BMCH2014-1109i�
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/7/2014
Application Number: BMCH2O14-1109
Owner:
Property Address: 79633 POMO
OLMA JERRY
APN: 776180019
79633 POMO
Application Description: A/C COIL FURNACE
LA QUINTA, Y3 92253
Property Zoning:
Application Valuation: $16,237.00
Applicant:
Contractor:
w ¢ aE
0 o c
GENERAL AIR CONDITIONING
GENERAL AIR CONDITIO
ING M o
0 OUTSIDE CITY LIMITS
0 OUTSIDE CITY LIMITS
g $
LA QUINTA, CA 92253
LA QUINTA, CA 92253
f— o
(760)343-7490
C z
Llc. No.: :LIC -0003606
--------------------------------------------------------------------------------------------
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.: :UC -0003606
`
Date: WkContractor: r
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.).
(_) 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 Address:
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: ISIMIR Applicant: c7-6^✓L _— --
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECTAN 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: :O f3 Signature (Applicant or Agent): ��� --
FINANCIAL •• •
{x
wDESCRIPTION„1:
+ACCOUNT r QTY' �' ,f PAID
�� 'rr
PAID DATE
a
t._ ?s> w� FAMOUNTr
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $0.00
t
,PAIQ
EIPT#zs.i CHECK # �Y
`CLTD- Y
BY
o
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
'DESCRIPTION .a
ACOUNTC
QTY'
aAMOUNT
PAID
PAID DATE
,:.
HVAC CHANGEOUT - PACKAGED UNIT
101-0000-42402
0
$36.26
.$0.00
K PAID BY '" : r
= METHOD M a a
J ; ' RECEIPT #
'CHECK # -•
' CLTD BY.'
!t W
0. 'DESCRIPTION ` } n
' : a A
ACCOUNT.. z.
CITY
AMOUNT `
,. PAID _
,PAID DATE
F .,
HVAC CHANGEOUT - PACKAGED UNIT PC,
101-0000-42600
0
'$24.17
$0.00
PAID By :' x
` _ r METHOD7,�'
�T r ='RECEIPT #
CHECK# ;Z.,
v •CLTD BY
Total Paid forCHANGEOUT: $60.43 $0.00
'.DESCRIPTION•;
-ACCOUNT: �;
QTY;AMOUNT:
`PAID 4
'PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY �� , ;
' METHOD -
' RECEIPT # _
CHECK #
, CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 00
{x
Al
Bin #
City of La Quinta
Building &r 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: ''�q b•� 3 �o
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: L0. Qv��n-k 4 C Ci
�
Contractor: A�-Otr���
Geer � ar .
,, �arc��
%
(,-
Address: -
Address: 3%X'70e; C__1 �Y
Project Description:
City, ST, Zip: jhovSea_�r.e�
Ir_ Y" s CA ct
Ge.- 4 avn A C_ ,- Ic
Telephone: %ioo-343-748
:>;<>>>::;;>,.; .:;: <:=::<::::«;:
90 ocx>
State Lie. #:
City Lie. .#;.
Arch., Engr., Designer:
Address:
City, ST, Zap.
Telephone:
. .
Construction Type: Occupancy:
Project type circle one): New Add' n Alter Repair
Demo
State Lie. #:
Name of Contact Person:e a' ham; f
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person: `760- 3Lt3- i4Pi
Estimated Value of Project: ((p, Z37. CXR
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACiQNG
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'`" Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name: JERRY OLMA Date Prepared: 2014-10-07
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, c
01
Project Name
JERRY OLMA
02
Date Prepared
2014-10-07
03
Project Location
79633 POMO
04
Building Type
Single family
05
CA City
La Quinta
06 •
Dwelling Unit Name
JERRY OLMA '
07
Zip Code
92253
08 "
Dwelling Unit Conditioned
3821
Is the SC � �
Installtngzay
x: �
�: �� '„�.
Floor Area (ft2)
_
SC System
rte;
..
CFA served
Number of space conditioning
refrigerant
09
Climate Zone
15
10
(SC) systems in this dwelling
1
Location or Area
°rsby thi's SC
ducted
containing
unit.
more than 40
entirely new
entirely new
Name
Served
Systern (ft2)'q;
rr
B. Space Conditioning OR
(SC) System Information,r� F t ori.
- � y"v' .E"...t✓r ,..-f: a.»Js.. �. .' ..-;;.c'�Sis r �: 4�ra7<
z ,,t' y:..
01
02
2
0.93,
09
10
"
�Ys
!.'e'zv
-�� �<� ?, M
Is the SC � �
Installtngzay
x: �
�: �� '„�.
_
SC System
SC System
..
CFA served
.r
system a
refrigerant
.,� •'s
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
°rsby thi's SC
ducted
containing
system •
more than 40
entirely new
entirely new
Name
Served
Systern (ft2)'q;
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type.
Altered space
System 1
Location 1
3821
' =;Yes
Yes
Yes
No
No,
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 15O.2(b)iDiib)
This section does not apply to this project.
Registration Number: 214-A0112642A-000000000-0000
CA Building Energy Efficiency Standards,- 2013 Residential Compliance -
Registration Date/Time: 2014-10-07 14:46:26 HERS Provider: CaICERTS
Report Version: 2014-03-31 Report Generated: 2014-10-07 14:46:16
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE _ CFlR-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)
O1
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 .
Centralas
g
All new
CentrAaCl split
All new
'18
This field or
This field or
System 1
furnace
heating
AFUE
0.78.
cooling.
SEER
Setback
section is not
section is not
components
components
applicable
applicable
Reouired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans ;..
-Duct insulation requirement for new plenums: R6.4«•
CF211-MCH-20-11 & 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%, ors SOY leakage to outside; or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required wtieh refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCExceptions: MCH -23 & CF3R-MCH-23 Air flow 2,..300 CEM/tomrequired when MCH 25�equird1 �e
..
?,r� :�t5s�r] r•
E
c+xx�� zF'.� n5y �i by gym,, 7i�T"r ;�,. f• - -
Duct
_
systems registered with HERS provider asevvously sealed areexempt from MCH 20 Duct Leakage Testingrrequirements
Heating -only systems and Air Handler/Furnace chariges do not requl[e veriflcatfon ofAir Flow MCH'23�orRefrigerant
LC%.y N%a,t 3 k'1' # k -.:.;'.v f
Charge MEC 125'
?F.§ "�:
q
Existing duct systems constructed, insulated orxsealeif with stns are exempt fpm MCH Duef Leakage Testting
A ee'n7K
(aexqu�lremertts�v < r r' '•
iasb
�� d
E. Entirely New or Complete Replacement Duct Systern,;wlth or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F)
ra" This section does not apply to this project.
Registration Number: 214-A0112642A-000000000-0000 Registration Date/Time: 2014-10-07 14:46:26
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
Schema Version: 0.551SDD
i
HERS Provider: CalCERTS
Report Generated: 2014-10-07 14:46:16
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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.
Registration Number: 214-A0112642A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2014-10-07 14:46:26
Report Version: 2014-03-31
Schema Version: O.SSISDD
HERS Provider: CaICERTS
Report Generated: 2014-10-07 14:46:16
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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
2014-10-07 14:46:26
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;Californla:
1. The information provided on this Certificate of Compliance is true.! nd correct.
-
2. I am eligible under Division 3 of the Business,and,Professlons Ce o accept responsibility for the building de llgn or system design identified on this Certificate of Compliance (responsible designer).
od
3. That the energy features and performah a 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'Pi 6'of the CallforraLa,Code of Regulations. µ �, h�
documents, worksheets,
4. The buildirig design features or system design features Ic�ehtlffed on this Certificate oaf Compliance a�e consistent wlth�the,in01
formatlo provided o�n4other applicable compliance
calculations, plans and specificatfonsYUbmitted to the enforcemerit,a ency for:approvit:wlth tMs bull�tlln (�prmit application �" � ."
t,,r } ,.a r.
S. I will ensure that a registered copy otFils,Certfiflcate of Gompllance5hall be made available with the bulldfngpermit(s) Issued for.the bultding and made available to the enforcement agency for all applicable
inspections. I understand that a registeredcopy of this Certtflcate of Compliance fs required to.be incl"utled'w'ith the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: z
ble Designer Signature:
Valdez, Dayana
Company: is -.
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2014-10-07 14:46:26
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
Digitally signed by CalCERTS. 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-A0112642A-000000000-0000 Registration Date/Time: 2014-10-07 14:46:26 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance ReportVersion: 2014-03-31 Report Generated: 2014-10-07 14:46:16
Schema Version: 0.551SDD