BMCH2015-045578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Twit 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BMCH2O15-0455
81035 GOLF VIEW DR
762280003
SHIN /CHANGE OUT (2) 21SEER/80AFUE SPLIT SYSTEMS
$33,474.00
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
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. C36 License No.: 686310
Date: ( Ci Contractor: � 4��
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
it
2015 u J
11111111111111111111
23
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/9/2015
Owner:
LLOYD SHIN
81035 GOLF VIEW DR
LA QUINTA, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
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 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. c . _
Date: 1S Applicants
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):
FINANCIAL •1•
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $2.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT:
$217.56 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID.
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
= RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Description: SHIN/ CHANGE OUT (2) 21SEER/80AFUE SPLIT SYSTEMS
Type: MECHANICAL Subtype: Status: APPROVED
Applied: 12/9/2015 SKH
Approved: 12/9/2015 SKH
Parcel No: 762280003 Site Address: 81035 GOLF VIEW DR LA QUINTA,CA 92253
Subdivision: TR 28838-1 AMENDED Block: Lot: 40
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $33,474.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME TYPE
Details: HVAC CHANGE OUT - (2)21SEER/80AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
IE INC.
32115 LA BAYA
WESTLAKE
VILLAGE
CA
91362
CONTRACTOR
HARRISON ENTERPRISES INC DBA
GENERAL AIR
31170 RESERVE DRIVE
THOUSAND
IPALMS
CA
92276
OWNER
LLOYD SHIN.
81035 GOLF VIEW DR
I LA QUINTA
CA
92253
FINANCIAL INFORMATION
Printed: Wednesday, December 09, 2015 9:47:02 AM 1 of 2 cp
SYSTEMS
Printed: Wednesday, December 09, 2015 9:47:02 AM 2 of 2
RWSYS TEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $2.00 $0.00
BSA:
HVAC CHANGEOUT -
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 for CHANGEOUT: $217.56 $0.00
PERMIT ISSUANCE
101-0000-42404 1
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• •0
Printed: Wednesday, December 09, 2015 9:47:02 AM 2 of 2
RWSYS TEMS
an.#
Ci Of � QUinta
Building 81: 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: 8.1035 Golf View Drive
Owner's Name:. Lloyd Shin
A. P. Number.
Address: 81035 Golf View Drive
Legal Description:
City, ST, Zip: La Quinta, CA '92253
Contractor: General Air ConditioningTelephone:
760-564-5403 ``
Address: 31170 Reserve Drive
Project Description: Replace (2) 4ton A/C Units, (2) Coils, & (2) .
City, ST, Zip: Thousand Palms, CA 92276
90,000 BTU Furnaces
Telephone: 760-343-7488
State Lie. # : 686310
City Lie. #t
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:.. �
m� � 3 y
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
F# Units
Telephone # of Contact Person: 8.18-735-7876 x 1
Estimated Value of Project: $33,474.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit, .
'Buss Cities.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted. ,
Mechaeical
Grading plan
2i4 Review, ready for correcfionstissue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for eorrections/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
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 03/15 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
Gol p i/� �>;
Enforcement Agency:
Dat
Prepared:
Permit#:
51035 �,,,
Q � La Qu.,a
Iz
,,- I is
Equi ment TYpe
Equipment EfcientY
New Dcting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
.
❑ Packaged
Evaporator Coil�p
AFUE
COP
0 R-6 (CZ2, 8-13) Ducting
Served:bysystem
_Setback
System
fi'g(Split System
Ji Condensing Unit
❑ Compressor
211
.
❑ R-8' (CZ 11, 14, IS) DuctingZlSLYJ
sgft
(If not already
❑ Mini Split
❑ LinesetEER.
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
beinsta/led)
Mumace
❑ TXV
13R-5: or R7.5) Lineset°
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.
;K1. 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-03, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2
Compressor, TXV, Uneset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS=, MECH-25-HERS2
Air Handler/Furnace= (Can include new ducting)
Installer Requirement: Duct leakage (<15%, or < 10% to outside, or seal all accessible leaks); Air Flow a 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or 0 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 1
❑ 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 CFI11-ALT-02-E, CF2R-MECH-01, and (CF211-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow z 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
CFI11-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 z 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'
CF111-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (:5.15% 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-2%", 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.
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 forapproval with this building permit application.
Responsible Designer Name:
�e�,�av� sch>1i
Responsible Designer Si nature:
www 5;f - �1
Date Signed:
Li is
License:
(0 8b 3 i0
Company:
A;�
Address;
City/State/Zip: Phone:
l 4 ��o- 3 �y8
e_r\c_m , ;
-311 Ides«ve
f ha
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at:1-Suo-77i-asuu
S�jS�em Z
STATE OF CALIFORNIA'
ALTERATIONS - HVAC
'4 "'
CEC-CFIR-ALT-04-E Revised 03/15 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFI1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF-1k=ALT-HVAC)(Page 1'of 1)
Site Address:
�Ip35 Got �/;�,,� br
Enforcement Agency:
Dat Pre .ared:
Permitlf:
C; Q� LaQ�;n�Q
fz a IS
Equipment Type
Equipment Efficient y
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (s ft)
Sy Packaged
KEva,porator CoilSD
Y AFUE
COP
O R..6 (CZ 2, 8-13) Ducting
Served by system
Setback
System
}3(Split System
A Condensing Unit
❑Compressor
Z1
p R-8' (CZ 11, 14, IS) Ducting
�ISQh sgft
(If not already
11 Mini Split
11 Lineset
�^ SEER
HSPF
13R-6 (all CZ's) Plenums
present must
be installed)
PZurnace
❑ TXV
EER
❑ R-5 or R7.5) Lineset°
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.
PK1. 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)' -HERS, MECH-25-HERS=
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS=, MECH-2.5-HERS
Air Handler/Furnace= (Can include new ducting
Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 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'(Iist manufacture date of building
❑ 2. New HVAC S stem
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) -HERS', MECH-25-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS'
Mini Splits require CF1R-ALT-02•E, CF2R-MECH-01, and (CF2R-CF3R).MECH-25-HERS
Installer Requirement: Duct leaks e < 6%, Fan Efficacy (.5$W/CFM), Air Flow 2 350 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
CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil,
CF2R: MECH=01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-2S-HERS
Compressor, TXV, Lineset, Furnace'
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow 2 350 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-HER$
Installer Required to: Duct leakage (L15% or, 5.10% to outside or, or seal all accessible. leaks)
❑ EXCEPTION: Existing ducts stems 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.
' 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-2%", 5T-4%"
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
1 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 sequirements 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 Si nature:
Date
i
Signed:
q ►s
License:
-5—
Company:
Address:
City/State/lip: Phone:
A;r �,.:
3W10 QeSerV1
Gra i��,l Q ?sao- !3
For assistance or questions regarding the Energy Standards, contact the Energy nowne ac: i-auv-i /I. -»uv