BMCH2016-043078-495 CALLE TAMPICOO a L CE7
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LA QUINTA, CALIFORNIA 92253 DE516N &DEVELOPMENT DEPARTMENT ® INSPECTIONS (760) 7 7 71 3
BUILDING PERMIT N.OV 2 9 2016
Date: 11/3 6
Application Number: BMCH2O16-0430 Owner: CITY OF LA QUINTA
Property Address: 80677 SPANISH BAY. WILLIAMy jrft DEVELOPMENT DEPARTMENT
APN: 775310021 MEDICIN
Application Description: BLACKWELL / CHANGE OUT (1)HVAC SYSTEM CANADA T113, A9 92253
Property Zoning:
Application Valuation: $36,235.00
Applicant: Contractor:
IE INC " HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 LA BAYA 31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA.92276
(760)343-7488
Llc. No.: 686310
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for Section.3700 of the Labor Code, for the performance
License Class: C20, C36 License No.: 686310 •
of the work for which this permit is issued.
11-1ZIAILP
I have and will maintain workers' compensation insurance, as required by
Date: Contracto
Section 3700 of the Labor Code, for -the performance of the work for which this permit .
is issued. My workers' compensation insurance carrier and polity number are:
OWNER -BUILDER DECLARATION
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031658
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
I certify that in the performance of the work for which this permit is issued, l
city or county that requires a permit to construct, alter, improve, demolish, or repair
shall not employ any person in any manner so as to become subject to the workers'
any structure, prior to its issuance, also requires the applicant for.the permit to file a _.
compensation laws of California, and agree that,.if.l should become subject to.the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
comply with those provisions.
3 of the Business and Professions Code) or that he or she is exempt therefrom and theV
'
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
Date:'il
3D Applicant:' .'—
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
(_) I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION,. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon; and who does the work
I INTEREST, AND ATTORNEY'S FEES.
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 contractors) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. B.&P.C. for this reason
i'
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. (f.).
Lender's Name:
Lender's Address:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official fora 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. r.
�" _ e
Date ,; o l to Signature (Applicant or Age'nt)��YI�
L/
Date: . 11/30/2016
Application Number:- .. BMCH2O1670430
Owner:
:Property Address: 80677 SPANISH BAY
WILLIAM BLACKWELL
APN: 77S310021,.
MEDICINE HAT AB
Application Description: BLACKWELL / CHANGE OUT (1)HVAC SYSTEM
CANADA T16, A9 92253
Property Zoning:
Application Valuation: $36,235.00 ,
Applicant:
ContractoY:`.,
IE INC
HARRISON ENTERPRISES INC DBA GENERAL AIR_ "
31225 LA BAYA
.31170.RESERVE DRIVE
WESTLAKEMILLAGE, CA 91362
THOUSAND PALMS, CA 92276
(760)343.-17488 "
Llc..No.: 686310
Detail: HVAC CHANGE OUT - (2)21SEER/80AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
BSAS SB1473 FEE 101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
DESCRIPTION
ACCOUNT -
QTY
AMOUNT
HVAC.CHANGEOUT -SPLIT-SYSTEM
101-0000-42402.
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT: SPLIT -SYSTEM PC
101-0000-42600
0
$76.00 .
Total Paid for.CHANGEOUT: $228.00
DESCRIPTION
ACCOUNT
QTY .
-AMOUNT
PERM IT'ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE:. $96.27
CERTIFICATE OF COMPLIANCE '•' CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) - (Page 1 of 3)*
Project Name: WILLIAM BLACKWELL Date Prepared: - :. 2016-11-29
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.
WILLIAM BLACKWELL
02 .
Date Prepared
2016-11-29
03
Project Location ,
80677 SPANISH BAY
04
Building.Type
Single family
05
CA City.
LA'QUINTA
06
Dwelling Unit Name
WHOLE HOUSE.
07
Zip Code
92253
08 w
Dwelling Unit Conditioned
Floor Area (ft2'
3200
F Installing
Installing
Installing
.
Number of space conditioning
,
09'
Climate Zone
15,
`10
(SC) systems in this dwelling.'
2
entirely new
{
Served,". -
unit.
' system? '
R. Space Conditioning (SC),System"Information''
01
02.
03
•04
05
µ
06 jy p
Uu-"'9!
07
.08-'
09..'
10
Is the SCS
(Installing.a (
SC System
SC System '
CFA served_,
system a
refrigerant .J
Installing new SC
F Installing
Installing
Installing
Identification or
Location or Area •
by this SC:.'
. ducteatnr
. cont - ing' 'l
:-s yds IEt —gam
more than 40
entirely new
entirely new
'Name`
Served,". -
SVstem-(ft2):
' system? '
component?,
components?
feet of ducts?
duct system.
SC system? '
Alteration Type
t
Altered space
$(STEM 1
WHOLE HOUSE.:;
1600
;"" Yes
Yes`
Yes
= No _
_No
'No
conditioning system
SYSTEM.2
WHOLE HOUSE
1600.
Yes
Yes
Yes
No
No
No -.
Altered space
conditioning system.
C. Extension of Existing, Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
- This section does not apply to this project.
Registration .Number: 416-A0009715A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
•
Registration Date/Time: 2016-11-29 13:22:48 HERS Provider: CHEERS
Report Version: 2013 Rev 1.008 Report Generated: 2016-11=29 13:22:54
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)1E and F) -
01
02
03
04
05
06
07
08
094-
10 .
11'
12
Heating
Cooling:
System
Heating
Altered
Heating
MinimumAltered
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
0.80
AC
Cooling
SEER
20.00
Setback ' •
section isnot .
section is not
components
components'
applicable
applicable
All new
., _~ +"
All new
This field or
• This field or
SYSTEM 2
Central gas
furnace.
heating
AFUE
0.80,
Centralaplit
�� ,r
i.ACt
» .
,`'cooling .'
4:
SEER
21:00
Setback,
section is not
section is not
components
1 t
r components
applicable' ,
applicable
.
Repuired 'Documentation:
CF2R-MCH-01E -Space Conditioning Systems Ducts and Fans,,
-Duct insulation'requirement for new, plenums R6.1' ?
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%, or <_ 10% leakage to outside, or seal all accessible leaks. �«
CF21R-MCH-25-11 & 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 & CF31R-MCH: 23 Air Flow 2 306 CFM/ton required when MCH 25.is required.'`t
Exceptions: :• i s .
Duct systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct Leakage Testing requirements,
-Heating-only systems and Air Handler/Furnace changes do not require verification=of Air Frow-MCH-237cir Refrigerant Charge MECH-25.
:-
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
. ' Registration Number: 416-A0009715A-00000000070000. Registration Date/Time: 2016-11-29 13:22:48 HERS Provider: CHEERS
CA Building Energy Efficiency Standards —2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-11-29 13:22:54
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Compliance documentation is accurate and complete..
Documentation Author Name:
Documentation Author Signature:
Patrick Somers
Pa&%ck.SQvviP.vk
Company: • -
Signature'Date:
General Air.Conditioning
2016-11-29
Address:
CEA/ HERS Certification Identification (if applicable):-
pplicable):31170
31176Reserve Orive-
City/State/Zip: `
Thousand Palms CA 92276 '
_Phone:
760`343-7488 • �. ..
.�
Responsible Person's Declaration statement`
I certify the following under penalty of perjury, under the laws of the State of California: 1
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 responsibilityfor 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 Part 6 of the California Code of Regulations:. ¢`
4.' The building desigri 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. submitted to.the enforcement agency''for:apProval;with this building permit application. '
moi. V > V
S. 1 will ensure that a registered copy of this. Certificate of. Compliance shall beimade available with the building.permit(s)•lssued for the building, and,made available to the enforcement agency for all applicable
kp •n *a
rk i
N re With
inspections. I understand that a registered copy of this Certificate of�Complyance irrequired-to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsi Ie -Designer Signature:
Patrick Somers a k.�4
` 3��4-,.. f.V
Company.: •-
Date Signed:
General Air Conditioning _ _ ;. _.
2016-11-29
Address: t
License:
31170 -Reserve Drive -
686310
City/State/Zip: " .
Phone:
Thousand Palms CA 92226 = •• •
760-343-7488
Digitally signed by CHEERS'". This digital signature is•provided in order
to secure the content of this registered document, and in no way implies
Registration Provider responsibility for the accuracy of the information.
Registration Number: 416-A0009715A-000000000-0000 Registration Date/Time: 2016-11-29 13:22:48 HERS Provider: CHEERS .
CA Building Energy Efficiericy Standards —2013 Residential.Cortipliance Report Version: 2013 Rev 1.008 Report Generated:.2016-11-29 13:22:54
Bin: #
PeVU/91P.O.
City 0f La Quin
Ruilding 81 Safety Division .
Boic 1504, 78-495 Calle Tampico
la.Quinta, CA 92253 -:(760) 7777012'. Building Permit Applicaiion'and Tracking Sheet
Project Address: 80677 Spanish Bay
Owner's Name:. William Blackwell
A P. Number.
Address: 80677 Spanish.Bay. .
Legal Description:
.City, ST, Zip: 'La QuintB;.CA 92253
Contractor. General Air Conditioning and Plunibin
[
Telephone: 760-689-8740 RN
Address: 31170 Reserve. Drive
Project Description: Replace 5:ton /.90,000.BTU"complete
City, ST, Zip: Thousand Palins, CA 92276:
HVAC system
.Telephone: 760-343-7488 a`-'
..,.
Replace.4 ton / 90,000 BTU complete HVAC system
State Lia'# : 686310 City Lie. #:
2 tankless water heaters with 20' gas line
Arch, Engr., Designer.
Address:
City., ST, Zip:'
Telephone:
vNO��
Construction Type Occupancy
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Steven Schnierer
Sq. Ft.:.
# Stories:.
# Units:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project: $36,235.00. .
APPLICANT: DO NOT WRITE BELOW THIS.LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural CaIcs.
Reviewed, ready for corrections..
Plan Check Deposit. .
Truss Caics.
-Called ContactPersonPlaa
Check Balance
Title 24 Cates.
I
Plans picked up
Construction
Flood plain plan
Plans resubmitted.:.
Mechanical
Grading plan..
2'! Review, ready for correctionstissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SAI.h
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for corre.etionsrwue
Developer Impact Fee
Planning Approval.
Called Contact Person .
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees