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BMCH2018-1148a .6 495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 T-iht 4 s(P Qu!Kz COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O14-1148 Property Address: 80600 WEISKOPF APN: 762100010 Application Description: HVAC CHANGE OUT - REPLACE (1) COIL Property Zoning: Application Valuation: $3,500.00 Applicant: HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS, CA 92276 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.: 686310 Date: `ZI + JL4 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 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 Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/1/2014 Owner: MICHAEL OSLAC 1364 SOUTHWIND CIR WESTLAKE VILLAGE, CA 92253 d cci Z o © CV S o Contractor:LU HARRISON ENTERPRISES INC DBA6�1 ® 31-170 RESERVE DRIVE STE A p� THOUSAND PALMS, CA 92276 z U (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 comply with those provisions. Date: 2 1 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: t 14 Signature (Applicant or Agent) CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: MICHAEL OSLAC I Date Prepared: CF1R-ALT-02-E (Page 1 of 4 ) 2014-11-28 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 MICHAEL OSLAC 02 Date Prepared 2014-11-28 03 Project Location 80600 WEISKOPF 04 Building Type Single family OS CA City La Quinta 06 Dwelling Unit Name MICHAEL OSLAC 07 Zip Code 92253 08 Dwelling Unit Conditioned 3796 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 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served system a 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 System 1 Location 1 3796 No 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: 214-A0148507A-000000000-0000 Registration Date/Time: 2014-11-28 21:46:11 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-28 21:45:42 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 4 ) D. Altered Space Conditioning System (Sections 150.2(b)1E 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 No heating This field or This field or This field or This field or System 1 Boiler component section is not section is not No cooling Fancoil AHU SEER 13 Setback section is not section is not altered applicable applicable 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 5 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 & CF3R-MCH-23 Air Flow >- 300 CFM/ton required when MCH -25 is required. - 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 MECH-25. -Existing duct systems constructed, insulated or sealed with.as6estos 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. Registration Number: 214-A0148507A-000000000-0000 Registration Date/Time: 2014-11-28 21:46:11 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-28 21:45:42 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 4 ) F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. L r. Registration Number: 214-A0148507A-000000000-0000 Registration Date/Time: 2014-11-28 21:46:11 HERS Provider: CaICERTS C -A Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-28 21:45:42 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 4 of 4 ) 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 c.Yail loco Jt, Company: Signature Date: Stratz Permit Service 2014-11-28 21:44:51 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 Business and Professions Code i o 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 of Regulations. J 1 r 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 for approval with this building permit application. 5. 1 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: Valdez, Dayana O �/ Company: Date Signed: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2014-11-28 21:46:11 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 noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 214-A0148S07A-000000000-0000 Registration Date/Time: 2014-11-28 21:46:11 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-28 21:45:42 Schema Version: 0.551SDD FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE 8SAS SB1473 FEE 101-0000-20306 0 F $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00. PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forCHANGEOUT: $16.92 $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 .s94tMM+++]3T+92/3/]q?2<?3/TlO! 15!4!526734!rg z*O■>_Oae �9VP&Wy•TTLLO +T°LkrJ-0 Description: HVAC CHANGE OUT - REPLACE (1) COIL Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 12/1/2014 SKH Approved: Parcel No: 762100010 Site Address: 80600 WEISKOPF LA QUINTA,CA 92253 Subdivision: TR 28444 Block: Lot: 56 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $3,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: HVAC CHANGE OUT -REPLACE (1) COIL [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL .. APPLICANT HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS CA 92276 CONTRACTOR HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS CA 92276 OWNER MICHAEL OSLAC 1364 SOUTHWIND CIR WESTLAKE VILLAGE CA 92253 Printed: Monday, December 01, 2014 1:54:54 PM 1 of CRW2 SYSTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL** CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 1 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION HVAC CHANGEOUT - 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PC Total Paid forCHANGEOUT: $16.92 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:0• 00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES MECHANICAL FINAL** Printed: Monday, December 01, 2014 1:54:54 PM 2 of 2 N?�sysumS Bin • Submittal City o -f La Q uln to •Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # Project Address: gc)Gclo - W e- i S t) Owner's Name: MM h C eJ Dst ac It A. P. Number: Address: 130 60CI) ei Legal Description: City, ST, Zip: C A Contractor: G ey%e-r-o,` Az rn Telephone: �1'�.� — z l%— �'' S �o) <>'> >::;•;•.; ;:« :>:>:`:: ;,.; <;. Address: '� U. eSery t Project Description: City, ST, Zip:hOVSc.��,c��0.,m$ �-1ZZ7(o COt Telephone: 7%6 ^ 34 3 _ 714 V8 <z�3:::;z:... :<;•<:<�ss:-s;:::r::>:::i::: State Lic. #: I o Called Contact Person City Lie. #.. Plan Chcck Balance. Arch., Engr., Designer: Title 24 Calcs. Address: Plans.pickcd up City, ST, Zip: Construction Telephone: State Lic. # Flood plain plan Construction Type: Occupancy: PhPa (circle one): New Add'n Alter Repair Demoroject Name of Contact Person:Sq. Ft.: # Stories: # Units: Telephone #,of Contact Person: Estimated Value of Project: ©tom APPLICANT: DO NOT WRITE BELOW THIS LINE 9 Submittal . Rcq'd Rcc'd , TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Chcck Balance. Title 24 Calcs. Plans.pickcd up Construction Flood plain plan Plans resubmitted Mechanical .Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. I-I.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrcctionsrissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permIt issue School Fees Total Permit Fees