BMCH2016-0178Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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: S 11. 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
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 Name:
Lender's Address:
'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.
•'!5�� 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: S Zg I Applicant: t
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): ti
VOICE (760)777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011COMMUNITY
LA QUINTA, CALIFORNIA 92253
DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/25/2016
Application Number:
BMCH2O16-0178
Owner:
Property Address:
52100 AVENIDA RUBIO
NICHOLAS ACORDI
APN:
773213005
P 0 BOX 239
Application Description:
ACORDI / HVAC CHANGE OUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$12,363.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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: S 11. 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
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 Name:
Lender's Address:
'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.
•'!5�� 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: S Zg I Applicant: t
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): ti
FINANCIAL INFORMATION
DESCRIPTION = ' -'ACCOUNT QTY -AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY METHOD �Y RECEIPT,# : `CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
- —DESCRIPTION .xr
-ACCOUNT :'F'.
QTY-
;' AMOUNT
'PAID
PAID DATE
HVAC CHANGEOUT - PACKAGED UNIT
101-0000-42402
0
$36.26
$0.00
a ° PAID BY "'' _.
':- METHOD s
_.,
_ .a RECELPyT# ;..
z ; ,
CHECK # -
_.CLTD;f3Y,
'...DESCRIPTION'
ACCOUNT
QTY-
AMOUNTS
-` PAID
PAID DATE,
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
0
$24.17
$0.00
PAID BY `' "
`- - METHOD „ ;'`
L RECEIPT # 1
- CHECK #
.CLTD BY
Total Paid for CHANGEOUT: $60.43 $0.00
' ` DESCRIPTION Y -
`ACCOUNT.* '
QTY
AMOUNT{ •>
x.� a PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.851
$0.00
_ .;.. ,,
n PAID BY'u -,.,r ' '
. ' •--, •METHOD d `..t
4' ',,`RECEIP:T #
_
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
w Q•�
OF'Tt�'
Description: ACORDI / HVAC CHANGE OUT
CONDITIONS
Type: MECHANICAL Subtype:
Status: UNDER REVIEW
Applied: 5/25/2016 SKH
Approved:
Parcel No: 773213005 Site Address: 52100 AVENIDA RUBIO LA QUINTA,CA 92253
5
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 3
Lot: 18
NAMETYPENAMEa
Issued: y
UNIT 1
CONTACTS
� � .- q _ k � s * �
CITY =
., STATE
i
Lot Scl Ft: 0 Building Sq Ft: 0
Zoning:
31225 LA BAYA
Finaled:
Valuation: $12,363.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
HARRISON ENTERPRISES INC DBA
GENERAL AIR
31170 RESERVE DRIVE
Details: HVAC CHANGE OUT - 14SEER/80AFUE PACKAGET SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
92276
ADDITIONAL .,
CHRONOLOGY
CONDITIONS
5
€
NAMETYPENAMEa
�r •
e .
..: AUDRESS1
t 3
CONTACTS
� � .- q _ k � s * �
CITY =
., STATE
i
.'APPLICANT
IE INC
31225 LA BAYA
WESTLAKE
VILLAGE
CA
91362
CONTRACTOR
HARRISON ENTERPRISES INC DBA
GENERAL AIR
31170 RESERVE DRIVE
THOUSAND
PALMS
CA
92276
FRANCISCO@CALLTHE
GENERAL.COM
' OWNER
NICHOLAS ACORDI
P O BOX 239
LA QUINTA
CA •
92253
r -
FINANCIAL• •
Printed: Wednesday, May 25, 2016 9:44:38 AM 1 of 2 ,
S YSiEM 5
DESCRIPTION
ACCOUNT
QTY
AMOUNT
E - PAID : `' =
DATE
RECEIPT #
CHECK #
PAID BY.
BY
r
_.
rPAID
,
tMETHOD
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
$36.26
$0.00
PACKAGED UNIT
HVAC CHANGEOUT - .
101-0000-42600
0
$24.17
$0.00
PACKAGED UNIT PC
Total Paid for CHANGEOUT: $60.43 $0.00
PERMIT ISSUANCE
1 101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:••
INSPECTIONS
F7 PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, May 25, 2016 9:44:38 AM 2 of 2 C
SYS 7EM5
Bln.#
of La Qutnta
Building 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 # .
ProjectAddtess: 52100 Avenida Rubio
er's Name:. Nicholas & Noelle Acordi
A. P. Number. T.Address:
52100 Avenida Rubio
Legal Description:
Contractor: General Air ConditioniAW
ng
City, ST, Zip: La Quinta, CA 92253
Telephone: 50653ss'`'' x
Address: 31170 Reserve Drive
Project Description: Replace 4ton Package Unit
City, ST, Zip: Thousand Palms, CA 922.76
Telephone: 760-343-7488
City Lie. #•;
State Lic. # : 686310
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:v
State Lie. #:`�"~r
.,;..,,.:.,,w�;i»,%�''��..'.� , ,N
Construction Type: . Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person: 8.18-735-7876
Estimated Value of Project: $12,363:00.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss C21cs.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.'.
Mechanical
Grading plan
2i4 Review, ready for corrections/issue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review' ready for correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 03/15 CALIFORNIA ENERGY COMMISSION "
CERTIFICATE OF COMPLIANCE CF -IR -ALT -04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
Szl m
Enforcement Agency:
Date Prefared:
Permit#:
C' O� Lo. G)vir,i
S 25
f(.
Equipment Type
Equipment Efficiency
New ucting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
XPackaged
❑ Evaporator CoilAFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
Setback
System
❑
13 Condensing Unit
(y
❑ R-8' (CZ 11, 14, IS) Ducting
sgft
(If not already
Split System
❑ Compressor
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present must
❑ Mini Split
❑ Lineset
EER
❑ R-5 or R7.S) Lineset°
be installed)
❑ Furnace
❑ TXV
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.
1. 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)' -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS'
Air Handler/Furnace' (Can Include new ducting)
Installer Requirement: Duct leakage (L15%, 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
133. 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 Ducts3
CFIR-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH=20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
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 2 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. 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
CF1R-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 z 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'
CFIR-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 includesin 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-22/.", 3.5 to 4T-2%', 5T -4X"
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.
Res onsible Designer Name:
Res sibie Designer Signature:
Dat Signe
License:
c. ie
vw.f2- ��-
Gello310
Company: - -
Gevwmt A� c- 'or Ji4V0"iyn
Address:
311-7'0 14sevve,br
G /State/ZIp:
�c� C122 -LI
Phone:
�(e0 343 74 R8
v�
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-7.72-3300