HomeMy WebLinkAboutMECH-19-1804 City of Arcadia, CA Permit NO. Mech-19-1804
Development Services Department Permit Type: Mechanical
240 West Huntington Drive,Post Office Box 60021
tArcadia,CA 91066-6021 Work Classification:HVAC New System, Residential
(626)574-5416 Permit Status:Issued
'ARCADIA Issue Date:09/09/2019 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1101 E Camino Real AVE Arcadia,CA 8510004042
Contacts ---
BOB LINDGREN Owner AIR-TECH AIR CONDITIONING& Contractor
HEATING INC*
(760)217-5709 204 S ROSEMEAD BLVD, PASADENA,CA 91107
(626)795-8880 541161
-,
Description: NEW HVAC SYSTEM PER APPROVED PLANS AND 13 Valuation: $ 0.00 Tenant
[DUCTS.HERS REQUIRED FOR FINAL
Total Sq Feet: 0.00 Plan Check U Plan U
Fees Amount Payments Amount Paid
Add/Alter bucts $9.94 Total Fees $163.80
Compressor 3-5 Ton(3 to 15 hp) $36.35 Cash/Receipt rY REC-02413-19 $163.80
Electrical Permit Issuance Fee $47.01
Amount Due: $0.00
Furnace or Burner<=100,000 BTU $19.86
Mechanical Permit Issuance Fee $47.01
Outlets-Receptacles&Switches $1.63
Solid Waste Management Fee 2 $1.00
Solid Waste Management Fee 2 $1.00
Total: $163.80
CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
This permit/plan review expires by time limitation and becomes null and
void if the work authorized by the permit is not commenced within 180 days
from the date of issuance or if the permit is not obtained within 180 days
from the date of plan submittal.This permit expires and becomes null and
void if any work authorized by this permit is suspended or abandoned for 180
consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
EXPIRED
4 September 09, 2019
Issued By: Date
September 09,2019 Page 1 of 1
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MI mown. PERMIT/PLAN REVIEW APPLICATION
• .
0, t4p• Development Services Department,240 West Huntington Drive,Post Office Box 60021 •
•�" Arcadia, CA 91066-6021,(626)574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 71....11,of Division 3 of the Business and
Professions Code,and my license is i, it f e and effect.
License Class C a 0 I have and will maintain a certificate of consent to self-insure for workers'
Lice . > .. (6( Exp, Dater ���'� compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor / performance of the work for which this permit is issued.
OWNER-BUILDER % ARATION 0 I have and will maintain workers'compensation insurance,as required by Section
❑ I herebyaffirm under 3700 of the Labor Code,for the performance of the work for which this permit
penalty of perjury that I am exempt from the Contractors is issued.M r rs' m tion insurance carrier and policynumbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve, Carrier Y � �OT ���
demolish,or repair any structure,prior to its issuance,also required the applicant 41 W L► Q 2_6(1 U
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I sh d become subject to the
workers'compensation provisions of Section 37 Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for 71-(0,
/
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT:APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
l of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further information.
Name Ali t/" \Title ,__'4
1
PRINT NAME
I certify that I have read ' application and state that the above information is correct and that I am the owner or duly authorized agent of the owner.
I agree to comply wi , .: ity ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter upo, 1 , 'i ore-mentioned property for inspection purposes.
S gnature Date
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
(Page 1 of 3)
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC)
Project Name:
1101 E.Camino Real Ave. Date Prepared: 2019-09-04
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 1101 E.Camino Real Ave. 02 Date Prepared 2019-09-04
03 Project Location 1101 E.Camino Real Ave. 04 Building Type Single family
05 CA City Arcadia 06 Dwelling Unit Name 1101 E.Camino Real Ave.
Dwelling Unit Conditioned 2804
07 Zip Code 91006 08 Floor Area(ft2)
Number of Space
09 Climate Zone 9 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(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type
Entirely new or
complete
5ys'em 1 Location 1 2SG.; Yes Yes Yes Yes Yes Yes replacement 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.
Re istration Date/Time: 2019-09-04 14:16:45 HERS Provider:CaICERTS
Registration Number:219-A020193168A-000.0060000000-0000 g
Version:2018.0.001 Report Generated:2019-09-04 14:16:40
CA Building Energy Efficiency Standards-2016 Residential Compliance Report
Schema Version:rev 20180426
1.
it
CF1R-ALT-02-E
CERTIFICATE OF COMPLIANCE
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)
This section does not apply to this project.
E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)lDiia 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)
01 02 03 04 OS 06 07 08
09 10 11
Heating Cooling
System Heating Minimum Cooling Minimum Required
Identification or Heating System Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct
Name Type Component Type Value System Type Component Type Value Type R-Value
Annual Fuel
Central split All new cooling SetbackTher R-6
Central gas All new heating Utilization 80 SEER 14 mostat
System 1 furnace components Efficiency AC components
(AFUE) K f V 4 y y - y
geauired i°^: ;-`S () # L i i i
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
-Leakage rate compliance:<=5%.
CF2R and CF3R-MCH-22 Fan Efficacy
CF2R and CF3R-MCH-23 Airflow Rate Verification
-Compliance:Fan Efficacy<e 0.58 W per cfm and System Airflow>e 350 cfm per ton.
-Alternative Compliance:CF2R and CF3R-MCH-28 Return Duct Design verification is an alternative to MCH-22 and MCH-23 verification.
CF2R and CF3R-MCH-25'H Refrigerant Charge verification required when refrigerant containing components are Installed or altered(applicable In C2 2,8-15).
Enceetinns:
Heating-only systems are exempt from the 0.58 W per cf m and 350 cfm per ton requirements.
(=An"entirely new or replacement duct system"means at least 75%of the duct system is new duct material,and up to 25%may consist of reused parts from the dwelling unit's existing duct system(e.g.,registers,
grilles,boots,air handler,coil,plenums,duct material)if the reused parts are accessible and can be sealed to prevent leakage
B
Re istration Date/Time: 2019.09-04 14:16:45 HERS Provider:CaICERTS
Registration Number.219•A020193168A-000-000-0000000-0000
rt Version:2018.0.001 Report Generated:2019-09-04 14:16:40
CA Building Energy Efficiency Standards•2016 Residential Compliance Re Po
Schema Version:rev 20180426
•
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1.I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: .y) /'i) (,
Rodriguez,Rod ClC r(CICO
Company: Signature Date:
Air-Tech Heating and Air Conditioning 2019-09-04 14:16:45
Address: CEA/HERS Certification Identification(if applicable):
204 S.Rosemead Blvd.
City/State/Zip: Phone:
Pasadena CA 91107 626-795-8880
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,materiab,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: Responsible Designer Signature:
Rodriguez,Rod �/Corl clto n uez
Company: Date Signed:
Air-Tech Heating and Air Conditioning 2019-09-04 14:16:45
Address: License:
204 S.Rosemead Blvd. 541161
City/State/Zip: Phone:
Pasadena CA 91107 626-795-8880
Digitely signed by CaICERTS. 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 accuracyof the information.
Registration Number:219-A020193168A-000-000-0000000-0000 Registration Date/Time: 2019-09-04 14:16:45 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2019-09-04 14:16:40
Schema Version:rev 20180426
4
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/ I AIR-TECH
/ I 209 S. ROSEMEAD BLVD.
/ I PASADENA,CA 91 107
626-795-8880
/ I
541161 -9/30/20
/ I OAK RIVER INS
/ I AIWCO26190- 1/1/20
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/ I
/ I
/ I
/ I
/ 10'I
/ Ili 4—* SCOPE OF WORK
/ I
/ I
/ I C/O: 5 Ton Furnace&Coil
/ I New Condenser
/ I
/ I (13)Ducts
/ I (1) Electrical disconnect
1101 E. Camino Real Ave
Bob Lindgren
760-217-5709
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