BMCH2014-114778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O14-1147
Property Address: 48105 VIA VALLARTA
APN:
Application Description: HVAC CHANGEOUT
Property Zoning:
Application Valuation: $11,234.00
Applicant:
REBECCA DRISCOLL
48105 VIA VALLARTA
LA QUINTA, CA 92253
Tws� 4 4 Qu&rcu
COMMUNITY DEVELOPMENT DEPARTMENT
n Q
l�
No 924 Z014]0
M OF LA. QUINTA
W&V=TY' E. 1'e.VfLMENT LAWTMENT
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: Contractor:
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 Name:
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/24/2014
Owner:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
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.
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: I _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.
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.
Date: Signature (Applicant or Agent):�tM JZ�"��
FT_
FINANCIAL •• 1.
a, DESCRIPTIONY; ACCOUNT f k.> QTY
t-'
AMOUNT,-�FPAID
.}1
:3'q
PAID DATE
x >s ;,
_. a
BSAS S61473 FEE 101-0000-20306
0
$1.00
$1.00
11/24/14
PAID BY` " p ��METHOD3 ` �,
RECEIPT #
CHECK# `ia
BY = �<
sd.. . • -
r
,,ag° :
,CLTD
HARRISON ENTERPRISES INC DBA G CHECK
R2991
20260
MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
. ,k* DESCRIPTIONfi ,
ACCOUNT
QTY
`;. PAID `B;.
PAID DATE`,
.�r
,$S-I,
MAMOUNT,.
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
.0
$72.52
$72.52
11/24/14
1 :... PAID BY "! .°
METHOD ;
�,
' " RECEIPT # '
CHECK #
'µCUD BY
r yt.
LL` x a..
b
,F
�4
HARRISON ENTERPRISES INC DBA G
CHECK
R2991
20260
MFA
a�DESCRIPTION ""
:. 1 :ACCOUNT - fi'
CITY <
: AMOUNT.
PAID �:
PAID DATE;
<
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
11/24/14
t �� PAID BY " `
w k11,
'METHOD S
#
CHECK #
CLTD BY,
n
1.-RECEI1 1:1PT
,'..
HARRISON ENTERPRISES INC DBA G
CHECK
R2991
20260
MFA
Total Paid forCHANGEOUT: $108.78 $108.78
-;!;DESCRIPTION;
AkCCOUNT 6
QTY;'
AMOUNT `
�° PAID `
PAID'DATE
G.t.
..i,.
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
11/24/14
`-;>PAI'D BY
; ` METHOD : '":; , $;
x °RECEIPT # " •°
.';CHECK<# ' ,'
CLT D BY
HARRISON ENTERPRISES INC DBA G
CHECK
R2991
20260
MFA
Total Paid forPERMIT ISSUANCE: $91.85. $91.85
TOTALS:
,F
�4
i.
if
•
City of La Quin a
LR R,M Iif N U:M 96
BMCH20+14-1.147
Description: HVAC CHANGEOUT
Type: MECHANICAL
Subtype:
Status: SUBMITTED
Applied: 11/24/2014 MFA
Approved:
Parcel No: Site Address: 48105 VIA VALLARTALA QUINTA,CA 92253
Subdivision:
Block:
Lot:
Issued:
Lot Sq Ft: 0
Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $11,234.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details:
ti.
,,. 0FINANC A NFORMATIO .. a" OR
N
...•
Printed: Monday, November 24, 2014 2:34:23 PM 1 of 2 (7,M
SYS7FMS
r., • DESCRIPTION.
"ACCOUNT
QTY
;' AMOUNT
PAID ,c
PAID DATE
RECEIPT#"
r CHECK#�
"-METHOD
AID B Y��
I a
BY';:
HARRISON
BSAS 581473 FEE
101-0000-20306
0
$1.00
$1.00
11/24/14.
R2991
20260
CHECK
ENTERPRISES INC DBA
MFA
G
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
HARRISON
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$72.52
11/24/14
R2991
20260
CHECK
ENTERPRISES INC DBA
MFA
SPLIT -SYSTEM
G
HARRISON
HVAC CHANGEOUT-
101-0000-42600
0
_ $36.26
$36.25 _._ _
11/24/14
R2991
20260
CHECK
ENTERPRISES INC DBA
MFA
SPLIT -SYSTEM PC
_
G
Total Paid forCHANGEOUT: $108.78 $108.78
HARRISON
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
11/24/14
R2991
20260
CHECK
ENTERPRISES INC DBA
MFA
G
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
TOTALS:•
PARENT PROJECTS
BONDINFORMATION
Printed: Monday, November 24, 2014 2:34:23 PM 2 of 2
• - srsrents
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
.Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 4 )
Project Name: REBECCA DRISCOLL Date Prepared: 2014-11-16
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 CHR -ALT -02 document for each dwelling unit.
01
Project Name
REBECCA DRISCOLL
02
Date Prepared.
2014-11-16
03
Project Location
48105 VIA VALLARTA
04
Building Type
Single family
05
CA City
La Quinta -
06
Dwelling Unit Name,.
REBECCA DRISCOLL
07
Zip Code
92253
08
Dwelling Unit Conditioned
2027
�y
y:
AFF ' ' >:`' .;
Floor Area (ft2)
SC System
09
Climate Zone
15�
10
Number of space conditioning
(SC) systems in this dwelling
1 '
Installing
Installing
}.,
Identification or
unit._
90, th SC
YHP- r• .+b#' '.: N _. 4W `�'Y a: ya% y�
B. Space Conditioning (SC) Systeminformat ion $ =" '
01
02_°
03
` 04 *`
4t
05''
l 06
4.
"
08 :
09
10 f
.'. a"�.�
„'.v, .- ;ae • A0 -
A.ux,<�
x'07
x
{}' '�Y
w
SC ?±•'34wz
e is th•
$'a` +d
Installiri aZ.
�y
y:
AFF ' ' >:`' .;
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
90, th SC
ducted
containing
system
more than 40
entirely new
entirely new
-
Name
Served
System (ft 2)•
k,:;.
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
;Location 1
2027
" `
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: 214-A0140616A-000000000-0000 Registration Date/Time: 2014-11-16 12:38:02 HERS Provider: CaICERTS`
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-16 12:37:32 A
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 4 )
D.. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
OS
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 split
All new
This field or
This field or
System 1
furnace
heating
AFUE
0.78
AC
cooling
SEER
14.5
Setback
section is not
section is not
components
components
applicable
applicable
Required 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: 5 15%, or 5 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 > 300 CEM/ton,required when MCH -25 is required
Exceptions: �`r,
r�
-Duct systems registered with HERS provider as previously sealed armee exempt fromm MCH -20 Duct Leakages Testing regwrements g
-Heating-only systems and Air Handler/Furnace changes do not regwrebenhcation'bf Air Flow MCH -'23, or Refrigerant
Charge MECH-25. a,
"
.+d. -. y .. F y-'
Existing duct systems constructed, insulated orzsealed with asbestos are;etxempt from MCH -20 Duct Leakage Tespng requ}rements.' - a
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)1E, F)
a
This section does not apply to this project.
Registration Number: 214-A0140616A-000000000-0000 Registration Date/Time: 2014-11-16 12:38:02 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-16 12:37:32
Schema Version: O.SSISDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 4 )
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 214-A0140616A-000000000-0000
Registration Date/Time
2014-11-16 12:38:02
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-11-16 12:37:32
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) , (Page 4 of 4 )
Documentation Author's Declaration Statement
---------------
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: �lllJ�lL�`
Valdez, Dayana -
- -
Company:
Signature Date:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2014-11-16.12:38:02 +
Address:
CEA/ HERS Certification Identification (if applicable):
31-170 RESERVE DRIVE STE A
City/State/Zip: -
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
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).
ry :. s?.�m _,tie' ,
3. That the energy features and performancespecifications, materials, ompo ents,.and manufactured devices for tthe building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and}�P�art;6 of the Califorma•Code of Regulations. F i�
4. The building design features or systernbesign features identdie�d on'this.,Certificate of�,Comphance are consistent withithe information provided on other applicable compliance documents, worksheets,
.
• calculations, plans and specifications,submitted.to:,the enforcement agency for approval with this bwldrng permit appheation°"a ,
'!x k:: Ar �`� .�` r.� :#E:� ,t 't a;;. •ar` ._ ..^� q .'�'
5. 1 will ensure that a registered copy of thisCertificate of�Compliahte shall be made available with the buildih ,permif(s) issued foF.1he building and made available to the enforcement a enc for all a licable
_ m
- r� " ' g y PP
-.
inspections. l understand that a re istered co
p g py of this Certificate of Compliance is required to be included with;the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:._
Responsible Designer Signature:
�lfR�LR�l��
Valdez, Dayana
Company: -
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2014-11-16 12:38:02
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip: , •
Phone: •
THOUSAND PALMS CA 92276
(760) 343=7488 • _
Digitally signed by CaICERTS. 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.
1
Registration Number: 214-A0140616A-000000000-0000 Registration Date/Time: 2014-11-16 12:38:02 HERS Provider: CaICERTS�
CA Building Energy Efficiency Standards 2013 Residential Compliance' Report Version: 2014-03-31 Report Generated: 2014-11-16 12:37:32
Schema Version: 0.551SDD
P lj�_ 'of, , )
Bin # City of La Quinta
Building $r Safety Division •
Permit # P.O. Box 1504, 78 495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Buildf-Ig Permit Application and Tracking Sheet
Project Address: G Vo,11 Owner's Name:
A. P. Number:
Address: V C�_ \ X11 O t;
Legal. Description:
City, ST, Zip: CA A ZZS3
Contractor: or:vie t- or. �� o
Telephone: �O 1Z—G6 �3 Z
Address: } »p�Sc��
Project.Description:
City, ST, Zip: �h0.)so. a l't3. vin Cid aZ276►�eJ
C�ce i c Co-) E .
Telephone:Cop-�f37y8�
•
:
11 O.
State Lic. # i O
City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip.
Telephone: .
aneY
Constructionn TYPe- Occupancy:
•
State Lica
Project type (circle. one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: I I 234, CID
APPLICANT: DO NOT WRITE BELOW THIS LINE
It
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Review<d, ready for corrections
Plan Check Deposit
Truss Cala.
..Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans r -:submitted
mechanical.
Grading plan
2" Rcv`_cw, ready for corrections/issue
Electrical
Subcontactor List.
Called Contact Person
Plumbing
Grant Deed
Plans Ocked up
S.M.I.
H.O.A. Approval
Plans submitted
Grading
IN IiOUSE:-
'`" Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date o' permlt issue
School Fees
Total Permit Fees