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BMCH2016-0136Applicant: IE INC 31225 LA BAYA'" WESTLAKE VILLAGE, CA 91362 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: C20. 66 License No.: 686310 �— Date: 5 2 I 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 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ZI-11\ to 5/2/2016 TR,rA,:AY 0 2' 2 01116 UTHERN HILL ITY OF LA QUINTA DEVELOPMENT DEPARTMENT Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE 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:,_ 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 LaborCode, I shall forthwith comply with those provisions. t Date: S 2)I b 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: Z le Signature (Applicant or Agent): rlcz . , 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA -92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O16-0136 FBA Property Address: 54922 SOUTHERN HILLS APN: 775120048 922' Application Description: TRAVIS RESIDENCE / HVAC CHANGE OUT QUI Property Zoning: Application Valuation: $11,234.00 COMM Applicant: IE INC 31225 LA BAYA'" WESTLAKE VILLAGE, CA 91362 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: C20. 66 License No.: 686310 �— Date: 5 2 I 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 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ZI-11\ to 5/2/2016 TR,rA,:AY 0 2' 2 01116 UTHERN HILL ITY OF LA QUINTA DEVELOPMENT DEPARTMENT Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE 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:,_ 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 LaborCode, I shall forthwith comply with those provisions. t Date: S 2)I b 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: Z le Signature (Applicant or Agent): rlcz . , -`-FINANCIAL • • ;• ,. ACCOUNT a QTY DESCRIPTION ;; AMOUNT:' PAID° PAID DATE< BSAS SB1473 FEE 101-0000-20306 0 ` $1.00 $0.00 f+�s Z.,�h f,yt G'•'. `T; f :. yy �'. '. 5..'Y � "N +Y .�\iT. `�f'{.' _ SA �_XCK "S. PAID BY, METHODZas�, '..Y A' CHECK#�_P.a9 * ,. ?D,` CLTBY,:' r3-. ilr• ._ 3 Y, Total Paid for. BUILDING STANDARDS ADMINISTRATION BSA: • $1.00 $0.00 y. a; DESCRIPgTIONP € S ,ACCOUNT `QTY PAID �� „-AMOUNT;' 4 � :PAIDmATE, HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $72.52 $0.00 PAID BY�,Ax�"'i METHODS ` RECEIPT# ''CHECK#' CLTD BY x ..� DESCRIPTION, g, 1 c dAMOUNT�PAID i Pp►1D DATE - ;ACCOUNT x� HVAC CHANGEOUT - SPLIT -SYSTEM PC ' . 101-0000-42600 0 $36.26 $0.00 `' PAID,BY f <R ' a 5 * ;� a ;sRECEIP # , £'q :METHOD -R 'Total Paid for CHANGEOUT: $108.78 $0.00 DESCRIP�TIONe1,� ` A000UNT� > ;QTY AMOUNT', z PAID Y =� PAID DATE z r'' ,& PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY a r:E.. A--tFc,'G �k �. METHOD -::, £ x. -i v - Ef2 RECEIPT # '> . P ua.'''n /��r - { :�' r I CHECK # s -CL BY` >. ;�:„ a 4,.. ,:? w. �.,... �`'. x. ,.,,3, n .... ,: i,'xx .,. •.: a..a�?�': ,. ^. ., -Total Paid for PERMIT ISSUANCE: $91:85 $0.00 • • •• .. u Description: TRAVIS RESIDENCE / HVAC CHANGE OUT Type: MECHANICAL Subtype: Status: APPROVED Applied: 5/2/2016 MFA Parcel No: 775120048 Site'Address: 54922 SOUTHERN HILLS LA QUINTA,CA 92253 Approved: -5/2/2016 MFA Subdivision: TR 28776 Block: - Lot:'24 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $11,234.00 OccupancyType: Construction Type: y Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: HVAC CHANGE OUT -14 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES. i � Appliedto Approved •`'� ` ADDITIONAL ' • • • CONDITIONS"" -CONTACTS -- ... ,-s»*.rs'... NAMErTYPE .<., n ..., -., •- r°ADDRESS1 ; �t, it ?°'"e.y i � CITY .:: " ZIP ,. ,NAME , »� ,�,; � tSTi4TEr�� APPLICANTIE INC " ' 31225 LA BAYA. WESTLAKE CA' 91362 (760)238-4512, VILLAGE ' CONTRACTOR • HARRISON ENTERPRISES INC DBA 31170 RESERVE DRIVE THOUSAND CA • 92276 (760)238-4512 FRANCISCO@CALLTHE GENERAL AIR PALMS' GENERAL.COM OWNER BARBARA TRAVIS. 54922 SOUTHERN HILL I LA QUINTA CA 92253 (760)238-4512 , '.DESCRIPTIONv ACCOUNT <rQTYa AMOUNTS ::PAID; PAIQDATE RECEIPT.;# CHECK# .:;METHOD PAID BY .' :;:_; „ t3Y BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING 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 for CHANGEOUT: $108.78 $0.00 PERMIT ISSUANCE 101-0000-42404 _F 70 ' $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 aO INSPECTIONS PARENT, PROJECTS — _..__- .z......a-,.w..r '.'—v -e..... •,- - .—., '-R— v �-._ .,... .z„, ... .—:. _.._ �....:', ....: -. - ... ...�� le=,., .. �.., a .� .��-�� .,. �, ..� �5., �...- . .,... __. -_-..-.......... Tf' ..."S' ... n•.0 � i u�� "`�?d.Z� 1 Naft City. of La Quints Building u Sarky Division P.O. Box 1504,78-495 Calle Tampico L4.Qulnta, CA 92253 -:(760)-777-7012 Building Permit Application and Tracking Sheet Permit # ProjectAddress: 54922 Southern Hill Owner's Name:. Barbara Travis A. P. Number. Address: .54922 Southern Hill Legal Description: City, ST, Zip: La Quinta, CA 92253 Contractor: General Air Conditioning • Telephone: 760-238-4512 Address: 31170 Reserve Drive Project Description: Replace 5ton A/C, Coil, & 110,000 BTU.: City, ST, Zip: Thousand Palms; CA 92276 Furnace Telephone: 760-343-7488 ;. State Lie. # : 686310 City Lic M. Arch, Engr., Designer. Address: City, ST. Zip: Telephone: Y' `� State Lia #: �w � ti :m>,... Name of Contact Person: Steven .$chniererSq.Ft.: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo #Stories: #Units: Telephone # of Contact Person: 818-735-7876 Estimated Valae of project: $11,234,00. APPLICANT: DO'NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG PERI TW FEES Plan Sets Plan Check submitted Item Amount Structural Wes: Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2`° Review, ready for corrections/issue Electrical Subcoutactor List Called Contact Person' Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 3"Review; ready for correetionsfissue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: BARBARA TRAVIS I Date Prepared: CF1R-ALT 02-E (Page 1 of 3 ) 2016-04-27 A. General Information MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit. 01 Project Name BARBARA TRAVIS 02 Date Prepared . 2016-04-27 03 Project Location 54922 SOUTHERN HILL 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name BARBARA TRAVIS Dwelling Unit Conditioned . Installing a 07 Zip Code 92253 08 Floor Area (ft2) 3372 SC System. "CFA served ,fir• refrigerant Number of space conditioning nstalling 09 Climate Zone 15 10 (SC) systems in this dwelling 1 ducted containing t w more than 40 unit. entirely new B. Space Conditioning (SC) System information ' .: 01 02 03.'" 04 �.�5 U6 � 07t 08x 09 30 _ Is the SC Installing a SC System SC System. "CFA served systema refrigerant Installing new SC nstalling Installing. installing Identification or Location or Area by this SC ducted containing system more than 40 ent ri ely new' entirely new Name Served System (ft2) system? component? components? feet of ducts? 1 duct system? SC system? I Alteration Type System 1 Location 1 3372 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section15O.2(b)iDiib) This section does not apply to this project. Registration Number: 216-A0158358A-000000000-0000 Registration Date/Time: 2016-04-27 23:21:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.001 ReportGenerated: 2016-04-27 23:21:21 Schema•Vetsion: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-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 Cental gas All new Central split All new This field or This field or System 1 furnace heating AFUE 80 AC cooling SEER 14 Setback section is not ' section is not components components applicable applicable Reouired Documentation: 62R -MCH -01-E -Space Conditioning Systems Ducts and Fans -Duct insulation requirement'for.new plenums: R6.gr CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing requlred when heating or cooling components are installed in ducted systems, or when more thah 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 & 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/fon required_w_hen_MCH-25 is required.. . Exceptions:. r: ' 1 �• -Duct systems registered with HERS provider as p eviously sealed are exempt from MCH -20 Duct Leakage Testing requirements. s.Hyd. v d`aK b s . Air Flow. MCH=23, Refrigerant Charge MECH 25," -Heating-only systems and Air Handler/Furnace changes do not require verification of or, MC -'20 DuctiLeakage Testg -Existing duct systems constructed, insulated or sealed with.asbestovare exempt£from r nequirrem enfs. E ;• ;, -'�i ,�. �.� � �� r.� •�;�„;,„•, �, �,o ��' 8�` axe � ` E. Entirely New or Complete Replacement,DuctaSystem, with or without Equipment Chan geout (,Sections-150.2(b)1Diia.and 150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 216-AO158358A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2016-04-27 23:21:.15 Report Version: 2013 Rev 1.007 Schema Version: O.SSSSDD HERS Provider: CaICERTS Report Generated: 2016-04-27 23:21:21 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: Shanley, Barbara Company: Signature Date: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2016-04-27 23:21:15 Address: CEA/ HERS Certification Identification (if applicable): . 317170 RESERVE DRIVE STE A City/State/Zip: Phone: THOUSAND PALMS CA 92276(_ 760-343-7488 Responsible Person's Declaration statements; 1 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. lam eligible under Division 3 of tk 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 ofd egulation s.x .. 4. The building design features or system design features identified onthis Certificate of Compliance are c6nsistent,wrtfiahe information.provided on,other applicalilecompliance documents, worksheets, calculations, plans and specifications sub6tted to the. enforcement agency fo�r.4 p va`l?itth�this building rm� ppllicati on. sq S. I will ensure that a registered copy of tFiis-Certificapte of Compliance shall be matle;available with bulId ng pe_rmit(s)�issued for€the building, and;;made avafiable to,tlie;enforcement agency for all applicable ,the inspections. I understand that a registered copy of thisCerxificate of Compl ance�is requ�red.to be included with the,documentaation tthe provides to,the building owner at occupancy. bbuilder Responsible Designer Name: t I L;; V-" Responsible Designer Signature: V 1111 Shanley, Barbara Company: Date Signed: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2016-04-27 23:21:15 Address: License: 31=170 RESERVE DRIVE STE A 686310 City/State/Zip: Phone: THOUSAND PALMS CA 92276 760-343-7488 Digitally signed byCaICERTS. 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: 216-A0158358A-000000000-0000 Registration Date/Time: 2016-04-27 23:21:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance . Report Version: 2013 Rev 1.007 Report Generated: 2016-04-27 23:21:21 Schema Version: 0.555SDD