BMCH2016-0274a�w
78-495 CALLE TAMPICO -
LA QUINT A, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0274
Property Address:
55�453`TANGLEWOOD
APN:
775152030
Application Description:.
TRAVIS / HERRICK RESIDENCE / HVAC
D
Property Zoning:
206
Application Valuation:
$10,939.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
COMMUNITY DeyE �FMrNI
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. C36 License No.: 686310
Date: —7Za } 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 7.77-7153
Date: 7/28/2016
Owner:
HERRICK R B & TRAVIS B A TRUST
54922 SOUTHERN HILLS
LA QUI NTA, CA 92253 .
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
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.
�. 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: INSURANCE COMPANY OF THE WEST Polity Number: WSD5031658
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: —7 Z8 jto Applicant: s z
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.
CONSTRUCTION LENDING AGENCY . I certify that I have read this application and state that the above information is correct.
1 hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all'city and county ordinances and state laws relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Lender's.Name:
r--
Date: Z8 )(`�' & Signature (Applicant or Agent):
Lender's Address:
Date: 7/28/2016
Application Number: BMCH2O16-0274 '
Owner:'
Property Address: 55453 TANGLEWOOD
HERRICK R B & TRAVIS B A TRUST
APN: 775152030
54922 SOUTHERN HILLS '
Application Description: TRAVIS / HERRICK RESIDENCE / HVAC
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $10,939.00
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
Detail: ,HVAC CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON
MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
PER 2013 CALIFORNIA BUILDING CODES.
FINANCIAL 7,7
•• •
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306
0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
,AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
10170000-426000
$36.26
Total Paid for CHANGEOUT: $108.78
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-4.2404
0
$91.85
Total Paid for PERMIT ISSUANCE: $91.85
TOTALS:
Description: TRAVIS / HERRICK RESIDENCE / HVAC .
Type:'MECHANICAL Subtype:. Status: APPROVED Applied: 7/28/2016 MFA
Parcel No: 775152030 Site Address: 55453 TANGLEWOOD LA QUINTA,CA 92253 Approved: 7/28/2016 MFA
Subdivision: TR 21846-2 Block: Lot: 4 Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $10;939.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0'
Details: HVAC CHANGE OUT - 14 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
m = �
......... - --
ADDITIONAL SITES
FINANCIAL INFORMATION
Printed: Thursday, July.28, 2016 8:24:17 AM 1 of 2 SYSTEMS
DESCRIPTION
ACCOUNT
~ CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY..
CLTD'
-
-
G
r
ATTACHMENTS
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total' Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 f
'
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 for CHANGEOUT: $108.78 $0.00 _
PERMIT ISSUANCE
101-0000-42404
0
$9.1.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:
INSP'ECTI'ONS
..,,—.�.__._,,....Y..r _ PARENT PROJECTS,
Printed: Thursday, July 28, 2016 8:24:17 AM 2 of 2 1132MMOVEMS -
' is
BOND
INFORMATION
G
r
ATTACHMENTS
Printed: Thursday, July 28, 2016 8:24:17 AM 2 of 2 1132MMOVEMS -
Bill#
city.
i Of La Q[lIr#1tc
Building 8T Sarety Division
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 55453 Tanglewood
Owner's.Naine:. Barbara Travis - Herrick
A. P. Number.
Address: 55453 Tanglewood
Legal Description:
Contractor: General Air Conditioning & Plumbing •
City, ST, Zip: La Quinta, CA 92253
Telephone: 760-238-4512
Address: 31170 Reserve Drive
ProjectDescription: Replace Ston A/C, Coil, & 90,000 BTU
City, ST, Zip: Thousand Palms, CA 92276
Furnace
Telephone: 760-343-7488
State Lic. # : 686310
{ ity Lic. #'.
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone: ,
P .� Construction Type:. Occupancy:
State Lic. #:' ::.`✓�
:�w•,rj� y','. , Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Steven Schnierer Sq. Ft.: #Stories: #Units:
#of Contact Person: 818-735-7876
Estimated Value of Project: $10,939.00.
APPLICANT: DO NOT WRITE BELOW THIS LINE
[Telephone
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
PIan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cafes.
Called Contact Person
Plan Check Balance
Tide 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Giading plan
V Review, ready for correctionsrmsve
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Pians resubmitted
Grading
IiY HOUSE-.-
''d Review; ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.T.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total•Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT-027E
Alterations to space Conditioning Systems (formerly CF-iR-ALT HVAC) • _ (Page 1 of 3 )
Project Name: BARBARA TRAVIS-HERRICK Date Prepared: _ 2016-07-26
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 MR -ALT -02 document for each dwelling unit. -
01
Project Name
BARBARA TRAVIS-HERRICK '
02
Date Prepared
2016-07-26
03
Project Location
55453 Tanglewood -
04
Building Type
Single family
05,
CA City
La Quinta
06
Dwelling Unit Name
BARBARA TRAVIS-HERRICK '
"*'ra
Dwelling Unit Conditioned
s `Installing
07
Zip Code
92253 a
•08
Floor Area (ft2)
1410
SC System r
"CFA'served
+,,system a' ?
refrige:cant
Klnstalling�new:.SC
Installing
Installing3
Installing.
Identification or
Number of space conditioning
by this SC
09
Climate Zone
15 r
10
(SC) systems in this dwelling
1
r:�.:A
^:<
System (ft2)
unit.
component?
B. Space Conditioning (SC) System Info!rmationx-
01
02.
03
04
US'
06
U7`
08
- 09
10'
; ,'
t
1
"*'ra
Is the SC`s°"
s `Installing
SC System
SC System r
"CFA'served
+,,system a' ?
refrige:cant
Klnstalling�new:.SC
Installing
Installing3
Installing.
Identification or
Location or Area
by this SC
4ducted
containing a
system
more than 40
entire a
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?,
Alteration Type.
- System 1
Location 1
1410
Yes
Yes
Yes
No
No
f
No
Altered space
conditioning system
Registration Number: 216-A0279624A-000000000-0000 ' Registration Date/Time: 2016-07-26 22:52:13 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007• Report Generated: 2016-07-26 22:52:11
Schema Version: 0.555SDD
D. Altered Space Conditioning System (Sections 150.2(b)lE and'F)
61'
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
All new
Central split
All new
YSetback
Less than or
System 1
furnace
heating
AFUE
gp
AC•
cooling
SEER .
14
equal to•40
R-8
components
components
feet
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%, or 510% leakage to outside',`or 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 2300 CFM/ton required when MCH -25 is required.
Exceptions:
MCH
-Duct systems registered with HERS provideras previously sealed are exempTfrom 20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verificati n of Air Flow MCH -23 o `Refrigeran Charge16ECH 25:.
'
j ,.
-Existing duct systems constructed, insulated or sealed with asbestos are exemptfrom MCH �Ouct}Leakage Testing,rregw emmeentts.
Registration Number: 216-A0279624A-000000000-0000 Registration Date/Time: ' 2016-07-26 22:52:13'- HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report'Generated: 2016-07-26 22:52:11
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-ALT-024
Alterations to Space Conditioning Systems (formerly CF -1R -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: ��//
Jacoby, Ian
cyan �aco Jt.
Company:
Signature Date:
i PERMIT E RATERS
2016-07-26 22:52:13
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
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 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 Part 6 of the California Code ofyRegulat'ons...
a-"�i
4. The building design features or system design features identified on this Certificate of Compliance are consistent with=the informatlon.provided on other applicable compliance documents, worksheets,
. > 'a .mcs 1 4 r .,-...,,..:. .
calculations, plans and specifications submitted to the enforcement agency for"approval with this building permit application.
S. I will ensure that a registered copy of.this Certificate of.Compliance shall_be"made available wiftitlie build irig perm it(s);issued for the: build ni g, andmade avaflable,to the_ehforcement agency for all applicable
inspections. I understand that a registered copy of this,Certificate of ComplanceF isrequred tobe,induded with thedocume ntationthebuilder prov des to the building owner at occupancy.
Responsible Designer Name: �` >M
Responsible Designer Signature: V t�/' 4 .. Ir' -*Jacoby,
Ian
cyan �aco y
Company:.
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-07-26 22:52:13
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-7488
Digitally signed by Ca10ERTS. 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: 216-A0279624A-000000000-0000 Registration Date/Time: 2016-07-26 22:52:13 HERS Provider: CaICERTS
CA Building Energy'Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-07-26 22:52:11
Schema Version: 0.555SDD