BMCH2015-023578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253,
Application Number:
Property Address:
APN:
Application bescription:
Property Zoning:
Application Valuation:
Twyl 4
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BMCH2O15-0235
48443 STILLWATER DR
623530015
JENZ RESIDENCE HVAC CHANGE OUT
$5,294.00
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
A
AN 3'0 2015
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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
Date: 1ST Contractors '
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:
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
Lender's
VOICE (760) 77777125
FAX .(760) 777-7011
INSPECTIONS (760) 777-7153
Dater 6/29/2015
Owner:
DIANE COOLEY TAMMY JENZ
48443 STILLWATER DRIVE
LA QUINTA, CA 92253
Contractor:
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 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: Polity 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: �oI3OI%� Applicant
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: % 30 Signature (Applicant or Agent): �A ,
FINANCIAL INFORMATION
y t' DESCRIPTION :ACCOUNT i,QTY AMOUNT
PA * a PAID DATE_
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
o
z c t=.. PAID$Yx METHOD * ` RECEIPT #
Nr" .. .. f. a. ,... ! _ z:s> .. "'x. 4 ^,.. .:-'...,'. •... v .,. i [.n Xf'
CHECK # r + CLTD BY
t • f ti. a� '.,
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
�a
_DESCRIP.,TION t P, ,r.
f t
£' `ACCOUNT, z ,
a `. `.; fa. ,
xQTY�:
�
LAMOUNT
� PAID
Y " .
PAID',,DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
L d .. A- -
PAID BY �rc T
al.
METHOD
G
f �' ' CHECK #•: ,
E %p CLTDYg BY.„
Y�.” • 3 DESCRIPTION &+ ;'�
ACCOUNT r"s
jQTY
I ' .,AMOUNT
{ PAID
`.:t+G�F
4PAID DATE:
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
.• } _ PAID BY
s; `X METHOD " {iRECEIPT.#
r,`
CHECK #
CLTD BY; i
Total Paid forCHANGEOUT: $108.78 $0.00
z;ACCOUNT
}QTY
AMOUNT T�
PAID s
;PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID`"BY
`METHOD K
RECEIPT #� ,
`%i ;, CHECK # u,
CLTD BY '
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:• 0•
Bln.#
Crt�r Of.U QujnLa
Butiding a Safety Division
P.O. Box 1504,78-495 Calle Tampico
ta.Qulnta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
a3M C. 2 -m s
Project Address: 48443 Stillwater Drive
Owner's Name:. Diane Cooley & Tammy Jen2
A P. Number.
Address: 4.8443 Stillwater Drive
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone: 816-588-7649
Address: 31170 Reserve Drive
Project Description: Replace 1.5ton Heat Pump & Air
City, ST, Zip: Thousand Palms, CA 92276
Handler
Telephone: 760-343-7488<-;"�r``MW
5
State Lic. # : 686310 City Lie'. #;
Arch, Engr., Designer
Address:
City., ST, Zip:
Telephone:
7 .L rs
State Lic. #: w,�^:: »
Name of Contact Person: Steven Schnierer
nstruction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories: #Unite:
Telephone # of Contact Person: 818-735=7876 X 1
Estimated Value of Project: $5,294.00 .
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
'Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Calcs.
Called Contact Person
Plan Check Balance
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
P° Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
M HOUSE:-
7id Review; ready for correctionsfkssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P'.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description: JENZ RESIDENCE HVAC CHANGE OUT
CONDITIONS
Type: MECHANICAL
Subtype:"
Status: APPROVED
Applied: 6/29/2015 EVA
Approved: 6/29/2015 EVA
Parcel No: 623530015 Site Address: 48443 STILLWATER DRLA QUINTA,CA 92253
Subdivision: TR 29436
Block:
Lot: 123
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $5,294.00
Occupancy Type:
Construction Type:.
Expired:
No. Buildings: 0-
No. Stories: 0
No. Unites: 0 -
CA. 92276
Details:
STE A PALMS
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
FAX EMAIL -
NAME TYPE . - t ., NAME a �,
a
„" : ADDRESSI ". CITY
STATE ZIP
PHONE `".
APPLICANT HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE THOUSAND
CA 92276
(816)588-7649
STE A PALMS
CONTRACTOR HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE THOUSAND
CA. 92276
(816)588-7649
STE A PALMS
OWNER DIANE COOLEY TAMMY JE
484.43 STILLWATER ,
LA QUINTA
CA 92253
(816)588-7649
DRIVE
FINANCIAL INFORMATION t
Printed: Monday, June 29, 2015 4:18:23 PM 1 of 2
srsrenas
DESCRIPTION
ACCOUNT..
QTY
AMOUNT _
PAID
PAID DATE
RECEIPT #
CHECK # :
METHOD
PAID BY > ..
CLTD'
BY
BSAS S131473 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
• PO
ARCItiIT PROJECTS
BOND INFORMATION",
ATTACHMENTS
Printed: Monday, June 29, 2015 4:18:23 PM 2 of 2' > x. YSTUMS
STATE OF CALIFORNIA
ALTERATIONS - HVAC
" �
CEC-CFIR-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE MR -ALT -04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -1R -ALT -HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
Date Prepared:
Permit#:
48443 Stillwater Drive
City Of La Quinta
06/29/2015
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
aporator Coil
AFUE
COP
❑ R-6 (CZ Z 8-13) Ducting
Served by system
Setback
❑ Split System
Condensing Unit
❑ R-8' (CZ 11, 14, 15) Ducting
3,349 sqft
(If not already
❑ Mini Split
❑ Compressor
14 SEER
7.7 HSPF❑
's
R - (all CZ) Plenums
present, must
❑ Furnace
❑ Lineset
EER
❑ R-55 or R7.5) Lineset
be installed)
❑ TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
folon 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.
1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CFIR-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
Air Handler/Furnace' (Can include new ducting)'
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 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 ....... I
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CF1R-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
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 2 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement
Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF1R-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, Furnace2
CF3R: MECH-20-HERS, MECH-(23 or 20HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow Z 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' CF111-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
11EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
9
' 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.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' 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%a", 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.
Responsible Designer Name:
Responsible Designer Signature:
Date Signed:
License:
Steven Schnierer
06/29/2015
686310
Company:
Address:
City/State/Zip:
I Phone:
General Air Conditioning
31170 Reserve Drive
11housand Palms, CA 9227
760-343-7488
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300