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BMCH2017-0189Applicant: IE INC. 32115 LA BAYA 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: License No.: 763937 /= s� r D.." Contractor:/%2��---� 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.). (_) 1, 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. BAP.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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: C` -` allCl/ ,78-495 CALLE TAMPICO 0 U . A.. LA gUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT ! LA QUINTA, CA 92253if BUILDING PERMIT Application Number: BMCH2O17-0189 Property Address: 56205 RIVIERA APN: 762021022 Application Description: GOTTLIEB / HVAC CHANGE OUT - (1)25SEER/80AFUE SPLIT SYSTEM Property Zoning: Application Valuation:. $14,700.00 Applicant: IE INC. 32115 LA BAYA 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: License No.: 763937 /= s� r D.." Contractor:/%2��---� 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.). (_) 1, 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. BAP.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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: Q JANICE GOTTLIEB z 56205 RIVIERA ! LA QUINTA, CA 92253if ,� 0 Contractor: VOTTA ENTERPtISES INC DBA C( 72248 NORTHSHORE ST STE 101 THOUSAND PALMS, CA 92276 (760)320-5800 Lic. No. :763937 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one or 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5034539 _ 1 certify that,in the performance of the work for which this permit is issued, l shall not employ any person in any manner sows 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. Cf �3L a Date:/ h q t1 ApplicanU '-� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIWAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,Or0). 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 tke Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this appleation 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 tie 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 issLance of such permit, or cessation of work for 180 days will subject permit to cancellatio•i. I certify that I have read this application and sate that the above information is correct. I agree to comply with all city and county ordi.iances and state.laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. r Date- I4l h1 Signature (Applicant or Agent) w_ v Date: .5/19/2017 Application Number:. BMCH2017-0189 Owner: '-Property Address: 56205 RIVIERA JANICE GOTTLIEB APN: 762021022 56205 RIVIERA Application Description: GOTTLIEB /HVAC CHANGE OUT - (1)25SEER/80AFUE SPLIT SYSTEM LA QUINTA, CA 92253 Property Zoning: Application Valuation: $14,700.00 Applicant: Contractor: IE INC. VOTTA ENTERPRISES INC DBA COMFORT AIR 32115 LA BAYA 72248 NORTHSMRE ST STE 101 , WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276 . (760)320=5800 Llc. No.: 763937 Detail: HVAC CHANGE OUT 25SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 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 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT - SPLIT -SYSTEM PC• 101-0000-42600 0 $38.00 Total Paid for CHANGEOUT: $114.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3) Project Name: JANICE GOTTLIEB Date Prepared: 2017-05-18 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 JANICE GOTTLIEB 02 Date Prepared 2017-05-18 03 Project Location 56205 RIVIERA .04 Building Type Single family 05. CA City La Quinta 06 Dwelling Unit Name JANICE GOTTLIEB � 4 X08 Dwelling Unit Conditioned 07 Zip Code 92253 08 Floor Area (ftZ) 2986 ' SC System Number of Space CFA served 09 Climate Zone `: 15 ' ` ` _ _ 10 Conditioning (SC) Systems in 1 Identification or Location or Area by this SC this Dwelling Unit: containing _,v -- a,1— ri 1-r --I- Ur --1-0. 7--1 1-* -� 1 B. Space Conditioning (SC) System Information `: ;IT t : . (. 01 02 03 04 05 06 Oµ 09 10 t. r A _ � 4 X08 FIs the SCr'� IaIIi 'ni't g 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 (ftZ) 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)lDiib) This section does not apply to this project. Registration Number: 217-A020166870A-000-000-0000000-0000 Registration Date/Time: 2017-05-18 15:19:41 HERS Provider: CaICERTS CA Building Energy Efficiency Standards 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-18 15:19:30 CERTIFICATE OF COMPLIANCE CF1R-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)lE and F) 01 02 03 04 05 06 07 08 09 10 it 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 This field or This field or System 1 furnace heating AFUE 80 AC cooling SEER 25 Setback section is not section is not components components applicable applicable Required Documentation: CQR,MCH-01-E - Space Conditioning Systems 1 - 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)- CF211 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% or <=10% leakage to outside;.or seal all accessible leaks. CF2R and CF313-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 Le akage Testing requirements., Heating -only systems and Air Handler Furnace changes do not requireverification of Air Flow MCH -23, Refrigerant Charge MCH 25t' -Existing duct systems constructed, insulated or sealed with asbestos<are exempt from MCH=2 OrDuct,Leakage Testing requirrem�nts. l;.. A' if' ti �.l%' , V1IL f E. Entirely New or Complete Replacement Duct -System, with or without -Equipment Changeout (Sections -1,50 F) *00It 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. Registration Number: 217-A020166870A-000-00070000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time: 2017-05-18 15:19:41 HERS Provider: CalCERTS Report Version: 2016.1.005 Report Generated: 2017-05-18 15:19:30 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. I certify that this Certificate of Compliance documentation is accurate and complete.. Documentation Author Name: Documentation Author Signature: � Jacoby, Ian Jan dacobJt^ Company: Signature Date: i PERMIT E RATERS 2017-05-18 15:19:41 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 manufactyred devices for the design or system design identified on this Certificate of Compliance conform to the ,building requirements of Title 24, Part 1 and Part .6 of the Ca^lifornia Code of Reg Iat ons. 4- The building design features or system design features identified on this Certificate of Compliance are consistentswithAhe information -provided on., '46rapplicable,compliance documents, worksheets, i i .-"'...x calculations, plans and specifications submitted to the enforcement agency fob approval .lith this building permit applicatio, . VtA 5. 1 will ensure that a registered copy of.this Certificate f Compliance shall -be matte available with the buildinglpermrt(s) issued forthe;building, and made available,to,theenforcement.agency for all applicable inspections. I understand that a registered copy of this,Certif cate of Compliance is required tobezincluded with the ej�ocumenSa� ion tthe builder proves to the building owner at occupancy. Responsible Designer Name: iE _, 1;4 Responsible Desig er Signature: V1, G VA 'an �ac0 Jacoby, Ian Company: Date Signed: i PERMIT E RATERS 2017-05-18 15:19:41 Address: License: 31225 La Baya Drive #213 City/State/Zip: Phone: West Lake Village CA 91.362 818-7SS-7876 Easy to. Verify. a. at CaICERTS.Com •— Digitally signed by CaICERTS. 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. a' Registration Number: 217-A020166870A-000-000-0000000-0000 Registration Date/Time: 2017-05-18 15:19:41 HERS Provider: CaICERTS CA.Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-18 15:19:30 # Ci/ Of Quinta Building 8L Safety Division. P:O. Box 1504,'78-4.95 Calle Tampico La..Quinta, CA 92253 -:(760) 777-7012 Building. Permit Application and Tracking Sheet Permit # Project Address: 56205 Riviera Owner's Name:.Janice Gottlieb A. P. Number. Address: 56205 Riviera Legal Description: Contractor. Comfort Air City, ST, Zip: La Quinta, CA 92253 r s'es �. Telephone: �a"' -'°'x ' Address: 72248 Northshore Street Suite 101 ProjectDescription: Replace 4 ton A/C, coil, & 70,000 City, ST, Zip: Thousand Palffs, CA 92276 BTU furnace Telephone: 760-320-5800 City Lic. #; State Lic. # : 7-63937 Arch., Engr., Designer- esignerAddress: Address: City., ST, Zip: Telephone: State Lic. #:` • :: " �j7µ� Name of Contact Person: Steven Schnierer Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories:. # Uriitp Telephone # of Contact Person: 818-735-7876 Estimated Value of project: $14,700.05) . APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACMd PERMIT FEES Plan Sets Plan Check submitted. Item Amount Stroduial Cases. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Pian Check Balance Title 24 Calcs. Pians picked up Constructioe Flood plain plan Plans resubmitted.. Mechanical Grading plan 2" Review, ready for co i•rectionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up SJ%LL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for eorrectionsrtssae Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees