BMCH2016-034978-495 CALLE TAMPICO D �KMUCl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0349
tJ
Property Address:
81355 LEGENDS WAY
APN:
762420036
S (' 2 0 2016
Application Description:
CLARK / CHANGE OUT (1) AC UNIT
Property Zoning:
------
any 0; UAQUINTA�
Application Valuation:
$5,864.00
COMilUN'.TY DEVELOPMENT DERiRTPdctiT
Applicant:
IE INC
31225 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. C36 License No.: 686310
fDate!� ZO � Contra"�ctor��in�.�fL ��—
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 i
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.).
(J 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: '9/20/2016
Owner:
TOM CLARK
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
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
oft ork for which this permit is issued.
(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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031658
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:" 10 Applicant:
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.
1 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: 2v I Signature (Applicant or Agent):'
Date: 9/20/2016
Application Number: BMCH2016-0349
Owner:
Property Address: 81355 LEGENDS WAY
TOM CLARK
APN: 762420036
1567 9TH AVE N
Application Description: CLARK / CHANGE OUT (1) AC UNIT
EDMONDS, WA 92253
Property Zoning:
Application Valuation: $5,864.00
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
Detail: HVAC CHANGE OUT-14SEER A/C UNIT [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
-DESCRIPTION ACCOUNT QTY AMOUNT
BSAS S131473 FEE • 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
FINANCIAL INFORMATION
QTY
AMOUNT
-DESCRIPTION ACCOUNT QTY AMOUNT
BSAS S131473 FEE • 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC•CHANGEOUT - REPAIR/ALTERATION. PC
101-0000-42600
0
$4.83
Total Paid for CHANGEOUT: $16.92
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
Total Paid for PERMIT ISSUANCE: $91.85
0
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
TOM & SALLY CLARK I Date Prepared:
CF111-ALT 02-E
(Page 1 of 3 )
2016-09-15
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented;
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
TOM & SALLY CLARK
02
Date Prepared
2016-09-15
03
Project Location
81355 LEGENDS WAY
04
Building Type
Single family
05
CA City
LA QUINTA
06
Dwelling Unit Name
WHOLE HOUSE
SC System
SC System
CFA served
F —
D welling Unit Conditioned
Installing new SC
07
Zip Code
92253 r`'-�- '�
08-
3
•
Floor Area (ft2)
4370
by this SC
ducteatilry
a.tcontaining'Vi
.
more than 40
entirely new
entirely new
Name
Served
Number of space conditioning
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
09
Climate Zone
15` _"'
1 10,
(SC) systems in this dwelling
1
No
No
_
Altered space
conditioning system
unit.
B. Space Conditioning.(SC) System Information. ~~`
01
02
03
04
n 1105 r7—€�.
, 06-
07
08
09
10
Is the SCS
i.lnstalling a '
I (.
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducteatilry
a.tcontaining'Vi
V"system)grftj;
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
4370
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: 416-A0004544A-000000000-0000 Registration Date/Time: 2016-09-15 17:1.4:35 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-15 17:14:43
CERTIFICATE OF COMPLIANCE CF111-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).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
No heating
This field or
This field or
Central split
All new
This field or
This field or
SYSTEM 1
furnace
component
section is not
section is not
AC
cooling
SEER
14.00
Setback
section is not
section is not
altered
applicable
applicable
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans ff A.
-Duct insulation requirement for new plenums: R6.
CF211-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.
-Leakage rate compliance: <_ 15%, or <_ 10% leakage to outside, or seal all accessible leaks. 1,`,
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 required when MCH -25 is required.
Exceptions:
-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 MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)1E, F)
rs odesnapyrThiS in 'ptothis-project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 416-A0004544A-000000000-0000 Registration Date/Time: 2016-09-15 17:14:35 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-15 17:14:43
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:
Patrick Somers
fPa&6ckl1Sc*vtAers-
Company:
Signature Date:
General Air Conditioning
2016-09-15
Address:
CEA/ HERS Certification Identification (if applicable):
31170 Reserve Drive
City/State/Zip: ,^ . a
Phone:
Thousand Palms CA 92276
7607343-7488
a,.•, ,
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California: 4'
# t.W f
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 manufacturefd 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 this building permit application.
4app�ro! allwith
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made availablewiththe building permit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Co Compliance is required -to be'included witj�the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
�r'G{tVuGlv$OvhPX�
Responsible Designer Signature:
Patrick Somers
Company:
Date Signed:
General Air Conditioning
2016-09-15
Address:
License:
31170 Reserve Drive.
686310
City/State/Zip:
Phone:
Thousand Palms CA 92276
760-343-7488
Registration Number:416-A0004544A-000000000-0000
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 Date/Time: 2016-09-15 17:14:35
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-15 17:14:43
Bin.# N
] / 0f Qainta
City..
Building 8= Safety Division
P.Q. Box 1504,78-495 Calle Tampico
L4.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 81355 Legends Way
Owner's Name:. Tom &.Sally Clark
A. P. Number-
Address: 81355 Legends Way
Legal Description:
General Air Conditioning & Plumbing
City, ST, Zip: La Quinta, CA 92253'
ff-IContractor:
Telephone: ; . �3`x
I.
Address: 31170 Reserve Drive
Project Description: Replace 4 ton A/C
City, ST, Zip: Thousand Palms, CA 92276
Telephone: 760-343-7488 t ;�'r;� ' ` " '�
State Lie. # : 686310 City Lie'. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone: : `�• ;
y� , „rV
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: 818-73577876
Estimated Value of Project: $5,864.0.0
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd •
'Recd
TRACK NG
PERMPF FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit. .
'buss Cates.
Called Contact Person
Plan Check Balance
Tide 24 Cales.
Plans picked up
Construction'
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Zad Review, ready for correctious/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S,l►q I
H.O.A. Approval
Plans resubmitted
Gradiag
IN DOUSE.-
Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
Schodl Fees
Total Permit Fees