BMCH2016-016378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: .
BMCH2016-0163
Property Address:
56205 RIVIERA
APN:
Application Description:
GOTTLIEB RESIDENCE / HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$17,237.00
Applicant:
IE INC
31225 LA BAYA
Z
WESTLAKE VILLAGE, CA 91362
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: C20, C36 License No.: 686310
Dam n It, 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).:
(_J 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 Na
Lender's Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-.7153
Owner: .
1ANICE GOTTLIEB
56205 RIVIERA
LA QUINTA, CA 9225:
Contractor:
HARRISON ENTERPRISES
31170 RESERVE. DRIVE
THOUSAND PALMS, CA S
(760)343-7488
Llc. No.: 686310
l� Date:
C=
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13
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in n
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:
bBA ENERALAI'
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 :he Labor Code, for the performance
ofork 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 performar ce of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier:_ Policy Number: _
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, i` I should become subject to the
workers' compensation provisions of Section 370C of the Labor Code, I shall forthwith
comply with those provisions.
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, a,nd the applicant, each agrees to, and
shall defend, indemnify and hold harmless the Ciy 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 applicatbn becomes null and void if work is
not commenced within 180 days from date of iss jance 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.
_ Signature (Applicant or
FINANCIAL •• l•
DESCRIP,TION;.•' x� 'ACCOUNT �'h�ya„ QTY' AMOUNT' A,ii,r PAIDt PAID DATE!.
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BYE * METHyOD R ? � * ` # ��CHECK # CLTD BYar
, r` � F ,RECEIPT
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
svDESCRIPTION
ACCOUNT>
"QTY.i4AMOUNT'
PAID
Nw
FPAID-DATE
HVACCHANGEOUT- SPLIT -SYSTEM.
101-0000-42402
0
$72.52
$0.00
k .�'� e � wn'". ��4,"'a4 `,a �R G zY.`X. � �
M
i'. .'�,,R' h` "�` �`"� f TY �S .: • v�Li Z
� .b� >..''�'v; g - ^^e � R ��
RECEIPT #
Cdr' };.'N k"� t :�i
CHECK #
tZLTD
mMETHOD x � _
;, ,
4 C
DESCRIPTION '.
r ACCOUNT
QTYn
' AMOUNT � �
"PAID s
PAID DATE;
. -s
,,
r
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAIDBY�METHODa
RECEIPT #
a a x.��c
CHECK #
T*.
� B Y
ky
gid, „tea.
,
KCLTD
Total Paid for CHANGEOUT: $108.78 $0.00
DESCRIPTION". ION" a"
ACCQUNT ' ''
QTY,
AMOUNTS',
2 PAID 2%s�:
PAID;DATE'
....
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAOD BY £x M
METHOD
° x RECEIPT #C,,TD
BY 2'
,
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
•0 00
Description: GOTTLIEB RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED Applied: 5/17/2016 MFA
Parcel No: Site Address: 56205 RIVIERA LA QUINTA,CA 92253 Approved: 5/17/2016 MFA
Subdivision: Block: Lot: Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $17,237.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 21 SEER/80AFUE SPLIT SYSTEM [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CONDITIONS
Printed: Tuesday, May 17, 2016 12:54:39 PM 1 of 2
CONW.IYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
PAID
P4 b DATE
''RECEIPT'#
CHECK # ;
METHOD
PAID BY
CLBTD:
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0600-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00'
TOTALS:i 00
INSPECTIONS
Printed: Tuesday, May 17, 2016 12:54:39 PM 2 of 2
` sysrr:Ms
Bin.#
City. of LQ Qut*n: t !
Building 8F Safety Division
P.O. Box 1504;'78-495 Ca(!e Tampico
U..Qutnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Shut
Permit #
QIP
Project Address: 56205 Riviera
Owner's Name:. Janice Gottlieb
A. P. N.uinber.
Address: 56205 Riviera
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. General Air Conditioning
Telephone:
. mar'
Address: 31170 Reserve Drive
ProjectDescription: Replace.4ton A/C, Coil, & 90,000 BTU .
City, ST, Zip: Thousand Paltns, CA 92276
Furnace
Telephone: 760-343-7488 _
;. Q. �=
State Lic. # : 686310 City Lia #;
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone:
State iia #: ;. ", `���
<°j
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo
Sq.Ft.: #Stories: #.Units:
Telephone# of Contact Person: 818-735-7876
Estimated Value of Project $17,237:00.
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACKNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Desosit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mecharilcal
Grading plan .
2"° Review, ready for correctionsliissue
Electrical
Subco¢tactor List
Called Contact Person
Pluubing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
TO HOUSE:-
3,d Review; ready for correetionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
JANICE GOTTLIEB I Date Prepared:
CFIR-ALT-02-E
(Page i of 3 )
2016-05-16
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.
0.1
Project Name
JANICE GOTTLIEB
02
Date Prepared
2016-05-16
03
Project Location
56205 Riviera
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
JANICE GOTTLIEB
07
Zip Code
92253
08
Dwelling Unit Conditioned
2986
Installing
Installing
;Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely n
09
Climate Zone
15
10
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information `.
01
02
03
04E0506
J 07(
68
09
10
,_ Is the k'
F )nsiall ng a'
SC System
SC System
CFA served
'system a
refrigerant tInstallingtnewSC
Installing
Installing
;Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely n
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
2986
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0180685A-000000000-0000
Registration Date/Time: 2016-05-16 08:19:29
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-16 08:19:55
Schema Version: 0.555SDD
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
Central split
All new
Less than or
System 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
21
Setback
equal to 40
R-8
components
components
feet
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fag's
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF311-MCH-20-H — Duct Leakage testing 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: 5 15%, ors 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & MR -MCH -25-H Refrigerant Charge Verification required. when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 300 CFM/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 M.ECH-25 * ;
,4 �x r., n t p ,I i
-Existing duct systems constructed, insulated'or sealed with asbestos;are exemp from MCH=20 DuKeakage Testiingyrequiremerts.
.s`k N"Aw-_.._J1 J;{ it N4 _ 1[ 11 At 11 ,.. 34 s t3 A' 1'.1 AN..
. .� ��,�-:..,,,�,.�.:'-n:N,,,cr � •.,.;.;::.. :-.,nom,-.,,•:. t-,ro-.-. +.�, +.�:�g'Y •,-; s•� ...�'<�a.rr -aa+
E. Entirely New or Complete Replacement Duct.System, with or without;.Equipment Changeout,(Sections 150.2(b)1Duasand 150.2(b)1E, F)
is 1- ii; 4 J
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC)
This section does not apply to this project.
Registration Number: 216-A0180685A-000000000-0000
Registration Date/Time: 2016-05-16 06:19:29
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards- 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-16 08:19:55
Schema Version: 0.555SDD
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. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: �
Jan
Jacoby, Ian
dacobJr
Company:
Signature Date:
i PERMIT E RATERS
2016-05-16 08:19:29
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake 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 forr-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�Reg IaUon
4. The building design features or system design features identified on this Certificate of Compliance are consistent wdhAhe information•provided on otherrapplicable compliance documents, worksheets, .
calculations, plans and specifications submitted to the enforcement agency for approval,wlth this building permit application.
5. I will ensure that a registered copy of,this Certificate of,compliance shall be lnade;available wtth'tfte bulldirig:,permit(s) issued for,the building, and,made available to the gnforcement agency for all applicable
inspections. I understand that a registered copy of thisCerti,icate of Compliance is,required to be included with the documentation the builder provides to -1. building owner at occupancy.
Responsible Designer Name:. ' _ «
Responsi6le Designer Signature: V I�l` >� -V
Jacoby, Ian
cyan cob`t
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-05-16 08:19:29
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-7488
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-A0180685A-000000000-0000 Registration Date/Time: 2016-05-16 08:19:29 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-16 08:19:55
Schema Version: 0.555SDD