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BMCH2015-023478-495 CALLE TAMPICO ,LA QUINTA, CALIFORNIA 92253 Application Number: BMCH2OIS-0234 Property Address: 79931 CASSIA ST APN: 600330007 Application Description: RUBISZ RESIDENCE Property Zoning: Application Valuation: $17,998.00 Applicant: HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS, CA 92276 C& 0 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/29/2015 Owner: GEORGE RUBISZ 79931 CASSIA STREET HVAC REPAIR LA QUINTA, CA 92253 A JUN 3 0 2015 CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTIIENT 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: C1301 IS 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 is 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.). (1 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: k Lender's Address: Contractor: HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A 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. 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: (o �30 V5- Applican 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: D 15 Signature (Applicant or Agent).T—=� ��— DESCRIPTION FINANCIAL INFORMATION ACCOUNT CITY 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 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 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 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:• 00 # Qty of LCA Quintd Bullding 8t Safety Aivision P.O. Box 1504,76-495 Calle Tampico La.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 79931 Cassia Street Owner's Name:. George &Linda Rubi§z A. P. Number. Address: 7.9931 Cassia Street Legal Description: City, ST, Zip: La Quinta, CA 92253 Contractor: General Air Conditioning Telephone: Address: 31170 Reserve Drive Project Description: Replace 4ton A/C, Coil, & 90,000 City, ST, Zip: Thousand Palms, CA 92276 BTU Furnace Telephone: 760-343-7488{a ` , State Lic. # : 686310 City Lic. M. Arch., Engr., Designer. Address: City., ST, Zip: Telephone: w 'r' State Lic. #: 3, • ' ' ' "`; 4�� Name of Contact Person: Steven Schnierer Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Univ: Telephone # of Contact Person: 8.18-735=7876 X 1 Estimated Value of Project: $17,998.00 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACIDTIG PERMIT FEES' Plan Sets Pian Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit. . 'Russ Coles. Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.' . Mechanical Grading plan tad Review, ready for correctionstiissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. MOA.Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for corrections/issuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees ' Total Permit Fees Description: RUBISZ RESIDENCE HVAC REPAIR Type: MECHANICAL Subtype: Status: UNDER REVIEW. Applied: 6/29/2015 EVA Approved: Parcel No: 600330007 Site Address: 79931 CASSIA ST LA QUINTA,CA 92253 Subdivision: TR 28601-1 Block: Lot: 19 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $17,998.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ADDRESSI. Details: HVAC CHANGE OUT - 18 SEER / .80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. Printed: Monday, June 29, 2015 12:38:17 PM 1 of 2 ff?A.J LJ SYSTEti1S PHONE FAX EMAIL NAME•TYPE NAME ADDRESSI. CONTACTS CITY STATE ZIP APPLICANT HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS CA 92276 ( Printed: Monday, June 29, 2015 12:38:17 PM 1 of 2 ff?A.J LJ SYSTEti1S DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CL 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 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 SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE MECHANICAL FINAL" BLD PARENT PROJECTS REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES DATE Printed: Monday, June 29, 2015 12:38:17 PM 2 of 2 r7 SYSTEMS STATE OF CALIFORNIA ALTERATIONS - HVAC EM CEC-CFIR-ALT-04-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E I.Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: 79931 Cassia Street City Of La Quinta 06/29/2015 Equipment Type Equipment Efficiency New Ducting, Plenums, Lineset: Conditioned Thermostat If Required R -value Floor Area (sq ft) Zackaged System aporator Coil 80%AFUE COP ❑ R-6 (CZ 2, 8-13) Ducting Served by system Setback Split System 19 Condensing Unit ❑ R-8' (CZ 11, 14, 15) Ducting 1,760 sqft (If not already V"ini Split ❑ Compressor 18 SEER HSPF ❑ R - (as) CZ's) Plenums present, must Funace ❑ Lineset EER ❑ R-55 or R7.5) Lineset be installed) ❑ TXV HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this foyn 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. Iff 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CFIR-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) -HERS, MECH-25-HERS2 Air Handler/Furnace' (Can include new ducting) Installer Requirement: Duct leakage (L15%, or < 10% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: 111. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. 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 Ducts' CF1R-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)-HERS2, MECH-25-HERS' Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge 113. 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 CFIR-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 dud 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 includes in walls, between floors etc. Z 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-2'/.", 3.5 to 4T-2%", 5T-4%" 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. Responsible Designer Name: Responsible Designer Signature: Date Signed: license: Steven Schnierer 1 06/29/2015 686310 Company: Address: City/State/Zip: I Phone: General Air Conditioning 31170 Reserve Drive 11 housand Palms, CA 9227 760-343-7488 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300