BMCH2015-0293!ru
Applicant: Contractor:
GENERAL AIR OUTSIDE CITY LOINDIITIONING & HEA JUL 3 �.',
Z01� GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
CITY OF LUIW
COMMUNITYOEVEL09h1 OE�� h�E�� (760)343-7490
Llc. No.: :LIC -0003606
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: License No.: :LIC -0003606
Date: � JO 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 Divisi 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 fo a
permit subjects the applicant to a civil penalty of not more than five hundred dolla s
($500).:
(_) 1, 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, thebuilding 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:
9,kr(v
4-44
VOICE (760) 777-7125
78-495 CALLE TAMPICO
0
FAX
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
(760) 777-7153
Lender's Address:
BUILDING PERMIT
Date: 7/30/2015
Application Number:
BMCH2O15-0293
Owner:
Property Address:
81214 SANTA ROSA CT
BIAN LEVY
APN:
764440002
81214 SANTA ROSA
Application Description:
EVAPORATIVE COIL REPLACEMENT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$3,500.00
_
!ru
Applicant: Contractor:
GENERAL AIR OUTSIDE CITY LOINDIITIONING & HEA JUL 3 �.',
Z01� GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
CITY OF LUIW
COMMUNITYOEVEL09h1 OE�� h�E�� (760)343-7490
Llc. No.: :LIC -0003606
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: License No.: :LIC -0003606
Date: � JO 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 Divisi 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 fo a
permit subjects the applicant to a civil penalty of not more than five hundred dolla s
($500).:
(_) 1, 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, thebuilding 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:
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: Applicant: S..z
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as_ a result of this application , the owner, and the applicant, each agrees to, and
shall defend, -indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
Itagree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Ne: —71301 15 . Signature (Applicant or Agent): 1�_ SZ�—
.V,-....,.. sL}rrccaNs:h:Lt <.$yf• -yK r x+; i
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}DESCRIPTION ...��t?��..<—�r
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BSAS SB1473 FEE . -.
„; 101 0000 20306
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PAID�-}DATEx
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0000;'42402a
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0
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Total Paid forCHANGEOUT:. $7252' $0.00'..
' DESCRIPTION q �' ?
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PERMIT ISSUANCE. '.
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Totaf Paid forPERIVIIT ISSUANCE , $91:85 $0.00
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NOME mmm�
Description: EVAPORATIVE COIL REPLACEMENT
Type: MECHANICAL
Subtype: Status: UNDER REVIEW
Applied: 7/30/2015 PIU
Approved:
Parcel No: 764440002 Site Address: 81214 SANTA ROSA CTLA QUINTACA 92253
Subdivision: TR 30023-4
Block: Lot: 21
Issued:
Lot Sq Ft: 0
Building Sci Ft: 0 Zoning:
Finaled:
Valuation: $3,500.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: REPLACE 4 TON EVAPORATIVE COIL 2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION
Printed: Thursday, July 30, 2015 11:44:30 AM 1 of 2
SYSTEMS
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAMETI(PE
5.�.3rd:.`.
°* ^` ;:NAME r ..-
✓. '... tt. f' -. C: -..a -t, ,..: � ,n ;�..... ._-.. .�: .:^: 'a
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ADDRE551 r;,`�.GITY '..STATE, ZIP.rn PHONE^fFAX'#
�¢ : :.: ,' �,"'L�'•�✓F- S Y+.. .,t -.
;* :EMAIL°
APPLICANT
GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
(760)771-3139
CONTRACTOR
GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
(760)771-3139
-OWNER
BIAN LEVY
81214 SANTA ROSA
LA'QUINTA
CA 92253
(760)771-3139
INFORMATION
FINANCIAL
-'�""DESCRIPTION=. QCCOUNT . N;; - QTY ;AMOUNT
::.
A?_
:"- #PAID:
, :�_..., tz+"'.'.. Y` ^�.. • ...
,PAIDDATE. ,RECEIPT#: ,CHECK #; ' METIiOD
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00
BSA:
$0.00
Printed: Thursday, July 30, 2015 11:44:30 AM 1 of 2
SYSTEMS
Printed: Thursday, July 30, 2015 11:44:30 AM 2 of 2 CRW.,YSTEMS
7 77 7
AMOUNT.NT
METHOD`
INSPECTIONS
CLT
DESCRIPTION: ,
-ACCOUNT ,
,
REMARKS',.,..*:
PAID`;
:,PAID DATE
RECEIPT#,
�CHECK1
� A
BY
D:,
,DATE ATE
MECHANICAL FINAL"
BLD
HVAC CHANGEOUT-
101-0000-42402
0
$36.26
$0.00
OTHEREQUIPMENT
HVAC CHANGEOUT-
101-0000-42600
0
$36.26
$0.00
OTHER EQUIPMENT PC
I
I
I
I
I
I
Total Paid forCHANGEOUT: $72.52 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
1 $91.85
$0.00
Total Paid.fdrPERMIT ISSUANCE: $91.85 $0.00
TOTALS: $165.37 $0.00
Printed: Thursday, July 30, 2015 11:44:30 AM 2 of 2 CRW.,YSTEMS
INSPECTIONS
TYPE'
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SCHEDULED
,
REMARKS',.,..*:
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.RESULT
� A
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,DATE ATE
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Printed: Thursday, July 30, 2015 11:44:30 AM 2 of 2 CRW.,YSTEMS
Bin. #
.. .
City. of.U Quinta
Building a Safety Division
P.O. Box 1504,78-495 Caiie:Tampteo
1.a.Quinta; CA 92253 -:(76.0) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
ProjeccAddress: 81214 Santa Rosa .Court
Owner's Name:. Brian'L'evy
A. P. Number.
Address: 81214. Santa Rosa Court
Legal Description:
City, ST, Zip: La,.QUlnta, CA 92247
Contractor: General Air Conditioning
telephone:_
WIN
;;>.;�
Address: 31170 Reserve. Drive
Projecibescription:
City, ST, Zip: Thousand Palms, CA 92276
Replace 4ton Evaporative Coil
Telephone: 760-343-7488r"'
'r:>: ai �a
State Lie. 4: 686310
City Lie. N.-
;Arch.,
Arch.,Engr., Designer:
Address:
City., ST, Zip: 1
Telephone: )
State Lie. #:•„/."iy`u ..<r .
Construction'Type: Occupancy:
Pro'ect a circle one New Add'n Alter Repair Demo
1 tyP i ) P
Name of Contact Person: Steven SchniererSq.
Ft.:
#Stories:
# Units:
Telephone # of Contact Person: 8.18-735'7876 X 1
Estimated Value of Project: $3,500.00 .
APPLICANT:,, DO NOT WRITE.BELOW-THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for;corrections
Plan Check Deposit. .
Truss Cafes.
x
Called Contact Person
Pian Check Balance_
Tide 24 Cates.
Pians picked ulf
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
tad Review, ready for correctionitiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked,up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for correetionsRssue
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
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
(Page 1 of 3 )
Project Name: BRIAN LEVY
02
Date Prepared: 2015-07-30
A. General Information
CF111-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.
02
01
Project Name
BRIAN LEVY
02
Date Prepared
�'
2015-07-30
03
Project Location
81214 SANTA ROSA COURT
04
Building Type
I
Single family
05
CA City.
La Quinta
06
Dwelling -Unit Name
BRIAN LEVY
�;
theSC
a ��ac+�a
Instalhng,aSCSystem
Dwelling Unit Conditioned
07
Zip Code
92253
08.
Flood Area (ft2)
CFA servedstema
1965
refrigOG, t
nstallin�g>negjS
stall ng..
Number'of 'space
conditioning .
09
Climate Zone
15
10
(SC) systems in this
dwelling
1
than 46
entirely new
..a., a
unit:
Served
System (ft2)
F'
B. Space Conditioning (SQ System Information,
�'
�N ...cit S'..r �- - YW=+s"ra�i. <.�� S�?� .'1 s�..
k.. -s4"�:2,�frc''z . •/riT -
01
02
U3..'
04-
05
06'
�'
09
1U
R
..�
�;
theSC
a ��ac+�a
Instalhng,aSCSystem
SC System
CFA servedstema
kjAl�s
w
refrigOG, t
nstallin�g>negjS
stall ng..
Installing
installing
Identification or .
Location or Area
by this SC
ducted
containing
system
=e
than 46
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet
of ducts?.
duct system?
SC system?
Alteration Type.
Altered space
System 1
Location 1
1965.
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.
Registration Number: 215-A0210149A-000000000-0000 Registration Date/Time: 2015L 07-30 07:22:54 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-0730 07:22:40
Schema Version: 0.555SDD
I
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)
•tions 150 2(b)1Diia;and 150.2(b)1E, 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
No heating
This field or
This field or.
I
This field or
This field or
System 1
Central.gas -
furnace
component .
section is not
section is not
Central split
AC
Indoor coil
SEER
14
Setback.
section is not
section is not
altered
applicable
applicable
applicable
applicable
Reauired Documentation:
ri
CF2R-MCH-01•E - Space Conditioning'Systems•Ducts and Fans,
-Duct insulation requirement for new'plenums: R6. 4``
CF213-MCH-20-H & MR -MCH -20-H Duct Leakage testing required when heating or cooling components are installed in ducted systems, of
when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 515%, or 5103'o.leakage to outside or seal all accessible leaks.-
CF2R-MCH-.25-H & MR -MCH -25-1i Refrigerant Charge Verification,fegiured;when refrigerant containing components are.installed or altered
(applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flowf2 300{FM/ton required when MCH -25 iviequired. '
Ekceotioris: ':' srr .�. Md
-Duct systems registered with HERS provider as prey ously sealed ale exempt fro�m'MCH-20D ct Le�akagerTesting regwremie is
-Heating-onlysystems and Air Handler/Furnace changes do nouregwre verification ul AIc F10W MCH -2 or Refrigerant Charge MECH-25
nr
-Existing duct systems constructed; insulated or sealed with asbestoscare exempt+from MCH=20 Duc@Leakage Testing regwrements:.
..94
iF � 1:
' ... :; ".;.. ."1�•L�Fs.�;..T .: ..-, Via,... ,�� ':ca v!+ `!nXk. .. 'Nye+: •Ivc..�r wn. .A.f'. sw� �-..o.nar� .yam z. +-a w.�•- sr
E. Entirely'New or Complete Replacement Duct System, with or w;ithoutTquipme,nt Changeouff
•tions 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 15;0.2(b)1C)
This section does not apply to this project.
Registration Number: 215-A0210149A-000000000-0000 Registration Date/Time: 2015 07-30 07:'22:54. HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-30 07:22:40
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3 ).
i
Documentation Author's Declaration Statement
1. 1 certify that.this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Sign
�lure*
Jan
Jacoby, Ian
loco y
Company:
Signature Date:
Stratz Pe" mit Service
2015-07-30 07:22:38
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 lawsof.the State of California:
a
1. The information provided on this Certificate of Co pliance is.true and correct.
2. 1 am eligible under Division 3 . f the Business and Profess+onsCode to accepk:resporisibility for the building design or system design
identified on this Certificate of Compliance (responsible designer).
3. That the energy featuresperformance specifications,...maatterials components, and manufa tured'c!6 ,ices for the building design
or�system design identified on this Certificate of Compliance conform to the
.and
requirements of Title 24, Part 1 and Part 6:of the California Code of.Regulations.
4. The building design features fea res
.
orsystem design identified o%tthis CertifitafeLof ComVpliance are�cons ste t ,the +nfor
calculations; lans•and s' ecifications submitted to'.the en'forcementt ag en fora vroval with th+s.buildin g Permit application.
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aUo provided ornotfier applicable compliance documents; worksheets,
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S. I will ensure that a registered copy of th+stC- i if+cat�e'of Compliance shalhbe`made available wdhythe:bwldfng+peamrt(s�Pissued fo
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athe�building, and„made ava+labl'eito�theleenforcement agency for all applicable.
inspections. hundersfand that a registe ed copy of ihlsCficate of Co�mpance srequi�rred to be included the�docume�ntaLion@he�bu
Ider proves to�the b {ilding owner at occupancy.
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Responsible Designer Name: `' , II>� 1�
Responsible Designer Signature:
� 1
Shanley, Barbara.
Company:
Date Signed:
HAARISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-07-30 07:22:5
Address:.`
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND- PALMS CA 92276' -
(1643143774.88 .> .
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: 215-A021014.9A-000000000-0000 Registration Date/Time: 2015-17-30 07:22:54. HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-30 07:22:40
Schema Version: 0.555SDD
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