BMCH2015-015078-495 CALLE TAMPICO ,
aw
LA QUINTA,_CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT '
-BUILDING PERMIT.
VOICE (760) 777-7125
k.FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
Application Number: BMCH2O15-0150
'Owner: .
Property Address: 78840 RIO SECO
JANE GAMMIE
APN: 646330013
P 0 BOX 52831
Application Description: GAMMIE / CHANGE OUT (2) 19SEER/8AFUE SPLIT SYSTEMS
BELLEVUE, WA 92253
Property Zoning: -
Application Valuation: $15,987.00
Applicant:
Contractor:
HARRISON ENTERPRISES INC DBA G
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92276
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.: 68633110 --
Date: N 6- Contractor ����1��—
7J
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
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 no
apply to an owner of property who builds or improves thereon, and who does the worl
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
r (760)343-7488
Uc. No.: 686310
4/30/2015
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 wdrk'for which this permit is issued.
f5l:-_ 1 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,:' -4 _Z50h 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: 4 3D IS Signature (Applicant or Agen/t)`�S�u��� c
�
r
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT r ''QTY �', AMOUNT ' ' ' PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY ' '' METHOD i�" ", " RECEIPT # CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION w
'ACCOUNT
QTY,
AMOUNT.,
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
PAID BY
;METHOD .�= `
RECEIPT #
CHECK #" r
CLTD BY
"DESCRIPTION
ACCOUNT:
QTY`
-AMOUNT -`
PAID
PAID,DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
PAID BYMETHOD
RECEIPT #
CHECK #;,
CLTD BY,
Total Paid forCHANGEOUT: $217.56 $0.00
' DESCRIPTION '`
L ACCOUNT - z
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 $0.00
TOTALS:• 00
r
Permit Details" PERMIT NUMBER—
'pew,`1.
City of LaaQuinta; BMCH2O15-0150
' '4:`..� - - ,_ � •yam _--�="'.�;�.'�d"Y.�'��.., �� -�j'-r +,. `�'irw$; ±r. �'-c �+ .r,�,S..*e
Description: GAMMIE / CHANGE OUT (2) 19SEER/8AFUE SPLIT SYSTEMS
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 4/30/2015 SKH
Approved: 4/30/2015 SKH
Parcel No: 646330013 Site Address: 78840 RIO SECO LA QUINTA CA 92253
Subdivision: TR 25154 Block: Lot: 21
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 y Zoning:
Finaled: _
Valuation: $15,987.00 Occupancy Type:. Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No: Unites: 0
Details: HVAC CHANGE OUT - (2)19SEER/8AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CONDITIONS
FINANCIAL INFORMATION
41
Printed: Thursday, April 30, 2015 2:15:14 PM 1 of 2 C SYSTEMS
ARE tOJECT
;._
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RETURNED STATUS
_
e REMARKS
REVIEW TYPE r REVIEWER SENT DATE
DUE DATE
,METHOD
-
CLTD
DESCRIPTION:
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT:#
CHECK #
PAID BY
BY .
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
+ .i, Y.* �` .:'~ �'' �a„ t '-4y a - ` 4i
.
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$145.04
$0.00
'�
SPLIT -SYSTEM
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
0
$91.85
$0A0
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
..-:"'' a i., i•k :.t `.� - • . T4. 1 .` .. ' I. k •c i i 4. 1 }f 1`1i fi _iS .;yam.-
�. .Y. '�ti1]!': �tJ"J3'-..I�•7� 3. .tiav
ARE tOJECT
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Printed: Thursday, April 30, 2015 2:15:14 PM 2 of 2 CbM SYSTEMS
RETURNED STATUS
_
e REMARKS
REVIEW TYPE r REVIEWER SENT DATE
DUE DATE
, _
-
NOTES x 2
DATE.:
j,i. ° :5^ -
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Printed: Thursday, April 30, 2015 2:15:14 PM 2 of 2 CbM SYSTEMS
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
JANE GAMMIE I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2015-04-28
A. General Information
CHR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CHR -ALT -02 document for each dwelling unit.
01
Project Name
JANE GAMMIE
02
Date Prepared
2015-04-28
03
Project Location
78840 RIO SECO
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
JANE GAMMIE
SC System
SC System
CFA served
Dwelling Unit Conditioned
a
refngevran�t
07
Zip Code
92253
08
Floor Area (ft2)
2566
Location or Area
by this SC
ducted
''nstalling<new
containing
Number of space conditioning
more than 40
09
Climate Zone
15
30
(SC) systems in this dwelling
2
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SC) System Information �
.
��
Ol
02
03
A 04��
US I k�
� � 06� �'"�`�
07� �
� � U$
� 09
10
� FIs the SC"""
R . _
Installing.'
�..z� k ar
�,€
SC System
SC System
CFA served
--,System a�
a
refngevran�t
S'*
Installing
4-00talling
Installing
Identification or
Location or Area
by this SC
ducted
''nstalling<new
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
1283
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
1283
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: 215-A0110896A-000000000-0000
Registration Date/Time
2015-04-28 09:13:41
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-28 09:13:07
Schema Version: O.SSSSDD
CERTIFICATE OF COMPLIANCE CFIR-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)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
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
19
Setback
section is not
section is not
components
components
applicable
applicable
Central gas
All new
Central split
All new
This field or
This field or
System 2
furnace
heating
AFUE
0.8
AC
cooling
SEER
19
Setback
section is not
section is not
components
components
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
-Leakage rate compliance: 515%, or <_ 10% leakage to outside, or seal.all accessible'leaks.
length is replaced.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant�'containing components are installed or altered (applicable in CZI,2; 8 15
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow >_ 300 CFM ton re uired'when MCH -25 ik re wired.�
/
71),
S,s
"q* U [n
{1,
L J
Exceptions: f
-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-2S.
-Existing duct systems constructed, insulated or sealed with asbestos are xempt 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)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: 215-A0110896A-000000000-0000
Registration Date/Time:
2015-04-28 09:13:41
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-28 09:13:07
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -SR -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
loco Jc
Company:
Signature Date:
Stratz Permit Service
2015-04-28 09:13:06
Address:
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. 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 ofd g lat on¢s y^t j'
4. The building design features or system design features identified on this Certificate of Comlpliance are.consistent.wdh-the information.provided on other,�applicable`cbmpliance documents, worksheets,
P - Y . . fit t
calculations, plans and specifications submitted to the enforcement agency fortapproval with this buil, 11 permit application. �� �
�
5. I will ensure that a registered copy of this Certificate of,Compliance shall,_, madewithtlje buildingpermit(s),issued for4hebuilding, and made available,to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Complliiianceis required to be included with the documeentationlh {builder provides to,he building owner at occupancy.
Responsible Designer Name:
I L
Responsible Designer Signature: V-.
Valdez, Dayana
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-04-28 09:13:41
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
Digitally signed by COURTS. 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: 215-A0110896A-000000000-0000 Registration Date/Time: 2015-04-28 09:13:41 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-04-28 09:13:07
Schema Version: 0.555SDD
Bin #
City of La Quinta
Building 8L 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: "fi8814 Q C 0
Owner's Name: J �t GGrn m e
A. P. Number:
Address: --? $ 8 E4 L-,
Legal Description:
City, ST, Zip: L a CA C! z 3
eneYcZr o�.dTelephone:
k ; ori n
�?GC>-
(0 3020
>[><>?>
Address:. 31)10 1Z-)P
Project Description:
City, ST, Zip: ovscLt,d7o.�rns CA �t22�10
�e `c.ce 310 L cc') 4 i0 dC0
Telephone:i O-3 y3-7�l2
U r
yoc 2 s sk ms
State Lic. # :
City Lie. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
h
Telephone:
one:
is
Con tru
s ti con Type: Occupancy:
P P Y:
State Lc #. Lie. •
Project cle one n Alter Repair Demo
h'Pe (circle New Add' 0
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: is, 9 -a i. IX0
APPLICANT: DO NOT.WRITE BELOW THIS LINE
tf
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god 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 HOUSE:-
3" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees .
Total Permit Fees