BMCH2015-0354W
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA792253-
41wQ,�r rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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 P\ofessions Code,
and my License is in full force and effect.
License Class: C20 License No.: 686310
9 Dat � � 1`! 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).:
( ) 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 Address: '
r
(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 Letior 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 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: `+ IS Applicant:
11
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:'1,+) 15 Signature (Applicant o: Agent): _
y �
Application Number: BMCH2O15-0354
Owner:
o®
Property Address: 50610 NECTAREO ST ST
JURIS KLAUS
O N
APN: 776280025
50610 NECTAREO
o�
Application Description: KLAUS / REPLACE (1) 3TON COIL
LA QUINTA, CA 92253
wa1 o w
o
Property Zoning:
ca
Application Valuation: $1,019.00
s_
2E�
Applicant:
Contractor:
� 0
l_` =�
HARRISON ENTERPRISES INC DBA GENERAL AIR
HARRISON ENTERPRISES INC DB
ERAL AIR
31-170 RESERVE DRIVE STE A
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
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 P\ofessions Code,
and my License is in full force and effect.
License Class: C20 License No.: 686310
9 Dat � � 1`! 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).:
( ) 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 Address: '
r
(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 Letior 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 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: `+ IS Applicant:
11
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:'1,+) 15 Signature (Applicant o: Agent): _
y �
FINANCIAL INFORMATION
xr':pESCRIPTION't�s;ACCO.UNT �; QTY"
` AMOUNT f,:,�
'PAID: �'r PAID DATE-
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
s PAID BY
- 3` METHOD , �� RECEIPT #
r r''
' = CHECK# CLTD' BY'
' c,
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
i f S' i DESCRIPTION `, y i
;',_ �, " ° ACCOUNT,:*``
' QTY
AMOUNT
_• PAIDPAID.DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
,y • . ' , r PAID BY tZ l t#;
t' r METHOD, �y;
Y ;RECEIPT'CLTD
BY
- •• -
`'DESCRIPTION ,� �`� tF
.. _ ..; .. _�.:... .�
;'' 's �z,ACCOUNT
� :..�_ .. ...... ..:
QTY,:
.� -AMOUNT u
y
�fi �'�.�,r PAID •'J",k
:PAID DATE
HVAC CHANGEOUT - REPAIR/ALTERATION
PC
101-0000-42600
0
$4.83
$0.00
PAID BY w - $ ' z * , s
°t t.• r L t' i
,y -`t METHOD i k g
h
; • 3rF RECEIPT #
�.
CHECK #
CLTD BY
t
Total Paid forCHANGEOUT: $16.92 $0.00
*� p r, DESCRIPTION: ' , y
E F ''ACCOUNT �.; - '
,QTY
;fAMOUNT
-_ _, .PAID e'
.PAID'DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
xPAID BY ;, x
R._
' �` ' METHOD ; ,. ��5
RECEIPT #
CHECK #
CLTD BY -
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:•• 00
Description: KLAUS / REPLACE (1) 3TON COIL
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 9/14/2015 SKH
Approved: -
Parcel No: 776280025• Site Address: 50610 NECTAREO ST STLA QUINTA,CA 92253 -
Subdivision: TR 28447 Block: Lot: 43
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $1,019.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - (1) 3TON EVAPORATIVE COIL [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES. `
ADDITIONAL SITES
CHRONOLOGY
^•r t�ShIRITl.tihlt
FINANCIAL INFORMATION
_ -- Printed: Monday, September 14, 2015 11:58:48 AM A 1 of 2
Z SYSTEMS -
i
/ t
f
A
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Monday, September 14, 2015 11:58:48 AM 2 of 2 CBFWSYSTEMS
ESCRIPTI
ACCOUNT'SY
OLINPAID
PAID
DATE
ECEIPTi
CHECK
'WETHOb
'PAID BY� �;w& Y;p
ke�
;�o
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
$12.09
$0.00
REPAIR/ALTERATION
HVAC CHANGEOUT-
101-0000-42600
0
$4.83
$0.00,
REPAIR/ALTERATION PC
Total Paid forCHANGEOUT: $16.92 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS: $109.77 $0.00
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Monday, September 14, 2015 11:58:48 AM 2 of 2 CBFWSYSTEMS
J
City
Building a Safety Division
P.O. Box 1504,78-495 Calle Tampico
ta.Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 50610 Nectareo
Owner's Name:. Juris Klaus
A. P: Number:
Address: 50610 Nectareo
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone: 310-940-6310 3; ;
Address: 31170 Reserve Drive
Project Description: Replace Ston Evaporative Coil
City, ST, Zip: Thousand Palms, CA 92276
Telephone: 760-343-7488MINE'
State Lie. # : 686310
City Lie. M
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:Construction
7
State Lic. #:.-
?iy ra
Name of Contact Person: Steven SchniererSq.
Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Ft.: # Stories: #Univ:
Telephone # of Contact Person: 8.18-735-7876
Estimated Value of Project: $1,019.00 .
APPLICANT: DO NOT WRITE BELOW THIS UNE
M
Submittal
Req'd
'Reed
TRACKING
PERMIT FEES•
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted, .
Mechanical
Giading plan
r' Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
30 Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval •
Called Contact Person
A.T.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees "
Total Permit Fps
J
o �n i c yr �.r�urvnrvin
ALTERATIONS - HVAC
CEG-CFIR-ALT-04-E Revised 03/15 CALIFORNIA Ei ERGY COMMISSION
CERTIFICATE OF COMPLIANCE CRR -ALT -04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
l�lecktareo
Enforcement Agency:
C;+
Date Prepared:
Permit#:
'sC)610
C4 La Q.;
-t 1 14 t�
Equipment Type
Equipment Efficiency
New Ducting, Plenums,. Lineset:
Condltiored
Thermostat
Required R -value
Floor Are.9 (sq ft)
❑ Packaged
1K Evaporator Coil
gFUE
COP
❑ R-6 (CZ2, 8-13) Ducting
Served b1 system
XSetback
System
❑ Condensing Unit
C) R-8' (CZ 11, 14,15) Ductirig "
sgft
(If not already
❑ Split System
O Compressor
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present must
❑ Mini Split
❑ Linesetbe
EER
❑ R-5 or R7.5)'Lineset
installed)
❑ Furnace
❑ 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. HVAC Changeout/Repair
Required Compliance Documents to -be left on site for Final:
All Equipment,
CF111-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS=
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handler/Furnace2 Can include new ducting
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, RefrZerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS providef as previously sealed, or ❑ 2. There is less than 40 linear feet of duct In uriaonditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
112. New HVAC System ""
Required Compliance0orcuments to•beleft on 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)-HEPS', MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-_5-HERS2
Mini Splits require CF111-ALT-02-E, CF211-MECH-03, and (CF2R-CF3R) ME:H-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy .58W/CFM), Air Flow k 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Duds with Replacement
Required Compliance Documents to be left on site for Final:
All New Duds' 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-HEFU
Compressor, TXV, Lineset, Furnace'
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow e- 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from dud leakage testing if: ❑ 1. Existing dud systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: 1
New ducting but less than All New Duds' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Dud leakage (:S.15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
'All new. ducting 11-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require, Air Flow MECH-(23 or 24), or Refrigerant Charge ve rificatlon 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 retsed parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
' R-5 (1" thick insulation) for Ilnesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require -Suction line Diameter
with insulation as the following 1.5 -2T -2'/e", 2.5-3T-2%", 3.5 to 4T-2%", ST -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 informaticin on this document.
3. That the energy features and performance specifications for the design Identified on this Certificate of Compliance 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 bolding 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 tie information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to ti -e enforcement
agency for approval with this building permit application.
Responsible Designer Name:
Responsible Designer Signature:
Date Signed:
cense:
e
S TLS �—,—.
X114nZZ7
16$b310
Company:
Gex.ercL1
Address:
3117p -R�S,.�. N-Ive-
City/State/Zip:
lhtw
Phone:
30-74g8
ens'7(ao-
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300