BMCH2016-0180A
78-495 CALLE TAMPICO I { C& 0 D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O16-0180
Property Address:
45410 DEERBROOK CIR CIR
APN:
604404032
Application Description:
LICON / CHANGE OUT (1) COIL
Property Zoning:
Application Valuation:
$3,674.00
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
.Dat" e2s ZS 'l.o 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).:
(_) 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/25/2016
Owner:
CARLY LICON
45410 DEERBROOK CIR
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 the work for which this permit is issued.
E,<Z', 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 S ZS I Lo 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. Eacn 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.
baa e:E 2 I1. Signature (Applicant or Agent):
v
DESCRIPTION
FINANCIAL •• •
:ACCOUNT QTY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD:.
RECEIPT #
CHECK #
CLTDBY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
PC
101-0000-42600
0
$4.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $16.92 $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:0• 00
Description: LICON / CHANGE OUT (1) COIL
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 5/25/2016 SKH
Approved: 5/25/2016 SKH
Parcel No: 604404032 Site Address: 45410 DEERBROOK CIR CIR LA QUINTA,CA 92253
Subdivision: TR 23995-6 Block: Lot: 1
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,674.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT- (1) COIL [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
FINANCIAL INFORMATION
- Printed: Wednesday, May 25, 2016 10:37:02 AM 1 of 2 CRw
SVCTFM.S
BOND INFORMATION
Printed: Wednesday, May 25, 2016 10:37:02 AM 2 of 2 CM-
CVRTFAAR
_
`
W 4
`METHOD
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
PAID BY
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
$12.09
$0.00
REPAIR/ALTERATION
HVAC CHANGEOUT -
101-0000-42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid for CHANGEOUT: $16.92 $0.00
PERMIT ISSUANCE
101-0000-42404 1
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
$109.77 $0.00
BOND INFORMATION
Printed: Wednesday, May 25, 2016 10:37:02 AM 2 of 2 CM-
CVRTFAAR
Bin. #
City of La Quinta
Building 8L Safety Division
Permit # P.O. Box 1504,•78-495 Calle Tampico
14.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 45410 Deerbrook Circle Owner's Name:. Carly Licon
A. P. Number.
Address: 45410 Deerbrook Circle
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor • General Air Conditioning
Telephone: ,,;,. ,�;;5;^;;,x'�;°
Address: 31170 Reserve Drive
Project Description: Replace 3ton Evaporative Coil
City, ST, Zip: Thousand Palms, CA 92276
Telephone: 760-343-7488
p?'r'
M. IN
State Lic. # : 686310
City Lic. M.-
;Arch.,
Arch.,Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Construction Type: • Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
State Lic. #:
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person: 8.18-735-7876
Estimated Value of Project: $3,674.00 .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
r4 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 ROUSE:-
'^' 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
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
CARLY LICON I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2016-05-24
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 MR -ALT -02 document for each dwelling unit.
01
Project Name
CARLY LICON
02
Date Prepared
2016-05-24
03
Project Location
45410 DEERBROOK CIRCLE
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
CARLY LICON
07
Zip Code
92253
08
Dwelling Unit Conditioned
1651
Floor Area (ft2)
SC System
CFA served
`system a
refrigerant I
.Installing new SC
Number of space conditioning
'I talli g
09
Climate Zone
15
10
(SC) systems in this dwelling
1
containing
system
more than 40
entirely ew
unit.
B. Space Conditioning (SC) System Information H� [�
Ol
02
03y
04{��
05 �
F 06 M
11 on),
I+ I 1
� 09
10
[
f
j
3 FIs the SC
Installing a
SC System
SC System
CFA served
`system a
refrigerant I
.Installing new SC
Installing I
'I talli g
Installing
Identification or
'Location or Area
by this SC
ducted
containing
system
more than 40
entirely ew
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts.
duct system?
SC system?
Alteration Type
System 1
Location 1
1651
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: 216-A0192543A-000000000-0000
Registration Date/Time: 2016-05-24 10:44:25
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-24 10:45:03
Srhamn Varcinn• n SSSCnn
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE 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
No heating
This field or
This field or
Central split
This field or
This field or
System 1
furnace
component
section is not
section is not
AC
Fancoil AHU
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
applicable
applicable
Required 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 testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: _< 15%, or < 10% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF311-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 required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
Air Handler/Furnace do Air Flow MCH X23; -Refrigerant Charge MECHH-2
-Heating-only systems and changes not require verification of or
-Existing duct systems constructed, insulated or sealed with asbestos are exempt`from MCH=20 Duct'Leakage Testing requiremerits'. JJ
VN_ It !( 1( 'ice 1Y I 1S II ,1J +r 11 11 11 lI
E. Entirely New or Complete Replacement Duct System, with or without,Equipment Changeout (Sections, 150.2(b)lDiia,and .150.2(b)lE, 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: 216-A0192543A-000000000-0000 Registration Date/Time: 2016-05-24 10:44:25 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-24 10:45:03
Crhpma VPrcinn• n SSSCnn
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:
Jan
Jacoby, Ian
Cl(laco Jr.
Company:
Signature Date:
i PERMIT E RATERS
2016-05-24 10:44:25
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
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. 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 Regulations.
wi
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,
r t a -- Fr a h i
'approva'l
calculations, plans and specifications submitted to the eif}rcement agency for eppproval�witht his building per ; }t application. # t
5. 1 will ensure that a registered copy of this Certificate of.Compliance shall be" made,available with the buildingpermit(s).issued for the building, and made available to the enforcement agency for all applicable
-J Iinspections. 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: Lw' � If .
Responsible Designer Signature: V IL.J L.. UA
Jan
Jacoby, Ian
acobJr.
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-05-24 10:44:25
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: 216-A0192543A-000000000-0000 Registration Date/Time: 2016-05-24 10:44:25 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-24 10:45:03
Crhpma Vprcinn• n SSSCnn