BMCH2015-025078-495 CALLE TAMPICO D VOICE (760) 777-7125
`LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/8/2015
Application Number: BMCH2O15-0250 Owner:
Property Address: 54330 SHOAL CREEK PAUL POSSEMATO
APN: 775060005 054330 SHOAL CREEK
Application Description: POSSEMATO RESIDENCE HVAC CHAN E OUT LA QUINTA, CA 92253
Property Zoning: ,� c
Application Valuation: $15,998.00-
Applicant-
15,998.00Applicant: GF0,NENSO� Contractor:
HARRISON ENTERPRISES INC DBA G GCI(19 HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A 31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276 C,0 THOUSAND PALMS, CA 92276
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.: 6863��11�0��'
Date: % $ Contractora�wL �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 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).:
(_J 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
(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: _ 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.
1 �
l
Date: 8 Applicant: '2
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: J Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION `' ACCOUNT . _ QTY "'AMOUNT'' s:a
_.... �.� _.... E'`-
_` PAID PAID. DATE
' * " r
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
e, PAID BY `� METHOD -'� RECEIPT#�
,.
n'.:, CHECK # r� CLTD
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
wDESCRIPTION U M?
ACCOUNT
QTY,
AMOUNT ' - '
PAID '
PAIDDATE.
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY '°, =
, pMETHOD ,
RECEIPT #
CHECK #
.,CLTD BY
" DESCRIPTION r"� £
ACCOUNT ",
QTY
c=x AMOUNT,
PAID F' �'
gPAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM -PC
101-0000-42600
0
$36.26
$0.00
x PAID BY y'
METHOD ' . z3 x`
RECEIPT #" --
CHECK#
CLTDµBY<
Total Paid forCHANGEOUT: $108.78 $0.00
DESCRIPTION x`.
,' " , ° ACCOUNT . ,
QTY
: " AMOUNT a
PAID
"PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
"= z'PAID-BY,
METHOD _.
,,'RECEIP.T,# � �_;� �
�� �� CHECK# � �
�CLTD BY E
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Bln.#
City of La Qulnta
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 #
mat 2-0 t;
Project Address: 54330 Shoal Creek
Owner's Name:. Paul Possemato
A. P. Number:
Address: 54330 Shoal Creek
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone: 760-534-2866
al
Address: 31170 Reserve Drive
Project Description:
City, ST, Zip: Thousand Palms, CA 92276
Replace Ston A/C, Coil, &-90,000 BTU Furnace
Telephone: 760-343-7488 a ,
State Lic. # : 686310 City Lie. #,,
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone: 'Y'
State Lic. #: �`
.,,;�. • `f
Name of Contact Person: Steven Schnierer
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: ' # Stories: #Units:
Telephone # of Contact Person: 8.18-735=7876 X 1
Estimated Value of Project: 15,998.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Pian Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.'.
Mechanical
Grading plan
Zai Review, ready for correctionsfissue
Electrical
Subcontactor List
Called ContactPerson
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN MOUSE:-
'"` Review', ready for corrections/issue
Developer Itupact Fee
Planning Approval •
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
Description: POSSEMATO RESIDENCE HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 7/8/2015 EVA
Approved:
Parcel No: 775060005 Site Address: 54330 SHOAL CREEK LA QUINTA,CA 92253
Subdivision: TR 27762 Block: Lot: 5
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning-
Finaled:
Valuation: $15,998.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT -16 SEER / .80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Wednesday, July 08, 2015 8:53:08 AM 1 of 2
sys•reMs
- DESCRIPTION
ACCOUNT
QTY
AMOUNT,
PAID "
PAID DATE
RECEIPT #
CHECK #-
METHOD,
PAID BY',,
CLTD
-
BY
BSAS SB1473 FEE
101-0000-20306
'0
$1.00
$0:00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
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 forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
.BOND INFORMATION
Printed: Wednesday, July 08, 2015 8:53:08 AM 2 of 2 j
SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE .
RESULT REMARKS NOTES
MECHANICAL FINAL*" BLD
.BOND INFORMATION
Printed: Wednesday, July 08, 2015 8:53:08 AM 2 of 2 j
SYSTEMS
CERTIFICATE OF COMPLIANCE
CF111-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name:
PAUL POSSEMATO I Date Prepared:
2015-07-03
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
PAUL POSSEMATO
02
Date Prepared
2015-07-03
03
Project Location
54330 SHOAL CREEK
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
PAUL POSSEMATO
07
Zip Code
92253
08
Dwelling Unit Conditioned
3400
Floor Area (ft2)
SC System
SC System
CFA served
°� ystem a
refriger nt t
Number of space conditioning
Installing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System Information
01
02
0304
05
F-061 �\
N
1 08 11
09
10
,67
N
l FIs the SC"" -
Installing a
SC System
SC System
CFA served
°� ystem a
refriger nt t
Installing new SC
Installing
+.,In lalling
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
System 1
Location 1
3400
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0182199A-000000000-0000
Registration Date/Time: 2015-07-03 12:23:07
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-03'. 12:23:10
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-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
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 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
16
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans fi
-Duct insulation requirement for new plenums: R6. p'
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: 515%, or 510% leakage to outside; or seal all accessible leaks.
CF2R-MCH-25-H & CF311-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 z 300 CFM/ton required when MCH -25 is required'•
^"
Exceptions: rt
-Duct systems registered with HERS provider as previously sealed are exempt ffOm'MCH-20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air FlowMC` -23; or Refrigerant Charge MECH-25.
duct insulated a+bestos MCH 20 DuctLeakage Testing a ts.
-Existing systems constructed, or sealed with are exempt from require
-
E. Entirely New or Complete Replacement Duct System, witWbr withoutCEqulpment Change out (Sections 150.2(b iia and 150.2(b)3E, F)
This section does not apply to this project.
ntirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project..
Registration Number: 215-A0182199A-000000000-0000 Registration Date/Time: 2015-07-03 12:23:07
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report. Generated: 2015-07-03 12:23:10
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: �/
cyan co
Jacoby, Ian
CIL Jc
Company:
Signature Date:
Stratz Permit Service
2015-07-03 12:22:47
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 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 of R g lat onT..F"' I
I I
�.; l`— rt'
4. Th building dein features or system design f atur s identified on this C rtificat of m li nc r c nsi n wdhahe information rovided on other a licable coin liance documents worksheets,
The g s g sy aa e e e e Co p a e are o� srteq t p pp p eels,
f a; s � E �
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. { `
5. 1 will ensure that a registered copy of this Certificate of,Compliance shall be,made available with the bullding'permit(sy issued for the building, and made available,to the,enforcement agency for all applicable
inspections. I understand that a registered copy of thisCert�,ficate of Compliance -required to be, included with the_documentation,the builder provides to.the building owner at occupancy.
Responsible Designer Name: `" .. $ i -j
Responsible Designer Signature: V or
Shanley, Barbara
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-07-03 12:23:07
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-A0182199A-000000000-0000 Registration Date/Time: 2015-07-03 12:23:07 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-03 12:23:10
Schema Version: 0.555SDD