BMCH2014-115554315 Alysheba Dr
-
78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253. COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O14-1155
Property Address:
54315 ALYSHEBA DR
APN:
767780004
Application Description:
HVAC CHANGE OUT
Property Zoning:
Application Valuation:
$3,000.00
Applicant:
GENERAL AIR CONDITIONING
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
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.::LIC-0003606
Date:_02-U&J14 Contractor: UMJ71 --
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).:
(_) 1, 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 Name:
Lender's Address:
IIIIIVIIIIIII 63
IE
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/16/2014
Owner:
ANGELOS THEODOSSIS
Contractor:
GENERAL AIR CONDITIONING
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)343-7490
Llc. No.: :LIC -0003606
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.
C s
Date: 1l. l -1 Applicant:
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: Signature (Applicant or Agent):
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
ANGELOS THEODOSSIS I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 4 )
2014-12-10
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
ANGELOS THEODOSSIS
02
Date Prepared
2014-12-10
03
Project Location
54315 ALYSHEBA
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
ANGELOS THEODOSSIS
07
Zip Code
92253
08
Dwelling Unit Conditioned
5667
Floor Area (ft2)
SC System
SC System
CFA served
system a
refrigerant
Number of space conditioning
Installing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
system
more than 40
unit.
entirely new
J.
B. Space Conditioning (SC) System'liiformatio.,
01
02
03; /,,
`, '041 -
.05.
06
" 07 `
'"` `08s -
09
10
a
Is the 5C;
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
System 1
Location 1
5667
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.
Registration Number: 214-A0156806A-000000000-0000 .
Registration Date/Time: 2014-12-10 18:55:33
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-10' 18:55:51
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 4 )
D. Altered Space Conditioning System (Sections 150.2(b)lE 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
No heating
This field or
This field or
Central split
All new
This field or
This field or
'section
System 1
furnace
component
section is not
section is not
AC
cooling
SEER
13
Setback
section is not
is not
altered
applicable
applicable
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. -
CF2R-MCH-20-H & CF3R-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%, or 5 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-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 g
Exceotions: r it`s •.. 9.. r 9' `P Y�i
`t j
-Duct systems registered with HERS provider as sealed are, exempt from.MCH-20 Duct Leakagel esting�requirements. *;r,
previously
-Heating-only systems and Air Handler/Furnace,do not require verdication'of Air Flow MCH,23 or Refrigerant Charge MECH-25.
Existing duct systems constructed, insulated or sealed with asbchanges
3.. - - �y.' Pestos are exempt frosm MCH 20 Duct Leakage Testing requirements Ti #
t
t:
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.
Registration Number: 214-A0156806A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time:
Report Version: 2014-03-31
Schema Version: 0.551SDD
2014-12-10 18:55:33
HERS Provider: CaICERTS
Report Generated: 2014-12-10 18:55:51
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 4 )
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
,4
x
?� ]. �S Yin•'' � ,=:!
Registration Number: 214-A0156806A-000000000-0000 Registration Date/Time: 2014-12-10 18:55:33 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-10 18:55:51
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 4 of 4 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Valdez, Dayana
Company:
Signature Date:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2014-12-10 18:55:33
Address:
CEA/ HERS Certification Identification (if applicable):
31-170 RESERVE DRIVE STE A
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
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 for ttie 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. " A, . +'� I . - IN ... .
�i
4. The building design features or system design features sidentified on this Certificate of Compliance are consistent with the information provided 'on applicable compliance documents, worksheets,
-,other
calculations, plans and specifications,submitted"to the enforcement agency for approval with this building permit application.
S. I will ensure that a registered copy of Phis Certificate of;Compliance shall'be made available.with the building, permits) 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:
Valdez, Dayana
Company :
Date Signed:
HARRISON ENTERPRISES INC dba-GENERAL AIR CONDITIONING
2014-12-10 18:55:33
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: 214-A0156806A-000000000-0000 Registration Date/Time: 2014-12-10 18:55:33 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-10 18:55:51
Schema Version: 0.551SDD
FINANCIAL , 1
DESCRIPTION ACCOUNT QTY AMOUNT PAID
PAID DATE
BSAS SB1,473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY METHOD RECEIPT # CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:• i0
Permit Details P..ERMIT NW.MBER
City of La Qqwuinta BMCH2O�14- .155
Description: HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 12/16/2014 MFA
Parcel.No: 767780004 Site Address: 54315 ALYSHEBA DR LA QUINTA,CA 92253 Approved:
Subdivision: TR 32879 Block: Lot: 52 Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $3,000.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT -13 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
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CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
Printed: Tuesday, December 16, 2014 2:56:29 PM 1 of 2 C(,J[(Wrsren+s
4
DESCRIPTION
ACCOUNTQTY
AMOUNT.
PAID
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 forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
BY
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Printed: Tuesday, December 16, 2014 2:56:29 PM
2of2
(rM 1../ SYSTEMS
Bin #
City of La. Quinta.
' Building 8t' 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: _544•3 1 S.- A ) s
Owner's Name:
A. P. Number:
Address: t5 ALI e
Legal Description:
City, ST, Zip: Lz buinia,q2Z53
Contractor: p
EY1 t:. �
h
telephone: o
s«
Address:\\7(] t�e5e`cve �Y
ProjectDescription:
City, ST, Zip:jhOvS�hA �c��Mr+S CA gZ27(o
i�e - C -c-
Telephone:
p leo - 3 3= 7 88
r
State Lic. #-:. 06-310
City Lie. #.-
Arch., Engr., Designer:
Address:,
City., ST, Zip:
Telephone-
p
:.r::::...:.::::::::r;,::::.:,::::.;•::.:::::..
X,
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rtq'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets'
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°, Review, ready for corrcctions/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
-
Plans resubmitted
Grading
IN IiOUSE:-
''° Reyicw, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees