BMCH2017-050678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT.
Permit Type/Subtype: MECHANICAL/
Application Number: BMCH2O17-0506. >
Property Address: 55151 WINGED FOOT
APN: 775330006
Application Description: SHACKELFORD /EVAP COIL CHANGEOUT
Property Zoning:
Application Valuation: $1,104.00 f_%, tN\ rn Rpt
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ALLEN SHACKELFORD
55151 WINGED FOOT
LA QUINTA, CA 92253
Date: 12/21/2017
Applicant:
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
FLDEC21Z
HARRISON EMTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
fTU
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
CITY OF LA QUINTA
DEPARTfilE.W
THOUSAND PALMS, CA 92276
COPM1iv1UIdITYDEVELOPhfEW
(760)343-7483
Llc. No.: 686=10
---------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
--------------------------------=--------
WORKER'S COMPEMSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed
under provisions of Chapter 9
1 hereby affirm under penalty of perjury or e.of the following declarations:
(commencing with Section 70001 of Division 3 of the Business and Professions Code, and
_ I have and will maintain a certiftate of consent to self -insure for workers'
my License is in full force and effect.
compensation, as provided for by Section 2700 of the Labor Code, for the performance
License Class: License No.: 686310
of the work for which this permit is issued.
_
1
I have and will maintain worker:' compensation insurance, as required by
C1-7 oln
Date.1
Section 3700 of the Labor Code, for the pe -forma nce of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are: .
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 ($500).:
(_) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided thafthe improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that he
or she did not build or improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
.Contractors' State License Law.).
(_) I am exempt under$ec: . 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 Address:
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD503165802
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manne - so as to become subject to the workers'
compensation laws of California, and agre 2 that, if I should become subject to the
workers' compensation provisions of Secti m 3700 of the Labor Code, I shall forthwith
�comply with those provisions.
Date�: 1 2J I--7 Apples i�•c�t :S ,u,— a
WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDEC FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACYNOWLEDGEMENT .
IMPORTANT: Application is hereby made -.o the Building Official for a permit subject to
the conditions and restrictions set forth or. this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is per•:ormed 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 actor omission relateclAo the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this a 3plication becomes null and void if work is not
commenced within 180 days from date ofissuance of such permit, or cessation•of work
for 180 days will subject permit to cancel) stion.
I certify that I have read this application aed state that the above information is correct.
I agree to comply with all city and county ardinances 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 G 2-1 I li Sign�(Applicant or Agent): �2��
-'
Date:' 12/21/2017.
Application Number: BMCH2O17-0506
Owner:
Property Address:." 55151 WINGED FOOT
ALLEN SHACKS LFORD
APN: 775330006
55151 WINGED FOOT
Application Description: SHACKELFORD /EVAP COIL CHANGEOUT
LA QUINTA, CA 92253
Property Zoning: 1.
Application Valuation: $1,104.00
Applicant:
Contractor.
HARRISON ENTERPRISES INC DBA GENERAL AIR
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92276
i
(760)343-7488
Llc. No.: 6863-10
Detail: EVAP"COIL CHANGE OUT -14 SEER..CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING
" CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSASSB1473 FEE.
101-0000-20306 0 $1.00 '
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY"•
AMOUNT''
APPLIANCE REPAIR/ALTERATION
101-0000742402
0
$13.00
DESCRIPTION.
ACCOUNT
QTY
AMOUNT
APPLIANCE REPAIR/ALTERATION PC
101-0000-42600
0
$5.20
Total Paid for MECHANICAL: $18.20 .
DESCRIPTION
ACCOUNT
QTY
AMOUNT -
PERMIT ISSUANCE
.101-0000-42404
0
$98.83
Total Paid for PERMIT ISSUANCE: $98.83.
DESCRIPTION.
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00 '
Total Paid for. TECHNOLOGY ENHANCEMENT FEE: $5.06
TOTALS- $133.03
i
l
I.
Total Paid for. TECHNOLOGY ENHANCEMENT FEE: $5.06
TOTALS- $133.03
CERTIFICATE OF COMPLIANCE CF1117ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3)
Project Name: ALLEN SHACKELFORD Date Prepared: 2017-12-21
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
CF1R-ALT-02 document for each dwelling'uni.t.
01
Project Name
ALLEN SHACKELFORD
02
Date'Prepared
2017-12-21
03
Project Location.
55151 WINGED' FOOT
04
Building Type
Single family
05
CA City'
La Quinta' r'
k06
Dwelling Unit Name
HOUSE
SC System
SC System
CFA served
system a
refrigerant
07
Zip Code
92253
08:
Dwelling Unit Conditioned
t
2369
Location or Area
by this SC
ducted
containing
Floor Area (ft2)
more than 40
entirely new
entirely new
14 a*�
Name
Served
System (ft2)
system?
component?
z r��
feet of ducts?
Number of Space
SC system?
Alteration Type
SYSTEM 1
WHOLE HOUSE
f
Yes
Yes
09
Climate.Zone
15'C�
No
Conditioning (SC) Systems in
1
`
this Dwelling Unit:
B. Space Conditioning (SC) System Information yrs
01
02
03
04 -
O5- 1.
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
WHOLE HOUSE
2369
Yes
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: 417-A020135745A-000-000-0000000-0000 Registration Date/Time:•2017-12-21 12:14:44 HERS Provider: CHEERS
r
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-12-21 12:14:45
Schema Version: rev 10/16
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
05
06
07
08
09
10 '
11
12
Heating
Cooling
System
Heating
Altered .
Heating
Minir114lf11
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 '
Central gas
No heating
This field or
This field or
Central split
This field or
. This field or
SYSTEM 1
furnace
component
section is not
section is not
AC
Fancoil AHU
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
applicable'
applicable
Required Documentation:
CF2R-MCH-01-E -Space Conditioning Systems c .
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums R6.(CZ 1 10 12 and'13) and R8 (CZ 11 and 14-16)
CF2R and CF311-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed inj6ded systems, or when more than 40 ft of duct length is replaced
-Leakage rate compliance: <=15% or <= 10%, leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing comp ents:are installed or altered (applicable in CZ 2, 8-15).
`
CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required.°
Exceotions: �<
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 MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
oE. EntirelyNew or.Com lete Replacement Duct System, with or withouEqdiPmnt Chg'et (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: 417-AO20135745A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-12-21 12:14:44
Report Version: 2016.1.006 -
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-12-21 12:14:45
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:
Patty Hernandez
Yaaey tiwncMeT
Company:
Signature Date:
I Permit E Raters
2017-12-21
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip:Phone
Westlake Village CA 91362
. k'a
818735-7876
I� W Jed
Responsible Person's Declaration statementM M
I certify the following under penalty of perjury, under the laws of the State of California: •jf
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. '* a
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,<approyal with this building permit application.
If
5. I will ensure that a registered copy of this Certificate of Compliance shall bejmade available with the buildiQ-*peemit(s),Rsued 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:
Patrick Somers
Patty hwna*"e�(a"dwr4ed.)
Company:
Date Signed:
General Air Conditioning
2017-12-21
Address:
License:
31170 Reserve Drive
686310 '
City/State/zip: -
Phone:
Thousand Palms CA 92276
760-343-7488
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 Number: 417-A020135745A-000-00070000000-0000 Registration Date/Time: 2017-12-2.1--'12:14:44 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016. i.006 Report Generated: 2017-12-21 12:14:45
Schema Version: rev 10/16
'
PERMIT # • /� .�_
+
PLAN LOCATION:
Project Address: SS 1S � sem �
Project Description: Pool, Remodel Add't, Elect, Plumb, Mech
APN #:
Telephone:
Patio/Porch SF
Email:
ApplicantName:
State Lic: City Bus Lic:
Address: 3\Zzs
State Lic: City Bus Lic:
City, ST, Zip: "e V -� e- Ck q t3b2
Telephone:
Email:
Valuation of Project $ 1 IOp
Contractor Name:
6GrerC_\ X c Cao\
-New SFD.Construction:
Address:31170 e.��
Conditioned Space SF
City, St, Zip CQ c12Z"7(o
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire -Sprinklers SF
State Lic: City Bus Lic:
;
t
Arch/Eng Name:
Construction Type: !Occupancy::
Address:
Grading: f -
City, St, .Zip
a 1
Telephone:
Bedrooms:
Stories:
# Units:
Email:
;
State Lic: City Bus Lic:
A/� 11 �n1 (1
Property Owner's, Name:gGGC
f'i6�.Q� �he� lora
New Commercial / Tenant Improvements:
`
Address: Jar �r j
Total Building SF'
City, ST, Zip LCA - -gZZS�
Construction Type: Occupancy:
Telephone: "7t�7_ —n•7- %S EB
Email-
!
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
-Reed
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
Grant Deed.
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License