BMCH2016-0019-
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
14'r41'w4�rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O16-0019
Property Address:
79205 QUAIL CROSSING
APN:
776011025
Application Description:
SEAN SARGENT / HVSC CHANGEOUT
Property Zoning:
Application Valuation:
$36,371.00
Applicant:
O C==
rn
IE INC.
i
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 70001 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:IO (Contractor.11;ZZZ_
A l
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
22
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
MICHAEL SMITH
74916 HIGHWAY 111
INDIAN WELLS, CA 92253
Contractor:LIL
HARRISON ENTERPRISES INC DM
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 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.
4
Date: 10 Il, 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: 10 Ile Signature (Applicant or Agent):
m »
�
D
O C==
rn
i
Contractor:LIL
HARRISON ENTERPRISES INC DM
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 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.
4
Date: 10 Il, 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: 10 Ile Signature (Applicant or Agent):
FINANCIAL • •
DESCRIPTION
ACCOUNT r 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
$217.56
$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
$108.78
$0.00
PAID BY
METHOD `
RECEIPT #
CHECK #
CLTD BY
Total Paid for CHANGEOUT: $326.34 $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: SEAN SARGENT / HVSC CHANGEOUT
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 2/10/2016 RSE
Approved:
Parcel No: 776011025 Site Address: 79205 QUAIL CROSSING LA QUINTA,CA 92253
Subdivision: TR 25429 Block: Lot: 72
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $36,371.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
IE INC.
Details: HVAC REPLACEMENT WITH (1) STON ,90,000 BTU COMPLETEHVAC SYSTEM, REPLACE (1)3TON,70,000 BTU COMPLETE HVAC SYSTEM
& (1) 2TON DUCTLESS MINI SPLIT SYSTEM. [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
NAME TYPE NAME
ADDRESSI
CONTACTS
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
I PALMS
CA
92276
OWNER
MICHAEL SMITH
74916 HIGHWAY 111
1 INDIAN WELLS
I CA
1. 92253,
1
i
Printed: Wednesday, February 10, 2016 9:57:31 AM 1 of 2 C
SYS7CAA5
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
•
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
$217.56
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$108.78.
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT:' $326.34 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:i 00
PARENT PROJECTS
ATTACHMENTS
Printed: Wedriesday, February 10, 2016 9:57:31 AM 2 of 2 r1?
SYSTEMS
. #
Qty Of , La Quih to
Building 8r Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Pennit Application and Tracking Sheet
Permit #
Project Address: 79205 Quail Crossing
Owner's Name:. Sean Sargent
A. P. Number.
Address: 79205 Quail Crossing
Legal Description:
Contractor. General Air Conditioning
City, ST, Zip: La Quinta, CA :92253
Telephone: 780-512-3094
Address: 31170 Reserve Drive
Project Description: Replace*(1) Ston, 90,000 qTU Complete
City, ST, Zip: Thousand Palms, CA 92276.
HVAC System, Replace (1) 3to.n, 70,000 BTU Complete HVAC
Telephone: 760-343-7488'''
System & 1 2ton Ductless Mini Split System
State Lic. # :
City Lie. 9. --
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone:
Statc Lic. #: �,a gjti
Name of Contact Person: StevenSchnierer
Construction Type:. Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 818-73577876
Estimated Value of Project: $36,371.00 .
APPLICANT: DO NOT WRITE BELOW THIS LIME
#
Submittal
Req'd
Reed
TRtACMG
PERMIT FEES
Plan Secs
Pian Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit, .
Truss Cslcs.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechaelcal
Grading plan
Z" Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
N ROUSE:-
'^' Review, ready for correetionstissue
Developer Impact Fee
Planning Approval-
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF-1R-ALT-1HVAC)
Project Name:
SEAN SARGENT I Date Prepared:
CF1R-ALT 02-E.
(Page 1 of 3 )
2016-02-09
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CF111-ALT-02 document for each dwelling unit.
01
Project Name
SEAN SARGENT
02
Date Prepared
2016-02-09
03
Project Location
79205 QUAIL CROSSING
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
SEAN SARGENT
07
Zip Code
92253
08
Dwelling Unit Conditioned
3180
a .....,. °'
u,c tee. �-+
w�
Floor Area (ft2)
SC System
CFA served
� stem a*%
r friger nt fInstalling
new SC
Number of space conditioning
In�stalli g
09
Climate Zone
15
10
(SC) systems in this dwelling
3
containing
system v
more than 40
entirely new
unit.
B. Space Conditioning (SC) System Information If - n �iT� : r
01
02
03
04U5
06
I 0 ))
l# 08 11
09
10
;
FIs the Sc—
x a ,� i . �,.:
Installing a
im.•�.=.,.. i..e sda
a .....,. °'
u,c tee. �-+
w�
SC System
SC System
CFA served
� stem a*%
r friger nt fInstalling
new SC
Installing
In�stalli g
Installing
Identification or
Location or Area
by this SC
ducted
containing
system v
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
1200
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 2
Location 2
1200
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
System 3
Location 3
780
No
Yes
Yes
No
No
NoAltered
space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (SectionIS0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 216-A0052589A-000000000-0000 Registration Date/Time: 2016-02-09 21:38:43 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-02-09 21:37:44
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-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
All new
Central split
All new
This field or
This field or
System 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
16
Setback
section is. not
section is not
components
components
applicable
applicable
Central gas
All new
Central split
All new
This field or
This field or
System 2
furnace
heating
AFUE
0.8
AC
cooling
SEER
19
Setback
section is not
section is not
components
components
applicable
applicable
Ductless split
All new
Ductless split
All new
This field or
This field or
System 3
HP
heating
AFUE
0.8
AC
cooling
SEER
18
Setback.
section is not
section is not
components
components
applicable
applicable .
...�
Required Documentation: if D -)cry
CF2R-MCH-01-E -Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new R6.
plenums:
€
CF2R-MCH-20-H & CF3R-MCH-20-H Duct Leakage testing heating ducted -systems,
1 €
than 40 ft
T
ducE€ length is
— required when or cooling:componentsare installedin or when more of
{
-Leakage rate compliance: 515%, or 510% leakage to outside ibl
r%seal all accesse leaks? Q..)SF
replaced.
o�a iA!;
i #
refrigerant
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification requcired when containing components are installed or altered (applicable in CZ 2, 8-15).
& CF3R-MCH-23 Air Flow z300 CFM/ton requirew
d hen MCH-2isequiE
Exce tFonsMCH-23
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 1S0.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 216-A0052589A-000000000-0000 Registration Date/Time: 2016-02-09 21:38:43 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance - Report Version: 2013 Rev 1.007 Report Generated: 2016-02-09 21:37:44
Schema Version: 0.5555DD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -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: ��//
JIn loco
Jacoby, Ian
y
Company:
Signature Date:
i PERMIT E RATERS
2016-02-09 21:37:32
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362 z
818-735-7876
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).
3. 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 California Code ofd g lat on ;/�",�^" �
r
4. The building design features or system design features identified on this Certificate of Compliance are consistent withRthe informatl'on.provided on othecapplicatile compliance documerits, worksheets,
00
calculations, plans and specifications submitted to the enforcement agency for approval with this building permlt application. t
S. I will ensure that a registered copy of this Certificate ofkcompliance shallabe,rriade available With the bulldirtg permit(s).assued for the building, and -made available t0he_enforcement agency for all applicable
inspections. I understand that a registered copy of this Ceriificate.of Cokmpliancef_iswrequIred to be, cluded with the documentation.he.builder p�vides to the bu�ild�ng owner at occupancy.
Responsible Designer Name: It wd
Respons161e Designer Signature: l� h
Shanley, Barbara
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2016-02-09 21:38:43•
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 noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 216-A0052589A-000000000-0000 Registration Date/Time: 2016-02-09 21:38:43 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-02-09 21:37:44
Schema Version: 0.55SSDID