BMCH2016-012378-495 CALLE>TAMPICO
LA QUINTA, CALIFORNIA 92253'
Application Number: BMCH2O16-0123 —
Property Address:
52580 EISENHOWER DR
APN:
773301004
Application Description:
SKRAK RESIDENCE / HVAC
Property Zoning:
Application Valuation:
$9,786.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
a& QUIRro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
r------
APR 2 5 21n_
CITYOFLA QUANTA
YDEVELOPMENTDEPARTMENT
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: C20, C36 License No.: 686310
r_Contractor:
<7&— -7
Gate: 25 I�
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. . 13.0.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:
FAYESKRAK
52580 EISENHOWER DR
LA QUINTA, CA 92253
Date: 4/25/2016
Contractor: ,
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
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.
1 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 polity 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: 25 lle 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: 4461w,Signature (Applicant or Agent): c U:71-7
DESCRIPTION
FINANCIAL .
ACCOUNT
•
CITY AMOUNT PAID PAID DATE
J iBSAS SB1473 FEE
101-0000-20306
0
$1.00 $0.00
PAID BY
METHOD,
RECEIPT # • CHECK # CLTD BY
Total Paid for BUILDING 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 for CHANGEOUT: $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 for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63 $0.00
Description: SKRAK RESIDENCE / HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED Applied: 4/25/2016 MFA
Parcel No: 773301004 Site Address: 52580 EISENHOWER DR LA QUINTA,CA 92253 Approved: 4/25/2016 MFA
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 144 Lot: 20 Issued:
UNIT 15
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $9,786.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
Printed: Monday, April 25, 2016 10:39:27 AM 1 of 2 C
SYSTEMS
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE FAX EMAIL
APPLICANT
IE INC
31225 LA BAYA
WESTLAKE
CA
91362
(760)764-7480
VILLAGE
CONTRACTOR
HARRISON ENTERPRISES INC DBA
31170 RESERVE DRIVE
THOUSAND
CA
92276
(760)764-7480
FRANCISCO@CALLTHE
GENERAL AIR
PALMS
GENERAL.COM
OWNER
FAYE SKRAK
52580 EISENHOWER DR
LA QUINTA
CA
92253
(760)764-7480
Printed: Monday, April 25, 2016 10:39:27 AM 1 of 2 C
SYSTEMS
INSPECTIONS
PARENT PROJECTS
ATTACHMENTS
Printed: Monday, April 25, 2016 10:39:27 AM 2 of 2 CRWSYSTEMS
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
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
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
INSPECTIONS
PARENT PROJECTS
ATTACHMENTS
Printed: Monday, April 25, 2016 10:39:27 AM 2 of 2 CRWSYSTEMS
Bin. #
Qty Of La Q uin to
Building a Safety Division
P.O. Box 1504,'78-49S Calle Tampico
la.Quinpa, CA 922#3 -:(760) 777-7012
Building Permit -Application and Tracking Sheet
Permit #
Project Address: 52580 Eisenhower Drive
Owner's Name:. Faye Skrak
A. P. Number.
Address: 52580 Eisenhower Drive
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone:
Address: 31170 Reserve Drive
Project Description: Replace 4ton Heat Pump & Air Handler.
City, ST, Zip: Thousand Palms, CA, 92276
Telephone: 760-343-7488 "Ell .`MI
x 1`1 AM
State Lic. # : 686310 City Lic. ft,:
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:
State Lia #: � r
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person: 818-735=7876
Estimated Value of project $9,786.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERI fi'FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cheek Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
2'4 Review, ready for corrections/issue
Electrical
Subcoutaitor 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 correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
I A.LP.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 -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: FAYE SKRAK I Date Prepared: 2016-04-22
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one MR -ALT -02 document for each dwelling unit.
O3
Project Name
FAYE SKRAK
02
Date Prepared
2016-04-22
03
Project Location
52580 eisenhower drive
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
FAYE SKRAK
07
Zip Code
92253
08
Dwelling Unit Conditioned
1721
Installing
�Installi g
�=
Floor Area (ft2)
Location or Area
by this SC
ducted
co taIrIng
system *
Number of space conditioning
en ely n
09
Climate Zone
15 '
10
(SC) systems in this dwelling
1
component?
components?
+ '
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System`Information� Fr---1
rn--Y�70 n ,�
O3
02
03
N 041
f b5 I k(I
f-661 N
I! 07))
1169 1 1
09
10
1� FIs the SC
St—
R gi t. i:..s "4k
stallin
Ing a
SC System
SC System
CFA served
'',,,system a
re igerant
alnstalling new SC
Installing
�Installi g
Installing
Identification or
Location or Area
by this SC
ducted
co taIrIng
system *
more than 40
en ely n
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1721
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0149231A-000000000-0000
Registration Date/Time: 2016-04-22 07:41:49
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-22 07:42:20
Schema Version: 0.5555DD
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)1E 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 split
All new
Central
All new
Less than or
System 1
HP
heating
AFUE
0.8
kd HP
pacage
cooling
SEER
14
Setback
equal to 40
R-8
components
components
feet
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. '
�required
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 5155, or 5103 leakage to outside, or seal all accessible leaks.
MR -MCH -25-1-1 & 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 & CF311-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceotions:
-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 verificatio of Air Flow MCHr23 or 11 frige'ranfCharge MECH "2r'
from buc I66ge Testing
-Existing duct systems constructed, insulated or sealed with asbestos are exeml t MC—H'20 requirements.JjF
+ -' - ,s"k.. 'l `L, 1`'4 ... f f i i i € 1, i .. 1 i . ... ! E 3 i ti .._ ,! f .•• € ! t � t 1 � 4„ �,.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F)
�r &-or INC U 7 �it A z S ii.t
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC)
This section does not apply to this project.
Registration Number: 216-A0149231A-000000000-0000 Registration Date/Time: 2016-04-22 07:41:49 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-22 07:42:20
Schema Version: 0.555SDD
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. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: �/
Jan
Jacoby, Ian
Baco t
Company:
Signature Date:
i PERMIT E RATERS
2016-04-22 07:41:49
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362 A
1818-735-7876
Responsible Person's Declaration statements
I certify the following under penalty of perjury, under the laws of the State of California:
�
1. The information provided on this Certificate of Comptliance 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, materiels, 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 land Part 6 of the California Code of� egulation"""
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the informil1nprovided on other,applicable compliance documents, worksheets,
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 this Certificate of,Compliance shall be made'available with the building permit(s) 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.require_d to be.included with the documentation*the.bu5cler provides to the building owner at occupancy.
Responsible Designer Name:Responsllile
Designer Signature: %..� I.
Jacoby, Ian
c9an �acobJr
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-04-22 07:41:49
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: 216-A0149231A-000000000-0000 Registration Date/Time: 2016-04-22 07:41:49 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-04-22 07:42:20
Schema Version: 0.555SDD