BMCH2019-044778-495 CALLE TAMPICO
T,ihy^&lwQuwra
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number: BMCH2O19-0447
Property Address: 50360 SPYGLASS HILL DR
APN: 770060009
Application Description: MUZZI / 14SEER/81AFUE SPLIT SYSTEM CHANGEOUT
Property Zoning:
Application Valuation: $13,900.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
DOMINIC MUZZI
172 BLUFF RD NO A
MOSS LANDING, CA 92253
Date: 11/21/2019
Applicant: /�\ Contractor:
ENERGUY P
L/"— , 0 BLAIR AIR INC DBA BLAIR HEATING & AIR
1215 K ST FLOOR 17 653 OLEANDER ROAD
SACRAMENTO, CA 95814 NOV 20 2019 D PALM SPRINGS, CA 92264
0 (760)537-1120
CITY OF LA QUINTA Llc. No.:953427
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: _ License No.: 953427
Date: lit-1201. 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).:
(_) 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:
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 work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti n 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:6CE AMERICAN INSURANCE COMPANY Policy Number: C66014447
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 pro/visions. _
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 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 enter upon the above -
mentioned property for inspection purposes.
Date: ��` V� Signature (Applicant or Agent):
Date: 11/21/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
ENERGUY
1215 K ST FLOOR 17
SACRAMENTO, CA 95814
BMCH2019-0447
50360 SPYGLASS HILL DR
770060009
MUZZI / 14SEER/81AFUE SPLIT SYSTEM CHANGEOUT
$13,900.00
Owner:
DOMINIC MUZZI
172 BLUFF RD NO A
MOSS LANDING, CA 92253
Contractor:
BLAIR AIR INC DBA BLAIR HEATING & AIR
653 OLEANDER ROAD
PALM SPRINGS, CA 92264
(760)537-1120
Llc. No.: 953427
Detail: HVAC CHANGE OUT - 14SEER/81AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT
QTY
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
$40.25
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$80.50
i Total Paid for MECHANICAL CHANGEOUT 2019: $120.75
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.97
Total Paid for PERMIT ISSUANCE: $101.97
DESCRIPTION I ACCOUNT I CITY I AMOUNT I
RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION I ACCOUNT I CITY I AMOUNT I
TECHNOLOGY ENHANCEMENT FEE 1 502-0000-43611 1 0 1 $5.00 1
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ta 0"Krev
- GEM f,i, nl•-SERT -
PERMIT If
PLAN LOCATION:
Project Address: 50� �' �Q S
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Applicant Name: T2Yj Z u
01 () IC 571-k . —
/(3e) 1
Address: 2(5 k 10 1-7
City, ST, Zip: 5�4CX ty-) e Gj J
Telephone: �'% Cpoc-j 0(
Email:
Valuation of Project $
IContractor Name: �1�, r ^)f ,r New SFD Construction:
Address: % 3 Q I r Conditioned Space
City, St, Zip PC Garage
Telephone: � l t) Patio/Porch
Email: Fire Sprinklers
State Lie: (Y,5� qa-7City Bus Lic:
SF
SF
SF
SF
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: �ryl I,rl 1' M� Zi
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone: _ 6C) .•
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
10?131io -.opt" H me
OFFICE USE ONLY
#
Submittal
Plan Sets
Req'd
Rec'd
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
A ent Authorization for Contractor
Company Name:
Contractor's Name:
Contractor's License Number:
}"i" Email: II M470' U11 111
The below listed individual employee(s) are autio rized to apply to the city/county for a building permit
and purchase of a business license on behalf of the above identified licensed contractor. i
understand that it is the licensed contractor's responsibility to provide a copy of this form with each
building permit application. If a copy of this form is not provided at the time that a building permit
application is filed, an agent(s) of the above identified licensed contractor may not apply for a
building permit.
The below listed employees are authorized to apply for permits for the above identified licensed
contractor:
1. APryah Quiroz
2. Bruce Edgar
3. Carolyn Christian
4. Charles Shaw
5.Jacob Kinney
6. Cody Chicourrat
7. Dan Ochipinti
B. Evan Volkwein
9. Harry Chi O
10. Jasna Sikic
1L John Maltman
Printed name and title of
Authorized
12. Kedar Sotomy
23. Stephanie Smith
32. Kyle Au Coin
13. Laura Johnson
24. Stephen Krale
33, Josh Homey
14. Mark Becker
25. Stephen Swinney
34. Nancy Rlsi
15. Matt McHattie
25. Teresa Kump
35. Rikki Niemeyer
16. Nate Colyott
27. rim Lane
36. Rob Cleaver
17.Omar Espinoza Mora
28. Tony Thai
37. Sam Lee
18. Peter Lujan
29. Tracy Shampine
38. Daniel Brizuela
19. Ronald Lai
30. Alyssa Ross
39. Breeana Peterson
20. Ryan Faris
31. Bri McLaughlin
40. Jessica Bara)as
21. Shaun Hogue
32. Brinder Grewal
22. Shawn Kugsemiller
33. Kyle Au Coin
Date: 5!
This certificate is attached to a _ page document dealing with/entrded
and dated
Witr1ess Of SI nature
STATE OF COUNTY OF
On this day of j, 20 before me, the undersigned notary public d
{ham erson acknowledging) proved t satisfactory evldeno', which
was (type of ice a person whose name is signed on the preceding or
29nffftnqjNbWyPUWk
Commission Flo"45V' OroreofNafty Puhfk
MOM 1-877-600.0123 wwwRnerguycom Faoc 1-HTM-M23
Esquire Rlaza 1215 K %eet r Floor 5acmmento, U MN r �G
&44ja,.au�De)jW
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CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
Countyof
On ZS I q before me, N
�. No
era inion name arAj p0p of Lhe OMM)
personalty appeared PIA-60i
who proved to me on the basis of satisfactory evidence to be the persory(s-whose
name (gis/afesubscribed to the within instrument and acknowledged to me that
he/sbeAhey executed the same in hisfhe~r authorized capacity(69e and that by
hisllile Ahek signature(p)7on the instrument the person4sy, or the entity upon behalf of
which the person�vyacted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of Califomia that
the foregoing paragraph is true and correct.
AMZ60RINA;ZAdRD0
WITNESS my hand and official seal. Commission 0 zifSao
3
Notary Public - California x
Riverside Calmty '
M Comm. Expires Jul 6, 2019 r
Notary PaVis Signature V(Notary Pubic Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THUS FORM
TUrform campfies with Chem Calrfomto statutes regarding notary wording and.
DESCRIPTION OF THE ATTACHED DOCUMENT ofneedrd, shmdd be completed andarachrd to the document Acknawledgmertts
frm other vaiew may be eompleted for dat-wnews being sent to that state so long
at the wording does fat rcqulrr the California notary to vlofdt, Callfornta notary
F.GuY AC•rs lase.
(Title or desai0m of attached doamanl) ■ State and County information must be the State and County where the document
A� � � signer(s) personally VP -fed befOM the notary public for acknowledgment.
ITRa a dastxlptiert o(ettachad document txntinusd) - Date of notarization must be the date that the signers) personally appeared which
must also be the same data the admowlodgmcat is completed.
- The notary public must print his or her mine as it appears within his or has
Number of Pages Document Date commission followed by a comma and then your title (notary public).
• Font the naime(s) of deeument signcr(s) who persenally appear at the time or
notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the corrccc singular or plural forms by crossing off incorrect forms (i.e.
harsh Owti- is faits ) or circling the correct forms. Failure to corroctly indicate this
,,0' Individual (or information may kad to feicction of document recording.
❑ Corporate Officer a The notary seal impression must be clear and photographically reproducible.
fmprossion must not cover text or lines. If seal impression smudges, reseal if a
t sufficient area permits, otherwise complete a different acknowledgment fora
❑ Partner(s) • Signature of On rotary public must match the signature on file with the office of
the county clerk.
❑ Attorney -in -Fact Additional information is not required but could help to ensare this
❑ Trustee(s) acknowledgment is not misused or attached to a different document
❑ Other 4 Indicoe title or type of attached docu mient, number orpages and date.
+l Indicate the capacity claimed by the signet If the claimed capacity) is a
corporate officer, indicate the lisle (i.e. CEO, CFO, Secretary).
2015 Verslon www.Notary0asses.corn 800-873-9866 securely attach the document to the signed document with a staple.
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CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-IR-ALT-HYAC)
Project Name:
50360 Spyglass Hill Drive I Date Prepared:
MR-ALT-02-E
(Page 1 of 3)
2019-11-19
A. General Information
MR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
MR-ALT-02 document for each dwelling unit.
01
Project Name
50360 Spyglass Hip Drive
02
Date Prepared
2019-11-19
03
Project Location
50360 Spyglass Hill Drive
04
Building Type
Single family
OS
CA City
La Quinta
06
Dwelling Unit Name
50360 Spyglass Bill Drive
07
Zip Code
92253
Dwelling Unit Conditioned
ism
Floor Area (ft2)
Number of Space
o9
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?
I component?
I components?
feet of ducts?
duct system?
1 SC system?
Alteration Type
System 1
Location 1
1500
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Dib)
This section does not apply to this project.
Registration Number. 419-AO20127966A
Registration Date/Time: 2019-11-19 16.41:15
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report, Version: 2018.0.001 Report Generated: 2019-11-19 16:41:42
CERTIFICATE OF COMPLIANCE CF111-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 gas
All new
Cerrtsplit
All new
This field or
This field or
System 1
furnace
heating
AFUE
81
A
AC
cooling
SEER
14
Setback
section is not
section is not
components
components
applicable
applicable
Required Qmumentation:
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 It 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, 8-151.
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)iDiia and 150.2(b)IE, 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-A020127966A Registration Date/Time: 2019-11-19 16:41:15 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-11-19 16:41:42
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:
Marc-Antuan Enriquez
M 0WC1_AYttUZL4 1 EYu,.-
Company:
Signature Date:
The Energuy
2019-11-19
Address:
CEA/ HERS Certification Identification (ifapplicable):
1215 K Street
City/State/Zip:
phone:
Sacramento CA 95814
877-600-0123
Responsible Pemon's Declaration statement
1 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 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 budding permit(s) Issued for the building, and made available to the enforcement agency for afl applicable
inspections. I understand that a registered copy ofthis Certificate of Compliance is required to be induded with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Adam Fuson
A damv
Company:
Date Signed:
Blair Air Inc dba Blair Heating & Air
2019-11-19
Address:
License:
653 Oleander Road
953427
City/State/Zip:
Phone:
Palm Springs CA 92264
760-537-1120
Digitally signed by CHEERS'"'. 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 infonnation.
Registration Number: 419-AO20127966A-000-000-0000000-0000
Registration Date/Time: 2019-11-19 16:41:15
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2018.0.001 Report Generated: 2019-11-19 16:41:42