BMCH2016-019978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
IE INC
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BMCH2O16-0199 U ��
56468 PALMS DR -
764020011 �UN 0 9 2016
WHITE- RESIDENCE / HVAC CHANGE OUT
$15,737.00
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
CITYOF1gOUINT" qJ
COMMUNITY DEVELOPMENT DEPARTMENT
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
RWr.14L�e__ Cara_ctor 5Z11: L
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury thaYl, 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 fora
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 contractors) 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 thework 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: 6/9/2016
Owner:
WENDELL & BETSY WHITE
56468 PALMS DR
LA QUINTA,,CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR'
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
7
(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.
::R� I have and will maintain workers'' compensation insurance, as required by
Section 3700 of the:Labor CodeJor 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 performanceof the,work for which this permit is issued, I
shall not employany person in any mannerso 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.
ate:L q I(e Applicant:Sw,Z� TL_
WARNING: FAILURE: TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
ANDSHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED. THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this.application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following: issuance of this permit.
2.; Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date,of issuance of such permit, or cessation of
work for.180 days will subject permit to cancellation.
I certify that l have read this application and state.that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
D tie:. -6 1 Signature Applicant or Agent):
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�:.,,.� DESCRIPT,IONxi->< ..•;€ ' ;s ,;sACCOUNT .,::.
:Selz:ni�v±•.ez.�.'TA1a�....,k:%�.,c.>c-:r>:n 5.+"�i`'.vF, M::,..?.z..Acsm$w'.,.vA.z.:ia1i'a...ai',..i'''"xr:'-+. .:a:?''v4''t;u+;.""'�'zsfEs:
yy dS'i.Y;: .X i!',{ •#.,. R, 1.:' f •� �„
F:• ;'? ?�j i"`^' x i*?°i- I ¢' , } .£"'-
QTY., r i ;AMO,UNT<• j PAIDs> W. EPAID D"ATE=
�,x:x 'e�."5+
BSAS SB1473 FEE - 101-0000-20306
A
0 i$1`OQ
$0:00
;a
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"RECEIPT # .:: +
T,
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HECK#r
Total:Paid for BUILDING STANDARDS:ADMINISTRATION
BSA $100 ` .y $0:00.
WIN+F°` -'.`Sc "' ;::.'.'sa;:.✓'.;.'KL".. `". '^4: " ;�u ar
;'° DESCRIPTION; , '°ACCOUNT'::
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AMOUNT
x
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�.
a r =
PAID.DATE
n .: : r
HVAC.CHANGEOUT - SPLIT=SYSTEM•
-101-0000-42402.
•Y
•u„
0
x$72 52, '
n,wl.
$0.00
�$.,._�..,,.�.2'�4e.�.iv',::$u:f;l-S"2i'' "X««: ii°x, '... :. t'�ya
�q? PAIDBYF�..
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r`,RE YEIP ;E
CT #
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CHECK # " `iin
,'-
�CLTD BYE
.. AL"M ., '07,
WINAW ?.ffi.-�..�,$�y.4' „ r is •y.�. "� J✓`"^i''Y. '' 'T'.. 1:�
.>:.iA*
::_ ' a DESCRIPTION
S. u'Y✓ ' .+,,'e '.+�r lf,svaa�x.�,"n'$�i4 ^..._e .. � a�b it�. #P? k�e,.
!�Y:. .5# :�Y i'`` xN :i: .�, '%� ... ':�J ''
3 ;ACCOUNT,.
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IN^i:., D4
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.. 'k!,cys`'''�2-'F'
AMOUNT,
'•^N' i i.:7 0vE.xE:z'.:Y�e3
PAID . r
PAID DATE
HVAC CHANGEOUT -;SPLIT-SYSTEM PC
101 0000-42600
0 ''
; :$36 26'
$0.00
tPAIDBY #
A?:?r`.rn'sra'�-sd'«..N;£.1.-a.
ME`,
'
va�' MOO.
,y ;RECEIPT #<r.:'CLTDr,BY''
�S.�d�,.'' 7i,'`';Y:S;e3�!'•`r'^xf.:'^"Y�a�„.,,3,�k.'�"
Total Pa' id for'CHANGEOUT ' $'108:28_: ,$0:00,
M ,
Wer'�3^' Y n 41: �"%: i' +'+.::..*.`i ?45."'';• :.' r. `F 'k_5"�i' :: K ��¢3=UcESC.rRte_IP.TI�ON�E?,�d°
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[
IODATt'cmEe
PERMIT ISSUANCE
101-0000-404 24
r.;
0'
$91 85-`
$0.00
.�a,�l" �:`�,i:. '� ,%� ""dam. „�';�. i :�`. �',;
. ' �'
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RECEIPT #��
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'�..,�.�-,`,'� �.
_ CHECK'#
t^.w�,•�'ttl x�+'�s'�, _. �.9'�..:
�CL�TD BY
Total Paid for PERMIT ISSUANCE $91 85 } $0 00'
'p IDENCE /HVAC CHANGE.OUT
Description: WHITE. RES
:
Type: MECHANICAL Subtype: ` Status: APPROVED `- -. ..
Applied: 6j§/2016 MFA
Parcel No: 764026011. Site•Address: 56468 PALMS DR LA QUINTA,CA 92253
Approved: 6/9/2016 MFA
' Subdivision: TR 28983 Block: - Lot: it
Issued:
Lot'Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $15,737.00 Occupancy.Type: Construction Type:
Expired:
-
No. Buildings: 0 No. Stoe ies: 0 No.. Unites: 0
Details: HVAC CHANGE.OUT - i8 SEER/804UE SPLIT SYSTEM [20.08 ENERGY) CARBON MONOXIDE ALARM(5) TO BE INSTALLED PRIOR 'TO
FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
•
�} Applied�to Approved
..
..
k. �- !- ,K b}, i.k�u 4i IC �fu a -�: 'j' :�-Z'•'+[v' $... S - .Y 1.K-€- �i �q „i .,�. ktit r, ti..'N i,.'T':.S e5i...•„3 tf•"i�s--4.G- . � =� .;�. �.. "N k �yi ..J-'.t:..M 5777.7)
_....,. �; �:-.::sa.L i.,.. `�'�cti�•:. ..e;....,..-�...e..: v& s= ., _..,, „-.� .. ..gym. :... er-.... .._.. A.. ^..., ,.ms's �.,._ -utr'.. .}.M.. .i.s� ,-a::..,.s �, .;.-.:.z�'r ..�+� �,s4°. �..sr: `.fi�E� —a�:.. . �N.�ix. x:2c..s.
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NAMETYPE
ha.» .ysa4t".+i'. - i _'..�... .._:
_. iP�.=t: �.,.' b. '". .":y&:i�:w"^�2'.te •:a, M-1111
7t NAME pADDRE551 CITY STATE
'...mak" ^'.
ZIP
°'>....,. 22•cM�ZA .S`riS «%.i -. - .•r. .'•.. ,-
PHONEr FAX}: EMA L '
,
,.
APP.LICANT..`'
IE INC': `" -_31225
�..-
LA BAYA WESTLAKE..
CA
91363
(760)777 1756
h
s
VIL'LAGE..
CONTRACTOR
HARRISON ENTERPRISES INC;DBA
31170 RESERVE DRIVE THOUSAND*
CA'
92276
(760)777-11S6"
`
FRANCISCO►L'@CALLTHE
-
.' .•,t,. ,.� "�.
-. �. �,, . r.. ¢Y.: '-04,l ..; r ._.0 :n r : - Y
GENERAL AIR ..
4: a '.ar � :M� } '.
PALMS
..
>
y . ka
.. _
:R'no3ti: <a C.1ib,.. Mi - 2:.�5"s
GENERAL.CONI:''
' OWNER
WENDELL & BETSY-WHITE
56468; PALMS DR LA QUINTA;'_
GA
;92253'
t (760)777 1756
Printed: Thursday, June 09, 2016 10:35:49 AM 1-of 2
-
CRF-SYSTEMS
F O�
CF`y'Ok'ft��'D�v
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID:
PAID DATE
RECEIPT #
CHECK # `-
METHOD
PAID BY
CLTD ;
-
..:
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
$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
TOTALS:• 00
INSPECTIONS
PARENT PROJECTS
Printed: Thursday, June 09, 201610:35:49 AM 2 of 2
SYSTEMS
Bin.#
C!ty ofla Oulpta
Building a-Safety. Aivision
P.O..Bo, 1504'749Calk-0# c
1A.Qu1ntaCA92253 =(70) 777-7012
-BuildingPermit A, pplrcatron and Trac 6z5heet
I v
Project Address: 56468 Palms Drive
''OwonersName:. UVendell=&'B'efsy White
A. P. Number.
Address: 56468. Palms Drive
Legal Description:
City,,ST, Zip: La Quint a, 'CA 92253
Contractor. GeneraLAir Conditioning
Telephone:'760-777=1756"
;�; Y ;
Address: 31170 Reserve Drive
Project Description: Replace 4ton A/C, Coil, & 90;000 BTU •.
City, ST, Zip:, Thousand Palms, CA ' 92276
Furnace
Telephone: 760-343-7488 Ea
StateLic.#: 686310 Lie. #,.
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: Construction Type:. Occupancy:
State Lic..#:;- :;J':�`✓r,
<lFµ„��!• y� ;-Project'type.(circle one): New Add'n Alter Repair Demo
Name of Contact Person: Steven Schnierer Sq.Ft.:. #Stories: #Units:
Telephone # of Contact Person: 8.18-735-7876Estiniated'Vali of Project '$15,737.00.
APPLICANT: DO NOT. WRITE:' BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
CalledContactPerson
Plan Check Balance-
Title 24 Calci.
Plans pieced up
Construction
Flood plain plan
Plans resubmitted
Mechanlcal
Gra6ng.plan
tad Review, ready for correct'ionslissue
Electrical
Subcoatactor List
,Called Contact Person
"
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IM HOUSE:-
'"' Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.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-1R=ALT HVAC) (Page 1 of 3 )
Project Name: WENDELL & BETTY WHITE Date Prepared: 2016-06-08
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 CF1114 T-02 document for each dwelling unit.
01
Project,Name
WENDELL&BETTY WHITE
02.
Date Prepared
2016-06-08 .
03
Project Location
56468 PALMS DRIVE
04..
'Building•Type
Single family.
05
CA City
La Quinta,
06•'
Dwelling Unit Name
WENDELL.& BETTY WHITE
DWelling Unit Conditioned- .
o- €�
:Installing a
07
Zip:Code
92253
08
Floor Area (ft2)
3078
SC System ..
CFA served
systema
..refrigerant
Number of space conditioning
Installing I
09
Climate Zone
15
10
(SC) systems in this dwelling
1 .
ducted
containing
system
more than 40
unit..
entirely new
rt
Served '` .:'System
(ft2)
system?
•_component? .
B. Space Conditioriing.(SC).System Information-
O1023
..
04
05
06 '
07
08
09
10
Is the'SC
o- €�
:Installing a
SC`SysPNO
tem
SC System ..
CFA served
systema
..refrigerant
Installing newySC
Installing I
Instalhngy
»Installing
Identification or.
Location or;Area
by this SC
ducted
containing
system
more than 40
entir'ely new
entirely new
Name
Served '` .:'System
(ft2)
system?
•_component? .
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1:.
3078
Yes
Yes
.Yes
No '
No
No
Altered space
conditioning system
C. Extension of Existing Duct System; Greater Than 40 Feet (Se ction150.21(b)iPiib),,
This section does not apply to'this project.
Registration Number: 216-A0213595A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-06-08 18:06:14.
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2016-06-08 18:05:18
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 (Sect'ions 150.2(b)lE and F)
01
02
03
04
05
06
07
08
09
10
11
1.2
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New.or.
Identification
System.
Heating '
Efficiency
Efficiency.
Cooling
Cooling
Efficiency
Efficiency
Thermostat
--'4Replaced
New Duct
or Name
Type'
Components
Type
Value
System1ype
Components
Type
Value
Type.
Duct-.Uheh.
R -Value
Central gas
All new
Central split
en
All new
This field or
This field or
System'1
furnace
heating
AFUE
78
4C
cooling
SEER
18
Setback
section is not
section is not
corriponents
components
applicable
applicable
Required Documentation:
CF2R MCH -01-E - Space Conditioning Systems Ducts.and fan's °
-Duct insulation requirement for new plenums: R6.'
CF2R MCH=20-H & CF3R MCH -20-H — Duct Leakage testing�FiOirecl when heating or cooling components are installed in ducted systems, or when -more than 40 ft of duct length is replaced.
3.
-Leakage rate compliance: 515%, or 510% leakage to outside,kor seal all accessible leaks.
CF2R-MCH-25-H & MR -MCH -25-11 Refrigerant Charge Verificatiororequired when refrigerant containing components are installed or altered (applicable in.CZ:2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH 23 AirFlow z43=CFMZiton regwred when MCH 25 is required
Exceotions: 4xY
-Duct. ysiems registered with HERS provider as pr� usly sealed are exempt from MCH .20 Duct Leakage Testing.requ rements.-
Heating-only systems and Air.Handler/Furnace changes do,riot regwre verification of'Air Flow. MCHC --23; orRefngerantChefge MEC
Tc.
-Existing duct systems constructed; in"sulated or seated withhasbe mare exemptffrom MCH 20DuLeakage Testing requiremenAs
.. - .i.q
'_.. �w .mss ':.• �°"» ".s 1
U� r
E. Entirely New or Complete Replacement`Duct System, with or without Equipment ,Changeout (Sections 2(b)1Diia.and 1S0.2(b)1E ��F)
This.secticn does not-apply.'to this prdject.
F. Entirely New.,or Complete'Replacehient Space..ConditioningSystem (Section 1501(b);C)
This section;does not apply to thisproject...
4 ...
.. .rw. . Y-_• - .. . .
Registration Number: 216-A0213595A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-06-08 18:06:14
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2016-06-08 18:05:18
CERTIFICATE OF COMPLIANCE MR -ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration. Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: ,
Shanley, Barbara
Company:
Signature Date:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-06-08.18:06:13
Address:
CEA/ HERS Certification Identification (if applicable):
31-170. RESERVE DRIVE STE A
City/State/tip:`
Phone:
THOUSAND.PALMS CA 92276
760-343-7488
77
Responsible Person's Declaration statement
I certify the following under penaltyof perjury, under theIGA of;the'State of California:
1. The information provided onahis Certificate 0#f'Compliance, is true and correct.
2. I am eligible under Division 3 ofkAh ssiness and.Pr essions Cod o acceptiresponsitiility'for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the features specifications, ria lscomponints, and manufactured devices fo-the building de3ign or system design identified on this;Certificate of Compliance conform to the
energy and.perfor%nce mate
requirements of Title 24 Part'1 and Partt6 of the CaliforniatCode of Regulations.
4.' The building design features or system;design featuresidentified:on his Certificate:of-..Compliance are consistent withithe information provided on other applicable compliance.documents, worksheets,
-: *', Qom: '
.calculations plans and specifications s6ibbmitted3to the ennfofeement;agency forapproval with this building permit application.'" NA
...V .. .
5. I will ensure_that a,regisiered copy of; this Certificateibf=Compliance shall , Made avail@ble with;,the buildingipermit(s)iissued:forathe)building, and made available tqjthe�nforcement agency for all applicable
inspections. l understand that a registered copy of this<Certificate of Compliance is,required to:b: included.with the'documentation,the b der provides to ti a buildirig owner afoccupancy.
.. -. ., .. .;.: -w`:a a" -*,-w. ay..:.. -
Responsible Designer Name:
Responsible Des finer Signature
Shanley, Barbaira
company:'.
bate Signed:
HARRISON•ENTERPRISES`ING dba GENERAL AIR CONDITIONING
2016-06-08 18:06:14
Address:
License:
31470 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-A0213595A-000000000-0000 Registration bate/Time: 2016-06-08 18:06:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-08 18:05:18
Schema Version: 0.555SDD