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BMCH2015-0198Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 JUN 10 2015 U—UrCOMMUNITYDEVELOPMENTM NT 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: (, 10 � Contractor: watt 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).: (_J 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 Contractor: HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS, CA 92276 (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. S�! 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: (01 10 1 1 J Applicant:9.,,..tz c 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 avid 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. � � r Date: �o l0 lJ Signature (Applicant or Agent): �twrL xr—� m4aw VOICE (760) 777-7125 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153. BUILDING PERMIT Date: 6/10/2015 Application Number: BMCH2O15-0198 Owner: Property Address: 79890 FIESTA DR WILLIAM HARTUNG APN: 600060034 79890 FIESTA DR Application Description: HARTUNG / REPLACE 15 DUCT RUNS LA QUINTA, CA 92253 Property Zoning: Application Valuation: $5,775.00 IIUI� ILII nnll Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 JUN 10 2015 U—UrCOMMUNITYDEVELOPMENTM NT 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: (, 10 � Contractor: watt 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).: (_J 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 Contractor: HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS, CA 92276 (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. S�! 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: (01 10 1 1 J Applicant:9.,,..tz c 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 avid 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. � � r Date: �o l0 lJ Signature (Applicant or Agent): �twrL xr—� FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT CITY 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 CITY 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:0• 00 Description: HARTUNG / REPLACE 15 DUCT RUNS CONDITIONS Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 6/10/2015 SKH Approved: Parcel No: 600060034 Site Address: 79890 FIESTA DR LA QUINTA,CA 92253 Subdivision: TR 2180 Block: Lot: 50 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $5,775.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: CHANGEOUT 15 DUCT RUNS [2013 ENERGY] 2013 CALIFORNIA BUILDING CODES. ADDRESS1 CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL APPLICANT IE INC 31225 LA BAYA WESTLAKE VILLAGE CA 91362 CONTRACTOR HARRISON ENTERPRISES INC DBA G 31-170 RESERVE DRIVE STE A THOUSAND PALMS CA 92276 OWNER WILLIAM HARTUNG 79890 FIESTA DR LA QUINTA CA 92253 FINANCIAL INFORMATION Printed: Wednesday, June 10; 2015 11:36:54 AM 1 of 2 ��^'Jff SYS TEM S Printed: Wednesday, lune 10, 2015 11:36:54 AM 2 of 2 Orp SYSTEMS LTD CBY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE ' 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 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:i• 00 Printed: Wednesday, lune 10, 2015 11:36:54 AM 2 of 2 Orp SYSTEMS Bin # .City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. a$ Building Permit Application and Tracking Sheet Permit # Project Address: 74 a CIO ee-4c. e, Owner's Name: -R i A. P. Number: Address: •') q a Q p Legal Description: City, ST, Zip: L. c- �, vire. CA G ZZ G 3 Contractor: Tele - '" Address: :)\I--70 1< v Project Description: Ci ST, Zi �- ty' P' ��nOVSohd \YYl CQ 2Z7(o Telephone: e 37 �• 3y ti 8 State Lic. # : %,21,-310 City Lie. #•: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: one: cY• n Type: Occupancy:an Constructi # oStateLic. e t type (circle one): New Add'n Alter Repair Demo roJP' Name of Contact Person: Sq. Ft.: -# Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: il& -7.75. GCS APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2". Review, ready for correctionsMsue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: BILL HARTUNG I Date Prepared: CF1R-ALT-02-E (Page 1 of 3 ) 2015-06-03 A. General Information CHR -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 BILL HARTUNG 02 Date Prepared 2015-06-03 03 Project Location 79890 FIESTA DRIVE 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name BILL HARTUNG A � � ails the SC Dwelling Unit Conditioned 07 Zip Code 92253 08 Floor Area (ft2) 2362 CFA served °*+system a�! refrigerant Installing-newSC Number of space conditioning Installing, 09 Climate Zone 15 10 (SC) systems in this dwelling 1 c ntaining system x more than 40 entirely w unit. B. Space Conditioning (SC) System Informationrf n Ol 02 03 04 ` 05 V 6#f 07 68 1 09 10 1 A � � ails the SC Installing a SC System SC System CFA served °*+system a�! refrigerant Installing-newSC �Installmg Installing, Rnstalling Identification or Location or Area by this SC ducted c ntaining system x more than 40 entirely w entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type System 1 Location 1 2362 Yes No No Yes No No Extension of existing duct system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) 01 02 System Identification or Name: New Duct R -Value: System 1 R-8 Required Documentation: Registration Number: 215-A0147605A-000000000-0000 Registration Date/Time: 2015-06-03 13:37:19 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-03 13:35:50 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 ) MR -MCH -01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF2R & CF3R-MCH-20-H — Duct Leakage Verification - Leakage rate compliance: 5 15%, or < 10% leakage to outside, or seal all accessible leaks Exceptions: Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 duct leakage testing requirements D. Altered Space Conditioning System (Sections 150.2(b)lE and F) This section does not apply to this project. 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. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) V Registration Number: 215-A0147605A-000000000-0000 sectiionldoe g;not`6pply-t 1 k1 1 *..9; fir U1 • Registration Date/Time: 2015-06-03 13:37:19 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-03 13:35:50 Schema Version: 0.555SDD 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: �! Jacoby, Ian cyan loco Jc Company: Signature Date: Stratz Permit Service 2015-06-03 13:35:52 Address: CEA/ HERS Certification Identification (if applicable): 5858 Dovetail Drive City/State/Zip: Phone: Agoura Hills CA 91301 ,f- 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 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 feat6res 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 per appgicati F.11 If It K 5. I will ensure that a registered copy of this Certificate, of,C�ompliance shall be,made available with_ttie buildm_'g permrt(s);issued foritfie;building, and made availableAb the—enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compl ance_is.required to be,included with the documentation,the�buillcler p�rov des to the building owner at occupancy. Responsible Designer Name: - Responsible Designer Slgnature: V i 0-1-01 t—W, Valdez, Dayana Company: Date Signed: HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING 2015-06-03 13:37:19 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: 215-A0147605A-000000000-0000 Registration Date/Time: 2015-06-03 13:37:19 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-03 13:35:50 Schema Version: 0.S55SDD