BMCH2015-0228Applicant: J)�N ® W5 1 Contractor:
HARRISON ENTERPRISES INC DBA G HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
CITY OF IAQUINT 31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
COMMUNITY DEVELOPMENT DEPARTMEt�I
(760)343-7488
LIC. No.: 686310
. 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
s
Date: �v r 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 11, 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 I 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
. 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.
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: 3O r 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: 6 Signature (Applicant or Agent): —�—
ZP
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011COMMUNITY
LA gUINTA, CALIFORNIA 92253
DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153 '
'
BUILDING PERMIT
Date: 6/29/2015
Application Number:
BMCH2O15-0228
Owner:
Property Address:
79130 CINDY CT CT
JACK KIMBRO
APN:
604361034
1
79130 COURT
Application Description:
KIMBRO RESIDENCEHVAC CHANGE OUT
LA QUINTA, CA 92253
Property Zoning:�
!
Application Valuation:
$9,874.00
�_—`
Applicant: J)�N ® W5 1 Contractor:
HARRISON ENTERPRISES INC DBA G HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
CITY OF IAQUINT 31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
COMMUNITY DEVELOPMENT DEPARTMEt�I
(760)343-7488
LIC. No.: 686310
. 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
s
Date: �v r 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 11, 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 I 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
. 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.
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: 3O r 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: 6 Signature (Applicant or Agent): —�—
DESCRIPTION.' :
FINANCIAL INFORMATION
ACCOUNT ,.;,; QTY AMOUNT
PAID PAID DATE
BSAS SB1473 FEE
101-0000-20306 0 $1.00
$0.00
PAID BY : :
METHOD .` RECEIPT # '.
CHECK # _ CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT ` ..
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
METHOD
;,RECEIPT:#
CHECK #
CLTD BY
DESCRIPTION :
ACCOUNT
QTY.
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
301-0000-42600
.0
$36.26
$0.00
PAID BY
METHOD
RECEIPT.#
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $108.78 $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 forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Bin. #
•
Crty of La Qurnta
Building a Safety Division
P.O. Box 1504,78-495 Calle Tampico
1.a.Quinta, CA 92253 - (760) 777-7012
UZ28 Building Permit Application and Tracking Sheet
Permit #
Project Address: 79130 Cindy Court
Owner's Name:. Jack Kimbro
A. P. Number.
JCity,
Address: 7.9130 Cindy Court
Legal Description:
ST, Zip: La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone: 't"''
Address: 31170 Reserve Drive
Project Description: Replace 3ton A/C, Coil, & 70,000 .
City, ST, Zip: Thousand Palms, CA 92276
BTU Furnace
Telephone: 760-343-7488
1r�!
f ,macMlz
State Lic. # : 686310
City Lic. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
'i M
Telephone: t a
State Lic. #: y,;w :: ,�,
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of CoatactPerson: Steven Schnierer
Sq. Ft.: # Stories:
# Units:
Telephone # of Contact Person: 818-735=7876 x 1
Estimated Value of Project: $9,874.00 .
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit. .
Truss Cales.
Called Contact Person Plan Check Balance.
Title 24 Calci.
Plans picked up Construction
Hood plain plan
Plans resubmitted Mecharilcal
Grading plan
2ad Review, ready for correctionsfissue Electrical
Subeoutactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN ROUSE:-
3a Review, ready for correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description: KIMBRO RESIDENCEHVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 6/29/2015 EVA
Approved: 6/29/2015 EVA
Parcel No: 604361034 Site Address: 79130 CINDY CT CT LA QUINTA,CA 92253
Subdivision: TR 27899 Block: Lot: 82
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $9,874.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 14 SEER /.80 AFUE SPLIT SYSTEM [2008 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Monday, June 29, 2015 8:46:08 AM 1 of 2
N?WSYSTEMS
CHRONOLOGY
CONDITIONS.,
CONTACTS
NAME TYPE-
NAME
ADDRESSI
CITY
STATE
.........._.__.
ZIP
_ _ _
PHONE FAX EMAIL
APPLICANT
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
(
Printed: Monday, June 29, 2015 8:46:08 AM 1 of 2
N?WSYSTEMS
Printed: Monday, June 29, 2015 8:46:08 AM 2 of 2
C§?EAI17E7 SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
-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
$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 for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:$0.00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
RESULT REMARKS NOTES -
DATE DATE
MECHANICAL FINAL" BLD
Printed: Monday, June 29, 2015 8:46:08 AM 2 of 2
C§?EAI17E7 SYSTEMS
CERTIFICATE OF COMPLIANCE
CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name:
JACK KIMBRO I Date Prepared:
2015-06-23
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 CF1R-ALT 02 document for each dwelling unit.
01
Project Name
JACK KIMBRO
02
Date Prepared
2015-06-23
03
Project Location
79130 CINDY COURT
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
JACK KIMBRO
07
Zip Code
92253
08
Dwelling Unit Conditioned
2454
Installing
Jnstalli g
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
15
10
(SC) systems in this dwelling
1
component?
_
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
i r '
01
02
03.E
04��
05tf
06 M,
if 07'
Q8 t
09
30
*� FIs the SC""
Installing a
SC System
SC. System
CFA served
ystem aF
r f iger nt i
Installing ew SC
14
Installing
Jnstalli g
Installing
Identification or
Location or Area
by this SC
ducted
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
2454
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 15O.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A0168197A-000000000-0000
Registration Date/Time: 2015-06-23 07:41:59
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-23 07:41:57
Schema Version: 0.555SDD
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
30
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
14
Setback
section is not
section is not
components
s
components
applicable
applicable
Repuired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans i
-Duct insulation requirement for new plenums: R6. 3
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: 515%, or 510% leakage to ou'tside,'or seal all accessible leaks.
CF211-MCH-25-H & CF3R-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 Fl6w 2 300 CFM/ton required when MCH -25 is required .�
Exceptions: -z,�'`
Duct systems registered with HERS provider as previously sealed are exempt from MCH-20_Duct LeakagX Testing r�eguireme; ts.
Heating -only systems and Air Handler/Furnace changes do not require 41 1verification of Air Flo MCH -23; or Refrigerant_Charge MECH-2
Existing duct systems constructed, insulated or sealed with asbestos are exempfrom MGH:20 Ductalea�kage Testing requirements.q
t
-
.--V-.1 # 0 rn f� f"' � 111_' M 41 s +"+�.or
E. Entirely New or Complete Replacement Duct System, with or wft11houffggtpment Changeout (Sections 150.2(b)1Diia and 15,0.2(b)1E, 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-A0168197A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time
Report Version: 2014-03-31
Schema Version: 0.555SDD
2015-06-23 07:41:59
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 jaco
Jacoby, Ian
Jr
Company:
Signature Date:
Stratz Permit Service
2015-06-23 07:41:41
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. lam eligible under Division 3 of the Business and ProfessionVCode 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, andnufa� devices for the building desig�system desn identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Reg lations.
4
4. The building design features or system design features identified o his Certific� a f compliance are co�nsisten!with-the informs ibn.provided on other p Iicatil le -compliance documents, worksheets,
a r4 of
L ✓+'�:, 4 ► ! ; T""""" S .
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of yCompliance shall beWade available withythe building permit(s),issued for�the building, and made available to thewenforcement agency for all applicable
inspections. I understand that a registered copy of this,C�rtificate of Comp wance�is required to be included with thedo�cumentationRhe�builder provides too he building owner at occupancy.
Responsible Designer Name: tZ ZI
Respons b Designer Signature: V IK� ,
Valdez, Dayana
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-06-23 07:41:59
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
Digitally signed by Ca10ERTS. 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-A0168197A-000000000-0000 Registration Date/Time: 2015-06-23 07:41:59 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-23 07:41:57
Schema Version: 0.5555DD