BMCH2020-0017Date: )) 2 i za 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 ofthe 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
78-495 CALLE TAMPICO D� VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/28/2020
Permit Type/Subtype: MECHANICAL/ Owner:
Application Number: BMCH2O20-0017 ELEANOR MATHIS / PATRICIA MATHIS
Property Address: 54625 AVENIDA RAMIREZ 54625 AVENIDA RAMIREZ
APN: 774275018 LA QUINTA, CA 92253
Application Description: MATHIS / HEAT PUMP AND AIR HANDLER 14SEER/80HSPF SPLIT SYST.
Property Zoning:
Application Valuation: $8,670.00
Applicant: Contractor:
IE INC D TIMO'S AIR CONDITIONING & HEATING INC
31225 LA BAYA D72232 CORPORATE WAY
WESTLAKE VILLAGE, CA 91362 JAN 2 8 2020 THOUSAND PALMS, CA 92276
CITY OF LA QUINTA 0 (760)770-4357
DESIGN& DEVELOPMENT DEPARTMENT Llc. No.:920062
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 1 hereby affirm under penalty of perjury one of the following declarations:
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: C20 License No.: 220062 of1bs4 rk for which this permit is issued.
—�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: N Policy Number: nW.056706
_ 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 provisions.
Date: I Applicant:=� u-- - ` ~�
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 behalfthis 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 property for inspection purposes.
Date: ! 2S ICJ Signature (Applicant orAgent)--
`
Date: 1/28/2020
Application Number:
BMCH2020-0017
Owner:
Property Address:
54625 AVENIDA RAMIREZ
ELEANOR MATHIS / PATRICIA MATHIS
APN:
774275018
54625 AVENIDA RAMIREZ
Application Description
MATHIS / HEAT PUMP AND AIR HANDLER 14SEER/80HSPF SPLIT SYST
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$8,670.00
Applicant:
Contractor:
IE INC
TIMO'S AIR CONDITIONING & HEATING INC
31225 LA BAYA
72232 CORPORATE WAY
WESTLAKE VILLAGE, CA 91362
THOUSAND PALMS, CA 92276
(760)770-4357
Llc. No.: 920062
Detail: 3.5 - HEAT PUMP AND AIR HANDLER CHANGE OUT - 14 SEER/80HSPF SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. PER 2019 CALIFORNIA BUILDING CODES.
local rasa Tor tsUILUINU JIANUAKUJAUMINIbIKAIIUN BbA: si.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$40.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$80.50
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
ACCOUNT
CITY
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: $5.00
-- GEM nfrb, DFSERF -
PERMIT # 6mcno o0l
PLAN LOCATION:
Project Address: 54625 Avenida Ramirez
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Replace 3.5 ton heat pump and air handler
Applicant Name: Steven Schnierer
Address: 31225 La Baya Drive Suite 213
City, ST, Zip: Westlake Village, CA 91362
Telephone: 818-735-7876
Email: swschnierer@outlook.com
Valuation of Project $ 8,670.00
Contractor Name: Timo's A/C & Heating
Address: 72232 Corporate Way
City, St, Zip Thousand Palms, CA 92276
Telephone: 760-770-4357
Email:
State Lic:920062 City Bus Lie:
New SFD Construction:
Conditioned Space SF
Garage SF
Patio/Porch SF
Fire Sprinklers SF
Arch/Eng Name:
Construction Type: Occupancy:
Grading:
Address:
City, St, Zip
Telephone:
Bedrooms: Stories:
# Units:
Email:
State Lie: City Bus Lie:
Property Owner's Name: Patricia Mathis
New Commercial / Tenant Improvements:
Address: 54625 Avenida Ramirez
Total Building SF
City, ST, Zip La Quinta, CA 92253
Construction Type: Occupancy:
Telephon 24
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
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
MR-ALT--02 document for each dwelling unit.
01 Project Name PATRICIA MATHIS
02 Date Prepared
2020-01-28
03 Project Location 54625 AVENUE RAMIREZ
04 Building Type
Single family
05 CA City La Quinta
06 Dwelling Unit Name
PATRICIA MATHIS
07 Zip Code 92253
Dwelling Unit Conditioned Floor
08
1536
Area (ftz)
Number of Space Conditioning
09 Climate Zone 15
10 (SC) Systems in this Dwelling
1
Unit:
B. Space Conditioning (SC) System Information
01 02 03 04 05
06 07
08 09
10
SC System Installing a
SC System ID or y CFA served b this
y y Is the SC system a refrigerant
Installing new SC Installing more
Installing entirely
Installing entirely
Location or Area
Name stem ft2 ducted s stem? containin
SC S
Served y ( ) y g
system than 40 feet of
new ducted SC
new duct system.
Alteration Type
component?
components? ducts?
stem?
Altered space
System 1 Location 1 1536 Yes Yes
Yes No
No No
conditioning
system
C. Extension of Existing Duct System, Greater Than 40 Feet (Sectionl50.2(b)lDiib)
This section does not apply to this project.
Registration Number: 420-A020010190A-000-000-0000000-0000 Registration Date/Time: 2020-01-28 09:39:07 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.002 Report Generated: 2020-01-28 09:39:26
Schema Version: rev 20191201
CERTIFICATE OF COMPLIANCE CHR-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)
O1
02
03
04
05
06
07
08
09
10
11
12
13
SC System
Heating
Cooling
Description
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
System ID/
of Area
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
Name
Served
System Type
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R-Value
All new
All new
N/A - no
System 1
Location 1
Central split
heating
HSPF
8
Central split
cooling
SEER
14
Setback
ducts
n/a
HP
components
HP
components
replaced.
Faoil AHU
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)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) `
Registration Number: 420-A020010190A-000-000-0000000-0000
This section does not apply to this project.
Registration Date/Time: 2020-01-28 09:39:07
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.002 Report Generated: 2020-01-28 09:39:26
Schema Version: rev 20191201
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:
Cassidy Snow
C V1tm
Company:
Signature Date:
I Permit E Raters
2020-01-28
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.
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:
Joey Timo
TI
Company:
Date Signed:
Timo's Air Conditioning & Heating
2020-01-28
Address:
License:
72232 Corporate Way
920062
City/State/Zip:
Phone:
Thousand Palms CA 92276 1760-770-4357
NOTICE: This Certificate has been generated by California Energy Registry, Inc. ("Cal ,Energy) using information uploaded by third parties not affiliated or related to Cal Energy.
Therefore, Cal Energy is not responsible for, and cannot guarantee, the accuracy or completeness of the information contained in this certificate.
Registration Number: 420-A020010190A-000-000-0000000-0000 Registration Date/Time: 2020-01-28 09:39:07 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.002 Report Generated: 2020-01-28 09:39:26
Schema Version: rev 20191201