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BMCH2017-005578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ty, 4 4 Qu&r(u DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/15/2017 Application Number: 5MCH2O17-0055 Owner: Z ` Property Address: 81637 RUSTIC CANYON DRLU CANDACE ANIOSZ APN: 764540004' ¢ Application Description: ANTOSZ /REPLACE 4 TON EVAP COIL 92253 aw Property Zoning: ® . � LU Application Valuation: $1,104.00 N = u >n a' Applicant: Contractor: ® '� � CD u IE INC HARRISON ENTERPRISES I A GEWRAL iA- 31225 LA BAYA 31170 RESERVE DRIVE fA U WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276 Z (760)343-748E ® c7 ------------------------------------------------- --------------------------------------------- LIc. No.: 68632-0 Lu LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect: License Class: C20, C36 License No.: 686310 �Date� 1$ i �ontracto�� '3— �� ' 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 contractors) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. B.&P.C. for this reason Date: Owner: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury oneof 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 oft work for which this permit is issued. __rI have and will maintain workers' .ompensation 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: WSD5031658 - 1 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 Mat, 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��3 IS �j 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 ($100,1000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to -he 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 Citi of La Quinta, its officers, agents, and employees for any act or omission related tache 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 issjance of such permit, or cessation of work for 180 days will subject permit to cancellation. CONSTRUCTION LENDING AGENCY I certify that I have read this application and. -.tate that the above information is correct. I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building the per of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize represen-.atives of this city to enter upon the above- mentioned property for inspection purposes - Lender's Name: F Date; 11 Signature (Applicant or Agent) —�+� �.'� Lender's Address: Date: 3/15/2017 Application Number: BMCH2017-0055 Owner:. Property Address: 81637 RUSTIC CANYON DR CANDACE AN70SZ APN: 764540004 Application Description: ANTOSZ / REPLACE 4 TON EVAP COIL 92253 Property Zoning: Application Valuation: $1,104.00 Applicant: ` Contractor: ! IE INC HARRISON ENTERPRISES INC DBA�GENERAL AIR 31225 LA BAYA 31170 RESERVE DRIVE WESTLAKE VILLAGE, CA 91362. THOUSAND PALMS, CA 92276 (760)343-748£ . -------------------------------------------------------------------------------------------- Llc. No.: 686320 Detail: REPLACE 5 TON EVAPORATIVE COIL - 16 SEER SPLIT SYSTEM. CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. P r FINANCIAL INFORMATIOW 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- REPAIR/ALTERATION 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT - REPAIR/ALTERATION PC 101-0000-42600 0 $5.07 Total Paid for CHANGEOUT:, $17.74 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: $5.00 • 9 1 3 Bin .# City. Of is Quints Building & Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # g Project Address: 81637 Rustic Canyon Drive Owner's Name:. Candace Antosz A. P. Number. Address: 81637 Rustic Canyon Drive Legal Description: Contractor: .General Air Conditioning City, ST, Zip: La Quinta, CA: 92253 Telephone: �;$;W Address: 31170 Reserve Drive Project Description: Replace 4 ton evaporative coil City, ST, Zip: Thousand Palms, CA 92276 Telephone: 760-343-7488 State Lic. # : 686310 sty Lic & i Arch., Engr.; Designer Address: City., ST. Zip: Telephone: Construction Type: Occapancy: State Lic #:j Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Steven Schnierer Sq.Ft.:#Stories: #Units: Telephone # of Contact Person: 818-735-7876 Estimated Value of project: $1,104.00 APPLICANT: DO NOT WRITE BELOW THIS LINE !l Submittal ^ Req'd Recd TRACMG [PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calm . Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Mood plain plea Plans resubmitted Meehalitcal Grading plan 2i4 Review, ready for correctionsfissue Electrical Subcoutactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE-- '"' Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person AXP Pub. Wks. Appr Date of permit issue School Fees Total PermitFees CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: CANDACE ANTOSZ I Date Prepared: CF1R-ALT 02-E (Page 1 of 3) 2017-03-14 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 CANDACE ANTOSZ 02 Date Prepared 2017-03-14 03 Project Location 81637 RUSTIC CANYON DRIVE 04 Building Type Single family 05 CA City LA QUINTA T" 06 Dwelling Unit Name WHOLE HOUSE SC System SC System CFA served . . Installing new'SC 07 Zip Code F ` 92253 �� 08, Dwelling Unit Conditioned s -Floor Area 1965 by this SC ducted containing system (ft2) entirely new entirely new h A qjl <f $ y c F y Number of space system? 09 Climate Zone 15 .� '"10 Conditioning (SC) Systems in 1 SYSTEM 1 WHOLE HOUSE 1965 Yes this Dwelling Unit: Yes B. Space Conditioning (SC) System Information 01 02 03 04 OS -- - 06 07 08 09 10 Is the SC Ory Installing a. r�4M Mwm , a� I lntitm °i� 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 WHOLE HOUSE 1965 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section15O.2(b)1Diib) This section does not apply to this project. Registration Number: 417-A020059366A-000-000-0000000-0000 Registration Date/Time: 2017-03-14 16:25:44 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-14 16:25:47 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-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)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 This field or No heating This field or This field or Central split This field or This field or SYSTEM 1 section is not component section is not section is not AC Indoor coil SEER 16 Setback section is not section is not applicable altered applicable applicable applicable applicable Required Documentation:' knti CF2R-MCH-01-E - Space Conditioning System` " -Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6 .11 10 41.and!13) and R8 (CZ 11 and 14-16) CF2R 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. �.. r; . CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing compon�entt amore installed or altered (applicable in CZ 2, 8-15). CF211 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 Leakage:Testing requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. AaE. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F) t" Thissection doe's not appy to t�ti s project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC) . This section does not apply to this project. t Registration Number: 417-A020059366A-000-000-0000000-0000 Registration Date/Time: 2017-03-14 16:25:44 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 20161.005 Report Generated: 2017-03-14 16:25:47 Schema Version: rev 10/16 a CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -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: Patrick Somers Pa 6c 1SCw rk Company: Signature Date: General Air Conditioning 2017-03-14 Address: CEA/ HERS Certification Identification (if applicable): 31170 Reserve Drive City/State/Zip: moi` CA 92276760-343-7488 Phone: Thousand Palms rv� Responsible Person's Declaration statement ri I certify the following under penalty of perjury, under the laws of the State of California: i!.— w "x 1. The information provided on this Certificate of Compliance is true and correct. iFP 2. I am eligible under Division 3 of the Business and Professions Code to accept responsibilitity,forthe 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 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 Regulations. 4. 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 approvakwith this building permit application. 5A tK Eg. � _ N, ,. S. I will ensure that a registered copy of this Certificate of Compliance shall be.made available with the bullding.permit(s) issued for the building, and made available to the enforcement agency for all applicable ,.�mrS4 3i . ' 9 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: j yy { »{i'; p@ v ..Fi.is'!.sC'Ad£;4.f'4 f'^y.,S1 Responsible,Designe_r Signature: h6F4 F iCY'3ii�iA �atYiGkrSO-wti?WT Patrick Somers Company: Date Signed: General Air Conditioning 2017-03-14 Address: License: 31170 Reserve Drive 686310 City/State/Zip: Phone: Thousand Palms CA 92276 760-343-7488 Digitally signed by CHEERS'"'. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 417-A020059366A-000-000-0000000-0000 Registration Date/Time: 2017-03-14 16:25:44 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-14 16:25:47 Schema Version: rev 10/16