BMCH2015-002678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TAtit 4laOu
Q,
IMMUNITY DEVELOPMENT DEPARTMENT
Application Number:
BMCH2O15-0026
Property Address:
79165 QUAIL CROSSING
APN:
776011023
Application Description:
REPLACE (1) 4 TON AND (1) 5 TON
Property. Zoning:
Application Valuation:
$20,322.00
Applicant:
HARRISON ENTERPRISES
INC DBA D
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT
D Q 0
JAN 27 20 55
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: 968141
s r
Date: � 1 21 S Contr�or.
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 fof 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.).
( 11, 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 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:
Owner:
LAVERNE HOPPER
, 92253
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/27/2015
Contractor:
HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-5562
Llc. No.: 968141
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 rk 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:
1 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.
� b
Dat S Applicarif
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-
mention-e-d1property for inspection purposes.
Date: , 27 15 Signature (Applicant orrfg nt): aZ5��>
,CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: ' GORDON HOPPER Date Prepared: 2015-01-20
A. General Information -
CHR -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
CORDON HOPPER
02
Date Prepared
2015-01-20
03
Project Location
79165 QUAIL CROSSING
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
GORDON HOPPER
07
Zip Code
92253. -
08
Dwelling Unit Conditioned .
2989
; fi 35' `
cam•
Floor Area (ft2)
SC System
SC System
1Location
CFA
system aj
refrigerant *
Number of space conditioning
Installing
E
Climate Zone
15 '
10
(SC) systems in this dwelling
2
,cl cted, .
•
x
more than 40
unit.
entirely new
a�. f
B. Space Conditioning (SC) Systemilnformation
01
02
: '• U3
k
04 > j
t 06 -
�' 07
' 08
09
10
-
�f= f
r9,�
i05
.-.. .
:Is'the 5C
Installing"a
; fi 35' `
cam•
SC System
SC System
1Location
CFA
system aj
refrigerant *
Installing new SC
Installing
Installing
Installing
Identification or
or Area °
_served
'by tFiis SC
,cl cted, .
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 •
1494
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
Altered space
System 2
Location 2
1494
Yes
Yes
Yes
• No
No
•No
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. *i
Registration Number: 21S-AO023057A-000000000-0000 p Registration Date/Time: 2015-01-20 19:22:00 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-20 19:21:30
- Schema Version: 0.551SDD'-
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
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
Less than or
System 1
furnace
heating
AFUE
0.78
AC
cooling
SEER
16
Setback
equal to 40
R-8
components
components
feet
Central gas
All new
Central split
All new
Less than or
System 2
furnace
heating
AFUE
0.78
AC
cooling
SEER
18
Setback
equal to 40
R-8
components
components
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
MR -MCH -20-H & MR -MCH -20-H — Duct Leakagetesting required when hung occooling components are installed
in ducfed systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 5 1536, or15 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H RefrigeranVi harge 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 required /
ti
Exceptions: .._ � .. , , , ..;
1
-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)1C)
This section does not apply to this project.
Registration Number: 215-A0023057A-000000000-0000 Registration Date/Time: 2015-01-20 19:22:00 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-01-20 19:21:30
Schema Version: 0.551SDD
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
t cyan dacobJt.
Company: r
Signature Date:
Stratz Permit Service
2015-01-20 19:21:24 `
Address: ; r
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. I am eligible under Division 3 of the Business and Professions Code toacc�ept•resp f sibility,for,the building design or.system.design identified on this Certificate of Compliance (responsible designer). '
3. That the ever features and performance s specifications, materials com onents)and manufactured devices fotthe building design ors stem design identified on this Certificate of Coni lianceconform to the
energy p P P g g Y„ g P
�..�- ,
requirements of Title 24, Part 1 and,Part 6 of the California Cod of Regulations.
r-.�i:
+•fir.. ag a
4. The building design features or system design featuresidentified on this Certificate of Compi>�liance are consistent with the informationprovided on other applicable compliance documents, worksheets,
y
it plicati•�'' . +* '.
calculations, plans and specifications submitted.to the enforcement agency for approval with this building permapon
. J'4; 4• a� �}
� = �'/rr-fi .
S. I will ensure that a registered copy of this„Certificate of Compliance shall be made,,available,,with the.building,pe,rmit(s) issued for the bwldii g, and mariP available to the enforcement agency for all applicable .
.- T ,
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: f a
Responsible Designer Signature:
Valdez, Dayana a -• }'
/J��
-(/J
Company: r
Date Signed:
^”
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING,
2015-01-20 19:22:00
Address: ,
License:
31-170 RESERVE DRIVE STE A
686310 .,
City/State/Zip: r
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488 '
' Digitally signed by WCERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. a
Registration Number: 215-A0023057A-000000000-0000 Registration Date/Time: ,- 2015-01-20 19:22:00 T + • HERS Provider: CaICERTS
CA Building Energy Efficiency Standards 2013 Residential Compliance 'Report Version: 2014-03-31 Report Generated: 2015-01-20 19:21:30"
.Schema Version: 0.551SDD . '
fINAINICIAL INF.011,MATION
F
r °DESCRIPTION „� _ .. r a +a ACCOUNT zQTY AMOUNT PAID ,
xPAID'DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY "i4 8 c ' "METHOD., s °:t Z ;?RECEIPT #'Y, a A, CHECK # t:
.. �< n_..
CLTD BY ,
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
' D RIPTION '""
t`.j r r ACCOUNT,h r €^
3AI1A0'UNT., ,
;PAID !
pPAID DATE'
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
R PAID.BY
" METHOD` '
¢ *v',RECEIPT #,CHECK
#
CLTD BY,
`a . ,'''DESCRIP-TION? E 3Y�
" ?ACCOUNT'S.
=,QTY
.�` a AMOUNT
Jr
E a .PAID F'
PAID DATE.
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
PAID BY ` m
�:`' `B r METHOD f' . '
E z RECEIPT
CHECK #
CLTD BY.
Total Paid forCHANGEOUT: $217.56 $0.00
- ;DESCRIPTION;,.:` _}
` "ACCOUNT' _
QTY
AMOUNT..
- PAID '
�`
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
M ETHODM
ECEIPT Fo
= R # b
; r, `+CHECK # ''
ti CLTD BY
Total Paid for PERMIT ISSUANCE: $91:85 $0.00
TOTALS:0.40.00
n
Description: REPLACE (1) 4 TON AND (1) 5 TON SYSTEM'
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 1/27/2015 MFA
Approved:
Parcel No: 776011023 Site Address: 79165 QUAIL CROSSING LA QUINTA CA 92253
Subdivision: TR 25429 Block: Lot: 70
Issued:
Lot Sq Ft:'O Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $20,322.00 Occupancy Type: Construction Type: s
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 2 HVAC CHANGE OUTS - 16 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
NAME TYPE a NAME
`ADDRES51
STATEYZIP; +
,i
k ,PHONE
APPLICANT HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND CA
92276
'
PALMS
CONTRACTOR HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND CA
92276
PALMS
OWNER LAVERNE HOPPER
92253
FINANCIAL
INFORMATION,
r
y
Description: REPLACE (1) 4 TON AND (1) 5 TON SYSTEM'
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 1/27/2015 MFA
Approved:
Parcel No: 776011023 Site Address: 79165 QUAIL CROSSING LA QUINTA CA 92253
Subdivision: TR 25429 Block: Lot: 70
Issued:
Lot Sq Ft:'O Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $20,322.00 Occupancy Type: Construction Type: s
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 2 HVAC CHANGE OUTS - 16 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAUSITES
CHRONOLOGY
CONDITI•
CONTACTS
NAME TYPE a NAME
`ADDRES51
STATEYZIP; +
,i
k ,PHONE
APPLICANT HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND CA
92276
'
PALMS
CONTRACTOR HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND CA
92276
PALMS
OWNER LAVERNE HOPPER
92253
FINANCIAL
INFORMATION,
_DESCRIPTION
yt ACCOUNT ;r,.
QTY,F
AMOUNTa
PAID
PAID
(RECEIPT#
CHECK#
:METHOD'
r` PAID BY h
eLTD
>
'.:k':. ..'. t '! ..
.... ,?'" + a...;
i ry
; .°t:rt
3
%..,
-..i:...y . `t,i
. s. *✓i
Ytt". _ f•
..x
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CH T -
101-0000-42402
0
$145.04
$0.00
SPLIT-SYSTEMSYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$72.52
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
• 00
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Tuesday, January 27, 2015 3:06:49 PM 2 of 2 CB?1"LFLF sysTEms
I
Bin #.City
of La Quin to .
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253.- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: -'?CI ((OS-. Q,
Owner's Name: apy
A. P. Number:
Address: 7af j (�$ Qu G; J c 'Ossi
Legal Description:
City, ST, Zip: Lc-- Gx,(h a CA G 2-ZS3
/+
Contractor: G�2�C � A\C hC�.��O
Telephone: '760-? 77- al0141
>;;•,.•> >>:. `>';=»';:;>;::•:i<
Address: 3\17O eSe.X-vG —br
Project Description:
City, ST, Zip:. Sand �G\vhs CA clzz-)
t 'iah.Or1- l Scor
Telephone: -7(,0-
;:,.:.,.;...,,;,.:.; :>;;:;.:;:
_Elm
State Lic. #: (�' (�� (Q
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
;:-:.::,;.:
� �i %�+-.•.v:I{':: � :' ::; :rn•'vv':::: iii
Construction Type: Occupancy:
State Lic.Project
type circle one): New Add'n . Alter. Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
#.Units:
Telephone # of Contact Person:
Estimated Value of Project: !tzn 3 Z Z_
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Rcc'd
TRACMIG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Revic)ved, ready for corrections
Plan Check Deposit
Truss Calcs.
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 corrections/issue
Electrical
Subeontaetor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
'`° Rcvicw, ready for eorrcctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue'
School FCCS
Total rermit Fees