BMCH2015-015278-495 CALLE TAMPICO
LA UINTA, CALIFORNIA 92253
c&tr 4 lwQum&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0152
Property Address:
52390 AVENIDA JUAREZ
APN:
773251007
Application Description:
BAILEY / REPLACE (1) 13SEER/8AFUE PACKAGE SYSTEM
Property Zoning:
Application Valuation:
$10,262.00
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: • 3i] IS 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).:
(1 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, 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.).
(1 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/30/2
Owner:
BAILEY NORMA SUE LIVING TRUS
52390 AVENIDA JUAREZ
—p
LA QUINTA, CA 92253
Cr9
Contractor:
HARRISON ENTERPRISES INC DBA G m r
31-170 RESERVE DRIVE STE A
4=
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 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.
01. 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: 4 30J6 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: U Signature (Applicant or Agent)
FINANCIAL
1 .
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 forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - PACKAGED UNIT
101-0000-42402
0
$36.26.
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT:. $60.43 .$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 for PERMIT ISSUANCE: $91.85 $0.00
• ••
Pel'I'Yllt �et�al�S PERMIT NUMBER
�.
6;.
City of La Quinfia BMCH2O1(5-0152
Description: BAILEY/ REPLACE (1) 13SEER/8AFUE PACKAGE SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 4/30/2015 SKH
Approved:
Parcel No: 773251007 Site Address: 52390 AVENIDA JUAREZLA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 8 . Lot: 16
Issued:
UNIT 1
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $10,262.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - (1)13SEER/8AFUE PACKAGE SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR T(
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
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ONDITIONS a:� .:������.�',� �,�.�. _,-. ' �:.�.:� � u-mY '�� I-�.:,��';
PIN,leifNFO MARION
Printed: Thursday, April 30, 2015 2:21:23 PM 1 of 2
LJ U SYSTEMS
O@
OF
Permit Details�
9City of La-.6min a
771,77,777
7. . . . . . .
-4c—
Printed: Thursday, April 30, 2015 2:21:23 PM 2 of 2 CTK?SYSYEMS
PERMIT
N01 NUMBER
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT#
CHECK #
METHOD
PAID BY
1
BSAS SB1473 FEE
I BMC
0
H 26,11510,1
$0.00
5v
2
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
771,77,777
7. . . . . . .
-4c—
Printed: Thursday, April 30, 2015 2:21:23 PM 2 of 2 CTK?SYSYEMS
CLTD
DESCRIPTION
ACCOUNT
CITY
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
$36.26
$0.00
PACKAGED UNIT
HVAC CHANGEOUT-
101-0000-42600
0
$24.17
$0.00
PACKAGED UNIT PC
I
Total Paid forCHANGEOUT: $60.43 $0.00
PERMIT ISSUANCE
101-0000-42404 -T-o
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
7
771,77,777
7. . . . . . .
-4c—
Printed: Thursday, April 30, 2015 2:21:23 PM 2 of 2 CTK?SYSYEMS
A. General Information
CHR -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 NORMA BAILEY 02 Date Prepared 2015-04-23
03 Project Location 52390 AVENIDA 1UAREZ 04 Building Type Single family
05 CA City La Quinta 06 Dwelling Unit Name NORMA BAILEY
07 Zip Code 92253 08 Dwelling Unit Conditioned 1600
Floor Area (ft2)
Number of space conditioning
09 Climate Zone 15 10 (SC) systems in this dwelling 1
unit.
B. Space. Conditioning (SC) System Information
}, �- � ��_
01 02 03 04 ;f05 t "6 07 08 09 10
ff
. FIs the St*"' ' stalling a.
SC System SC System CFA served °''Nsystem a re igen nt installing newSC Clnstalli g In falli 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 1600. Yes No Yes No No No Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0107004A-000000000-0000 Registration Date/Time: 2015-04-23 12:39:07
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
Report Generated: 2015-04-23 12:38:30
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
01
02
03 .
04
05
06
07
08
09-
applicable
10
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
System 1
Central
packaged HP
All new
heating
AFUE
0.8
Central
All new
cooling
SEER
13
Setback
components
p
packaged AC
components
_Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
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: 5 15`Y, or s 10% leakage to outside, oa seal all accessible leaks.
CF2R-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 Flow >_ 300 CFM/ton required when MCH -25 is required.
Exceotions•
-Duct systems registered with HERS provider as previously sealed are exempt frof - H 20 Duct Leakage:T� es g requi meats.
-Heating-only systems and Air Handler/Furnace changes do not require verificablon of Air FIoiMCH'123,'or Refrigeran_fChaje NISCH-2
Existing duct systems constructed, insulated or sealed with asbestds are exempt from MCH=20 Duc'hea_kage Test"ng requi a n" s.
ere � 1W s� ar aw
CF1R-ALT-02-E
(Page 2 of 3 )
New or
Replaced
New Duct
Duct Length
R -Value
This field or
This field or
section is not
section is not
applicable
applicable
E. Entirely New or Complete Replacement Duct'
ystem, with -or w tho VEqu pment h ng out{S ti ns 150.2
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
Registration Number: 215-A0107004A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
This section does not apply to this project.
Registration Date/Time:
Report Version: 2014-03-31
Schema Version: 0.555SDD
2015-04-23 12:39:07
0.2(b)1E, F)
HERS Provider: CalCERTS
Report Generated: 2015-04-23 12:38:30
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete. .
Documentation Author Name:
Jacoby, Ian
Company:
Stratz Permit Service
Address:
5858 Dovetail Drive
Documentation Author Signature: ////
c..Yltl2 �CZCO
CNu
Signature Date:
2015-04-23 12:38:26
CEA/ HERS Certification Identification (if applicable):
City/State/Zip:
Phone:
Agoura Hills CA 91301 1818-735-7876
Responsible Person's Declaration statement`
CF1R-ALT-02-E
(Page 3 of 3 )
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 Business'and Professions'Code 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, 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 Parf6 of the California Code of Regulations.
4. The building design features or system design features identified o n this Certiffca a of mpliance are�consistent,witti the inf ati n,provided on�othe ,-applicable compliance documents, worksheets,
calculations, plans and specifications submitted too the enforcemen'tlgency for�approval;with this building permrt application. y
5. I will ensure that a registered copy ofxhis Certificate of, Compliance shall�be;made,a ailable w,th the bu ldfng pe�mit(s),issued for the tiu ding, and�mad�e avai�labl�`e to the enforcement agency for all applicable
,.:
inspections. I understand that a registered copy of this Certificate of Complliance is required to bezincluded with the-clocumentation.the builder provides to the building owner at occupancy. p
.
_ _.,_. - .k x k.. _.K.. ,- ��
Responsible Designer Name: . it. a i .. Responsible Designer SignafLre: 1 � �.., F-1,
Valdez, Dayana �� _ -- _tel_ 0-/-
Company:
/
Company:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
Date Signed:
2015-04-23 12:39:07
Address:
31-170 RESERVE DRIVE STE A
License:
686310
City/State/Zip:
THOUSAND PALMS CA 92276
Phone:
(760) 343-7488
Digitally signed by CalCERTs. This digital signature is provided in order to secure the coritent of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0107004A-000000000-0000
Registration Date/time: . 2015-04-23 12:39:07 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
Report Generated: 2015-04-23 12:38:30
Schema Version: 0.555SDD
Bin #
City of La Quinta
Building &' 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: S Z 3G 0 /yam,� � d c, V Y.e
Owner's Name: N or mo- U c-, e
A. P. Number:
Address: S Z3�i O Av e-ni cIe .l v arez
Legal Description:
Contractor:
a;o r
City, ST, Zip: L� Qvih� a CA 92-2,S3
Telephone: _ - . .........................................
Address: v�
Project Description:
City, ST,Zip: Il�av'so�r�c� �0.1mS CA C12Z")lo
Ke Ic�ce �i FoY, I�ctckc e ia-
T ne• _7
ele h o .
P -?la0- 34 4
3 8
State Lic. # : (6Z,63k.0
City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
one:
Construction TY
Type: Occupancy:
P P Y:
tate Lic. •
S Lc #.
ProJct 'e h'Pa (cir cle w one): New Add' n Alter Pr D Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2o. Review, ready for.corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees .
Total Permit Fees