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BMCH2017-019278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 DESIGN & DEVELOPMENT DEPARTMENT BUILDING -PERMIT Application Number: BMCH2O17-0192 Property Address: 81838 SUN CACTUS LN APN: 764330054 Application Description: HATCH / CHANGE OUT (1)20SEER/8AFUE SPLIT Property Zoning: Application Valuation: $19,428.00 Applicant: IE INC. 32115 LA BAYA WESTLAKE VILLAGE, CA 9.1362 LICENSED CONTRACTOR'S DECLARATION 1 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.•C36 License No.: 686310 Da er5 zz 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).: (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 Lender's VOICE (760) 777-:125 FAX (760) 777-:011 INSPECTIONS (760) 777-:153 (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 worker:' compensation, as provided for by Section 3700 of the Labor Code, for the performa,ue of the work for which this permit is issued. !� I have and will maintain workers', compensation insurance, as required b+ 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: INSURANCE COMPANY OF THE WEST Policy Number: WSDS031658 _ _ 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,1 shall forthwith comply -with those provisions. Dates LZ I _ApplicantC_ 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 subjec 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 inued 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 i! not commenced within 180 days from date of issuance of such permit, or cessation of vmrk 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 builciing ,onstruction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. Daie: Zz 7 Signature (Applicant or Agent): JuZ_5Z C�� Date: 5/22/;017 Owner: BEVERLY HATCH Ci 81838 SUN CACTUS LN z LA QUINTA, CA 92253 -< C3 , b M .5 ' Contractor: o7aN r—i HARRISON ENTERPRISES INn DBA 4;GaERALAIR 31170'RESERVE DRIVE I THOUSAND PALMS, CA 92?27fi (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 worker:' compensation, as provided for by Section 3700 of the Labor Code, for the performa,ue of the work for which this permit is issued. !� I have and will maintain workers', compensation insurance, as required b+ 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: INSURANCE COMPANY OF THE WEST Policy Number: WSDS031658 _ _ 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,1 shall forthwith comply -with those provisions. Dates LZ I _ApplicantC_ 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 subjec 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 inued 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 i! not commenced within 180 days from date of issuance of such permit, or cessation of vmrk 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 builciing ,onstruction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. Daie: Zz 7 Signature (Applicant or Agent): JuZ_5Z C�� Date: 5/22/2017.. Application Number:. BMCH2017-0192 Owner. Property Address: ' 81838 SUN CACTUS LN BEVERLY HATCH APN: 764330054 81838 SUN CACTUS LN Application, Description: HATCH / CHANGE OUT (1)20SEER/8AFUE SPLIT LA QUINTA, CA 92253. Property Zning: Application Valuation: $19,428.00 Applicant: Contractor: IE INC. HARRISON ENTERPRISES INC DBA GENERAL AIF 32115 LA BAYA 31170 RESERVE DRIVE WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276 (760)343-7488 Llc. No.: 686310 Detail: HVAC CHANGE OUT - (1)205EER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 201E CALIFORNIA BUILDING CODES.. Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: DESCRIPTION • � • ACCOUNT QTY AMOUNT . Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT . HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT- SPLIT -SYSTEM PC 101-0000-42600 0 $38.00 -Total Paid for CHANGEOUT: $114.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 '0 $5.00•. Total Paid for TECHNOLOGY ENHANCEMENT FEE: • $5:00 Bin # 0ty. of La Quint'a Building U Safety Division 78-495 Calle Tampico. La Quinta, CA 92253 - (760) 777-7012 Building Permit'Application and Tracking Sheet. Permit # Project Address: g\ 3 8 S CQG4vS 1. Owner's Name: A. P. Number: Address: $1838 Sv,, CCAis. L., Legal Description: City, ST, Zip: • e, ' 4a CA � 9Z Z3 3 Contractor: CeY�ec \_ — a Telephoneh ne•7dD. s E1- i1ZZ Address: 3 i \-10 1C� 5e the \ Project Description: IZ 5ib , A Co.-. i City, ST, Zip: CR?-Z--7L qb Ott -ivv Telephone: % b03- 3 - 7c{ P State Lic. # : 6?6'31 O City Lie. #.. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: one: Construction n TY e: Occupancy: P � • State Lie. #: roJ Alter Re tYPa circle one : New Addn pair Demo Name of Contact Person: Sq: Ft.: # Stories: # Units: Telephone # of Contact Person: B 1$- 73$--7Q Estimated Value of Project: i9•, 42 CC> APPLICANT: DO NOT WRITE BELOW THIS. LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. 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:- 3' 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 - 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: BEVERLY HATCH Date Prepared: 2017-05-22 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 BEVERLY HATCH 02 Date Prepared 2017-05-22 03 Project Location 81838 SUN CATUS LANE 04 Building Type Single family 05 CA City La Quinta y.�"�r ` -06 Dwelling Unit Name WHOLE HOUSE Identification or Location or Area by this SC ducted containing 07 Zip Code 92253. 8 DwellingUnit Conditioned E 2216 Served System (ft) ;Y component? Floor Area (ftZ) feet of ducts? duct system? SC system? 4 SYSTEM 1 WHOLE HOUSE 2216 Yes _ Yes {{ Number of Space No 09 Climate Zone 15 ""' 10' Conditioning (SC) Systems in 1 this Dwelling Unit: e B. Space Conditioning (SC) System information if 01 02 03 04 NO OS 106 07 08. 09 10 SC System SC System CFA served Is the SC QnrT system a Installin, g a •atl" 'eu � r Vt refrngerant , . w with In'�t Ki Installing new C Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than,40 entirely new entirely new Name Served System (ft) system? component? components? feet of ducts? duct system? SC system? Alteration Type. SYSTEM 1 WHOLE HOUSE 2216 Yes Yes Yes No No' No Altered space conditioning system C. Extension of Existing Duct System, Greater Than, 40 Feet (Section 150.2(b)Mill b) This section does not apply to this project. Registration Number: 417-A020094603A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration .Date/Time: 2017-05-22 10:01:02 Report Version: 2016. 1.005 Schema Version: rev 10/16 HERS Provider: CHEERS Report Generated: 2017-05-22 10:01:02 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) 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 All new All new Central gas Central split This field or This field or SYSTEM 1 heating AFUE 80 cooling SEER furnace AC 20 Setback section is not section is not components components applicable applicable Required Documentation: : CF2R-MCH-01-E - Space Conditioning Systems �' �� - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6:(CZ1 30 12 an 13) and R8 (CZ 11 and 14-16) CF2R and CF3R-MCH-20-H - Duct Leakage Test 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: <=15% or <= 10% leakage to outside, or seal all accessible leaks. O� 'I CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing corn ents � �llled or altered (applicable -in CZ 2, 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 Is required. F Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. - Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. R'_ I lei __ I . K -M I I E.'Entirely New or Complete Replacement Duct System, with or without -Equipment Changteou (Sections 150.2 b lDiia and 150.2(b)1E F) Umms ched Service with .Irk�c�rl l 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: 417-AO20094603A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time: 2017-05-22 10:01:02 Report Version: 2016.1.005 Schema Version: rev 10/16 HERS Provider: CHEERS Report Generated: 2017 -OS -22 10:01:02 CERTIFICATE OF COMPLIANCE CF1R-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: Patrick Somers - PaLY6ck1S& ie4, k Company: Signature Date: General Air Conditioning 2017-05-22 Address: CEA/ HERS Certification Identification (if applicable): 31170 Reserve Drive City/State/Zip: �'` Phone: Thousand Palms CA 92276 W13-7488 Responsible Person's Declaration statement,„ I certify the following under penalty of perjury, under the laws of the State of California: 1. The information N 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 responsitAity,for:ihe: 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. 4. 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 -app oval with tfiis building permit application. ' 'for 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available wltFi the bui18iri permits) issued for the building, and made available to the enforcement agency for all applicable bm k aecRt: maw , r '-.'" inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: ari€��uls'tX� Responsible.Designer Signature: Patrick Somers(tSCfx'Itd Company: Date Signed: General Air Conditioning 2017-05-22 Address: License: 31170 Reserve Drive 686310 City/State/Zip: Phone: Thousand Palms CA 92276 760-343-7488 Digitally signed by CHEERS'". This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 417-A020094603A-000-000-0000000-0000 Registration Date/Time: 2017-05-22 10:01:02 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-22 10:01:02 Schema Version: rev 10/16