BMCH2015-02657.8-495'CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O15-0265
Property Address: 78525 VIA SEVILLA
APN: 604212013
Application Description: BIRD RESIDENCE HVAC CHANGE OUT
Property Zoning:
Application Valuation: $4,050.00
Applicant:
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
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: 7 13 LS 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
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.).
(_)1, 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 Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/2015
Owner:
REBECCA BIRD
78525 VIA SEVILLA
LA QUINTA, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA
31-170 RESERVE DRIVE STE A
THOUSAND PALMS, CA 92276
(760)343-7488
LIC. 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.
S� 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: _ Polity 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: � 13 )br 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 themork 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): Su. -47
1
NANOAC IN FORMATION'
; �� AMOUNT'S' X4PAIDg PAID DATE:
DESCRIP,TION �-..
E�fi.,"ACCOUNT hQTY
sT,
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
`4 PAID BYv ' METHOD{ x # t xC.HECK #.1.. yLTD.B:
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in x�4!4kf nRECEIPT
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Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
;.DESCRIPTION ¢' `ACCOUNT
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PAID '
+PAID,`DATE
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HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0 $72.52
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HVAC CHANGEOUT - SPLIT -SYSTEM PC
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$36.26
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RECEIPT #,
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Total Paid for CHANGEOUT: $108.78 $0.00
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DESCRIPTIONS
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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
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C(�/ 0� iLCt QUinta
Building 8t Safety Division
P.O. Box 1504,78-495 Calle Tampico
ta.Qulnta, CA 92253 - (760) 777-7012
OL(oS Building Permit Application and Tracking Sheet
Permit #
130 04,20 5
Project Address: 78525 Via Sevilla
Owner's Name:. Rebecca Bird
A. P. Number.
Address: 78525 Via Sevilla
Legal Description:
City, ST, Zip: La Quinta, CA 92253'
Contractor: General Air Conditioning
Telephone: 760-200-3976
9
,� <:3 xx
Address: 31176 Reserve Drive
Project Description:
City, ST, Zip: Thousand Palms, CA 92276
Replace 4ton Coil
Telephone:760-343-7488
_�' `
„)fON.
City Lic. #;
State Lic. # : 686310
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: M �.
State Lic. #: wj�
Name of Contact Person: Steven Schnierer
'Construction type: . Occupancy:
Project type (circle one):. New Add'n Alter, Repair Demo
Sq.'FL: #Stories: #Units:
Telephone # of Contact Person: 818-735-7876 X 1
Estimated value of project: $4,050.00 .
APPLICANT: DO NOT WRITE BELOW THIS, LINE
N
Submittal
Req'd
Recd
TRACIQPIG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24, Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
2nd Review, ready for correctionsfessue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
i
Grading
IN HOUSE--
*d Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description: BIRD RESIDENCE HVAC CHANGE OUT
Type: MECHANICAL ' Subtype: Status: APPROVED
Applied: 7/13/2015 EVA•
Approved: 7/13/2015 EVA
Parcel No: 604212013 Site Address: 78525 VIA SEVILLA LA QUINTA,CA 92253
Subdivision: TR 23971-1 Block: Lot: 51
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $4,050.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC REPAIR -CHANGE 4 TON COIL [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
Printed: Monday, July 13, 2015 10:57:55 AM _ 1 of 2 CREAJF
E7EY
srszenns
DESCRIPTION
-7-7]=
;ACCOUNT ...::
77
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
CH
:METHOD
PAID BY
CLTD
BY
BSAS 561473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSAr
HVAC.CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT-SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT-SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
• i6 3 00
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Monday, July 13, 2015 10:57:55 AM 2 of 2
SYSTEMS
STATE OF CALIFORNIA
ALTERATIONS - HVAC
:EC-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:
Da a Prepared:
Permit#:
?915_' �10.
Ci JrJ OF `0. 0 U V, k c—,
7 13 15
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
X Evaporator Coil
COP.
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
XSetback
❑ Split System
❑ Condensing Unit
—AF..UE
❑ R-8' (CZ 11, 14, 15) Ducting
sgft•
(If not already
❑ Mini Split
❑ Compressor
SEER
HSPF
❑ R-6 (oil CZ.'s) Plenums
present, must
0 Furnace
❑ Linesetbe
EER
❑ R-5 or R7.5) Lineset`
instolled)
❑ 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,
CFIR-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS1
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24}HERS=, MECH-25-HERS1
Air Handler/Furnace2 (Can include new ducting)
Installer Requirement: Duct leakage L15%, 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' CFIR-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERSZ, MECH-25-HERSZ
CF3R: MECH-2D-HERS, MECH-22-HERS, MECH-(23or24)-HERSZ, MECH,25-HERSZ
Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow t 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. 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 CFIR-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, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow Z 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing ducts stems 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 partsfrom the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) 1
4 R-5 (1" thick Insulation) for Iinesets 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 -2W, 3.5 to 4T -2%a", ST -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 f& 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 land Part 6 of the CCR.
S. 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:
Res onsible Designer Signature:
Dat Signed:
license:
pr -
M4AAJ _ �'�
'7 13 IS
Q lagb310
Company:
Address:
Oty/State/Zip:
Phone:
Gehercl Air
31110
,�WC,G d 922
-7c0-343-$$
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P
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