BMCH2015-021578-495 CALLE TAMPICO T 0 D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0215
Property Address:
51735 VIA ROBLADA
APN:
777430029
Application Description:
BRANDT RESIDENCE HVAC REPAIR
Property Zoning:
Section 3700 of the Labor Code, for the performance of the work for which this permit
Application Valuation:
$500.00
Applicant:
OWNER -BUILDER DECLA TION
IE INC.
Carrier: - Policy Number'-
32115 LA BAYA
tractor's State
WESTLAKE VILLAGE, CA 91362
License Law for the following reason (Sec. 7031:5, Business and Professions Code: Any
JUN 18 2015
CnYOFI.AOUINTA •
COMMUNITYDEVELONAEN? DEPARTMENT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/18/2015
Owner:
JAMES BRANDT
51735 VIA ROBLADA
LA QUINTA, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND PALMS, CA.92276
(760)343-5562
LIC. No.: 968141
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,
I 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: C20 License No.: 9681
of the work f hich this permit is issued.
have and will maintain workers' compensation insurance, as required by
1
Dater 6ont
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:
OWNER -BUILDER DECLA TION
Carrier: - Policy Number'-
I hereby affirm under penalty of perjury that I am exempt from the Co
tractor's State
1 certify that in the,performance of the work for which this permit is issued, I
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 .
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
comply with those rovisions.
-
of the Business and Professions Code) or that he or she is exempt therefrom and the
Datrtt% Applicant:'
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
permit subjects the applicant to a civil penalty of not more than five hundred dollars
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO OVERAGE IS UN WFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE UP TO.
(� 1, 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 CQDE,
(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.
(_J 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
Lender's Address:
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 ro erty f r inspection purposes.
Date1Signature (Applicant or Ag
City of La Quinta
Btdt v at Safety Dmion'
P.O. Box 1504,78-495 Cage Tampko
IA.Qtti 94 CA 92253 -.-(760) 777-7012
Building Pem* Applicadon and Tracking Sheet
pem* #
M C44 20 1-51-09-
Pr*dAddcess: 51735 VIA ROBLADA.
Owna'sName:. JIM BRANDT
A-P•Number
Addtcss:5.1735 VIA ROBLADA
ugai D=ipdm=
Contractee GENERAL A/C & HEATING
city, sr, zip. LA QU I NTA, CA 92253
Tdeowm: 760-296-1632
Addr=:31170 RESERVE DRIVE
PmjcgDc=iptioa:
city. $..f.zip: THOUSAND PALMS, CA 92276
CHANGE OUT.5 TON COIL ONLY
Tdephono: 760-343-7488
State Lia # : 686310. City Lic &
Arch, Eng, Designer:
Addmcsx
City. ST. Zip:
TdvhIIe:
State Lie. C
Con*uctioa Type: , Occupancy:
Project type (code one): New AcWn . Alter Repair Dena
Sq: > t : # stones # Units:
Estimatod.V'ahm of Project 000000
Name of Contsa Person: PAT RIC K
Teic � c # of Contact Person: 760-343-7488
APPLICANT: DO NOT WRITE BELOW THIS UNE
it SobmtttN Req'd .- Rena . TBACIQMG • . P138MIT FEES'
Plain seh Plea Check tabmltted Item Amonat
&raetarat Ca[n
Reviewed, ready &ir oorteet[oo Pkn Check Deposit_
7n= Cda.
CaUM Coataet Person Plat Chale l3dance.
'Me U cdci.
Ptaas picked up Conumcdon
now pinta pigs
Plea raubm ttM Meebarakil
G -&n plea
Z'! Review, ready for torreetioaafissae Mcnial
Sabenumr List
Caned Coalad Person Plotubing
Gnat Deed
Pleas Okked up s mJL
ILO.A. Approval
Plans rembmitted Gradtug
IN Housz:-
''' Review; may for carmcdonsAaft Devdope.r Impact Fee
Pb uninf APpr'ovai
Can Coaget Person e4I.P8.
Pub. Wk. Appr '
Date otpermit bene
School Fees
Total Permit Fees.
FINANCIAL INFORMATION
`,Ax1sF , DESCRIPTION x aQTY7 AMOUNT,,,; PA€IDa` `PAID DATE
�£�ACCOUNTY�� E�
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
a�PAID',BY� `.=m..xs METHOD£µr :RECEIPT#5�"4CHECK#.,y.CLTD BY
xe. s '1'� 'bS' �^ 0.f
Total Paid for BUILDING•STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION „� �£
p ACCOUNTQTY
'AMOUNT ;`°'
; PAID
PAID;DATE>,
.
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
PAID'BY q
=� 3� METHODS Y�
RECEI?Ty# V '"3
XHECIC # 2
' CLT.D BY Y
M , , , ? " M�?,
,
F�
K. ESCRIPTION
`ACCOUNT $
QTY=
r AMOUNT�1 `
o it 7 -PAID
PAID'DATEs
:' •��
,
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42600
0
$4.83
$0.00 -
PC
9 s .Y•+ 1. F _ S'
�Mkz�M-��PAIDBYz�*
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b '.. c"T
fr,RECEIPT#
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CHEGIC#k
A
CLTDBY
.. t . "s+. • z _ . w. �. < . t 'd"".
�� ,METHOD'
.... ,:_ . _ ... xt" •
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Total Paid forCHANGEOUT: $16.92 $0.00
DESCRIPTION*
E
�ACCOl1NTs
,:maxfx,•K:.�
QTY
AMOUNT
PAID
PAID DATE:
,�, :.
y� .
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
R�z $:PAID BY
METHOD z�
RECEIPl #' gs
CHECK #
�a GITDFBYz
Total Paid forPERMIT ISSUANCE: ,$91.85 $0.00
TOTALS:0• • 60
Description: BRANDT RESIDENCE HVAC REPAIR
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 6/18/2015 EVA
Approved: 6/18/2015 EVA
Parcel No: 777430029 Site Address: 51735 VIA ROBLADA LA QUINTA,CA 92253
Subdivision: TR 311234 • - Block: Lot: 29 -
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0., Zoning:
Finaled:
Valuation: $500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: -0 No. Unites: 0
Details: CHANGE OUT 5 TON COIL ONLY [2008 ENERGY) CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
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..ADDITIONA , L•SITE S
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M, R CITY STATES ZIP:.PI4ONE
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APPLICANT'
IE INC.
32115 LA BAYA
WESTLAKE
CA 91362
(760)296-1632
-
VILLAGE'
CONTRACTOR
HARRISON ENTERPRISES INC DBA D
31170 RESERVE DRIVE
THOUSAND
CA 92276
(760)296-1632
PALMS
OWNER
JAMES BRANDT
51735 VIA ROBLADALA
QUINTA
CA 92253
(760)296-1632
FINANCIAL INFORMATION —
Printed: Thursday, June 18, 2015 9:20:57 AM 1 of 2
. ......... . .....
.............. . . . . . . . . . . . . . . ................ r .................
PARENT. PROJECTS, ... ....
... .......
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, June 18, 2015 9:10:57 AM` 2of2 CRWSYSTEMS
"DE
DESCRIPTION
�IPAIDZATE:
-1RECEIPT�
-'CHE K,#,.
c
9.Y,
41
�4
BSAS SB1473 FEE
101-0000-20306
0,
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT-
101-0000-42402
0.
$12.09
$0.00•
REPAI-R/ALTERATION
HVAC CHANGEOUT -
101-0000-42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid forCHANGEOUT: $16.92 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0'00�
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
.. . .... .. .... ... .. . .... .... . .....
. .. . . . .. . . ........ .. ............. ... . ........... $6.00::,� ..... ....... h i
. ......... . .....
.............. . . . . . . . . . . . . . . ................ r .................
PARENT. PROJECTS, ... ....
... .......
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, June 18, 2015 9:10:57 AM` 2of2 CRWSYSTEMS
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: JIM BRANDT Date Prepared: 2015-06-12'
A. General Information .
CF1R-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling.unit. When multiple dwelling units must be
documented, use one CF1R-ALT 02 document for each dwelling unit.
01.
Project Name
JIM BRANDT
02
Date Prepared
2015-06-12
03
Project Location
51735 VIA ROBLADA
04
Building Type
Single family
05
CA City
La Quinta
06.
Dwelling Unit Name
JIM BRANDT
x
Dwelling Unit Conditioned
Ins ailing a
t
07
Zip Code
92253
08
Floor Area (ft2)
3502
SC System r
CFA served
9�^
e rigerant
Number of space conditioning.
.
09
Climate Zone
15
10
(SC) systems in this dwelling
1
ducted
41;Identification
containing
Raz
more than 40
unit.
entirely new
Name
Served
System (ft2)
system?.
component?
B. Space Conditioning (SC) SystemInformation` -
mai
01
02
`04,
OS''
06
07.
0$
09
10
x
Is the SC
Ins ailing a
t
x
'"
SC System
SC System r
CFA served
System a
e rigerant
nstalling�nevi SC
lgstallliing
I talli gp
installing
or
Location or Area
by this SC
ducted
41;Identification
containing
system
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
3502.
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A0158335A-000000000-0000 Registration Date/Time: 2015-06-12 17:22:37 HERS Provider: CaICERTS.
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 17:21:33 '
Schema Version: 0.555SDD
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)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
This field or
This field or
System 1
furnace
component
section is not
section is not
AC
Indoor coil
SEER
13
Setback
section is not
section is not
altered
applicable
applicable
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 testing0iJired when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced.
g, q, g g P Y Bt P
-Leakage rate compliance: 515%, or 510% leakage to outside, o,seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H RefHgerantiChargeVerificatloSn tequired-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'ex�empt fro MC -20 20 Duct Lc�akagerTesting requirements
-Heating-only systems and Air Handler/Furnace changes do not require verifica on of Air Flow MCH#25 or RefngeranG. - age MECH 25 '
a� jv- t a
-Existing duct systems constructed, insulated or sealed wifh:asbestos°are exemp�trom MG,H 20 buctLeakage Testing requiremenss
a.
fix'' Fi M% f.-, '."
E. Entirely New or Complete Replacement Duct System, with pr withoutlEquipment thangeout {Sections 156.2(b)rvliDna and 1�0.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 215-A0158335A-000000000-0000 Registration Date/Time: 2015-06-12 17:22:37 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance.. Report Version: 2014-03-31 Report Generated: 2015-06-12 17:21:33
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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 JacobJr
Company:
Signature Date:
Stratz Permit Service
2015-06-12 17:21:23
Address:
CEA/ HERS Certification Identification (if applicable):
5858 Dovetail Drive
City/State/Zip:
Phone:
Agoura Hills CA 91301
818-735-7876
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the1aws:of the State of California:
1. The information provided on this Certificate of Compliance is true and correct:
2. I am eligible under Division 3 of the, Business and Professions Code to accept:responsitiility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and perfo mance specifications, mateiials'}c ponents, 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:6of the Calrfornla Code of Regulaattlons -
4. The building design features or system design features'identlfied or, CertiflcEa eof Comrrerten with the informatlbn,provided orther applcaHle compliance documents, worksheets,
to.the p pplicatio
calculations, plans and specificationssubmitteil ehforcemenagency for approvlwth this bufldln rmlt _.
,a ,{ i ;Ys� for all applicable
shall;befr>ader2,ailable 8 to_theenforcement
5. I will ensure that a registered copy of th is Cettific$te"'of Cb pliance wlthltFie bBlldln ermitgqs. `€iss forathebullding ancmade available agency
P l
inspections. I understand that a registe"red copy of thi , t lcate of ComplYance is:requvired to be included with thegdo�cumnenta_tion,the-b finder proy�des to the bu�ng owner at occupancy.
Responsible Designer Name: "
Responsible Deslgner Signature: -11k
Valdez, Dayana
�4y
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-06-12 17:22:37
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-A0.158335A-000000000-0000 Registration Date/Time: 2015-06-12 17:22:37 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-06-12 17:21:33
Schema Version: 0:555SDD