BMCH2015-020278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BMCH2O15-0202
Property Address:
47205 VIA ANTIBES
APN:
643160024
Application Description:
EBNER RESIDENCE
Property Zoning:
Application Valuation:
$10,088.00
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
�r°F lwQur rw
COMMUNITY DEVELOPMENT DEPARTMENT
13UILDJUG E f�b IT
Owner:
PATRICIA EBNER
J1J,� QF IAa111NDE AR�tvAENS 92253
100
LICENSED
.,,wTV 10
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 License No.: 686310
r �
Date: G1 10 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
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:
Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 6/10/2015
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
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. th�✓ork for which this permit is issued.
`'9 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: G1 10Applicant:�i.�L
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: Signature (Applicant or Agent): ��
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $1.00 6/10/15
FINANCIAL INFORMATION
LRECEIPT # CHECK#`1. CLTD BY
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $1.00 6/10/15
BYE > METHOD '
LRECEIPT # CHECK#`1. CLTD BY
x w
F?e
IE, INC. CHECK
R6946 23824 AZA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00.
y* `fir DESCRIPTIONr�rn`
, ACCOUNT
£QTYF
` '
° *, PAID t sk
PAID:DATEs
,� ,AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0.
$72.52
$72.52
6/10/15 .
h PAID BY
METHOD'7i
RECEIP-T # `.'
CHECK #
BY
y
6: ECLTD
Ij
IE, INC.
CHECK
R6946
23824
AZA
�6 .DESCRIPTION,
RACCOUNT « "
QTY
AMOUNT
PAID
PAID:DATEt
g`
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
6/10/15
�* " PAID; BY ¢ xa.�
,METHOD `
RECEIPT#' 3-'
CHECK #CLTD
BY
�,.r
�`
IE, INC.
CHECK
R6946
23824
AZA
Total Paid forCHANGEOUT: $108.78 $108.78
` D >.
ESCRIPTION
CCOUNT
QTM�
( PAID
PAID DATE
"`,:..
._� �AMOUNT,,i¢,
• .. x., -o
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
6/10/15
�Fr PAID'BY,
n METHOD '"As .
' ,�j
F CLTD BY
^RECEIPT#
;g.CHECK#
IE, INC.
CHECK
R6946
23824
AZA
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
TOTALS:
Description: EBNER RESIDENCE
Type: MECHANICAL
Subtype: Status: ISSUED
Applied: 6/10/2015 AZA .
Approved: 6/10/2015 AZA
Parcel No: 643160024 Site Address: 47205 VIA ANTIBES LA QUINTA,CA 92253
Subdivision: TR 26152
Block: Lot: 150
Issued: 6/10/2015 AZA
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $10,088.00
Occupancy Type: Construction Type:
Expired: 12/7/2015 AZA
No. Buildings: 0
No. Stories: 0 No. Unites: 0
THOUSAND
Details: HVAC CHANGE OUT - REPLACE EVAPORATIVE COIL UNIT 90,000 BTU, 80% AFUE, 14.5 SEER 2013 ENERGY CODE, CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES DESCRIPTION.
Y
Printed: Wednesday, June 10, 2015 12:32:38 PM 1 of 2
SYSTEMS
CONDITIONS
•
NAME_TYPE -
NAME
.ADDRESS1 :s
.- CITY
1STATE '; ZIP -PHONE } x -• . FAX EMAIL.:
APPLICANT
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
STE A
PALMS
CONTRACTOR
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
-
STE A
PALMS
OWNER
PATRICIA EBNER
I
1 92253
Y
Printed: Wednesday, June 10, 2015 12:32:38 PM 1 of 2
SYSTEMS
747
DESCRIPTION
sACCOUNT ' �,
'QTY
-, .AMOUNT !
`' zyPAID ° ``
PAID DATE
4RECEIPT#
CHECK At
METHOD ,
, PAID BY
Y
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00 '
$1.00
6/10/15
R6946
23824
CHECK
IE, INC.
AZA
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$72.52
6/10/15
R6946
23824
CHECK
IE, INC.
AZA
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0,
$36.26
$36.26
6/10/15
R6946
23824
CHECK
IE, INC.
AZA
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $108.78
PERMIT ISSUANCE
101-0000-42404
0
$91.85
'$91.85
6/10/15
R6946
23824
CHECK
IE, INC.
AZA -
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
•$201.63
SEQID INSPECTIONPTYPE, INSPECTOR SCHEDULED COMPLETED RESULT REMARKS'- NOTES
{ DATE DATE
MECHANICAL FINAL" BLD .
„ BOND INFORMATION
Printed: Wednesday, June 10, 2015 12:32:38 PM 2 of 2
SYSTEMS
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
1,11
��G� %dIy�DZOZ
Project Address: f-l"12p�; Ahs; bis
Owner's Name:'
A. P. Number:
Address: LA110S V 3 q A J beS
Legal Description:
City, ST, Zip: L 0. 1�u5 rA c, G 2253
Contractor:
telephone: -760-- 7-)-)_ coo
Address: 311-70 �ege,� v� �4.
Project Description:
City, ST, Zip:61�.cuscx.c�?a rc�s CA •
QZ2
�t �t7,ct -V
t� CG ( s` c1 000\
Telephone: foO- 3 ci3 -7 yS g
.................
T3 v
State Lic. # : 68(6310
City Lic. #;
Arch., Engr., Designer:
Address:
City,, ST, Zip:
Telephone: e.
Construction T YP e: Occupancy:,
Y•
State te Lic. #:
ProJ'e t hPe (circle rcle ne)New Add'
• n Alter Reai
Pr Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: co
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
r
t
Total Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVAC
EM
CEC-CFIR-ALT-04-ERevised 061141 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
—t �i
Enforcement Agency:
Da Prepared:
Permit#:
2-o i eS
C:} Lr^ �h !c
(o to is
Equipment Type
Equipment Efficienty
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
JZSplit System
•WEvaporator Coil
Xq.AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
JKSetback
❑ Mini Split
;Condensing Unit
❑ Compressor
*-' ;SEER
❑ R-8' (CZI1, 14, 15) Ducting
18S5 sqft
(If not already
�( Furnace
❑ Lineset
HSPF
❑ R-6 (all CZ's) Plenums
present, must
be installed)
❑ TXV
EER
13R 5 or R7.5) Lineset"
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.
X 1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)'•HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Air Handler/Furnace' (Can include new ducting)
Installer Requirement:. Duct leakage (L15%, or < 10% to outside, or seal all accessible leaks), Air Flow z 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building .......
❑ 2. New HVAC System—
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts3
CF1R-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 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 Ducts' and.one or more of the following CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (L15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
3 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 reused 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 linesets 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%", 2.5-3T-2'/.", 3.5 to 4T-2%", 5T-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 information 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 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 CCR.
5. The building design 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.
Res onsible Designer Name:
�e�rev� Sc
Rcessonsible Designer Signature:
sZ. Com%---
Date Signed:
License:
X8(03 i O
e 2
J�
(o I D IS
Company:
�(nc em'i �e, -
Address:
31t7oPeserve�
Cit _/State/Zip:
lh�sa�•d l7o�rh Q2
Phone:
'-7�O 343-'�48g
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300