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BMCH2016-023178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Twit 4 lwQuiRrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O16-0231 Property Address: 79555 BLAZING STAR TR APN: 604092010 Application Description: LOMBOY RESIDENCE / HVAC CHANGE OUT Property Zoning: Application Valuation: $17,987.00 Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 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, C36 License No.: 686310 Mg,Da Le, Eontractor: � 9 141M.7 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).: (_) 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 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: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/29/2016 Owner: LUIS LOMBOY 79555 BLAZING STAR TR LA QUINTA, CA 92253 Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE 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 twork for which this permit is issued. hM 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. 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 4� )Ur ONSignature (Applicant or Agent). —_ C z DESCRIPTION FINANCIAL INFORMATION 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 for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY 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 for CHANGEOUT: $108.78 $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 TOTALS:• 00 Permit Det►a1�5 PERMIT NSMBE.. Is- City of La Quints BMCH2O1f-023►1 IDescription: LOMBOY RESIDENCE/ HVAC CHANGE OUT . 1 Process Summary 1 Applied t, o Approved FINANGIAL INFORMATION Printed: Wednesday, June 29, 2016 7:49:17 AM 1 of 2 CWiJIJ SY57EM5 •o e o e r o o NAME TYPE . NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT IE INC 31225 LA BAYA WESTLAKE VILLAGE CA 91362 (760)641-4854 CONTRACTOR HARRISCIN ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE THOUSAND PALMS CA 92276 (760)641-4854 FRAN CISCO@CALLTH E GENERAL.COM OWNER LUIS LOMBOY 79555 BLAZING STAR TR LA QUINTA CA 92253 (760)641-4854 FINANGIAL INFORMATION Printed: Wednesday, June 29, 2016 7:49:17 AM 1 of 2 CWiJIJ SY57EM5 Permit Detai'IS P.ERMIIT N.U,MB:ER Cit of la Quint°a BMCH�2� 6-02 V7 Y INSPECTIONS PARENT PROJECTS REVIEW TYPE . REVIEWER ':SENT DATE DUE DATE- - RETURNED STATUS REMARKSDATE NOTES _ BOND INFORMATION A,T GAMENTS Printed: Wednesday, June 29, 2016 7:49:17 AM 2 of 2 (7/ L! TLJ SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT: # _ CHECK # METHOD - PAID BY - BY; BSASSB1473 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 for CHANGEOUT: $108.78 $0.00 PERMIT ISSUANCE 101-0000-42404 0. $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 5@v98 mmm & INSPECTIONS PARENT PROJECTS REVIEW TYPE . REVIEWER ':SENT DATE DUE DATE- - RETURNED STATUS REMARKSDATE NOTES _ BOND INFORMATION A,T GAMENTS Printed: Wednesday, June 29, 2016 7:49:17 AM 2 of 2 (7/ L! TLJ SYSTEMS # City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Pennit Application and Tracking Sheet Permit # Project Address: 79555 Blazing Star Tail Owner's Name:. Louie & Liviette Lomboy A. P. Number. Address: 79555 Blazing Star Trail Legal Description: City, ST, Zip: La Quinta, CA 92253 Contractor. General Air Conditioning Telephone: 1, 1 Address: 31170 Reserve Drive Project Description:Replace'4ton A/C, Coil, 90,000 BTU City, ST, Zip: Thousand Palms, CA 92276 Furnace & 1 Duct Telephone. 760-343-7488��`'Ml State Lie. # : 686310 City Lie'. #; Arch., Engr., Designer Address: City, ST. Zip: Telephone: State Lia #: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Ft-: #Stories: # Units: Name of Contact Person: Steven SchniererSq. Telephone # of Contact Person: 818-735-7876 Estimated Value of Project $17,987.00. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRAC MG PERMIT FEES Plan Sets Plan Check submitted Item Amonai Structural Cales. Reviewed, 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 correctionstiissue Electrical Subcoetactor List Called ContactPerson 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 M.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees ............................ ... ... ................... 1 CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 ) Project Name: . LOUIE & LIVIETTE LOMBOY I Date Prepared: 2016-06-27 A. General Information MR -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 LOUIE & LIVIETTE LOMBOY 02 Date Prepared 2016-06-27 03 Project Location 79555 BLAZING STAR TRAIL 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name LOUIE & LIVIETTE LOMBOY 07 Zip Code 92253 08 Dwelling Unit Conditioned 1621 �f . Floor Area (ft2) SC System CFA served N `system a re rf igerant t '#Y Installing ne SC w Number of space conditioning 1 Lalli g 09 Climate Zone 15 ` 30 (SC) systems in this dwelling 1 U- 3 containing i w it system `_... entirely new unit. B. Space Conditioning (SC) System lnformation 01 02 ,1 cl Q Ofl k� ( f'061 IJ 07)08 09 10 103 ri` f • 'N�, `Is the SC"""" 'Insfalling a �f . SC System SC System CFA served N `system a re rf igerant t '#Y Installing ne SC w Installing 1 Lalli g Installing Identification or Location or Area by this SC ducted U- 3 containing i w it system W 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 1621 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib) This section does not apply to this project. Registration Number: 216-A0238875A-000000000-0000 Registration Date/Time: 2016-06-27 21:19:44 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-27 21:19:26 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT-024. Alterations to Space Conditioning Systems (formerly CF -1R -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 80 AC cooling SEER 21 Setback section is not section is not components components applicable applicable Reauired Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testingrequiredwhen heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced. -leakage rate compliance: 515%, or 510% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & COR -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 z 3.00 CFM/ton required when MCH -25 is required. Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCHi20 Duct Leakage Testing requirements.,,ti o -Heating-only systems and Air Handler/Furnace changes do not require verificatio of Air Flow MCH �23; Refi igerant Charge MECH;25 Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH=20 Duct Leakage Testing regwr6ments. I JE 1F N fF I if 1\ 11_.__ 1f i► f1 — J .. 11 18 1t 1% E. Entirely New or Complete Replacement Duct System, with or without.Equipment Changeout (Sectionsr150.2(b)1Diia and 5 .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: 216-A0238875A-000000000-0000 Registration Date/Time: 2016-06-27 21:19:44 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-27 21:19:26 Schema Version: 0.5555DD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -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: �`Z�� iG/iG!JrC/1 Shanley, Barbara O Company: Signature Date: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2016-06-27 21:19:44 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. 1 am 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 Regulation 11 rlr�11�1 irr 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information.provided on othMapplicable compliance documents, worksheets, calculations, plans and specifications submitted to the e'nforcemeni agency for4pprovai vith,this building permit application. 5. 1 will ensure that a registered copy of this Certificate of.Cornpliance shall"be_made"available with_th"e 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.require_d to be.included with the;documentation.the,builder provides to the building owner at occupancy. l Responsible Designer Name: ' i 11 # 11 Responsible Designer Signature: V 1 4-0 4—/ Shanley, Barbara �% !f Company: Date Signed: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2016-06-27 21:19:44 Address: License: 31-170'RESERVE DRIVE STE A 686310 City/State/Zip: Phone: THOUSAND PALMS CA 92276 760-343-7488 Digitally signed by Ca10ERTS. 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. Registration Number: 216-A0238875A-000000000-0000 Registration Date/Time: 2016-06-27 21:19:44 HERS Provider: CaICERTS CA Building Energy. Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-27 21:19:26 Schema Version: 0.555SDD