BMCH2015-0213Q44VOICE (760) 777-7125
78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/18/2015
Application Number: BMCH2O15-0213 Owner:
Property Address: 79460 CITRUS- ji nA n r+ ARCHIE CHAPLIN
APN: 776140015 �I AL1 'J 79460 CITRUS
Application Description: CHAPLIN RESIDENCE HVAC CHANE OUT' INA' (� LA QUINTA, CA 92253
JU
Property Zoning: 18 201�
Application Valuation: $5,864.00
CITY,
COMMUN YDEV� 0 MEENTOEPARi�,.eNT
Applicant: r' Contractor:
IE INC. HARRISON ENTERPRISES INC DBA 0
32115 LA BAYA 31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362 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.: 968
Dater Contra
OWNER -BUILDER DECION
I hereby affirm under penalty of perjury that I am a empt from the Con actor'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 Name:
Lender's
(760)343-5562 .
Llc. No.: 968141
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 wor rs' compensation insurance carrier and polity number are:
Carrier olicy 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 wi th se pro 'sions.
Date: a O �✓Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLA%
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR S
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•
mentionedroperty for ir�5pection purposes.
or Ag �_
_ ! Signature (Applicant
n
t I
Ck'f La Quinta
F< t
Pic
P.O. Box 1504,78-495 Case Tampko
Ck'f La Quinta
&Muw a Sarety Uvhiott
Pic
P.O. Box 1504,78-495 Case Tampko
4.Qdnta, CA 92253 -(760) 777-7012
$06 i k 20 (S "vz `7z,
Building PenWt'Applicadon and Tracking Sheet
Project.Addtetis: 79460 CITRUS
OwuWsName:. ARCH CHAPLIN .
A- P. Number
Addtess: 79460 CITRUS
Legal De=ipdon:
City, sT, zip: LA QU I NTA, CA 92253
Conuwwr: DCS
Tdephaae:
Addttss: 72078 CORPORATE WAY #101
ProjeaDes«ipdon: CHANGE OUT A/C 4 TON
City. $T, Zip: THOUSAND PALMS, CA 92276
Telephone: 760-343-5566
Stan Lir. N: 968141.
Crty Lit, 1k.
Arch., ems•. Dosignv:
- .. •
Addtesx
City. ST. Zip.
Tehphone:
Construction Type: Ocarpaary:
Stow Lir. 6:
Project type (*de one): Now AWn Alter Repair Demo
Name of Const Pam: FRANK_
Sq. F.: a stones: unitx
•Tdv6neiofComactPasna 760-343-5566 F.sdmatod.V$hwofpMj=t: 5864.00
APPLICANT. DO NOT WRfM SHAW TM LINE
N
submittal
Req'd
mLeed TRAC,ICING PERbRT FSE&
Plan sets
Pian Auk tabmitted - Iaew Amount
shvctual Glen
Revkwed, ready for correction Pia (beck Deposit.
'rows Gta.
Glltd Gomori Pcraon Plan Ckeel, Balance,
We ZI Calci.
Plan patted up Cosmtracdon
Flood Aft piss
Plans resubmitted Meekasical
Gindlag plan
T' RzOew, ready for eorrrcttonskaue FJeetrial
Sabeostaetor U6
Called Contact Person Plumbing
Grant Deed
Plans Ptcktd up �bfy
H.O.A. Approval
Plans resubmitted Gradlag
UV HotSB:-
s^ Review; may for eorratiocaftsne Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pab Wln Apps '
Date of permit issne
sdrodi Fees
Total Permit Fees
FINANCIAL INFORMATION
DESCRIPTION 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 for BUILDING 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
101-0000-42600
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD•BY
i
i
i
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
Description: CHAPLIN RESIDENCE HVAC CHANE OUT
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 6/18/2015 EVA
Approved: 6/18/2015 EVA
Parcel No: 776140015 Site Address: 79460 CITRUS LA QUINTA,CA 92253
Subdivision: TR 24890-7 Block: Lot: 25
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,864.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 13 SEER/ SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
IE INC.
32115 LA BAYA
WESTLAKE
VILLAGE
CA
91362
(
Printed: Thursday, lune 18, 2015 9:05:00 AM 1 of 2 .
SYSTCMS
INSPECTIONS
SE ID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL•• BLD
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 forBUILDING 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
INSPECTIONS
SE ID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL•• BLD
BOND INFORMATION
Printed: Thursday, June 18, 2015 9:05.:00 AM 2 of 2,
R SYSTEMS
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
ARCH CHAPLIN I Date Prepared:
CKR-ALT-02-E
-(Page 1 of 3 )
2015-06-17
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.
01
Project Name
ARCH CHAPLIN
02
Date Prepared
2015-06-17
03
Project Location
79460 CITRUS
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
ARCH CHAPLIN
07
Zip Code
92253
08
Dwelling Unit Conditioned
2762
va
°,
+!
Floor Area (ft2)
SC System
SC System -
"CFA served
stem a
refrigerantInstallinggnew=SC
l:
Number of space conditioning
Installing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
n
containing
system
more than 40
unit.
entirely new
Name
Served
System (ft2)
system?
component?
B. Space Conditioning (SC) Systerin`Wormation „
00
s :�, ' -:
01
02
s
04,
yOS'
6
�. 07
08 ' •
; 09
10
r' X03- s
fi
t3 :r:
R
w ,
as
Is the SC
z ^� : x . to
Installing ad
va
+!
SC System
SC System -
"CFA served
stem a
refrigerantInstallinggnew=SC
l:
,r• �
Installing
lnstallingr
Installing
Identification or
location or Area
by this SC
ducted
n
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
2762
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C: Extension of Existing Duct System, Greater Than 40 Feet (Section15O.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A0163115A-000000000-0000
Registration Date/Time: 2015-06-17 16:18:20
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 201403-31 Report Generated: 2015-06-17 16:18:03
Schema Version: 0.555SDD
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)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
No heating
This field or
This field or
Central split
All new
This field or
This field or
System 1
furnace
component
section is not
section is not
AC
cooling
SEER
13
Setback
section is not
section is not
altered
applicable
applicable
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 & CF311-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 outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF311-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 Flow 2 300 CFM/ton required when MCW25 is required.
Exceptions:
Duct systems registered with HERS provider as previously sealed are.exempt from'' M H 20 Duc4t LeakagerTestingequireme�nts. .
'
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH 23; or Refngerant'CJ�arge MECH-2
n
Existing duct systems constructed, insulated or sealed with asbestos are exemp from MCH 20 DuetfLeakage Testl'ng requirre ts._;
-
wtf Chan NIf
. Entire) New or Complete Replacement DuctsYs�em with'or ihoUt E Pment out (5cti_15Q.2b' iq-'d0.2(b)1E, F)I15
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 215-A0163115A-000000000-0000
Registration Date/Time
2015-06-17 16:18:20
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-17 16:18:03
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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 Jr
Company:
Signature Date:
Stratz Permit Service
2015-06-17 16:17:58
Address:
CEA/ HERS Certification Identification (if applicable):
5858 Dovetail Drive
City/State/Zip:
Phone:
Agoura Hills CA 91301 f.
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 Busihess'and Profissions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
identified n this Certificate of Compliance conform to the
3. That the energy features and performance specifications, materials; components, and manufactured devices for the building or design ide t ed o t s e p
_
requirements of Title 24, Part 1 and Part 6 of the California Code of Regul'at ons
4. The building design features or system design features identified on this Certificate of Compliance are#consistent with the informat(on,provided on other app licable-compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approvalawlth this bwldmg permit application.
S. I will ensure that a registered copy of this Certificat --6f,CCoompliance shall be,matle,available with th'e building-permit(s).,issued forthe building, and_made available,fo the enforcement agency for all applicable
inspections. 1 understand that a registered copy of th6Certifiicate of Compliance requvired to g.,included with the,documntation�the builder provides to the building owner at occupancy.
Responsible Designer Name: -X
Responsible Designer Signature:
ROGAN, LESLIE
Company:
Date Signed:
HARRISON ENTERPRISES INC
2015-06-17 16:18:20
Address:
License:
72078 CORPORATE WAY #101
968141
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-5566
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: 215-A0163115A-000000000-0000 Registration Date/Time: 2015-06-17 16:18:20 . HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-17 16:18:03
Schema Version: 0.555SDD