BMCH2015-0075�z
78-495 CALLE TAMPICO
c&tlt 44 Q"
LA QUINTA, CALIFORNIA 92253 1 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0075
Property Address: 78304 CALLE LAS RAMBLAS [OM
APN: 770015008!i/�Application Description: BENNETT RESIDENCE/HVAC CHANGEO
Property Zoning:MAR ryApplication Valuation: $17,000.00 I 205
OffYOFLAQUINTA
Applicant: NIfiiGQE1fELOPMENTDEPARTMENT
IE INC.
32115 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 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
Licensee Class: C20 License No.: 6863100C --
DatecJ �i �� Contra`
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 Na
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/17/2015
Owner:
BENNETT', THOMAS F
78304 CALLE LAS RAMBLAS
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: _ 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
com I with thosep rovisions.
WIL
D e: 3 17 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.
•ate:
3 » IS Signature (Applicant o, gent): St.uwti� Y�
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
0S
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
This field or
This field or
System 1
Central gas
heating
AFUE
0.8
Central split
cooling
SEER
14.5
Setback
section is not
section is not
furnace
components
AC
components
applicable
applicable
Central gas
All new
Central split
All new
This field or
This field or
System 2
heating
AFUE
0.8
AC
cooling
SEER
14.5
Setback
section is not
section is not
furnace
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: 5 15%, or <_ 10% 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 & MR -MCH -23 Air Flow >— 300 CFM/ton, required when MCH -25 is required 1
Exceptions:\, ✓/� 11( , \ u, , r' . r
-Duct systems registered with HERS provider as previously sealed acre 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 MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, 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: 215-A0069625A-000000000-0000
Registration Date/Time:
2015-03-16 10:00:45
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-16 09:59:45
Schema Version: 0.5555DD
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: ////
�aco
Jacoby, Ian
clan Jc
Company:
Signature Date:
Stratz Permit Service
2015-03-16 10:00:04
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 Rusinp mand.P�nfPssions Code to a pt,;responsibility forsthe bu.ilding,,�ie `gn orsystem design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and specifications, materials, components; and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
performance
requirements of Title 24, Part 1 and Part'6 of the California Code of Regulations. I ]/
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 submittedrto the enforcemenf5a :ency for approval with this building permit application.
�=
5. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for.the building, and made available to the enforcement agency for all applicable
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:
Responsible Designer Signature: n�
Valdez, Dayana
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-03-16 10:00:45
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 no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0069625A-000000000-0000 Registration Date/Time: 2015-03-16 10:00:45 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-16 09:59:45
Schema Version: 0.555SDD
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT
QTY
AMOUNT PAID
PAID.DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00 $0.00
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 '$0.00
DESCRIPTION
- ACCOUNT
QTY
AMOUNT
PAID.
PAID DATE.
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
PAID BY
METHOD:.'
RECEIPT #
CHECK #
CLTD BY,
DESCRIPTION - .'`
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
PAID BY
-METHOD
RECEIPT #
CHECK#
CLTD BY
Total Paid forCHANGEOUT: $217.56 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Description: BENNETT RESIDENCE/HVAC CHANGEOUT
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 3/17/2015 MFA
Approved: 3/17/2015 MFA
Parcel No: 770015008 Site Address: 78304 CALLE LAS RAMBLAS LA QUINTA,CA 92253
Subdivision: TR 29586 Block: Lot: 2
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $17,000:00 Occupancy Type: Construction Type:
Expired:
No. Buildings:.O No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT- 1- 3 TONAND 13.5 TON 14.SSEER/80AFUE SPLIT SYSTEM 12008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE
INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Tuesday, March 17, 2015 3:31:14 PM 1 of 2
II SYSTEMS
CHRONOLOGY
CONTACTS
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE FAX
EMAIL
APPLICANT
IE INC.
32115 LA BAYA
WESTLAKE
VILLAGE
CA
91362
(760)771-3833
CONTRACTOR
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
STE A
THOUSAND
PALMS
CA
92276
(760)771-3833
OWNER
BENNETT, THOMAS F
78304 CALLE LAS
RAMBLAS
LA QUINTA
CA
92253
(760)771-3833
Printed: Tuesday, March 17, 2015 3:31:14 PM 1 of 2
II SYSTEMS
INSPECTIONS
SECIID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL" BLD
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS
DATE
REMARKS NOTES
7
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
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
$145.04
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$72.52
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:0.4•00
INSPECTIONS
SECIID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL" BLD
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS
DATE
PARENT PROJECTS
Printed: Tuesday, March 17, 2015 3:31:14 PM 2 of 2
SYSTEMS
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS
DATE
REMARKS NOTES
7
Printed: Tuesday, March 17, 2015 3:31:14 PM 2 of 2
SYSTEMS
Bin #
City of La Q urn to .
Building & Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pro ;ectAddress: 7830q Co11e- Las -�cmb6s Owner's Name: -� ly, ,Czs E ; et e>1
A. P. Number:
Address: $3O4 CoJkle-.Les c
Legal Description:
City, ST, Zip: Ley Z .� C tC� q 2Z S 3
Contractor
��her6-1 it
. c,*o
Telephone: Telc -
Address: 311-70 e.SGr vC. �bc- .v C.
Project Description:
City, ST, Zip: VSGha �c�rns C,A 9 Z7--1�,
Telephone: -7G6-3e43. 7t42g
Q0,,,\\eNr- aVAC, skexn
Statc Lic. # : (,201.o
City Lie. 41;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
....... -.<.z.>..:.::•.>. ...`.:
Construction Type: Occupancy:
ProJect tJPc (circle one): New Add'n Alter Repair Demo
State Lie................................
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: V7 O , c3c)
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plari Check Deposit
Truss Cates.
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 corrcctions/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready for corrcctionsrissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P..
Pub. Wks. Appr
Date of permit issue
School Fees
Total Pcrmii Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
THOMAS BENNETT I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3 )
2015-03-16
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
THOMAS BENNETT
02
Date Prepared
2015-03-16
03
Project Location
78304 CALLE LAS RAMBLAS
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
THOMAS BENNETT
07
Zip Code
92253
08
Dwelling Unit Conditioned
2412
Floor Area (ft2)
SC System
SC System
CFA served
systema
refrigerant
Number of space conditioning
Installing
09Climate
Zone
15
10
(SC) systems in this dwelling
2
ducted
containing
system
more than 40
unit.
entirely new
B. Space Conditioning (SC) System"Informationh�:'
r
O1
02
03 �
04'1
y 06
07
v 1 ' 08
09
10
s
j�
305
Is the SC w
Installing a
SC System
SC System
CFA served
systema
refrigerant
Installing new SC
Installing
Installing
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
Altered space
System 1
Location 1
1206
Yes
Yes
Yes
No
No
No
conditioning system
Altered space
System 2
Location 2
1206
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A0069625A-000000000-0000
Registration Date/Time: 2015-03-16 10:00:45
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-03-16 09:59:45
Schema Version: 0.555SDD