BMCH2014-1005.1% D VOICE (760) 777-7125
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/3/2014
Application Number: BMCH2O14-1005 Owner:
Property Address: 50565 BREVA MARK.WINKLER
APN: 776330015 50565 BREVA ST
Application Description: REPLACE 5 TON HVAC LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $5,000.00
Q
Applicant: D Contractor:
HARRISON ENTERPRISES INC DBA G UHARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A JUL 4 3 24t1� 31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
CITY OF LA QUINTA (760)343-7488
FINAMCE DEPT_.
-" Llc. No.: 686310
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
D�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 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).:
(1 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 ) 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 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:
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:
Carrier: _ Policy Number. Z. cam" 20-7 1.714 Pspy�
_ 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:. - i 3 )LF 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:' 3� Signature (Applicant or Agent):
FINANCIAL •• !,
DESCRIPTION ACCOUNT QTY AMOUNT
PAID
PAID DATE
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
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
$35.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $59.58 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
Permit Number: BMCH2O14-1005
Applied: 7/3/2014
Issued: 7/3/2014
Status: ISSUED
Parent Permit:
Parent Project:
Approved:7/3/2014
Finaled:
Description: REPLACE 5 TON HVAC
Site Address: 50565 BREVA
City, State Zip Code: LA QUINTA, CA 92253
Applicant: HARRISON ENTERPRISES INC DBA G
Owner: MARK WINKLER
Contractor: HARRISON ENTERPRISES INC DBA G
Details:
HVAC CHANGE OUT - 16SEER CONDENSOR ONLY [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
LIST OF
SENT DATE RETURNED DUE DATE TYPE CONTACT STATUS REMARKS
DATE
Review Group: AUTO
NON-STRUCTURAL BUILDING BUCKET
Notes:
Printed: Thursday, 03 July, 2014 , 1 of 1 C
Y$iEMi
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC
Climate Zones 10 - 15
Site Address:
Enforcement Agency: Date:
Permit #:
50565 BREVA STREET La Quinta, CA 92253
City of La Quinta Jun 30, 2014
Duct insulation
Conditioned Floor
Equipment Typel
List Minimum Efficiency2
requirement
Area
Thermostat .
❑ Package Unit
❑ Furnace
❑ Indoor Coil
❑ AFUE
® SEER 15.0
Q COP
❑ HSPFIf
❑ R 6 (CZ 10-13)
Served by system
7980 sf
® Setback
not already present, must be
® Condensing Unit
0 EER
[3 Resistance
R 8 (CZ 14 -ZS)
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R
forms (no hand filled CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -IR
and CF -611 shall also be on site for final inspection.
IM 1. HVAC Changeout
Required Forms:
. All HVAC Equipment
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced
CF -4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or
CF -411 forms: MECH-21 and (for split systems) MECH-25
. Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage. testing 'if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2.. Duct systems with less Wig 171.40 linear feet in unconditioned space, or
0-3i- Existing duct systems are &nstructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted {ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
112.. New HVAC System
Required: Forms:
. Cut in or Changeout:with
- .:..
;:_n;x:....:;....:::..:;: ;.;.;'..::;:•::>.:..:.:>
CF 6R forms MECH 04 MECH 20 HER5 arsd {for split systems): MEGki 22 HERS, and
new ducts :{alt neVw'..
MECH.;-2 ii'HERS:::.: :
:..:.:::..
ducting and:afl new
equiprraerrf)`.
CF-4R'forms MECH-20,. and (for split systems; MECH 22, and MECH
s.=.. .
For Spltt Systems;:Duct leakage
< 6 percent; RC CcA > 350;iFM/ton, FTMAH, SIMS, and either tfSPP or PSPP
For P c U. =-..i).uct.,lea:ka
-
:_< 6-: rcen : -
e e t::°:.::::..:
❑ 3. New:Ductssnritfi f or without i
Required;forms '
Replacement .::::..... .
. Indudes:,replaciftd:;pr installing all :new
ducting° and%or'oufdoor con en Unit
CF -6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil acid/br furnace N6 or some
CF -4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage <:6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage.-,< 6 percent
❑ 4. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
. I certify that this Certificate of Compliance documentation is accurate and complete.
. I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
. I certify 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.
. The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Dayana Valdez Signature: boyano Valdez
Company: HARRISON ENTERPRISES INC Date: Jun 30, 2014
Address: 31-170 RESERVE DRIVE STE A License: 686310
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-7488
Reg: 214-A0048974A-000000000-0000 Registration Date/Time: 2014/06/30 11:46:00 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms July 2010
Din # City of La Quinta
Building &r 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: SOS1oS l� fit- Owner's Name:
A. P. Number:
Address: SOS b5 i -e -V a Sa
Legal Description:
City, ST, Zip: L0. v i n E 0. CA . 9 ZZ S 3
Contractor: e ;
\ �; i
Telephone: -
Address: 3 W) o
-'b r.
Project Description:
City, ST, Zip: 1 �O� Sa V% d ��rn S C� q 221(0
�e �ac� S ov, eov�cle-
Telephone: 7t00- 343- %r -i 28
State Lie. # : (o$(o3j D
City Lie. C
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #:
'" <.; ? "? ''' ? ~' ""'` `'°'
Construction Type: Occupancy:
Project type circle one): New Add'n Alter Repair Demo
Name of Contact Person: lltx C—rc
Sq. Ft.:
# Stories:
11 Units:
Telephone #,of Contact Person: 1 t0U' jjM 3,43 -74 a2
Estimated Value of Project: -4,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#1
Submittal
Req'd
Rec'd
TRACMG
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for correctionsfissue
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 correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees