BMCH2020-0038VAUf
78-495 CALLE TAMPICO D 44"NAV
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
MECHANICAL/
Application Number:
BMCH2O20-0038
Property Address:
53911 AVENIDA HERRERA
APN:
774163022
Application Description:
DODSON / HVAC CHANGE OUT- 14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$8,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
DONALD & LINDA DODSON
53911AVENIDA HERRERA
LA QUINTA, CA 92253
Applicant: Contractor:
CLAIRE BACHUS - SIMMONS AIR y'� SIMMONS AIR
PO BOX 314 D PO BOX 314
LA QUINTA, CA 92247 LA QUINTA, CA 92247
FEB 2 4 2�020
0 (760)863-5254
G}TYOF IAQUINTA Llc. No.: 780534
DESIGN &DEVELOPMENTDEPARTN[ENl
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: CILicense No.: 780534
Date e_ 1 21. Contractor: Biro C �
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 Name:
Lender's Address:
Date: 2/24/2020
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
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: STATE FARM GENERAI<_INSURANCE COMPANY Policy Number:
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 t ose provisions.
Date: Z� Applicant: ze �
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 property for inspection purposes.
Date: �- G Signature (Applicant or Agent};
Date: 2/24/2020
Application Number:
BMCH2020-0038
Property Address:
53911 AVENIDA HERRERA
APN:
774163022
Application Description:
DODSON / HVAC CHANGE OUT- 14SEER/80AFUE SPLITSYSTEM
Property Zoning:
Application Valuation:
$8,000.00
Applicant:
CLAIRE BACHUS -SIMMONS AIR
PO BOX 314
LA QUINTA, CA 92247
Owner:
DONALD & LINDA DODSON
53911 AVENIDA HERRERA
LA QUINTA, CA 92253
Contractor:
SIMMONS AIR
PO BOX 314
LA QUINTA, CA 92247
(760)863-5254
Llc. No.: 780534
Detail: 4 - TON HVAC CHANGE OUT - 14SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2019
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 - 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
QTY
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: $5.00
� ta
-- GFM nfdY, DrNEKT
PERMIT # � �G` 1 2-0 2-0
PLAN LOCATION:
Project Address: Pr 1 J
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Applicant Name:
McA, V
prge 0 U �—
Address:
City, ST, Zip: CA 1 J]Z1
Telephone: f d 7 5 S`
Email: �r
Valuation of Project$ Q V
Contractor Name:
New SFD Construction:
Address: '
Conditioned Space SF
City, St, Zip �,r j n +a
Garage SF
Telephone: 6G6 f 2?, 3 — 5-2-5 LI
Patio/Porch SF
Email: 141114
Fire Sprinklers SF
State Lic: -7 0,� a CityBus Lic:
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: L tDfhj
ic,New
Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zips Q
Construction Type: Occupancy:
Telephone
l:
78495 CALLE TAMPICO
LA QU I NTA, CA 92253
760-777-7000
CERTIFICATE OF COMPLIANCE MR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF-1R-AIT HVAC) (Page 1 of 3)
Project Name: 5$911 Avenc9a Herrea Date Prepared: 2020-02-20
A. General Information
CFMALT 02 is applicable to multiple space conditioning systems contained) within a single dwellimg unit. When mLiltipie dwelling units must be documented, use
one
CF1R-ALT 02 document for each dwelling unit.
01 Project Name 53911 Avendia Herrea
02 Date Prepared
2020402-20
03 Project Location 53911 Avendia Herrea
04 Building Type
Single family
05 CA Clay La iQuinta
06 Dwelling Unit Name
53911 Avendia Herrea
07 . Zip Code 92i?53
Dwelling Unit Conditioned Floor
0E! 1600
Area (ft2)
Number of Space Conditioning
09 Climate Zone 15
10 (SC) Systems in this Dwelling
1
Unit:
IS. Space Conditioning (SC) System Information
01 02 03 04 05
06 07
08 09
10
SC System Installing a
SC System ID Y CFA served B this
Y Y Is the SC system a mefrigerant
Location or Area
Installing;new SC Installing more
Installing entirely
Installing entire)
g Y
Name
Served SC *stem (ft2) ducted system? containing
system than 40 feet cif
new duct system? new ducted 5C
Alteration type
component?
components? duds?
system?
Altered space
System ] Whole House I 1600 Yes Yes
Yes No
No No
conditioning
f
system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Dlib)
This section does not apply to this project.
Registration Number: 220-A02C-D34929A-000-000-00000@0-0000
Registration Date/Time: 2020-02-20 07:24:02
HERS Provider: CaICERTS
CA Bullding Energy Efficiency Standards - 2019 Resdentiafl Compliance Report Version: 20:19.1.002 Report Generated: 2020 D2-20 07:23:47
Schema Version: rev 20191201
CERTIFICATE OF COMPLIANCE CF111aALT-02-E
,Alterations to Space Conditioning Systems (formerly CF :1R-ALT HVAC) (Page 2 of 3)
ID. Altered Space Conditioning System (Sections 150.2(b)lE and F)
OIL
02
03
04
0S
06
07
08
09
20
11
.12
13
SC System
Heating
(tooling
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
Na me
Served
System Hype
Components
Type
Value
System Type
Components
Type
Value
Type
Duct Length
R-Value
System 1
Whdle House
Central as
g
furnace
Allinew
heating
AFUE
gig
Central sprit
All new
cooling
SEER
14
Setback
+than or
Lequalto 40
R-8
components
components
feet
Required Documentation.
CF2R-NVCH-01-E - Space Cianditioning 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)
CUR and CF3R-MCH 20-H Duct Leakage Test required when heating or cooling components are installed in ducted systems, orewhen more than 40 ft of duct length is
replaced
4i.eakage rate compliance: <= 151Percemt or <= 10 percentlleakage to outside, or seall all accessible leaks.
CUR and CF 4R-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 requireed.
Exce 'ions:
Duct systemm registered with HERS provider,as previously sealed are exempt from MCH-20 Duct Leakage Testing requirements.
Heating -only systems anil Air Handler Furnace changes d+o not require verificationlof Air Flow MCH-23, or Refrigerant Charge MCH-25.
4Existirg duct systems constructed, inswlated or sealed willh asbestos are exempt from MCH-20 Duct Leakage Testing requirements.
1E. Entirely New or Complete Relplacement Duct System, with or without Equipment Changeout (Sections 1'50.2(k()1Diia and 150.2(bj1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 15D.2(b)1C)
Registration Number: 220-A020D34929A-000-000-0000000-0000
This section does not apply to this pnoject.
Registration Date/Time: 2020-02-20 07:24:02
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2019 Residentiall Compliance Report Version: 20:19.1.O02 Report Generated: 2020-D2-20 07:23:47
Schema Version: rev 20191201
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-1R-AU-HVAC)
CFlRALT 02-E
(Page 3 of 3)
Documentation Author's Declaration:Stateinent
I. I certify that this Certificate of Compliance documentation is accurate andcomplete.
Documentation Author Name:
Bachus, Tom
Documentation Author Signature: T
/j,�Li04od4r4,
Company:
Signature Rate:
MLC Building Performance
2020-02-20 07:24:02
Address:
CEAY HERS Certification Identification (if applicable):
77825 Delaware Place
City/State/Zip:
Phone:
Palm [desert CA 92211
760-836-0066
Responsible Person's Declaration statement
I,certifytthe following under penalty of perjury, under the laws ofthe 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 responsibilhy for the building design or 4ystem design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials. components,and manufactured devices for the buildingidesign;cir system design identified on this Certificate of Cvmpliaince conform to the
requirements of Title 24, Part land Part 6 of the California Code of Regulations,
4. The building design features or system: designlfeatures identified on this Certificate of Compliance are consistent withtthe 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 Complianceshall be made,available withithe building permit(s4 issued for the building, andimade 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 r/� —00WAkrev
Company: Date Signed:
Ii ILC Building Performance 2020-02-20 0.7:24:02
Address: License:
77825 Delaware Place 780534
City/State/Zip: Phone:
Palm Desert CA 92211 760-836-0066
Easy to Verify 0
at CalCiERTS,com
Digitally signed by CalCERTS, 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 oftthe inhumation,
Registration Number: 220-A020D34929A-000-000-iD0000@0-0000
CA Building Energy Efficiency Standards - 2019 Residential] Compliance
Registration Date/Time: 2020-02-20 07:24:02
Report Version: 20:19.1.002
Schema Version: rev 20191201
HERS Provider. CaICERTS
Repoctt Generated: 2020 D2-20 07:23:47