BMCH2015-028478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
I
Application Number: BMCH2O15-0284
Property Address: 78380 VIA TUSCANY
APN: 604600040
Application Description: (2) HVAC CHANGE OUTS SPLIT SYSTEMS
Property Zoning:
Application Valuation: $0.00
Applicant: IF:
GENERAL AIR CONDITIONING & HEAt�OUTSIDE CITY LIMITS. 2 0 20q 5
Cf iY OF LA WIN, A
COhIIMIiNITY DEVELOPIVENT DEPARTf"ER1
Owner:
KATHERN GORDON
78380 VIA TUSCANY
LA QUITNA,
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 7/20/2015
Contractor:
GENERAL AIR CONDITIONING & HEA
OUTSIDE CITY LIMITS
(760)343-7490-,
Llc. No.: :LIC -0003606
---------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
------------------------------------
WORKER'S COMPENSATION DECLARATION.
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
1 have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: - License No.: :LIC -0003606
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
p_ _Dater 2-0 is Contractor:
Section 3700 of the Labor Code, for the performance of the rwork for which this permit
is issued. My workers"compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, 1 •
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
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
a e: 2.V Applicant: S�.u.cr2 --
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER.TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
() I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result -of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or•omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. B.&P.C. for this reason
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.
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 Address:
l
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.
�) S Signature (Applicant or Agent):
•
DESCRIPTION t, '` `R ACCOUNTS `:'f Rf AMOUNT e`s� � ` PAID ���
Y �PAID'DATE-.
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HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0 . •
$145.04
$0.00
T.'L�`f.Yg4Y$5 f`�l FN,Sa";!
PAID BYyK
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HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
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.$72.52
$0.00
PAIDBY�ss
RECEIPT#3
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CHECK#CLTDBY
Total Paid forCHANGEOUT: $217.56 $0.00 '
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9S DESCRIPTION
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-PERMIT ISSUANCE
.101-0000-42404
0
$91.85
$0.00
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Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:0• f 00
•
Description: (2) HVAC CHANGE OUTS SPLIT SYSTEMS .
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 7/20/2015 PJU
Approved:
Parcel No: 604600040 Site Address: 78380 VIA.TUSCANY LA QUINTA,CA 92253
Subdivision: TR 30521-2 Block: Lot: 50
Issued:
Lot Sq Ft: 0 Building Sq Ft:_0 Zoning:
Finaled:
Valuation: $21;372.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: (2) HVAC CHANGE OUT SPLIT SYSTEMS 3 TON & 3.5 TON CARBON_ MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ubu•
. i ... i. ..ter
CONDITIONS
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Printed: Monday, July 20, 2015 1:39:10 PM 1 of 2
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PAID BY
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HVACCHANGEOUT-
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 ----T-101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
S310.41 $6.66" 7
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MECHANICAL FINAL" BLD
PARENT PROJECTS
Printed: Monday, July 20, 2015 1:39:10 PM 2 of 2
CRWSYSTEMS
3�oY. Sy S}ere-N
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF111-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
Enforcement Agency:
D to Pr pared:
Permit#:
7$380 V� G IVSCC,Yn
C,� OF L0.2.u:Y.}a-
-7 2c�Is
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
RI Evaporator Coil
��AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
)Setback
X Split System
13 Mini Split
Off Condensing Unit
❑ Compressor
'',,II
s
❑ R-8' (CZ 11, 14, 15) Ducting
$ 3 sgft
(If not already
I'f SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
0 Furnace
❑ Lineset
EER
❑ R-5 or R7.5) Lineset'
be installed)
❑ TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS=
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts'
CF1R-ALT-02-E
including Mini Split
CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
113. All New Ducts with Replacement
Required Compliance Documents to be left on site for Final:
All New Ducts' and one or more of the following
CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace2
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
' All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
" R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5-3T-2%", 3.5 to 4T -2Y.". 5T-4'/"
Contractor (Documentation Author's /Responsible Designer'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 California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. 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 CCR.
5. 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 approval with this building permit application.
Responsible Designer Name:
Responsible Designer Signature:
DatSigned:
License:
zo (1 S
06,310
Company:
�o�eral Ac C6,N4;Ai'Dlnirx
Address:
"311717 17.csetvcl>r
City/State/Zip:
l�e�vSa�Y. l�a►,� q22
Phone:
�b0 3'i3-7`fgFs
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-80b-772-3300
Bin #
City of La Quinta i
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: -?83aC7 \%-jc_ IvSCG�r,�
Owner's Name:{G}�t h G otc�wr�
A. P. Number:
Address:
Legal Description:
City, ST, Zip: L c Qujv\Ac_- ; CSA GZ25--N
Contractor: G A �cab
C ;
a ons r
-Telephone: —7 b0-2 Up --
Address: 3W)0 ��Se�cve f
Project Description:
City, ST, Zip: wSa�.c��0.1mS CA q ZZ 7lo
-Qej,Ac-C-0 3AQ, . 1 3.5 "t01.1 -A C
Telephone: le h
o -
7 4
P O 3 3_7 4
L .o
rl�
2 G�O� �V r
� 2 O Cf ce
Oi S
State Lic. # : C A63t O
City Lic. #.
Arch., Engr., Designer:
2
City., ST, Zip:
Telephone:
o e.•
on structto
Cn Type: ccu
P Occupancy:
P Y:
State to Lic. #
Project type (circle one):: New Add'n Alter Re pair. Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: 21, 372
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
-Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for'corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
"' Reyiew, 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
45�? — 7e52!2 I I