BMCH2014-1124i
78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O14-1124
Property Address: 44150 OCOTILLO DR
APN: 604180038
Application Description: HVAC CHANGE OUT 14.SEER/78AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $11,234.00
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
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.: 686310
Date: 'S
' Contractor: tiwJZ� SQL,
�r
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/21/2014
Owner:
ARTHUR TEUNISSEN
44150 OCOTILLO DRIVE
LA QUINTA, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DFIVE STE A
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 certificateof 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 perfornance 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 ss 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: 1612-11114 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 F03 IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to th.e Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this app cation 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 th:a 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 app1cation becomes null and void if work is
not commenced within 180 days from date cf 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: IdZ.J I 14A Signature (Applicant or Agent):
Lender's Address: I r
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificateof 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 perfornance 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 ss 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: 1612-11114 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 F03 IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to th.e Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this app cation 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 th:a 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 app1cation becomes null and void if work is
not commenced within 180 days from date cf 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: IdZ.J I 14A Signature (Applicant or Agent):
Lender's Address: I r
FINANCIAL •
1 •
4 f ,ebb 4i- DESCRIPTION 7�. x,..
:r• x+� ACCOUNT
'AMOUNT,
PAID'
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PArt *�
ID
' CHECK #
:CLTD BY
Total Paid forBU1LDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION, '`_';�
.. .. a L4.:.. .....
ACCOUNT .", i
QTY
_AMOUNTr
. , _
PAID
..
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PA6.I3Y
METHOD - .'
"RECEIPT-#
CHECK #
CLTD BY,
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 forCHANGEOUT: $108.78 $0.00
L "" �� " ``'
DESCRIPTION
.. .�.- .
,.ACCOUNT,,',
._ .. A �
QTY
AMOUNT:; zx'PAID
Y
tip ..
'PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
kPAIDBY ;;.., "
Y" METHOD `, •:
`.'RECEIP.T# `.
' CHECK#
s^.CLTD'BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 00
Description: HVAC CHANGE OUT 14.SEER/78AFUE SPLIT SYSTEM
4
t
Type: MECHANICAL Subtype: Status: SUBMITTED
Applied: 10/21/2014 SKH
Approved:
Parcel No: 604180038 Site Address: 44150 OCOTILLO DR LA QU1NTA,CA 92253
Subdivision: TR 24517 Block: Lot:2'
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $11,234.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT- 14.5SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL
CHRONOLOGY
CONDITIONS
1.
FINANCIAL INFORMATION
Printed: Tuesday, October 21, 2014 5:04:32 PM
1oft
CSYSTEMS
Printed: Tuesday, October 21, 2014 5:04:32 PM
1oft
CSYSTEMS
PARENT PROJECTS
41V
BOND
INFORMATION
T;j7l:
DESCRIPTION
A kc6bW -�v
I `:AMOUNT
1,,�...,PAID
E EIPT
ieC K
METHOD,'
PAID B
BY
Z
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0. 00
• B3A. - -
HVACCHANGEOUT-
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 forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS: $201.63 $0.00
PARENT PROJECTS
Printed: Tuesday, October 21, 2014 5:04:32 PM 2 of 2 0?wSYSTEMS
BOND
INFORMATION
ATTACHMENTS
Printed: Tuesday, October 21, 2014 5:04:32 PM 2 of 2 0?wSYSTEMS
Bi„ #
City Of .QuInta
-Building 8f Safety Division
P.O. Box 1504, 78 495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking-Sheet
Permit #
Project Address: 4 [ j 150 OCGo4 , 110 �vC.Owner's
Name: A,
A. P. Number:
Address:. U y 1 St> 1 o U
Legal Description:
City, ST, Zip: L Qv� hk. c, CA q zZ53
Contractor: GPn2t't:. ; �O t
Telephone: 95) S3Z—S Z 5
Address: 31110
Project.Description:
City, ST, Zip: `ho.��ar� �o.�MS ci ZZ 7(0
Telephone:
4 8 S
k Tv c�
State Lic. # : (p$ (0 3 to
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:.
Telephone:
st< < >is:::;:
:;.a:.:.;>. ,;l;,::<<;;:<.;;:.:::.:
Construction Type: Occupancy
State Lic. #:
•Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project: �, 2347, 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical .
Subcontactor List
Ca11cd Contact Person
Plumbing.
Grant Deed
Plans picked up
S.M.I.
{
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
,
STAT. OF CALIFORNIA
ALTERATIONS - HVAC
02
CEC-CFIR-ALT-04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:\
LH ISO
Enforcement Agency:
Da a Prepared:
Permit#:
�c>�;��o Vr�vrr
G:�. O>< L� ui G
)c z1 W
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor >rea (sq ft)
❑ Packaged System
X Evaporator Coil
AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Serve) by system
C►Setback
Split System
K Condensing Unit
❑ R-8' (CZ 11, 14, 15) Ducting
sqft
(If not already
❑ Mini Split
❑ Compressor
L4.S SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
)Furnace
❑ Lineset
EER
❑ R-5 or R7.5) Lineset°
be installed)
❑ TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
1<1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-15-HERS2
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)=HERSZ, MECH-25-HERSZ
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/tor,, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building .......
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CF1R-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERSZ
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', ",/TECH -25 -HERS'
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement
Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' I CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes n walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Gtarge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
4 R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg w1l require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5-3T-2%", 3.5 to 4T-2%", 5T-4'/"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the :reformation on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Comp:iance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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, calculations, plans and specifications subnitted to the enforcement
agency for approval with this building permit application.
Responsible Designer Name:
�cvc�n S��r�e
Responsible Designer Signature:
S. av ��-
Date Signed:
l0 2t tti
License:
(o8b3t0
Company:
Address:
City/State/Zip:
Phone:
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31l" -)C)
housand
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eerier
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e:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800=772-3300