BMCH2015-033078-495 CALLE TAMPICO C� 0 D 4�
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
T BUILDING PERMIT
Application Number: BMCH2O15-0330
Property Address: 79760 TANGELO
APN: 776230003 r
Application Description: HINDEN BARY REPLACE AIR CONDITION FURNACE
Property Zoning:
Application Valuation: $13,933.00 D
Applicant:
GENERAL AIR CONDITIONING & HEA AUG 2 4 2 15
OUTSIDE CITY LIMITS
CITY OF LA QUINT
COMMUNITYDE ELOPMEMDEPARTMENT
. LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 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: $ Z4 15 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 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:
VOICE (760) 777-7125
FAX (760)777-7011
INSPECTIONS (760) 777-7153
Date: 8/24/2015
Owner:
BARRY HINDEN
79760 TANGELO
LA QUINTA, CA 92253
Contractor:
GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
(760)343-7490
Llc. No.: -LIC-0003606
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.
! 5 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: R '-4 'Applicants n �
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.,
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed -under or pursuant to any permit
issued as.a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building .
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date. Signature (Applicant or Agent): ��
'FINANCIAL ,• 1
x DESCRIPTION `° £ g ?' £ACCOUNTI� {' QTY; AMOUNT : `�$ e, PAIDp 4 iPAID DATEt.
e :YXx' ...._
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
=u 4 r.CHEC# `CLTD BYPAIDBY, METHOD
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00.
, DESCRIPTION ."
�.
; .ACCOUNTS "4
;QTY
F
AMOUNTt=
r - PAID '
tiPAIDbATE'
HVAC CHANGEOUT — SPLIT—SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID BY
�METIiOD�ary
" RECEIPT#
€ CHECK#I
CLTD BY
DESCRIPTION { fief
, fs £ ACCOUNTIi ` t r
41 ., -_..:
';QTY
. AMOUNT
t q.:... ..:_
spy PAID .;�
PAID:MATE`
p ....
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAID BY1rT 1
a METHOD `
> r RECEIPT #
;= CHECK #
CLTD BY f..
r
Total Paid forCHANGEOUT: $108.78 $0.00
DESCf21PTION } I
r ACCOUNTH
QTY
AMOUNT' s
PAID
PAID DATE;
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
* PAID BY
.. ..: °.
tVIETHOD . '
M
RECEIPT # } '} `` k
CHECK # s
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:••
Description: HINDEN BARY REPLACE AIR CONDITION FURNACE
Type: MECHANICAL Subtype: Status: UNDER REVIEW.
Applied: 8/24/2015 PJU
Approved:
Parcel No: 776230003 Site Address: 79760 TANGELO LA QUINTA,CA 92253
Subdivision: TR 24890-3 Block: Lot: 3 -
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $13,933.00 Occupancy Type: Construction Type:
Expired:
t
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: REPLACE 5 TON 16 SEER A/C COIL & 80,000 BTU FURNACE [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TC
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: ivionday, August 24, 201S 1:26:06 vivi 1 of Z
' SYSTEMS
. .. .
...... . . . . ...... . . .......
. .
.. . .... - --__-_. . . .........
DESCRIPTION
ACCOUNT
QTY
'AMOUNT
PAID
PAID DATE
RECEIPT#
CHECK #:
METHOD
PAID BY
13Y
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
_F0
PERMIT ISSUANCE
101-0000-42404
$91.85
$0.00
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
. ... ..... . . .... .... . . ...... ... TOTAI.Si $0.00
.......
.. .. .
BOND INFORMATION ................. ... . .
. .... ............ ... . .......
Printed: Monday, August 24, 2015 1:26:08 PM 2 of 2 (r)"W'YSTEMS
Bin.#
0f L.CI Quinta
-Building 8r Safety Division
P.O. Box 1504,78-495 Calfa Tampico
U.Quinta, CA 92253 -:(700) 777,7012
Building Permit Application and Tracking Sheet
Permit # t, i
t—�
{�
Project Address: 79760 Tangelo
Owner's Name:. Barry Hinden
A. P. Number.
Address: 79760 Tangelo
Legal Description:
City, ST, Zip. La Quinta, CA 92253
Contractor: General Air Conditioning
Telephone: 323-371-1776
Address: 31170 Reserve Drive
Project Description: Replace 5ton A/C, Coil, & 80,000 BTU
City, ST, Zip: Thousand Palms, CA 92276
Furnace
Telephone: 760-343-7488
s::si xilga z
State Lie. # : 686310
City Lie'. #<
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:w
7
State Lic. #:~'~
!^»4�
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories:
#Univ:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project: $13,933.00•
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING
PERMITFEES
Pian Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cales.
Called Contact Person
Plan Check Balance •
Tide 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mecharilcal
Grading plan
r' Review, ready for correctionstissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review; ready for eorrectionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: BARRY HINDEN Date Prepared: 2015-08-20
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 CFIR-ALT-02 document for each dwelling unit..
O1
Project Name
BARRY HINDEN
02
Date Prepared
2015-08-20
03
Project Location
79760 TANGELO
04
Building Type
Single family. ,
05
CA City
La Quinta
06
Dwelling Unit Name
BARRY HINDEN
07
Zip Code
92253
08
Dwelling Unit Conditioned
3000
r . ,t
Installing
r a
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
30
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
Ol
02
03-
04
USl06fr"A
, 07` n
Q8 t
09
10
i, :.�kn
►`T .z;ls the SC
,i "S ' X�.�,isr:..ri('
Installing a
,
/
SC System
SC System
CFA served
systema
r�efnge�rant
r%s,'
Installing newrSc
r . ,t
Installing
r a
Installing
installing
Installing
Identification or .
Location or Area
by this SC
ducted
containing
system
e than 4
entirely new
new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
3000
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not.apply to this project.
Registration Number: 215-A6298449A-000000000-0000 Registration Date/Time: 2015-08-20 13:29:25 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance' Report Version: 2014-03-31 Report Generated: 2015-08-20 13:29:07
Schema Version: 0.555SDD
r
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)lE and F)
O1
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
-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: 515%, or 510% leakage to outside, orseal 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 2 300 CFM/ton required when MCH -25 is'required.
Exceptions:,, ,, y
-Duct systems registered with HERS provider as previously sealed are exempt froi;-MCH-20 Duct Leakage,Testing requirements.
-Heating-only systems and Air Handler/Furnace do require Air Flow M'14CH-23 Refrigerant
changes not verification of or Charge-MECH-25.
asbestoa are Du e
N
I n'
Existing duct systems constructed, insulated or sealed with exemp from MCH 20 Ys.
aiLeakkaage Testi g re
-
• A -.•m. — .. - __ .- — Vii• .. �..� .w
E. Entirely New or Complete Replacement Duct System, with or wighout-Eclgipment Changeout (Sections 150.2(:b)_iDiia,;and r50.2(b)3E, 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-A6298449A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-08-20 13:29:25
Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2015-08-20 13:29:07
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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: n
Jacoby, Ian
cyan �aco�
Company:
Signature Date:
Stratz Permit Service
2015-08-20 13:29:16 t
Address:
CEA/ HERS Certification Identification (if applicable):
5858 Dovetail Drive
City/State/Zip:
Phone:
Agoura Hills CA 91901
818-735-7876
Responsible Person's Declaration statement..
I certify the following under penalty of perjury, under thelaws 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 'commpoonnents, and manufactured devicesfor 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. `;" IV
onsistent
4. The building design features or system design features identified on this Certifica a of Compliance are with the information provided or ther;applica le"compliance documents, worksheets,
calculations, plans and specifications submitted.io the enforcement agency for approval with this building permit application. if
t N:
_+!. $ k! ;i.) . la - $' 3- 4414 .E .-,s
5. 1 will ensure that a registered copy of this Certificate of Compliance shall'be:made available with_the build ing,permit(s)ussued for the liiiilding and.made available.to the;onforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate ofCompliance,is.required to be included Xwith the docume,Ctation�thevbuilder pr vides to toe building owner at occupancy.
Responsible Designer Name: t`% W
-1�
Responsible Des gner Signature: V IL -1 EI
Shanley, Barbara
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-08-20 13:29:25
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: 215-A6298449A-000000000-0000 Registration Date/Time: 2015-08-20 13:29:25 .HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance . Report Version: 2014-03-31 Report Generated: 2015-08-20 13:29:07
Schema Version: 0.555SDD