BRES2015-007878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BRES2015-0078
4
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address: 57545 BLACK DIAMOND
APN: 762340015
Application Description: PGA/HUMPHREYS/(2) STON HVAC (2) TANKLESS WATER HEATERS
Property Zoning:
Application Valuation: '$47,333.00
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
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 License No.: 686310
Date: 3 Contractor:
VOICE (760) 717-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
THOMAS HUMPHREYS
Contractor:
HARRISON ENTERPRISES INC DBA
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
Date: 3/5/2015
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I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
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city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
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of the Business and Professions Code) or that he or she is exempt therefrom and the
Date: 3 S
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:
OWNER -BUILDER DECLARATION
Carrier: _ Polity Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
C� �—
of the Business and Professions Code) or that he or she is exempt therefrom and the
Date: 3 S
1 Applicant: S +v
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
( ) I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
( ) I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is.performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. . B.&P.C. for this reason
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.
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
Lender's Address:
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: 3 S Signature (Applicant or Agent): ye
N
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
TOM HUMPHREYS I Date Prepared:
CF1R-ALT 02-E
( Page 1 of 3 )
2015-03-04
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
TOM HUMPHREYS
02
Date Prepared
2015-03-04
03
Project Location
57545 BLACK DIAMOND
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
TOM HUMPHREYS
07
Zip Code
92253
08
Dwelling Unit Conditioned
4600
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
2
ducted
containing
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System'Information �° {
01
02
03;
04
106, ;
07'�
s` 1 "08�
09
10
�1`/
X05
,
Is the SC
Installing a
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
2300
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
2300
Yes
Yes
Yes
No
No
No
Altered space
conditioning 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-A0059526A-000000000-0000
Registration Date/Time: 2015-03-04 08:05:11
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-04 08:04:38
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-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
furnace
heating
AFUE
0.8
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Central gas
All new
Central split
All new
This field or
This field or
System 2
furnace
heating
AFUE
0.8
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.►^^cw-�wk
r
mo
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or -cooling components are installed in ducted systems, or when than 40 ft of duct length is replaced.
-Leakage rate compliance: 515%, or 510% leakage to outside, or seal all accessible leaks. f _f ! -,, ,
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).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM/ton; required when MCH -25 is regruired
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 MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 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)1E, F)
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: 215-A0059526A-000000000-0000
Registration Date/Time:
2015-03-04 08:05:11
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-04 08:04:38
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:
Valdez, Dayana
Company:
Signature Date:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-03-04 08:05:11
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 California:
1. The information provided on this Certificate of Compliance is true and correct.
2. lam 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, 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
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.
S. I will ensure that a registered co of this Certificate of Com rliarice shall be made available with the building permitis) issued for.the buildin and made available to the enforcement agency for all applicable
g PY P g P 1) g g Y PP
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:
Valdez, Dayana
Responsible Designer Signature:
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-03-04 08:05:11
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-A0059526A-000000000-0000 Registration Date/Time: 2015-03-04 08:05:11 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-04 08:04:38
Schema Version: 0.S5SSDD
FINANCIAL INFORMATION
DESCRIPTION.
ACCOUNT ..
QTY
AMOUNT
PAID
PAID DATE
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$72.52
$0.00
PAID BY ..
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
OTHER MECHANICAL EQUIPMENT PC
101-0000-42600
0
$72.52
$0.00
PAID BY
f METHOD
RECEIPT # .
.. CHECK #
CLTD BY
Total Paid forMECHANICAL: $145.04 $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
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID -DATE
WATER HEATER/VENT
101-0000-42401
0
$24.18
$0.00
PAID BY _
METHOD
RECEIPT :#
CHECK #
CLTD BY.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$14.50
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $38.68 $0.00
TOTALS:00
Description: PGA/HUMPHREYS/(2) STON HVAC (2) TANKLESS WATER HEATERS
CONDITIONS
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: UNDER REVIEW
Applied: 3/5/2015 SKH
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: $47,333.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
HARRISON ENTERPRISES INC DBA G
Details: REPLACE (2) STON HVAC 16SEER/.8AFUE SPLIT SYSTEMS AND (2)TANKLESS WATER HEATERS. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CLTD
DESCRIPTION ACCOUNT QTY AMOUNT PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY
- e BY
ZIP
PHONE
FAX
EMAIL
............
NAME TYPE
NAME
ADDRESS1
CONTACTS
CITY
_
STATE
APPLICANT
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
STE A
THOUSAND
PALMS
CA
92276
CONTRACTOR
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
STE A
THOUSAND
PALMS
CA
92276
OWNER
THOMAS HUMPHREYS
2 E 75TH NO PH
NEW YORK
NY
92253
FINANCIAL INFORMATION
CLTD
DESCRIPTION ACCOUNT QTY AMOUNT PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY
- e BY
APPLIANCE 101-0000-42402 0 $48.36 $0.00
REPAIR/ALTERATION
Printed: Thursday, March 05, 2015 1:33:10 PM 1 of 2
TWsysrrnns
PARENT PROJECTS
Printed: Thursday, March 05, 2015 1:33:10 PM 2 of 2 crw
SYSTEMS
LTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
APPLIANCE
101-0000-42600
0
$19.32
$0.00
REPAIR/ALTERATION PC
Total Paid for MECHANICAL: $67.68 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$24.18
$0.00
WATER HEATER/VENT
101-0000-42600
0
$14.50
$0.00
PC
Total Paid for PLUMBING FEES: $38.68 $0.00
TOTALS:00
PARENT PROJECTS
Printed: Thursday, March 05, 2015 1:33:10 PM 2 of 2 crw
SYSTEMS
Bin #
Permit #
ProjectAddress: 57S4j
City of La Quinta.
-Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012,
Building Permit Application and Tracking Sheet
e,,e\,- ��cxrnor� Owner's Name: 1Orr% ,}u M Oamsj 45
A. P. Number:
Address: 57S4S Z3�cek. �iQmor.�
Legal Description:
City, ST, Zip: r' ( u �� CA r -L -LS -3
Contractor: 6shcr�X ,�
� ;
:::,.;;:;>:r.;;::«:«•;>:• •<::
Address: 3wio er
Project Description:
City, ST, zip:s CA 9 ZZ -7k.
1C cx_ Z SA-otr-, C p Ae_ i•ivAC_ •
Tele hone: _7(,0 -3L43 --7L488
P
�-«<€�:
}e.1M •
Statc Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #
; ;
>= < ':«:.Y<:<><%r;:>: #<v<
Construction Type: Occupancy:
•
Pro ject c circle one): New Addin Alter Re
J tYP ( air Demo
) P
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: y —] 333, QCT
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Clieck Deposit
Truss Cala. .
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrections/issue
Electrical
Subcontactor 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
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fces
,_