISSUANCE: $101.97
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
TOTALS:i :4
Project Address: ? 7'7f f
APN #:
Applicant Name:
Address: fir.
�m
City, ST, Zip flt ut' I-L(OLa-�;z
Telephone: ::tbc> - 7-5
Email:
PERMIT #
`oe
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Valuation of Project S
/8495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
CERTIFICATE OF COMPLi*f*eE-
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC) (Pagel of 3) I
Project Name:
DEVEREAUX, DR. ASHA I Date Prepared:
2019-10-29
A. General: Information
CHR-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
DEVEREAUX, DR. ASHA
02
Date Prepared
2019-10-29
03
Project Location
77711 LOS ARBOLES
04
Building Type
Single family
05
CA City
Coronado
06
Dwelling Unit Name
DEVEREAUX, DR. ASHA
07
Zip Code
92118
08
Dwelling Unit Conditioned
1389
Floor Area (ft)
Number of Space
09
Climate Zone
7
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
1389
Yes
Yes
Yes
No
No
No
Altered spaceconditioning
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-A020118820A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registrat on Date/Time: 2019-10-29 07:07:57
Report Version: 2018.0.001
Schema Version: rev 20180426
HERS Provider: CHEERS
Report Generated: 2019-10-29 07:07:57
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)1E and F)
01
02
03
04
05
06
07
08
09
10
it
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
ponents
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R-Value
Central gas
Central split
All new
This field or
This field or
System 1
furnace
Indoor coil
AFUE
0.8
AC
cooling
SEER
14
Setback
section is not
section is not
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)1C)
This section does not apply to this project.
Registration Number: 419-A020118820A-000-000-0000000-0000 Registration Date/Time: 2019-10-29 07:07:57 ,HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-10-29 07:07:57
Schema Version: rev 20180426
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC)
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Diana McGinnis I .,-t-_. __ _ I ■ _.—,
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
Signature Date:
2019-10-29
CEA/ HERS Certification Identification (if applicable):
Phone-
951-276-9744
CF1R-ALT 02-E
(Page 3 of 3)
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 forthe 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 ofthe 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. 1 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:
Diana McGinnis r.-N , _ _ - _ I . _ .-. , ,
Company
Date Signed:
ARS American Residential Services of CA dba Rightime Home Services
2019-10-29
Address: iLicense:
965 Ridge lake Blvd, Suite 201
765074
City/State/Zip:
Phone:
Memphis TN 38120
951-276-9744
Digitally signed by CHEERST". 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=-AO291t&820A-000-000-0000000-0000 Registration Date/Time: 2019-10-29 07:07:57 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-10-29 07:07:57
Schema Version: rev 20180426