BMCH2015-0296Q
4 arw
VOICE (760) 777-7125
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
FAX
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT
(760) 777-7153
BUILDING PERMIT
Date: 7/30/2015
Application Number:
BMCH2O15-0296
Owner:
Property Address:
47085 VIA ANTIBES
ROBERT FRANCISCO
APN:
643160018
47085 VIA ANTIBES
Application Description:
HVAC CHANGE OUT & FURNACE (2)
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$25,896.00
Applicant: -"� — _ Contractor:
GENERAL AIR CONDITIONING & HEA GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS -- -- OUTSIDE CITY LIMITS
JUL 3 0 2015
(760)343-7490
Cl` FIA(lj!(11ZF'' Llc. No.: :LIC -0003606
100h MUNITYDEVELOPA!£NTDEPARTMENT,
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: License No.: :LIC -0003606
Date: 30 S Contractor: �iLZ L ��—
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 Divisio 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 fo a
permit subjects the applicant to a civil penalty of not more than five hundred Bolla s
($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.).
(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:
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.
4 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.'
te: 3 IJ Applicant: JAL
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. `
Vie: �O (, Signature (Applicant or Agent):
FINANCIAL INF611MATION
DESCRIPTION `. 000ONT �,;�k , QTYr AMOUNT
;PAID° ` "PAID.DATE
BSAS SB1473 FEE 101-0000-20306 0
$2.00
$0.00
L ya r PAID BY k� ` :' " ;{� F� METHOD.cl �" Y `RECEIPT;#,
;:aCI1ECK # t CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $2:00 $0.00
t�{''DESCRIPTION - y" t#
` ' + •, ACCOUNT "�= �, '9�
QTY
'+' AMOUNT "
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
r 161-0000-42402
0
$145.04
$0.00
PAIDyBY �•:s r .;�"y
' fr i =,`,.: METHOD ..;+
� RECEIPT'#car a
�.�P„`CHECK# xt>;
CLTD BY .
E ..,,� s d DESCRIPTION” '
ar ACCOUNT y s£ r h
• Dg ���
QTYF
'''_ AMOUNT z €Y
�'• !
x PAID' , '
�` 4
RAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC-
101-0000-42600
0
$72.52
$0.00
's PAID BY 4
x
,METHODS ,
i :RECEIPT:;#�.
�. T �CkCK #� :w
CLTD BY
Total Paid forCHANGEOUT: $217.56 $0.00
1;"DESCRIP.TION'y
rpt �s� ":ACCOUNT ;i
QTY
M
?rte AOUNT[ `
" PAID `.
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID`BY ,• ., �
.. k. s� ",
a-
r RECEIPT#
CHECK # .., :
CLTD BY�r`�
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
i
Description: HVAC CHANGE OUT & FURNACE (2)
Type: MECHANICAL Subtype: Status: UNDER REVIEW -
Applied: 7/30/2015 PJU
Approved: `
Parcel No: 643160018 Site Address: 47085 VIA ANTIBES LA QUINTA,CA 92253
Subdivision: TR 26152 Block: Lot: 144
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $25,896.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ADDRESSi.
Details: TWO ONE (4) TON ONE 3 TON A/C & HTNG CENTRAL SPLIT SYSTEM 16.5 SEER 4 TON PER 2013 MECHANICAL CODES 2013 ENERGY]
CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION
Printed: Thursday, July 30, 2015 2:31:33 PM 1 of 2 CB SYSTEMS
CONDITIONS
CONTACTS
NAMETYPE" ;^ �= e.^�NAME�r x`j:'
ADDRESSi.
}y-`� STATE
ZIPz' += PHONE,
APPLICANT
GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
(760)771-3139
CONTRACTOR
GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
(760)771-3139
OWNER
ROBERT FRANCISCO
47085 VIA ANTIBES
LA QUINTA CA
92253 (760)771-3139
Printed: Thursday, July 30, 2015 2:31:33 PM 1 of 2 CB SYSTEMS
7
A;�
CLTD,,
DESCRIPTION
ACCOUNT
C
QTY
AMOUNT
'PAID DATE
AEC"iEIP'T
6 EC'K_�
METHOD�
'PADBY-.,
w
HVAC CHANGEOUT-
101-0000-42402
0
$145.04
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT-
101-0000-42600
0
$72.52
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS: $311.41 $0.00
HAAF
Printed: Thursday, July 30, 2015 2:31:33 PM 2 of 2 0MUSYSTEMS
Bill #
QtOf La QUInta
Buttdtng 8T Safety Division
P.O. Box 1504,78-495 Calle Tampico
la.Qtrinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ProjeciAddress: 47085 Via Antibes .
Owner's Name:. Robert Francisco
A. P. Number.
Address: 47085 Via Antibes
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor.' General Air Conditioning
Telephone: 760-771-3139
g
err*
Address: 31170 Reserve Drive
Project Description:
City, $T, Zip: Thousand Palms, CA 92276
Replace (1) 4ton / 80,000 -BTU Complete System
Telephone: 760-343-7488
a `'z '�`
? , ril '
Replace (1) 3ton /.60,000 BTU Complete System
State Lic. # : 686310
City Lir. #;
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #Univ:
State Lic. #:f" v
^., ;�..,:.. �;,
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person: 818-735=7876 X 1
Estimated Value of Project: $25,896:00.
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd 'Rec'd TRACIC NG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2id Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.I.
H.O.A. Approval
Plant resubmitted
Grading
IN HOUSE:-
7n° Review; ready for correctlonslissuc
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name:- ROBERT FRANCISCO Date Prepared: 2015-07-30
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
ROBERT FRANCISCO
02
Date Prepared
2015-07-30
03
Project Location
47085 VIA ANTIBES
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
ROBERT FRANCISCO
07
Zip Code
92253
08
Dwelling Unit Conditioned
2486
Installing
Installing}
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
15
10
(SC) systems in this dwelling
2
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
- .., --1- - _.
B. Space Conditioning (SC) System InformationtX4! .." .. ,.
01
02
03
04
05
06
67
08
09
10
�.
*FIs the SC
; e•;'? •s3 "�
Installing a
arc+r�r.�' tea+ ,w
�s+ �,w.�a�'
raa .yw x�
`�r� �'
SC System
SC System
CFA served
systema
refrigerant !
ylnstalling�newrSC
Installing
Installing}
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
Altered space
System 1 •
Location 1
1243
Yes
Yes,
Yes
No
No
No
conditioning system
Altered space
System 2
Location 2
1243
Yes
Yes
Yes
No
No
No
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: 215-A0210132A-000000000-0000 Registration Date/Time: 2015-07-30 06:53:06. HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-30 06:52:52
Schema Version: 0.555SDD
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)lE and F)
01
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
This field or
This field or
System I
furnace
heating
AFUE
0.8
AC
cooling
SEER
16.5
Setback
section is not
section is not
components
components
applicable
applicable
Central gas
All new
Central split
All new
This field or
This field or
System 2
furnace
heating
i' AFUE
0.8
AC
cooling
SEER
16.5
Setback
section is not
section is not
components
y^`,
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans 1:1,.
-Duct insulation requirement for new plenums: R6
CF2R-MCH-20-H & CF3R-MCH-20-H —Duct Leakage testing required when heating or cooling components ar._e_,installed.in ducted systems or.When than 40 ft of duct length is replaced.
,more
-Leakage rate compliance: 515%, or 510% leakage to.outside or seal all'access'bl'e leaks.
nY-ont'ining cable
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigera` componentsare installed o red'(a (applicable in CZ,2, 8tN-
CF2RCF3R-MCH-23 & CF313-MCH-23 Air Flow 2 300 CFM/ton required when MCH 25 is required
Exceptions:i
-Duct systems registered with HERS provider as previously sealed are exempt from MCHIt 11P-20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace•cfianges do not require verification of Asir FI � or &_. rigerant Charge M RH-2
.MCHL23,,
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System; with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 215-A0210132A-000000000-0000 Registration Date/Time: 2015-07-30 06:53:06 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-30 06:52:52
Schema Version: 0.5555DD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -111 -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
Jan Jaco�
Company:.
Signature Date:
Stratz Permit Service.
2015-07-30 06:52:46
Address:
CEA/ HERS Certification Identification (if applicable):
5858 Dovetail Drive
City/State/Zip:
Phone:
Agoura Hills CA 91301
818-735-7876
Responsible Person's Declaration statement ,
I certify the following under penalty of perjury, under the lawsof 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 of Regulations. ..:.
•. «aw
4. The building design features or system design feat res identified on this Certi icf" a e of Compliance are consistent with4he informat on,provided on',otherapphcabl'e pliance documents; worksheets,
to syr- .p...�bx.
r rE t'z e&
calculations, plans and specifications submitted to the enforcement agency for;approval,witl this building permit application.
` �°a'.. ',
C n'-� > Al iof iR4a;' '3 -s * z"4 r•,.
S. I will ensure that a registered copy of this certificate of Compliance shall be�made;available wdhrthe buildmg:pe_rmit(s)sissued forithelliding, and,made available toahe enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Complances requed to bencluded w,i the�docume�gt�ation�thebu Ider provides to the building ow, ner at occupancy.
th
Responsible Designer Name: r w
Respons b Des g er 5 gnature:L--
Shanley, Barbara
' rr
'or
U
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-07-30 06:53:06
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
Digitally signed by CaICERTS. 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: 215-A0210132A-000000000-0000 Registration Date/Time: 2015-07-30 06:53:06 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-30 06:52:52
Schema Version: 0.555SDD