BMCH2015-027578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
"&.Y'°i'�1'Q.Infw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0275
Property Address: 45505 DEERBR0 K CIR
APN: 604404015
Application Description: GOSEWISCH /CHANGE OUT (1) 18SEER/8AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $4,784.00
Applicant:
IE INC.
3211511A 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.
License Class- C20 License No:: 489046
Date: ' -4 b Contractor:
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty.of perjury that I am exemptfrom the Contractor'sState
Ucense'Lawfor the following reason (Sec. 7031.5,'Business and Professions Code: Any
city or county that requires a permltto construct, after, 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 is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Divlslon.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 archfil penalty;of not more than five hundred dollars
($500).:
U I, as owner of the property, or my employees with wages as their sole
compensation, will do thework, 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 ownemployees, 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.).
U 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 contractors) licensed pursuant to
the Contractors' State License Law.).
(� 1 am exempt under Sec. . B.&P.C. forthis 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. Q.
Lender's Name:
Lender's Address:
VOICE'(760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/16/2015
Owner:
JAN.GOSEWISCH
4405 NIAGARA AVE
SAN DIEGO, CA 92253 -
f
C
Contractor: 2 1 r
ESSER SERVICES INC,DBA ES ERiA !
P O BOX 1636
CATHEDRAL CITY, CA 92235
an
(760)324-0550
Llc. No.: 489046 = —_
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.
S 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 inthe performance of the work for which this permit Js 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: % � I•S 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:Applicationils 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 andfor 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 for180 days will subject permit to cancellation.
I certify that 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:. 15 Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT . _
'QTY _ AMOUNT' :, PAID PAID DATE
BSAS 581473 FEE
101-0000-20306
0 $1.00 $0.00
PAIDBY.;-' _ ' ''
METHOD :. ;
RECEIPT#CHECK#. CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
- _ DESCRIPTION
ACCOUNT
QTY
AMOUNT
RAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52,
$0.00
PAID BY_ 'METHOD
RECEIPT p .
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT'
QTY
AMOUNT'
PAID
:PAID DATE:
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
PAIDBY1
METHOQ'
.1 ..d RECEIPT #
CHECK #
CLTD BY
Total Paid forCHANGEOUT: $108:78 $0.00
DESCRIPTION
ACCOUNT',
QTY'
,-:AMOUNT
:PAIDr.
PAID,DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY'- „k
METHOD:'
RECEIPT #
CHECK#
CLTD BY
Total Paid for PERMIT. ISSUANCE: $91.85 $0.00
TOTALS:00
Description: GOSEWISCH�/ CHANGE OUT (1)18SEER/8AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 7/16/201S'SKH
Parcel No: 604404015 Site Address: 4SSOS DEERBROOK CIR LA QUINTACA 92253 Approved:
Subdivision: TR 23995-6 Block: Lots 18 Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation. $4,784.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 - ' No-Stories,0 No. Unites: 0
Details: HVAC CHANGE OUT - (1)18SEER/8AFL1E:SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE'
+' NAME
ADDRESSl
-.
CITY
STATE, "
ZIP
PHONE' . ,..
F„ AX
EMAIL
>�. r
APPLICANT
IE INC.
32115 LA BAYA
WESTLAKE
CA
91362
VILLAGE
CONTRACTOR
ESSER SERVICES INC DBA ESSER A
P O BOX 1636
CATHEDRAL
CA
92235
CITY
OWNER
JAN GOSEWISCH
FINANCIAL INFORMATION
Printed: Thursday, July 16, 2015 12:01:12 PM 1 of 2 C srsTEMS
771, 77, F. ,
DESCRIPTION
PA
0 BATE'
REC291F - F'
Y,
N
:AMOUNT
�P.
BY
3a
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDINGSTANDARDS ADMINISTRATIONI $1.00 $0.00
_BSA:.
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$O.W
SPLIT -SYSTEM
HVACCHANGEOUT-
101-0000-42600
0
$36.26
.$0.00
SPLIT-SYSTEM PC
Total Paid forCHANGEOUT: $108:38 $0.00
PERMIT ISSUANCE
101-WO042MM
0
$91.85
Total Paid forPERMIT ISSUANCE: $91.85 $0,00
TOTALS: $201.63 $0.00
IPARENT PROJECTS
Printed: Thursday, July 16, 201512:01:12 PIVI 2 of'2 cimlysTEMS
Bin.#
i
Pemgt '
ProjetAddtess:, 45505 Deerbrook Circle
City .Of Lel Q[IIl1C1
Buffaft ec. Safety Dit+1slon
P.O Box 1504,•78-495 Calle Tampico
La.Qt*4 CA. 92253 --(760) 777-7012
Building Permit Application and Tracking Sheet
owneesName:. Dani Gosewisch
A. P. Number.
Address: 45505 Deerbrook Circle
Legal Deskaiption:
Contsador: Esser Services Inc.
Address: PO Box 1636
City,;sT, Zip: La Quinta, CA .92253
Telephone:
PmjeotDwoription:
city, ST, Zip: Cathedral City, CA 92235
Replace 4ton A/C & 48,000. BTU Furnace
Telephone: 760-324-0550
State Lie. #.: 489046 Ci 'Lint
Arch, Bags'., Designer:
Address:
City, ST. Zip:
Telephone:
State Lic. #:
Name of contotPerson: Steven �Scjhnierer
Canstrsuxioa Type: Occnpatwy:
Project type (circle ono): Now Add'n Alter Repair Demo
Sq. Ft: #Stories: # Unitg'
Telephouv# of Contwt Person: 1's mated Value of Project: $4,784.00 .
APPLICANT: DO. NOT WWTESELOW THIS LINE
M
Submittal
Wd
-.Beed
TRACIONG PERwrFEES
Plea Sw
Plan Cheek tabmtued
Item Amount
Stmdufti cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Tram Galea.
Called Contact Person
Phan Check Balance-
Title U Cults.
Plain, picked up
Construction
Flood plata plan
Plans raubmitted.' .
Mecharikal
Grading plan
2-! Revlew, ready for correcdowasue
Electrical
Subcoutaetor List
Called Contact Person
Ylumblag
Grant Deed
Plein picked up
S.M.I.
H.O.A. AppwM
Placa retabmN6rd
Gradhtg
W $OIISEs-
34Review, ready for co"Ved . naAasae
Developer Impact Fee
Runwag Approval.
Called Contact Person
A".P.
Pub. Wks. Appr -
Dstaofpermit issue
School Few
Total Permit Fees
CERTIFICATE OF COMPLIANCE
CFIR=ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
I Project Name: DANI GOSEWISCH I Date Prepared: 2015-07-15 I
A. General Information
CFIR-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.
01
Project Name
DANT GOSEWISCH
02
Date Prepared
2015-07-15
03
'Project Location
45505 DEERBROOK'CIRCLE
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
DANT GOSEWISCH
O7
Zip Code,
92253
08
Dwelling, U nit.Conditioned
1651
`
Floor Area (ft2)
SC System
SC System
CFA served
qb,� �
em a
rr-^ ti-. �
refrigerant µ
Number of space conditioning.
-moo. r p
(�InstallIiing I
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
system
more than 40
unit.
entirely new
B. Space' Conditioning (SC) System Information F
01
62
03
04
="°`fie
µ 06 t,
071
08
09
10
4 sthe.S-Ilinga
`
SC System
SC System
CFA served
qb,� �
em a
rr-^ ti-. �
refrigerant µ
- �. �-
nstallirri%ew,'SC
-moo. r p
(�InstallIiing I
yam'".
(AAs IIQ, '
�)nstalling
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirelymew
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SCsystem?
Alteration'Type
System 1
Location 1
1651
Yes
Yes
Yes
No
No
No
Altered space.
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0193553A-000000000-0000
Registration Date/Time:
2015-07-15'08:47:17
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 201403-31 Report Generated: 2015-07-15 08:47:22
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
30
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 Dud
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
Du Length
R -Value
Centralgas
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
0:8
AC
cooling
SEER
18
Setback
section is not
section is not
_
components
components
applicable
applicable
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning systems Ducts and Fans
-Duct insulation requirement fornew plenums: R6.
CF211-MCH-20-11 & CF311-MCH-20=11 -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%, or5 30% leakage to outside, or seal all accessible" leaks.
CF2R-MCH-25-H & CF311-MCH-25-1-1 Refrigerant Charge Verification required when refrigerant containing components are Installed or altered (applicable in CZ 2, 8-15).
CF2RU21WMCH-23 &"CF3R-MCH-23 Air Flow 1300 CFM/ton required,when.MCH-2544 required.
Exceptions:
-Duct systems registered'with HERS provider as previously sealed.are exempt frog MCH -20 Dtk�t Lealoge/'Testing r}eh@i'em�e
-Heating-only systems and AirHandler/Furnace changes do not require venficat 0n of Air Flow CH:,2J orRefrigerant:C-harge•MECH 25
-Existing duct systems tonstructed,.insulated or sealed with re exernpfrom MCf20 Duet leakage Testing requiremelats. "%71
E Entirely New or Complete Replacement Duct S�m, wijh-' r wrthotl qu�ipment ehIngeout JS3 tions 150.2(b),LDii 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-A0193553A-000000000-0000
Registration Date/Time: 2015-07-15,08:47-17
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-15 08:47:22
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-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:
Jacoby, Ian
can Jacor
Company:
Signature Date:
Stratz Permit Service
2015-07-15 08:46:59
Address:
CEA/ HERS Certification Identification (if applicable):
5858 Dovetail Drive
Gty/State/Zlp:
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 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,spedfications, materials; co vents, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
r� �
requlrements'of Title.24, Part 1 and Part 6 of the California Code of Regilafions.
I*' — . ��i
4. The building design features or system design features itlentified on this Certificate of �omphance are�consictenf witjr the informaUon,provided ons other(appIjcable minpliencedocuments, worksheets,
calculations, plans and specifications submitted to the dRforcementgency forapproval.ywrth this budding perms[ a��}liption.'1
S. I will ensure that a registered copy of this"Certificateo�Coihpliance s�iall;be:m6" available with the bUllding.permit(sj;issued forthe-building,•and�thade avafiable tothe:enforcement agency for all applicable
inspections. I understand that,a registered copy. of th3>t?erti icate of Co�nplj�ance i regt(ire�d to heJncluded �!f,�h the documentationgthe�biAllder pF,. A es to,> he bgp!4ng owner at occupancy.
Responsible Designer Name: U!, ,•
Respon ` ble De3{grher Signature: V' & Z
Esser, Michael
Company:
Date Signed:
ESSER SERVICES .INC
2015-07-15,08:47:17
Address:
License:
P O BOX 1636
489046
City/State/Zip:
Phone:
CATHEDRAL CITY CA 92235
(760) 324-0550
Digitally signed by CalCERTS. 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-A0193553A-000000000-0000 Registration Date/Time: 2015-U7-15 08:47:17 HERS Provider: CalCERTS
CA Building Energy Efficiency.Standards- 2013.Residential Compliance. Report Version: 2014-03-31 Report Generated: 2015-07-15 08:47:22
Schema Version: 0.555SDD