BMCH2015-020778-495 CALLE TAMPICO w f C` 0 D 4
I4dI1IC(/ VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT 0 26.) 777-7011
�NSPE(�IONS ( ) 777-7153
BUILDING PERMIT
JUN 1 $ 201Ta 6/18/2015
Application Number: BMCH2O15-0207 Owner
Property Address: 81250GOLFVIEWDR PATRI KL gs 6R'Ty0FLA0UINTA
�1
E
�LOPMENTDEPARTMENT
APN: 762390017 81250 LF -V JNFD.
Application Description: BOLGER RESIDENCE HVAC CHANGE OUT LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $29,000.00
Applicant:
IE INC.
32115 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 License No.: 968141
Date: Contractor:
OWNER -BUILDER DECLARATIO
I hereby affirm under penalty of perjury that I am exempt from the Contractor'State
License Law for the following reason (Sec. 7031.5, Business and Professions Co e: 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 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 Add
Contractor:
HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-5562
LIC. No:: 968141
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, asp vided for by Section 3700 of the Labor Code, for the performance
of the work ich 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 polity 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 Poll provisions.
``�
Date: / /✓ Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIC&KCOVERAGE IS Uf LAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
i
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued.as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes.
DaZ O J Signature (Applicant or,4191 r T__e, v- i_-e,�
a O• , •
fINANCIAL
y - �E - .(. F i � h :: .2: ?%V4..:e:. ^N'� : 5i f'."�.. �T� Ca.�n �'�5+: - j•F� �'i �e Td £X�..� ��. �ii �nv 3. �f'; f� , ��: Y zff 1'hi':�"(:Y7{ �# � i' ?'E4Fi F��` - ..� rf YSm+�.� fi�.�$ f 'j.>.s 1e }� � 5. y ; . i ii
DESCRIPTION QTY € PAID PAID:'DATE
... r rs � ACCOUNT � s f MAMOUNT4 V E F h
BSAS SB1473 - 101-0000-20306 0 _ $2.00 $0.00
y {FLEE E
'.€X}�R�'X 1 "£�`Xbfita{: E3` �f£it. $. H(�°,"ir�'�Y-.�.'. .`ey.�.•=a;t. a'+k'Y�v;.•'„r'Es".('�Pl�'.� q�'a yF •§4;S..s.*�-�v4'r2.i '$r-�,�d'. I}�'�i'.: �- ,
i?AID BYES RECEIPT # CHECK # t
CCTD BY5
E EYE METHOD, a ,
;,Fa.F;'_.ai„_ti
;
Total Paid -for BUILDING STANDARDS ADMINISTRATION BSA' $2.00 $0.00
X DESCRIPTION' rte`= k
zACCOWNT����QTYAMOUNTe�DATE
;'>; 4a _...t`... S. .,.� ' ..., .:
�,. 7. <.�.�`' <.. t 3 : s
v
IR
HVAC CHANGEOUT -,,SPLIT-SYSTEM
101-0000-42402
0•
$145.04
$000
XY S..# f - �• y, Y
M� PAID"BY
- 'W.f�Ya4'C" .=we`.'r" .A:�v°'xTY`.FS'?�,
4.
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SIi'� �..A .�,.Y5
RECEIPT #
' CHECK #
CLTD BY
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�METIiOD�y
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*' D�ESCRIPTIONy,
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PAIb
PAIDMATE
F � f
i r
QN
rs AMOUNTx �
t F
HVAC CHANGEOUIT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
...;,x S•yrt_,
ygS��4 xd�i i, s° f .,FFP< i:4Y. '.K.�.C.6 &{
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Total Paid forCHANGEOUT: $217.56 $0.00
�5DESCRIPTriN s,�ACCOUNTx
QTY,AMOUsNT
'�
" '',
PAID DATE
ION
*
,PAIRS rr
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
b`•%.rt h d Y:ii �Y•�Yvy. } ... 4t...i
° PAID'BY '
.�+-+f' ..n'i.' .;: x;
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#male's
CHECK #
CLTD BY
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Total Paid for PERMIT ISSUANCE: 91.85' $0.00
• • ••
E.
s
s
Permit Details PERMIT NUMBER
City of La Quinta BMCHeZi94 X5;10207
Description: BOLGER RESIDENCE HVAC CHANGE OUT
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 6/18/2015 MFA
Approved:
Parcel No: 762390017 Site Address: 81250 GOLF VIEW DR LA QUINTA,CA 92253
Subdivision: TR 28838-2 Block: Lot: 28
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $29,000.00 OccuNdIicy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: HVAC CHANGE OUT - (2) 18 SEER / SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI•
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
IE INC.
32115 LA BAYA
WESTLAKE
VILLAGE
CA
91362
(
FINANCIAL INFORMATION
Printed: Thursday, June 18, 2015 8:00:59 AM 1 of 2 r7
SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
C
BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$145.04
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$72.52
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:0•
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
MECHANICAL FINAL'' BLD
BOND INFORMATION
Printed: Thursday, June 18, 2015 8:00:59 AM 2 of 2 r7 .
SYSTEMS
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -SR -ALT -HVAC) (Page 1 of 3 )
Project Name: PAT BOLGER Date Prepared:. 2015-06-12
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 CF111-ALT 02 document for each dwelling unit.
01
Project Name
PAT BOLGER
02
Date Prepared
2015-06-12
03
Project Location
81250 GOLFVIEW DRIVE
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
PAT BOLGER
Dwelling Unit Conditioned
Installing a
07
Zip Code
92253
08
Floor Area (ft2)
4084
SC System
`f CFA served
. -
refrigera t
Number of space conditioning
stalling
09
Climate Zone
15
10
(SC) systems in this dwelling.
2
ducted
containing
system
more than 40 or
unit.
entirely new
Name
Served
System (ft2)
system?
component?
,#,
B. Space Conditioning (SC) System I formation,`:`
:: .Amk Aft
Ol
02
3`
� 04
05
U6
U8 i
09
10
.
r`..r K
� Is the SC
Installing a
amaQww
SC System
SC System
`f CFA served
systema
refrigera t
nstalling4nev. 4.
stalling
ns alli g
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40 or
new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
.2042
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
2042
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: 215-A0158338A-000000000-0000 Registration Date/Time: 2015-06-12 17:33:15 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03.31 Report Generated: 2015-06-12 17:33:02
Schema Version: 0.5S5SDD
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)
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
Central gas
All new
Central
tral split .
All-new
This field or
This field or
System 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
18
Setback
section is not
section is not
components
components
applicable
applicable
Centralas
g
All new
}`
Central split
All new
This field or-
This field or
System 2
furnace
heating
A AFUE
0.8
AC
cooling
SEER
18
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 _"' d
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.
jaw
-Leakage rate compliance: 515%, or 510% leakage to,outside, or seal ali eccess.iwblW eaks. owft' 01
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant`contamigg components are installed or alte'red'(!pplicable
in CZ 2, 8',.1^5)
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow z 300 6lvl/t6'iiir6uirdhen MC -25 is regiilr"ed.,
Now
Exceptions: '
-Duct systems registered with HERS provider as previously sealedare;exempt from MCH -20 Duct Leakage Testing requirements ..
Heating -only systems and Air Handler/Furnace,cfianges do not require erificatiori of Air FIoMCH 23`, or` frigerant Charge MECH-25.
Existing duct systems constructed, insulated or sealed with asbestos are �exempt from MCH -20 Duct Leakage sting requirements:
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (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: 215-A0158338A-000000000-0000
Registration Date/Time:
2015-06-12 17:33:15
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015706-12 17:33:02
Schema Version: 0.5555DD
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: �
Jan CU
Jacoby, Ian
loco
Company:
Signature Date:
Strati Permit Service
2015-06-12 17:32:52
Address:
CEA/ HERS Certification Identification (it applicable):
5858 Dovetail Drive
City/State/Zip:
Phone:
Agoura Hills CA 91301,
818-735-7876
Responsible Persons Declaration statemenfh
I certify the following under penalty of perjury, under thelawss1`0!-f the State of California:
1. The information provided on this.Certificate:of Compliance;is true and correct.
2. 1 am eligible under Division 3 ofth'e;Ustness-and Professions Code toraccept.responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and perfo mance specifications materials':cocomponents, 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 _egu'la ons.
11.102iiance
4. The building design features or system design features identified onathis ic areconsistenf wit . the mformat oh:provided on'othe�app',licat3 ecompliance documents, worksheets,
Certi f'aYe of
calculations, plans and specifications submittetl:_to the nforcement agency fora p ovawlth this building permit application. i
X a �c wx1; *d' IMP
5. I will ensure that a registered copy of�s Certificat�e�ofmpliance shal(tbe made available with the bulldmg permit(s);issued forath'e$tiuild g and made availabledtotheenforcement agency for all applicable
inspections. I understand that a registered copy of thirGerCificate of Co�mpl ance is required to 4included,�wit�h the�documpt ation�the�buildder pro24'.,vd es to the b ding owner at occupancy.
Responsible Designer Name:Responsible
Designer Signa ure:
Valdez, Dayana
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-06-12 17:33:15
Address:
License:
31-170 RESERVE DRIVE STE A
686310 .
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
1(760) 343-7488
Digitally signed by CaICERTS. 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=A0158338A-000000000-0000 Registration Date/Time: 2015-06-12 17:33:15 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 17:33:02
Schema Version: 0.5555DD