BMCH2016-021278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4 w
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 77.7-7011.
INSPECTIONS (760) 777-7153
Date: 6/16/206
Application Number: BMCH2O16-0212 %n1 Owner:
Property Address: S60S9 WINGED FOOT D (�_ _ DONALD HAYS
APN: 775300006 CC 56059 WINGED FOOT
Application Description: HAYS / HVAC CHANGE -OUT Vy 7 LA QUINTA, CA 922S3
Property Zoning:
Application Valuation: $11,734.00 Om(OFI 'QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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
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
D� �-)Contract_or__"T,---��
%--
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 thathe 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 Name:
Lender's Address:
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.
p 11 Ito " Applicant:—,S:-7ie-
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 LA80R 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: ` 1=1 l to Signature (Applicant or Agent).—� �—
I
1 . • { .
FINANCIAL
$'DESCRIPTIONS '�' c �" ACCOUNT QTY t."+AMOUNT "¢:PAID' iPA1D DATE;
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $0.00
4-1
PAID BY 3�
METHOD p r4y / +''.RECEIPT # CHECK #
%CLTD BY?
s .= s�
,txs
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00'• $0.00
DESCRIPTION r ' ' '
R ,ACCOUNT<' '' �
QTY
' AMOUNT S
s;;v¢ "� PAID " ,
PAID DATE4
= -W e ;_;ix ,.., .a.,ls. . ?3 c'.:a �, t'
"r� .?-lt ., .P- e,
si
.,:
} f _N
HVAC CHANGEOUT - PACKAGED UNIT
101-0000-42402
0
$36.26
$0.00
gp,,.METHOM<,zkQ,`Dk.�,. � .:RECEIPT# a
CHECK#E
r CLTDBY t.
'z,;'
> Y
a
`s- DESCRIPTION`
ACCOUNTS X `z
sQTY
7Y AMOUNTS{
PAID
PAID DATE,,
f
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
; 0
$24.17
$0.00
x�%
PAID`BY�
,. _ ��
METHOD
r_>`: Ar
RECEIPT #�
��CHECK#��
CLTDBYi
L-„
Total Paid for CHANGEOUT: $60.43 r $0.00
E,� -41
AMOUNT
{
':PAIACCOUNTSCRIPTIOND
=PAID OATS;
y
f�
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAIDBYy
METHOD
h�
CHECK##CLTD
BY;
;
r;,3y�'`RECEIPT#
€`ts .y.
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
• 00
DESCRIPTION 'r+.....
_ y
ACCOUNT:'.
:.
QTY;
_..:
AMOUNT
= PAID
PAID GATE
RECEfPT #
.,
CHECK#
IVIETHODs
PAID.BY
,
BSAS SB1473 FEE
101-0000=20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.(lA $0:00
BSA:
HVAC CHANGEOUT-.
101-0000-42402•
0
$36.26
$0.00
PACKAGED UNIT
HVAC CHANGEOUT - . .
101-0000-42600
0
$24.17
$0.00
PACKAGED UNIT PC
Total Paid for CHANGEOUT: $60.43 $0.00 .
PERMIT -ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALSi $0,00''
•
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
10
it ,
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
Central gas
All new_
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE'
80
AC
cooling
SEER
14
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 for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H – Duct Leakage testing req fired 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 2'300 CFM/ton requiredwhen,MCH-25 is required,
Exceptions: f ,.rte
-Duct systems registered with HERS providerpreviously sealed are,exeinpt fromMCH-20 Duct Leakage Testing requirements .
do Au Flow MCH23 Charge M,ECH 2
-Heating-only systems and Air Handler/Furnace changes not require verification of or'Refngerant
^H^ �r� k s w<,k a h r '
Existing duct systems constructed, insulated or sealed with asbestosare exemptfrom MCH 2OUDuct,Leakage Testing reguuements.
�m
d F.A' i ,ihi .. VAI CK �:.. 4M 11 Ilr� ' �:, - ;J *1 q;:t Al d f — Na tK M T43L_
E. EntirelyNew or Complete Re lacement Duct Sy stem with or u � � � C a o � ion � a 2(
i d
without. -Equipment Changeout (Sections.�l`50.2(b)iDiiarand,150.2(b)lE, F)
P P Y» . fi e Vow S I A' I A N":
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: 216-A0221166A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2016-06-14 22:09:07
Report Version: 2013 Rev 1.007
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2016-06-14 22:09:39
CERTIFICATE OF COMPLIANCE CF111-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:
Shanley, Barbara
lJ12�i'(itClit!!� .7lKGJ✓<.LG�
O
Company:
Signature Date:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-06-14 22:09:07
Address:
CEA/ HERS Certification Identification (if applicable):
31-170 RESERVE DRIVE STE A
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276 A
760-343-7488
Responsible Person's Declaration statement\
I certify the following under penalty of perjury, under the laws of the State of California:
y r A i
1. The information provided on. this. Certificate of Compliance is truce 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 specifications, materials, components, and manufactured devices. for the building design or system design identified on this Certificate of Compliance conform to the
t
requirements of Title 24, Part 1 and Part 6'of the California Code of Re Mations,..,.
q -a?;s;,.
1
e r;.dg ,pp`4r,' ek 'k�l-•i°'hs.
4. The building design features or system design (features identified on his Certificatte,of Compliance are„consistent.40the in formation provided on applicable'compliance documents, worksheets,
tother
calculations, plans and specifications submitted, to the enforcement agency for;approval;wiEh this building permit application. '
'x.
r ,... ,X §,r.,,4, 1-. ..a
Q9 i i At . as p
S. I will ensure that a registered copy of this'Certificate-of,Compliance sfiall be;made available with�the bwlding permd(s),issued for the;building, and;made available to the:enforcementagcncy for all applicable
inspections. I understand that a registered copy of this Certificate of Com pl ance,ls.required to be,included with the, documentation, he,,builder provides to the building owner at occupancy.
Responsible Designer Name:xk +w
Responsible Designer Signature:`rw
Shanley, Barbara
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-06-14 22:09:07
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
760-343-7488
Digitally signed by Ca10ERTS. 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: 216-A0221166A-000000000-0000 Registration Date/Time: 2016-06-14 22:09:07 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-06-14 22:09:39
Schema Version: 0.555SDD
MO
Bin. #-
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8WMw of Safety Divitfori
Perim #P.O.
y
Box 1504,•78-495 Cage Tampko
P.
- LJ.Q&4 CA92253 -.-(760) 777-7012
' ' • '
ng Pemit Appllcadon� and Tracing Sheet
Pmjeot.Add=:' •'
j e pD` Owncesm mG. X�git% .'
A. P. Number.
Address: . J'
Adm:
City. a. Zip: z z .�
Co�mador. General Air ac.and
heating
Tdeprwnc: ? ''
PmjoaDesaipdw:
Address: 31'170 reserve drive
Ciry, ST, Tsp: thousand palms 92276
Telephone: 760 343-7488
.�
State Lia # : 686310.
City Lia C- 4.ol (� K
Address:
F
red hone:
consttmeonn'ljrpe:. Oxepanq:
State Lie. #
Project type (citde one): 'New Add'n Alter Repair ' Demo
Name of ConiHct Penson
yr Sq. Ft.: # stories:
Tdq)h6ne # of Contest Pason 818 735-7876 Estimaood. Value of Pt'ojcct: -4� ' z
APPUCMff: DO NOT WRITE BELOW TM Un -
Y
sebmrlial
'd
Beed
TBACiG rE MIT FM
�'
Plan SW
Pian Cbeek saba"a Item - ' AMD%"
Structsra! Cain .
Revicimek ready for correcdoau Pian Cbedc D *osit.
Ttea Cala. -
\
Called Contact Perm Plan Cheek Bounce..
'Lute 2A Caret.'
Plans~ up Constraetlom.
now PWI plan'
Plats resubmitted Meebaiieal .
Giadlat 0"
r! Review, ready for cotrectiomrR sue , Electrical
Snbeoataetor Lit
r -.
Carted Contact; Person Ptnmbiag
Grant Dad
Plats sew up &M.L
H.O.A. Approw aPlans
resabmrt0ed Gradktg 1 .
IN HOUSIC--
" Review; ready kr enrrectionsibm s Developer Tnpaa Fee y
planning Approval'
Cana Costae ram. . A.I P.Y.
Pub. Wks. Appr
Date of permit lune
Seboor Fen
Total Pern it Fees
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
1
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: DON HAYS Date Prepared: 2016-06-14
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 CFIR-ALT-02 document for each dwelling unit.
01
Project'Name
DON HAYS
02
Date Prepared
2016-06-14
03
Project Location
56059 Winged Foot
04
Building Type
Single family
05
CA City
La Quinta ,
06
Dwelling Unit Name
DON HAYS
07
Zip Code
9225308
l
Dwelling Unit Conditioned
3669
.'
a ` `'"
+' '
Floor Area (ft2)
SC System
SC System
'CFA served
'� S, em a,
"`�"s.h�
refrigerant
Number of space conditioning
, Installing �
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
containing
system
more than 40
unit.
entirely new
Name
..� . ,.
System (ft2)
system?
component?
LMENO
B. Space Conditioning (SC) System I nformationy'`'y g5
01
02A,
03...05:06.1
07�
08
09
10
l
lis the SCS
Installing ate"
.'
a ` `'"
+' '
SC System
SC System
'CFA served
'� S, em a,
"`�"s.h�
refrigerant
Installing neva>SC
, Installing �
+Installing
� Installin g
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
3669
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: 216-A0221166A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration DateMme: 2016-06-14 22:09:07 M HERS Provider: CaICERTS
Report Version: 2013 Rev 1.007 Report Generated: 2016-06-14 22:09:39
Schema Version: 0.5555DD