BMCH2016-038178-495 CALLE TAMP.ICO Twit D ati� Quif
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0381
Property Address:
54495 WINGED FOOT
APN:
775110016
Application Description:
ETHEREDGE / CHANGE OUT (2)HVAC SPLIT SYSTEMS
Property Zoning:
Application Valuation:
$21,496.00
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 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
Dater: -106 11k,.7 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).:
( 11, 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 11, 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.&R.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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/21/2016
Owner:
ETHEREDGE
54495 WINGED FOOT
LA QUINTA, CA 92253
on 0
Contractor:
HARRISON ENTERPRISES INC DER AIR
31170 RESERVE DRIVE S
THOUSAND PALMS, CA 92276 o C�
o�
(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.
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 polity number are:
Carrier: INSURANCE COMPANY OF THE WEST Polity Number: WSD5031658
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: 1 b v lb 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, t
INTEREST, AND ATTORNEY'S FEES. I
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: Signature(ApplicantorAgent):
,a. Date: 10/21/2016
Application Number: BMCH2016-0381 Owner:
Property Address: 54495 WINGED FOOT ETHEREDGE
APN: 775110016 54495 WINGED FOOT
Application Description: ETHEREDGE / CHANGE OUT (2)HVAC SPLIT SYSTEMS LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $21,496.00 .
Applicant: Contractor: "
IE INC HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 LA BAYA 31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276
(760)343-7488 '
Llc. No.: 686310
Detail: HVAC CHANGE OUT - (2)15SEER/80AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
r
• 5
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM, PC
101-0000-42600
0 _
$76.00
Total Paid for CHANGEOUT: $228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
i
'Bin .
City of La Quinto
Building tai: Safety Division
Permit # 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
%Out�ol Building Permit Application and Tracking Sheet
Project Address: 5 14 H q!5 Wer c-d Owner's Name: �Y) ; k e .EAAr, Qrc a e
A. P. Number:
Address: S y ` clS UYh A �C>oAr
Legal Description:
City, ST, Zip: CA
3
Contractor: �e� \ r
A h � or
Telephone: • S
P 3 lS_ - z
z
Address: 3 11�� �eServG \
Project Description'.
City, ST,zip 1" h vsa..,d �o.\
5 CA
3.5 .+a„:JqDV.Z7Q Co lei Vr4c
TeleP hone: 3- y
sk m
State Lic. # : (0810 310
City Lie. #.-
Ic�e� 3 Ove '1 O 37V
e
Arch.,`Engr., Designer:
Address:
,
City, ST, Zip: s
Telephone:
ne:
antY
n TY e• Occupancy:
Construction P :
State a Lie. ic.
'-Repair. De
0ProJecttYPe circle one • New Acd'n Alter
m
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 2.1, y quo . t�
APPLICANT: DO NOT WRITE BELOW THIS LINE
tf
. Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs. _
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.,
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact-Person.
Plumbing
t
. Grant Dced
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.:-
'rd Review, ready for correct ions/issuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
I.Total Permit Fees
- � ,icy a _ •:p ., '' , a J• r 'r ;• .` •
r ,
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)4
Or..
01
02
., o03
04
05
06
07
08 ,'
09'
10
11 ..
, . ,'12' .3
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 #13.5.
Central gas
heating
,AFUE •
80.00
Central split
cooling
SEER
., 15.00 •
Setback
section is not
section is not
TON
furnace
components
AC
components
applicable
applicable
All new
All new
This field or
This field or
SYSTEM # 2
3 -TON
Central gas
furnace
heating
AFUE
80.00,
Central split
AC�`
' I -� .
�"cooling
3�
SEER
.16.00
Setback
section is not,
section is not`
componentscom
ponents
applicable
applicable
Required Documentation: ` P
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.
cents
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing are installed or altered (applicable in CZ 2, 8-15). �•
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow 2 300 CFM/ton required when MCH -25 is required.
Exceptions: ,I� .
-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 n of Air Flow MCH -23, or Refrigerant Charge MEC Q5.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
. _ s•,�'1i.�'�Tl��=�!"`�� ?�dat�'t i�7�1'iFt� ''
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F) ,
This section does not apply to this project. r
r4.
Registration Number: 416-A0006287A-000000000-0000 - Registration Date/Time: 2016-10-21' 12:58:47 ° HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance , Report Version: 2013 Rev 1.008 Report Generated: 2016-10-21 12:58:57 - `
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -111 -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 ..
i c� tv%ck.SPvv�P�3
Company:
Signature Date:
General Air Conditioning
2016-10-21
Address:
CEA/ HERS Certification Identification (if applicable):
31170 Reserve Drive
City/State/Zip: .,,�
,�<.
"Phone:
Thousand Palms CA 9227617'760-343-7488
Responsible Person's Declaration statement `
I certify the following under penalty of perjury, under the laws of the State of California:
c j�f
1. The information provided on this Certificate of Compliance is true and correct. � r
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 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 agencylfor-approvaliwith this building permit application.
it —All t P1 �4 1 4--Yi - t�. —
5. 1 will ensure that a registered copy of this Certificate of Compliance ihaallll be:mlaade-available with the building p6rmit(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:
��rmtd Se�
Responsible Designer Signature:
`' 11V,lMYiC.kr0S trOmPWvb
Patrick Somers
Company:
Date Signed:
General Air Conditioning
2016-10-21
Address:
License:
31170.Reserve Drive
686310
City/State/Zip:
Phone:
Thousand Palms CA 92276
760-343-7488
Registration Number: 416-A0006287A-000000000-0000
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 Date/Time: 2016-10-21 12:58:47 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-21 12:58:57
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3 )
Project Name: MIKE ETHEREDGE Date Prepared: 2016-10-21
A. General Information
CF111-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
MIKE ETHEREDGE
02
Date Prepared
2016-10-21
.._.:__..:,....... .... .......... ..........;....;,......,.,.,......,.._...,_..,.,,..._..,,..,...N.._..:......
Single family
03
Project Location
54495 WINGED FOOT
04
Building Type
OS
CA City
LA QUINTA
06
Dwelling Unit Name
HOUSE
07
Zip Code
92253
-
x
Dwelling Unit Conditioned
��
2380
Installing new SC
Installing
[
.. x'08
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted# p
i i co talnmg'
Number of space conditioning
more than 40
09
Climate Zone
153
f,
10 �
(SC) systems in this dwelling
unit.
2
system?
component?
components?
feet of ducts?
duct system?
SC system?
_kzXx Ail
B. Space Conditioning (SC) System Information`
01
02
03
04,0t4
IT 8 05 -
re— 06
07
08
09
10
Is the -0
),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# p
i i co talnmg'
VA - iem gt%.
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM #13.5
WHOLE HOUSE
1190
Yes
Yes
Yes
No
No
No
Altered space
TON
conditioning system
Altered space
SYSTEM # 2 3 -TON
WHOLE HOUSE
1190
Yes
Yes
Yes
No
No
No
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: 416-A0006287A-000000000-0000
Registration Date/Time: 2016-10-21 12:58:47
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-10-21 12:58:57