BMCH2015-0363o
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253'
Ttty/ 4 ZP QUM&
Application Number:
BMCH2O15-0363
Property Address:
50070 VIA DE MODA
APN:
776300002
Application Description:
HICKS RESIDENCE/ HVAC CHANGE
Property Zoning:
Application Valuation:
$1,000.00
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
ING PQRMI
SFO 2 4 2015
CITY OF LA QUINTA
Tf DEVELOPMENT DEPARTMENT
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
D`a ` �� l ✓ Contr�or:
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
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
Lender's Address:
VOICE (760) 777-7125
r I FAX (760) 777-7011
ENT INSPECTIONS (760) 777-7153
Date: 9/24/2015
Owner:
VICTORIA HICKS
50070 VIA DE MODA
LA QUINTA, CA 9225_
Contractor:
HARRISON ENTERPRISES INC DBAGENERALAIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)601-3500
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 o8 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 performa ice 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 :o become subject to the workers'
compensation laws of California, and agree that, f I should become subject to the
workers' compensation provisions of Section 3703 of the Labor Code, I shall forthwith
comply wit thos rotvisions.
Datta: w O \� Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLA UL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T
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 ACKNOWP.EDGEMENT
IMPORTANT: Application is hereby made to the 3uilding Official for a permit subject to
the conditions and restrictions set forth on this zpplication.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performe 9 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 Cty 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 cancell.tion.
I certify that I have read this application and stave 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 representatves of this city to enter upon the
above -m, nti ed property for inspection purpcses.
Date Signature ('Applicant or -Agent)
FINANCIAL INFORMATION
e� DESCRI,PTION a ; '<;rCiCCOUNTr F '
,.m, . z QTY AMOUNT K"` PAID t PAID DATE*
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
s y
EC IPT# CHECK#` �CLTDBY`<
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 ,
ZSg� is - a
x X k4hDESCRIPTION�ACCOUNT
x✓�
QTY.
u
AMOUNT?
NPAID
wax
PAID`DATE
CONDENSER/COMPRESSOR
101-0000-42402
0
$36.26
$0.00
:✓� v'�"Q� �? %#'"+en ..°J �.a".,F
X h PAID BYE � $ � ,`
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.4
AMOUNTA�
v%.L4
PAID
PAID DATE r.
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$24.17
$0.00
ti` a
RECEIPT'h
f CHECK #
CLTD BY i
Total Paid for MECHANICAL: $60.43 $0.00
� � £
sou��DESCRIPTION t'
'.i � _ � Y �A•
mACCOUNT
'.y
CITY*
i k°'."{'�"v
`AMOUNT
PA D
?
PAID�DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
t Y `PAIDBY l
METHOD
4x" ° "RECEIPT # " F'
` • CHECK #
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:•-
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Description: HICKS RESIDENCE / HVAC CHANGE OUT. -
Type: MECHANICAL ) Subtype: Status: APPROVED
Applied: 9/24/2015 MFA
Approved: 9/24/2015 MFA
Parcel No: 776300002 Site Address: 50070 VIA DE MODA LA QUINTA,CA 92253 •
Subdivision: TR 29858-1 Block: Lot: 2
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $1,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT,- 16 SEER SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES. -
FINANCIAL INFORMATION
Printed: Thursday, September 24, 2015 12:55:31 PIA •1 of 2
SYSTEMS
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"m-",:'-'�'�PAID BY
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BSAS SB1473 FEE
101L0060-20306
0
$1.00.,
$0.00
Total Paid for BUILDING STANDARDS- ADMINISTRATION $1.00 $0..00
BSA:
CONDENSER/COMPRES
101-0000-42402
0
$36.26
$0.00
SOR
CONDENSER/COMPRES
101-0000-42600
0
J $24.17
$0.00
SOR PC
Total Paid for MECHANICAL: $60.43 $0.00
PERMIT ISSUANCE
101-0000-42.404
0
$91.115
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
7
TOTALS: $IS3.28 $0.00
INSPECTIONS
PARENT PROJECTS,
F. ...
...........
BOOWATION ...... ..... . ... ... ...
Printed: Thursday, September 24, 2015 12:55:31 PM 2 of 2 CBFWSYSTEMS
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Perinit 1 P:Box ac Safety Diplon
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rr504, 78-49S Cage Tampico
V 4.Q, CA 92253 -=(760) 777-7012
Building Pem* Application and Tracking Sheet
Owaer's Name• . ( O "i 'I
A. P. Number.
�� �' Add,ess:
city.sr,zip: LA QUINTA, CA
Cmftcor. GENERAL A/C & HEATING Tdephoae .�
Address: 31170 RESERVE DRIVE Projax Fksctiption:
City. $T, Zip: THOUSAND PALMS, CA 92276
TSO: 760-343-7488
Swc Lir- #: 686310. City Lie: ti:
(o
ArchL. Bagr.. Designs: r
Address, hA
may. ST. Zip:
Telephone:
SM Lic. #: Conmuction Type: pc�upaa'cy:
Pro3edtype (Arlt oto) New Add'n Alta Repair Demo
Name ofCMWPam
: PATRICK_
_-- Sq Ft: #stories # vnitx
Telephone # of Cordact Pelson: 760-343-7488
11 Ewraaw Valine of Project: ,
APPLICANT: DO NOT WWM BELOW THIS UNE
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Plans resubmitted
Total Permit Fees
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Pub. Wks. App, -
Date of pmnit
School Fees
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CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to.Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: VICTORIA HICKS Date Prepared: 2015-09-24
A. General Information -
MR -ALT -02 is applicable to multiple space conditioning systems contaihed'wlthln a single dwellhig uiiit. When multiple dwelling units must.ha rinnimPntP.d;
use one CF1R-ALT 02 document for each dwelling unit.
01
Project Name
VICTORIA HICKS
02
Date Prepared
2015-09-24
03
Project Location
50070 VIA DE MODA
04
Building Type
Single family
OS
CA City
La Quinta
06
Dwelling Unit Name
VICTORIA HICKS
07
Zip Code
92253
08
Dwelling Unit Conditioned
4613
Floor Area (ft2)
SC System
SC System s
'CFA served
system a�
-i
refrigerant t
Number of space conditioning
stalling
09
Climate Zone
15 ' .�
10
(SC) systems in this dwelling
1
ducted
$
containing
F
1
more than 40
unit.
entirely new
..
B. Space Conditioning (SC) System Information -e',-
OS
02
, 04"�'
�
X05"
06 '
07)"N,
08
09
10
r
c
FIs the SC"""
F lnia ^.d "
Installing a
SC System
SC System s
'CFA served
system a�
-i
refrigerant t
*Installing°new SC
W
stalling
nstailing,
installing
Identification or
Location or Area
by this SC
ducted
$
containing
� �
system
1
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
4613
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A6336513A-000000000-0000 Registration Date/Time: 2015-09-24 10:05:19 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-24 09:23:25
Schema Version: 0.5555DD
CERTIFICATE OF COMPLIANCE UlR-ALT-024
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
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
C
All new
This field or
This field or
System 1
furnace
component
section is not
section is not
AC
cooling
SEER
16
Setback
section is not
'section is not
altered
applicable
applicable
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 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: 515%, ors 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 z300 CFM/ton required when MCH -25 is required.
Exceptions: `ti -
-Duct systems registered with HERS provider is previously sealed are exempt from MCH -20 Duct Leakage Testing requirements..--
-Heating-only systems and Air Handler/Furnace changes do not requireverdication of Air Flow MCH-23for Refrigerant Charge MECH 25:
ap t§ a in-
Existing duct systems constructed, insulated or sealed with asbestos, are exemp from MCH 20 DuctLeakage Testl�ngrequi dements.C
0 'r,
.;
k1k U,? 1` .� ii l'
,ate-1W...x+
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 1'S0.2(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)
This section does not apply to this project.
Registration Number: 215-A6336513A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-09-24 10:05:19
Report Version: 2013-1.006
Schema Version: 0.555SDD
HERS Provider: CaICERTS
Report Generated: 2015-09-24 09:23:25
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 can daco�
Company:
Signature Date:
i PERMIT E RATERS
2015-09-24 09:23:22
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
1818-735-7876
Responsible Person's Declaration statement t
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
wK _:rr
requirements of Title 24, Part 1 and Part 6 of the California Code ofd egulation ��`
r
4. The building design features or system design features identified on.this Certificate of Compliance are consistent with=the ihformation:provided on otherapplicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval•wfth.this building permit application.
5. I will ensure that a registered copy of,this Cerfificafe oACompliance shall be made<available withthe building%permit(@)yissued for the,puild'�ng, and made available ftthe„enforcement agency for all applicable
i�des %,the building owner at occupancy.
inspections. I understand that a registered copy of this.Certifcate of Compliance red to be included with the documentationtithe�builder Prov
Responsible Designer Name: '
Responsible Designer Signature:
Shanley, Barbara
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-09-24 10:05:19
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 no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A6336513A-000000000-0000 Registration Date/Time: 2015-09-24 10:05:19 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-24 09:23:25
Schema Version: 0.555SDD