BMCH2014-1131Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
OICT 30 2014
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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: License No.: 686310
Date: )b 3V' 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
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 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
1 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/30/2014
Owner:
DAVID HILTON
4430 SHEPHERDS LN
LA CANADA FLINTRIDGE, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
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: _ 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, 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: 16I3DI11-4 Applicant: Sew L
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: i° -i Signature (Applicant or Agent): �4+tr1► ...�--
78095 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: '
BMCH2O14-1131
Property Address:
80224 RIVIERA
APN:
762130020
Application Description:
REPLACE 5 TON COIL
Property Zoning:
Application Valuation:
$2,856.00
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
OICT 30 2014
CITY OF LA OUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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: License No.: 686310
Date: )b 3V' 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
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 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
1 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/30/2014
Owner:
DAVID HILTON
4430 SHEPHERDS LN
LA CANADA FLINTRIDGE, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
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: _ 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, 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: 16I3DI11-4 Applicant: Sew L
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: i° -i Signature (Applicant or Agent): �4+tr1► ...�--
FINANCIAL •• •
13 $'; , ; DESCRIPTION', ' ACCOUNT „' :a QTY' 's > AMOUNT. D*
PAI PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00. $0.00
PAID BY , �. METHOD �zr� - ` •RECEIPT # '' CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA' $1.00, $0.00
DESCRIPTION'.. }
:''°ACCOUNT
QTY.
, ` AMOUNT
,
"` PAID
PAID DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
PAIDBY°:�
4 _
METHOD
�`�"--',RECEIPT # ,
`�
HECK o'
CLTD BY,
DESCRIPTICiN
. ACCOUNT g
QTY
"• • • AMOUNT
; .PAID -7
PAID DATE,
HVAC CHANGEOUT - REPAIR/ALTERATION
PC
101-0000-42600
,
0
$4.83
$0.00
PAID BY, �,. 5
°, METHOD • "
RECEIPT •#
CHECK W
CLTD BY. .
Total Paid forCHANGEOUT: $16.92 $0.00
DESCRIPTION'
ACCOUNT, ,
QTY
."r AMOUNT..
PAI
'D
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY „.
; 'METHOD' -`i E ' ,'
RECEIPT#
"" 3CHECK #ar
CLTDfBY.
r'
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:0• 0i
oX
Description: REPLACE 5 TON COIL
Type: MECHANICAL"
Subtype: Status: APPROVED
Applied: 10/30/2014 MFA
Approved: 10/30/2014 MFA
Parcel No: 762130020 Site Address: 80224 RIVIERA LA QUINTA,CA 92253
Subdivision: TR 28340-2
Block: Lot: 33
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,856.00
Occupancy Type: Construction Type: •
Expired:
No. Buildings: 0
No. Stories: 0 No: Unites: 0
HARRISON ENTERPRISES INC DBA G
Details:. REPLACE 5 TON COIL [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
CA
FINANCIAL INFORMATION
Printed: Thursday, October 30, 2014 3:34:40 PM 1 of 2 - srsTeMs
CONTACTSCONDITIONS
NAME TYPE ` s t NAME : ` - wADDRE5S1
aCITY u "� = STATE ZIPP ' � PHONE 2 FAX ".. _ 4EMAIL 3
F
rs s
APPLICANT
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
STE A
PALMS
CONTRACTOR
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
STE A
PALMS
OWNER
DAVID HILTON
4430 SHEPHERDS LN
LA CANADA
CA
92253
FLINTRIDGE
FINANCIAL INFORMATION
Printed: Thursday, October 30, 2014 3:34:40 PM 1 of 2 - srsTeMs
CFA Ok
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r
. �- . �• • _ � �o-, , yr
w
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*
SEQID
*INSPECTION TYPE
. .INSPECTOR
L_.
SCHEDULE D'
COMPLETED
RESULT
REMARKSr
_
'' NOTES
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
"DATE
z` S�17
�y.
MECHANICAL FINAL"
BY
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
$12.09
$0.00
REPAIR/ALTERATION
HVAC CHANGEOUT -
101-0000-42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid forCHANGEOUT: $16.92- $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
-k Y7 1
*
SEQID
*INSPECTION TYPE
. .INSPECTOR
L_.
SCHEDULE D'
COMPLETED
RESULT
REMARKSr
_
'' NOTES
_
t
ri
-
F
"DATE
z` S�17
�y.
MECHANICAL FINAL"
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, October 30, 2014 3:34:40 PM 2 of 2
SYSTEMS
STATE OF CALIFORNIA
ALTERATIONS - HVAC,
EU
CEC-CFIR-ALT-04-E (Revised 06/14) CALIFORNIA ENERGY CUMMISSIUN
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
Date Prepared:
Permitil:
QC�2Z�-1 :-4 ecc_
C- 6- Off' L v' !c
t� 30114
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Required R -value
Conditioned
Floor Area (sq ft)
Thermostat
❑ Packaged System
]WEvaporator Coil
AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
XSetback
❑ Split System
❑ Condensing Unit
❑ R-8' (CZ 11, 14, 15) Ducting
sgft
(If not already
❑ Mini Split
❑ Compressor
SEER
HSPF❑
-'
R (all CZs) Plenums
present must
❑ Furnace
❑ Lineset
❑ R-55 or R7.5) Lineset
be installed)
❑ TXV
EER
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
W1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) --HERS, MECH-25-HERS2
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CF111-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
113. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following CF111-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5-3T-2'/.", 3.5 to 4T-2%", 5T-4%"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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.
Responsible Designer Name:
c„cv-
Responsible Designer Signature:
—<.� sL
Date Signed:
bol•'50ty
License:
1 0631(3
Company:
a�k-%orc�n
Address:
3\k �e
City/State/Zip:Phone:
1 2Z�(.
�cQo-3�;3--71488
r.re_
oh usard aim
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
Bin.#
Crty �f Q[(llltd
Buildmg a Safety Division
P.O. Box,1504,'78-495 Calle Tampico
La.Quinta, CA 92253 • (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #.
Project Address:gO 2ZL.� Y r0.
Owner's Name:. IZ . ba , -.e� N : 1 }per
A. P. Number.
Address: . g o 2 Z y : v er
Legal Description:
City, ST, Zip: L QV i Y.;i CA CI Z-4,3
Contractor. &-rC,XCO As -r
Telephone; $
Project Description:
Address: '411-70 �e:Se�tVve_ rr•
City, ST, Zip: IhOV tid �0.Xvn5 C A
Pcok�xce— S C ; 1
Telephone: ?IS -7 / Q0 � "t,(t� r _ £ ���•C��" ; /
'� f�c✓iE3i'R�t.'
.
State Lic. # : `(.26"316 City Lie'. M.
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
ra
State Lic. #:_
`,.�;; � %y:�ru .,
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project—4 . S6
APPLICANT: DO NOT WRITE BELOW.THIS UNE
#
Submittal
Req'd
Recd
TRACMNG
PERMIT FEES
Plan Sete
PIan Check submitted
item.Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechaciical
Grading plan
2'd Review, ready for correctionstissue
Electrical
Subcontactor List
Called ContactPerson
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE--
Review', ready for eorrectious/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees