BMCH2017-0378P a CU
78-495 CALLE TAMPICO T 0 G{/ Q D
LA QUINTA,.CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
BMCH2O17-0378, Owner:
53700'AVENIDAVILLA CAROLYN"WILSON '
rl D
774134010 . 3700 AVENIDA VILLA
WILSON RESIDENCE/ HVAC CHA G 0 U QUINTA, CA 92253 '
$11,165.00 AUG 2 9 201
Applicant: Contractor:
IE INC. CITY OF LA QUINTA HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 Ls' BAYA DESIGN AND DEVELOPMENT DEPARTMEM170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276
(760)343-7438
Llc. No.: 686310
8/29/2017
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7006) 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
�1 r 1 ` Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjuy 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 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 Na
Lender's
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury cne of the following declarations
I have and will maintain a certficate 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.
Ihave and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the p•arformance of the work for which this permit
is issued. My workers' compensation inSL rance carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031658
I certify that in the'performanoe of the work for which this permit is issued, I
shall not employ any person in any mannr.r 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 Sect -on 3700 of.the Labor Code, I shall forthwith
comply with those provisions.
Date: 11 Applicant:
WARNING: FAILURE TO SECURE WORKER? COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDE. FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST,.AND ATTORNEY'S FEES.
APPLICANT ACF_NOWLEDGEMENT
IMPORTANT: Application is hereby made V, 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
re'q'uest and for whose benefit work is perormed 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 harmlessrthe City of La Quin„ta, its officers, agents, and
employees'for any actor 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 forA80 days will subject permit to ca -icellation.
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 represe ntatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: Z�l l Signature (Applicant or Agent):
DESCRIPTION ,ACCOUNT QTY AMOUNT
'
— BSAS.SB1473 FEE 101-0000-20306 0 $1.00
' -
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
502-0000-43611
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION PC
101-0000-42600
0
$5.07
Total Paid for CHANGEOUT: $17.74
DESCRIPTION
ACCOUNT
QTY
AMOUNT
AIR HANDLER
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
AIR HANDLER PC
101-0000-42600
-0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR•
101-0000-42402
0 •
$38.00
'DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0-
$25.33
Total Paid for MECHANICAL: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for -PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY:
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Bin.#
Cl of LQ Quth
Btrilding u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La.Qtrinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 53700 Avenida Villa
Owner'sName::Carolyn Wilson
A. P. Number.
Address: 53700 Avenida Villa
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. General Air Conditioning
Telephone: 504-5394065M=.�'
Address: 31170 Reserve Drive
Project Description: Replace 3 ton Feat pump, air handler &
City, ST, Zip: Thousand Palms, CA 92276
8 ducts
Telephone: 760-343-7488
State Lic. # : 686310
City Lie. M.
Arch, Engr., Designer
Address:
City., ST, Zip:
)
Telephone } v Y
State Lic. #: .,; � �j�»�4''. ' •, ,.
Name of Contact Person: Steven Schnierer
Construction Type: , Occupancy:
Project type (circle one): New Adti'n Alter Repair Demo
Sq. Ft : # Stories: —TO—Units:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project $11,16E.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
SubmittalReq'd
ReNd
j TRAQMG
PERhW FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.Reviewed,
ready for corrections
Plan Check Deposit. .
Truss gates.
Called Contact Person
Plan Chock Balance
Title 24 Calm
Plans picked up
Construction
Flood plain plan
Pians resubmitted.'.
Mecharikai
Grading plan
2" Review, ready for correctionshssue
'Electric4l '
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A.Approval
Plans resubmitted
Grading
M HOUSE:- "
3d Review; ready for corrections/issue
Developer Impact Fee'
Planning Approval
Called Contact Person
AJ.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total P?rmit Fees
..... ......... _:- .... ....... +...............
f
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 1 of 3)
Project Name: CAROLYN WILSON Date Prepared: 2017-08-28
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
CAROLYN WILSON
02
Date Prepared
2017-08-28 .
03
Project Location
53700 AVENIDA VILLA
04
Building Type
Single family
05 '
CA City
La Quinta
X06
Dwelling Unit Name
CAROLYN WILSON
v 'r
refrigerant
new
07
Zip Code
.I
92253 4
._
08
Dwelling Unit Conditioned
1212
by this SC
ducted
f
system
Area (ftZ)
entirely new
entirely new
Name
Served
;Floor
system?
component?
components?
°a t� ��
.��
.,
_10'
Number of space
Alteration Type
09
Climate Zone
15i .
Yes
Conditioning (SC) Systems in
1
Yes
No
No
=f
this Dwelling Unit:
B. Space Conditioning (SC) System. Information
01
02
03
04
OS
._ 06 "
07
08
09
10
SC System
SC System
CFA served
Is the SC
�.4 rf
Installing a
n C)1�-o v
Installing SC
Installing
Installing
Installing
systema
refrigerant
new
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM #1
LOCATION #1
1212
Yes
Yes
Yes
Yes
No
No
Altered space
conditionine 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: 417-A020112545A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential -Compliance
Registration Date/Time: 2011-08-28 13:55:59
Report Version: 2016 .1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-08-28 13:55:59
CERTIFICATE OF COMPLIANCE CFiR-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)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
•
SYSTEM #1
Central split
All new
heating
COP
80
Central split
Fancoil AHU
SEER
14
Setback —
Greater than
R-8
HF
HP
40 feet
components
Required Documentation:" h�
CF2R-MCH-01-E - Space Conditioning Systems � �
Duct insulation requirement for the new portions of supply -air and return-alr ducts or plenums R6.(CZ 1 10.12 and 13) and R8 (CZ 11 and 14-i6)
CF2R and'CF3R-MCH-20-H -Duct leakage Test required when heating or cooling components are installed in d`ucte'd 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.n ,
71
W
CF211 and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF211 and CF3R-MCH-23 Airflow Rate.>= 300 CFM per ton required when MCH -25 is required` ^"
Exceptions: �
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Le kage 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.
M.
i tt I
*14
E. Entirely New or Complete Replacement Duct, System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)lE, F)
I This section do sn app y to"this pro ect.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
Thi3 >cction doc3 not opply to thi3 project.
Registration Number: 417-A020112545A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-08-28 13:55:59
Report Version: 2016.1.006
Schema Version: rev 10/16 ,
HERS Provider: CHEERS
Report Generated: 2017-08-28 13:55:59
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:
Jaci Jones
Jam" o—w
Company:
Signature Date:
I Permit E Raters
2017-08-28
Address:
CEA/ HERS Certification Identification (if applicable):
31225.La Baya Drive
City/State/Zip: `' t
Phone:
'818735-7876
Westlake. Village CA 91362
Responsible Person's Declaration statement
� h ,
1 certify the following under penalty of periury, under the laws of the State of California: tat
i. The information provided on this Certificate of Compliance is true and correct. '�;,` t`0 ` !f
2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility,forahe building design or system.design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactu ed'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 agency for-approvaliwith this building permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall bemadeavailatil�wlth the bwlding-p mit(s)�ued 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:
Patrick Somers • -
Responsib(e:Designer Signature:
Company:
Date Signed:
General Air Conditioning
2017-08-28
Address:
License:
31170 Reserve Drive
686310
City/State/Zip:
Phone:
Thousand Palms CA 92276.
760-343-7488 '
Digitally signed by CHEERSTM 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-A020112545A-000-000-0000000-0000 Registration Date/Time: 2017-08-28 13:55:59 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-28 13:55:59
Schema Version: rev 10/16