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Home My WebLink AboutHVRC20-0108 CITY OF PALM DESERT Department of Building & Safety 73-510 Fred Waring Drive Palm Desert, CA 92260 TEL: 760-776-6420 EMAIL: building@cityofpalmdesert.org CONTRACTOR DECLARATION CONTRACTOR LIC#:_________________ PERMIT#:_________________ ______ 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. Worker’s Compensation Declaration: 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. I hereby affirm under the penalty of perjury ONE of the following declarations (SELECT ONE): OWNER BUILDER DECLARATION PERMIT#:___________________ ______ I have and will maintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit 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: ______ 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:________________ PRINT NAME:_______________________________ SIGNATURE:____________________________________ ______ I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to 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 Contractors' 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 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 the property, 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 it was not built or improved 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a licensed contractor pursuant to the Contractors' State License Law.) ______ I am exempt from Licensure under the Contractors' State License Law for the following reason: DATE:________________ PRINT NAME:_______________________________ SIGNATURE:____________________________________ 920062 SS SS 5/11/2020 Steven Schnierer 73-510 Fred Waring Drive, Palm Desert, CA 92260 • (760) 776-6420 • www.cityofpalmdesert.org Project Address: _______________________________________________________Suite #_____________________ Total Value of work: $_______________ Project Description (be specific): Contractor Business Name Property Owner Name Address Address City Zip City Zip Phone Phone E-mail E-mail Contractor License No. Architect Name Designer Name Engineer Name Address Address City Zip City Zip Phone Phone E-mail E-mail License No. License No. *THE REVERSE SIDE MUST BE COMPLETED FOR RESIDENTIAL REMODELS AND TENANT IMPROVEMENTS Applicant Name Signature Date Contact Telephone Number E-Mail (For Office Use Only) PERMIT NO: _________________________ PLAN LOCATION: ____________________ APN: _______________________________ City of Palm Desert Department of Building and Safety Building Permit Application 72232 Corporate Way Thousand Palms, CA 92276 760-770-4357 920062 Timo's A/C & Heating Steven Schnierer May 11, 2020 818-735-7876 steve@ipermitca.com 42635 Adalin Way 8,360.00 Replace 3 ton package unit Wilma Curran 42635 Adalin Way Palm Desert, CA 92211 760-345-4265 jwcurran125@msn.com Registration Number: 420-A020047537A-000-000-0000000-0000 Registration Date/Time: 2020-05-06 19:10:13 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.002 Schema Version: rev 20191201 Report Generated: 2020-05-06 19:11:30 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: WILMA CURRAN Date Prepared: 2020-05-06 A. General Information CF1R-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 WILMA CURRAN 02 Date Prepared 2020-05-06 03 Project Location 42635 Adalin Way 04 Building Type Single family 05 CA City Palm Desert 06 Dwelling Unit Name WILMA CURRAN 07 Zip Code 92211 08 Dwelling Unit Conditioned Floor Area (ft2)1576 09 Climate Zone 15 10 Number of Space Conditioning (SC) Systems in this Dwelling Unit: 1 B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 SC System ID or Name SC System Location or Area Served CFA served by this SC System (ft2) Is the SC system a ducted system? Installing a refrigerant containing component? Installing new SC system components? Installing more than 40 feet of ducts? Installing entirely new duct system? Installing entirely new ducted SC system? Alteration Type System 1 Location 1 1576 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 2 of 3) Registration Number: 420-A020047537A-000-000-0000000-0000 Registration Date/Time: 2020-05-06 19:10:13 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.002 Schema Version: rev 20191201 Report Generated: 2020-05-06 19:11:30 D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 13 System ID/ Name SC System Description of Area Served Heating System Type Altered Heating Components Heating Efficiency Type Heating Minimum Efficiency Value Cooling System Type Altered Cooling Components Cooling Efficiency Type Cooling Minimum Efficiency Value Required Thermostat Type New or Replaced Duct Length New Duct R-Value System 1 Location 1 Central packaged HP All new heating components AFUE 0.8 Central packaged AC All new cooling components SEER 14 Setback N/A - no ducts replaced. n/a 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. CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF-1R-ALT-HVAC) (Page 3 of 3) Registration Number: 420-A020047537A-000-000-0000000-0000 Registration Date/Time: 2020-05-06 19:10:13 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.002 Schema Version: rev 20191201 Report Generated: 2020-05-06 19:11:30 Documentation Author's Declaration Statement 1. I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Shayley Wright Documentation Author Signature: Company: I Permit E Raters Signature Date: 2020-05-06 Address: 31225 La Baya Drive CEA/ HERS Certification Identification (if applicable): City/State/Zip: Westlake Village CA 91362 Phone: 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.I 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.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: Joey Timo Responsible Designer Signature: Company : Timo's Air Conditioning & Heating Date Signed: 2020-05-06 Address: 72232 Corporate Way License: 920062 City/State/Zip: Thousand Palms CA 92276 Phone: 760-770-4357