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BMCH2015-0097Qumrcu 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Application Number: BMCH2O15-0097 Owner: Property Address: 57545 BLACK DIAMOND THOMAS HUMPHREYS APN: 762340015 Property Zoning: Application Valuation: $12,666.00 Applicant: Contractor: GENERAL AIR CONDITIONING GENERAL AIR CONDI 0 OUTSIDE CITY LIMITS 0 OUTSIDE CITY LIMI S LA QUINTA, CA 92253 LA QUINTA, CA 922 (760)343-7490 LIc. 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. )'DLicense Class: License No.::LIC-0003606 ate: � � 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 Division3 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 exclusivelyecontracting 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 ) 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 Addre! Date: 3/25/2015 N(MAR t3 0 2015 CRYOFLA QUINTA Iiurrvn. _-- 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 ofItte 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. am�,, Owe: 3C9 l) Applicant:—ccv"-- 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. 01 Date: 3 .� j Signature (Applicant or Agent). CERTIFICATE OF COMPLIANCE , CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 ) Project Name: TOM HUMPHREYS I Date Prepared: . 2015-03-19 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 MR -ALT -02 document for each dwelling unit. 01 Project Name TOM HUMPHREYS 02 Date Prepared 2015-03-19 03 Project Location 57545 BLACK DIAMOND 04 Building Type Single family 05 CA City La Q6inta 06 Dwelling Unit Name TOM HUMPHREYS 07 Zip Code 92253 08 Dwelling Unit Conditioned 4600 ;1-r - s iF..ir.:: " " '�'veFeF'riP" " LX • ' F Y3 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 ..d�'""�A.�o _:ss�""'h.s... �k,�r:+w+�-mu�5' x-�. .*'•e.w,.rs,.•�H .,N�n"�r.., B. Space Conditioning SCS stem'Infoi-mation Ol 02 03. f .� 1 04k -T . 05' ; ' ; 06 �' r 07 "` �'' y08 ''°'' 09 10 a� r 7` i —-'v Is the SC' .. ... .d Installing'a °. ;1-r - s iF..ir.:: " " '�'veFeF'riP" " LX • ' F Y3 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 4600 Yes Yes Yes No No TAltered No space onditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) This section does not apply to this project. Registration Number: 215-A0073373A-000000000-0000 Registration Date/Time: 2015-03-19 11:20:40 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-19 11:19:51 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF11R-ALT-024 Alterations to Space Conditioning Systems (formerly CF -IR -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 gas All new Central split All new This field or This field or System 1 heating AFUE 0.8 AC cooling SEER 21 Setback section is not section is not furnace components 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 & CBR -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: 5 159., or <_ 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). CF2RCF311-1VICH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM/ton required when MCH-25,is.required.�. Exceptions: / r�,l -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 MECH-25. Existing duct systems constructed, insulated orsealed with asbestos are exempt from MC!tj20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 215-A0073373A-000000000-0000 Registration Date/Time: 2015-03-19 11:20:40 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-19 11:19:51 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 j Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: � Jacoby, Ian can c7czco J Company: Signature Date: Stratz Permit Service 2015-03-19 11:19:45 Address: CEA/ HERS Certification Identification (if applicable): 5858 Dovetail Drive City/State/Zip: Phone: Agoura Hills CA 91301 818-735-7876 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 responsibilityyfor�the building design or system design identified on this Certificate of Compliance (responsible designer). .3. That the energy features and performarice 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. r' '. 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 approval with this building permit application. R 5. I will ensure that a registered copy of this Certificate of'Compharice.shall be rriade.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 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 2015-03-19 11:20:40 Address: License: 31-170 RESERVE DRIVE STE A 686310 City/State/Zip: Phone: THOUSAND PALMS CA 92276 (760) 343-7488 Digitally signed by CaICERTS. 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: 215-A0073373A-000000000-0000 Registration Date/Time: 2015-03-19 11:20:40 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-19 11:19:51 Schema Version: C.555SDD Bin # City of La Quin to . Building 8Z• Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico .. La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: � 75 � 3I Qdz- � Gm o"� Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: LE, Quiv A c,, CA cl 22S`3 Contractor: Telephone: � h nc:G�r Address: 3� \'7 �e�� Project Description: Cit T, Zip: ��— Y' Shovsc v.d lAIN s. CA 'Q22S3 1� lace ZDV— A Coi L Telephone: ZI Z 49�9 11-{o-79S %Di aco State Lic. # :10-3 )D CityLic. #1: U; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: nc: ;:<::........ ...................................................... an Occupancy: cY•Co struction TYPe• State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: S� evevl SC er e C- Sq. Ft.: # Stories: Units: Telephone # of Contact Person: Zy - (p$� (o Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKING PERMIT FEES Platt Sets Plan Check submitted Item Amount Structural Cates. Revictived, ready for corrections Plan Check Deposit Truss Cales. 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 corrcctionsrissue Electrical Subcontaetor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. Ii.O.A. Approval Plans resubmitted Grading IN ROUSE:- '`d Revicnv, ready for eorrcctionsfissuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Dale of permit issue School Fccs Total- Permit Fccs FINANCIAL INFORMATION ACCOUNT ' CITY AMOUNT PAID PAID DATE DESCRIPTION BSAS SB1473 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 CITY 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 CITY 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 CITY 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:i 00 Description: HUMPHREY TOM HVAC CHANGE OUT Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 3/25/2015 PJU Approved: Parcel No: 762340015 Site Address: 57545 BLACK DIAMOND LA QUINTA,CA 92253 Subdivision: TR 29147-1 Block: Lot: 45 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $12,666.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC UNIT CHANGE OUT FURNACE,CONDENSER,215EER 4TON PER 2013 MECHANICAL CODES 2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. ADDITION TO BRES2015-0078 ADDITIONAL SITES Printed: Wednesday, March 25, 2015 2:22:56 PM 1 of 2 CR SYSTEMS CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT GENERAL AIR CONDITIONING 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 CONTRACTOR GENERAL AIR CONDITIONING 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 OWNER THOMAS HUMPHREYS 2 E 75TH NO PH NEW YORK NY 92253 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK,# METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 BSA: $0.00 Printed: Wednesday, March 25, 2015 2:22:56 PM 1 of 2 CR SYSTEMS INSPECTIONS 0 SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL" BLD CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY 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 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:• • •• INSPECTIONS 0 SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL" BLD Printed: Wednesday, March 25, 2015 2:22:56 PM 2 of 2 CRWYSrEMS