BMCH2014-100678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O14-1006
Property Address: 55111 TANGLEWOOD
APN: 775150070
Application Description: REPLACE 5 TON HVAC D
Property Zoning:
Application Valuation: $4,724.00
Applicant:
HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
Ttty,,. .4 44"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
JU 00 d, 2 01N
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
BJARTE TUNOLD
55111 TANGLEWOOD
LA QUINTA, CA 92253
Date: 7/3/2014
Contractor:
�L"7QUINTA HARRISON ENTERPRISES INC DBA D
EPY 31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-5562
Llc. No.: 968141
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 1 hereby affirm under penalty of perjury one of the following declarations
{commencing with Section 7000) of Division 3 of the Business and Professions Code, and
_ I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance of
License Class: C20 License No.: 968141
the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: 7 3 ) + Contract y!�
Section 3700 of the Labor Code, for the performance of the work for which this permit is
v r
issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number: -Z V_, -*V., -Z. 07 17 14 I S(7"j
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
_ I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any
compensation laws of California, and agree that, if I should become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
statement that he or she is licensed pursuant to the provisions of the Contractor's State
comply with those provisions.
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
Date ,'_�? 13 144 Applicant.
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).:
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 ONE
compensation, will do the work, and the structure is not intended or offered for sale.
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
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
I 11, as owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed.under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, and
as a result of this application , the owner, and the applicant, each agrees to, and shall
who contracts for the projects with a contractor(s) licensed pursuant to the Contractors'
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
State License Law.).
employees for any act or omission related to the work being performed'under or
(_) I am exempt under Sec. B.&P.C. for this reason
following issuance of this permit.
2. Any permit issued as a result of this application becomes hull and void if work is not
commenced within 180 days from date of issuance of such permit, or cessation of work
Date: Owner:
for 180 days will subject permit to cancellation.
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 Na
Lender's
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: Signature{Applicant or Agent):—�-�
FINANCIALINIF
•• •;•
{ DESCRIPTION a.e �.
; �` ACCOUNT -
QTY
-AMOUNT
r PAID PAID DATE
BSAS 561473 FEE
101-0000-20306
0
$1.00
$0.00
aPAIDBY # `'Y;'�METHOD�'�
w. .:,. ...
-_
RECEIPT # ; =
CHECK# � ,� �.CLTD:BY.,
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
:',,DESCRIPTION.
a , ACCOUNT`
QTY,x
� . AMOUNT
,PAID .
4.
uPA1D DATE
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
$35.75
$0.00
PAIDBY
NIETHOD.�,
�. RECEIPT#=
,'CHECK#CLTD=BY:
i
.'DESCRIPTION%>.
` ` g"ACCOUNT
'CITY
' 3`.: AMOUNT
an PAID { ��
''PAID DATE'
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$23.83
$0.00
PAID BYE
r`
CHECK 4' r� '
CLTD ;BY' '
Total Paid forCHANGEOUT: $59.58 $0.00
x =DESCRIPTION' ,
SF
ACCOUNT t • „°
.; QTY
._ AMOUNT : $
.s p PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
{ PAID BY
- METHOD'S
' "t RECEIPT.# r
CHECK # t' �.
;CLTDBY ,
Total Paid for PERMIT ISSUANCE:. $90.57 $0.00
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Permit Number: BMCH2014-1006
Applied: 7/3/2014 Approved:?/3/2014
Issued: 7/3/2014 Finaled:
Status: ISSUED
Parent Permit:
Parent Project:
Details:
Description: REPLACE 5 TON HVAC
Site Address: 55111 TANGLEWOOD
City, State Zip Code:,
Applicant: HARRISON ENTERPRISES INC DBA D
Owner: BJARTE TUNOLD
Contractor: HARRISON ENTERPRISES INC DBA D
Printed: Thursday, 03 July, 2014 1 of 1
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LIST
OF -REVIEWS
4RETLIRNIED4
SENTDATE � 'DLIIE DATE
'i�""
TYPE; E CT -S S REM,
DAfET,3
C"
Review Group: AUTO
NON-STRUCTURAL
BUILDING BUCKET
Notes 41,
Printed: Thursday, 03 July, 2014 1 of 1
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Bin #
Submittal
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta,CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: Ss")
10.Y tewOpCi
Owner's Name: 3 car v ►101 ci
A. P. Number: 5-,
Address: SS 111 pv, 1 ew Oocl.
Legal Description:
City, ST, Zip: , L Q Qv� h -Vo CA cl ZZ.S 2,
Contractor: bcs k
•,1�
Telephone: '760- (010- Q4 (o$
Address: %Z - p7 $ eor praLl e: (,,)a -kI Ot
Project.Description:
City, ST, Zip: 76,\ s, CA ctzz7t0
_t,2ei 1C Ce: Sko o' cr
Telephone: (0 O - 3�i3 - SS(c(o>.
;
State Lie. #: 9 (0$ L)1
City Lie. #;
Called Contact Person
Arch., Engr., Designer:
Plan Check Balance
Address:
Title 24 Calcs.
City., ST, Zip:
Plans picked up
Telephone:
:;<:<:.:;•:::.:.::. <:rs :;;:::::,«.::
:: _ >::;.: .;; -<.x::<:;::• :
Construction Type: Occupancy:
State Lie. #:
,Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: X70.
�r
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
•7(-0 .:343-SS(a(o
Estimated Value of Project: 4, -7.7-4, 00
APPLICANT: DO NOT WRITE BELOW THIS LINE 1
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctionsrssue
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 correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Simplified Prescriptive -Certificate of Compliance: 2008 Residential HVAC Alterations CF -IR -ALT -HVAC
Climate Zones 10 - 15 ,
Site Address: Enforcement Agency:, Date: Permit #:
55111 TANGLEWOOD La Quinta,•CA 92253 City of La QuintaJun 30, 2014
'Duct
Equipment Typel.
List Minimum Efficiency2.
insulation
requirement :
Conditioned Floor
Area
Thermostat
❑ Package Unit
® Furnace =
❑ Indoor Coil
❑ AFUE
® SEER 13.0
❑ COP
❑ HSPF
.❑ R 6 (CZ 10-13)
Served by system
f Setback ,
If not already present, must be
® Condensing Unit
❑ EER -
❑Resistance
❑ R 8 (CZ 14-I5)
1621' sf
installed)
L] Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, •78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the'work completed by the installer. The inspectoralso verifies that each appropriate CF -6R and registered CF -4R
forms (no hand filled'CF-4Rs allowed) are filled out and signed. Beginning October 1, 2010, a registered copy of the CF -1R
and CF -6R shall also be on site for final inspection. "
® 1. HVAC Changeout
Required Forms:
.All HVAC Equipment
CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH7257HERS
replaced
CF -4R forms:'MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or
. Indoor Coil and /or
CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Furnace
CF -4R forms: MECH-21 and (for split systems) MECH-25 '
For Split Systems: Duct leakage a 15 percent; RC, CCA <_ 300 CFM/ton (Minimum.Air Flow Requirement), TMAH
.. i
c- n--.n� ed omit-. . c :. ..
, Duet 10- 19
pereeFit
Exempted from duct leakage . if:
'testing
E]1. Duct system was docurn4hted to have been previously sealed and confirmed through HERS verification, or
❑ 2.,.•Duct systems.with less than:40 linear feet in unconditioned space, or
'.' Q 3: Existing duct systems are:°:constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2: New HVAC System
Require# Forms:
Cut in orChan eout.wit
new ducts all new <?'>:
_.
CF 6R forms MESH-04MECH ZO.-HERS, and Efor split systems) MECi 22 HERS, and
�::.
ductrn an .. ..
a vv
Il ne
equipment).:
MECH 2&.=HERS..:. t._
... -
CF -4R forms MECH-20,. and (for it system )MECH 22 ,ar►d MECH 35
For Split Systems:: Duet leakage < 6 percent; RC CCA . 35Q.'CFM/ton, FWD ;TMAH SIMS :and :eifiher H5PP or PSPP
r..7- ..... ..
_D
:.s: -0-
For: :. k
o Pack— eat U : Dud,aea a e>:<. -. .-:.:.::. "
_.._.
❑ .New "asi.. ith ^.or w��>=?s
R uFred;FaYtsis:.:-:s:->::.:.:.,::..:::-
Replacement
;
. Indudes.,replaymg:ar installing all'new
R
d:uciirig andJor`ouIt oor condenssiig-unit
CF -6R forms: MECH-04, MECH-20-HERS, and'(for split systems) MECH-257HERS
and/or indoor coif a7id%or furnace Nb or some
CF -411 forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage` <:6 percent; RC, CCA >_ 300 CFM/ton, TMAH
For Packaged Units: Duct leakage`< 6 percent \
114. New Ducting over 40 feet
Required Forms:
. Includes adding or replacing more than 40'
CF -6R forms: MECH-04, MECH-2I-HERS
linear feet of dud in unconditioned space.
CF -4R forms: MECH-21
For split system or packaged units:.Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement) -
t
. I certify that this Certificate of Compliance documentation is accurate and complete.
. I am eligible under Division 3 of the California Business and Professions Code to accept respon;ibility for the design identified on this Certificate of -
Compliance.
. I certify that the energy features and performance specifications fog 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.
. The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: BEATRIZ MORA-PICASO, - Signature: BEATRIZ MORA-PICASO
Company: HARRISON ENTERPRISES INC. Date: Jun 30, 2014
Address: 31170 RESERVE DRIVE . r. License: 968141
City/State/Zip: THOUSAND PALMS / CA / 92276 Phone: (760) 343-5562
Reg: 214-A0049463A-000000000-0000',Registration Date/Time: 2014/06/30 22:11:47 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms': July 2010