BMCH2015-039778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O15-0397
Property Address: 55090 SHOAL CREEK
APN: 775142013
Application Description:
Property Zoning:
Application Valuation:
SMITH RESIDENCE / HVAC
$5,794.00
Applicant:
IE INC.
32115 LA BAYA
WESTLAKE VILLAGE, CA 91362
Q.�i � I111111I66 IIIIIIIIIIII
D VOICE (760) 777-7125
FAX (760) 777-7011
nni mnry nr
CO �.,,.......,.—�.`,FE#9 NT � INSPECTIONS (7601777-7153
D BUILT — PER IT
OCT 14 2015 '
OUT CITY OF LA QUINTA
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: i HIS' 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 N
Lender's
Date: 10/14/2015
Owner:
ROLAND SMITH
55090 SHOAL CREEK
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, l shall forthwith
comply with those provisions.
0.
Date: 101 14+]1-5-Applicant:L �G.---
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.
r �_ a
Date: )O 1`i L5 Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT. ;QTY AMOUNT PAID PAID DATE::
"BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY METHOD: ' ' RECEIPT # ;: CHECK #. CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION _
:'ACCOUNT
CITY,,
AMOUNT
PAID
RAID DATE
AIR HANDLER
101-0000-42402
0
$36.26
$0.00
PAID BY r_
METHOD ::
;:. RECEIPT #
CHECK #.
CLTD BY
DESCRIPTION
ACCOUNT,
QTY;:
:AMOUNT
PAID '
PAID DATE
AIR HANDLER PC
101-0000-42600
0
$12.09
$0.00
PAID BY
= METHOD
RECEIPT #
CHECK #
CLTD.BY
Total Paid for MECHANICAL: $48.35 $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: SMITH RESIDENCE / HVAC CHANGE UU 1
Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 10/14/2015 MFA
Parcel No: 775142013 Site Address: 55090 SHOAL CREEK LA QUINTA,CA 92253 Approved: 10/14/2015 MFA
Subdivision: Block: Lot: Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled:
Valuation: $5,794.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 21 SEER/80AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES.
CONDITIONS
NAME TYPE NAME
-CONTACTS
CITY STATE
ZIP
PHONE
FAX
EMAIL
ADDRESSI
APPLICANT IE INC.;
32115 LA BAYA
WESTLAKE CA
VILLAGE .
91362
(760)564-2204
CONTRACTOR HARRISON ENTERPRISES INC DBA
GENERAL AIR
31170 RESERVE DRIVE
THOUSAND CA
PALMS
92276
(760)564-2204
OWNER ROLAND SMITH
55090 SHOAL CREEK
LA QUINTA CA
92253
(760)564-2204
Printed: Wednesday, October 14, 2015 11:36:46 AM 1 of 2
SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
AIR HANDLER
101-0000-42402
0
$36.26
$0.00
AIR HANDLER PC
101-0000-42600
0
$12.09
$0.00
Total Paid for MECHANICAL: $48.35 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:i0
INSPECTIONS
ATTACHMENTS
Printed: Wednesday, October 14, 2015 11:36:46 AM 2 of 2
V?WsYSTEMS
'l�lJ Tql- o(l
Bin.# ...
Qty 0f La Quin' ta
Sididing a 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: 55090 Shoal Creek
r's Name:. Roland Smith
A P. Number. T.Address:
55090 Shoal Creek
Legal Description:
City, ST, Zip: La Quinia, CA 92253
Contractor: General Air Conditionin"�°
9
Tele hone: 760-564-2204
s^
34 mow^
x
Address: 31170 Deserve Drive
Project Description: Install 1'.5ton Mini Split Heat Pump & .
City, ST, Zip: Thousand Palms, CA 92276
Air Handler
Telephone: 760-343-7488
MUM
M
State Lic. # : 686310
City Lic #:
Arch, Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #: r
Name of Contact Person: Steven Schnierer
Construction Type:. Occupancy:
Project type circle one New `Add'n Alter Repair Demo
Sq.Ft.: #Stories: #Units:
Telephone # of Contact Person: 818-735-7876 x 1
Estimated Value of Project: $5,794.00
APPLICANT: DO NOT WHITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACE NG
PERMIT FEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cale$.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance _
Title 24 Calcd.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
2id Review, ready for correctiou&rwue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.MX
H.O.A. Approval
Plans resubmitted
Grading
IPI HOUSE:-
—Review; ready for correetionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
STATE OF CALIFORNIA
ALTERATIONS - HVAC
W1Y
CEC-CF1 R -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:
SSa90 S�oc�� C
Enforcement Agency:
Date Pre ared:
Permitil:
'✓e�.
e; L -
toll4 t
Equipmerit Type
Equipment Efficiency
New Ducting, Plenums, Lineset.
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged
KEvaporator Coll
COP
❑ R-6 CZ 2, 8-13 Ducting
( 1 g
Served b
by system
Setback
System
❑ Split System
Condensing Unit
❑
—AFUE
Z1.
❑ R-8' (CZ 11, 14, 15) Ducting
sgft
(If not already
Compressor
SEER
HSPF
❑ R-6 (all CZ's) Plenums
present, must
Mini Split
❑ Lineset
EER
_
❑ R-5 or R7.5) Lineset°
be installed)
❑ Furnace
❑ 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.
'X1. 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)Z -HERS, MECH-25-HERSZ
Compressor, TXV, Lineset,
CF311: MECH-20-HERS, MECH-(23 or 24) -HERS=, MECH-25-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 dud 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 Ducts3
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-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERSZ, MECH-25-HERS1
Mini Splits require CFSR-ALT-02-E, CF2R-MECH-0l, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/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-25-HERS
Compressor, TXV, Lineset, Furnace'
CF3R: MECH-20-HERS, MECH-(23 or 24}HERS, MECH-25-HERS
Installer Requirement: Dud leakage:S 6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from dud leakage testing if: ❑ 1. Existing dud systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet
I Required Compliance Documents to be left on site for Final:
New ducting but less than All New Duds'
I CF1R-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage f<15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing dud 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
I 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-r/a", 2.5 -3T -2y:", 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 land 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.
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.
Res onsible Designer Name: Responsible Designer Signature: Date Signe license:
LS /v gio31D
Company:
Address: ' `
City/State/23p:
Phone:
6�' e A:,r C'vtr�cl��io1/�\Y,
311.70 eL�r
Ihnv d1� ZZ%
-foo-3/} - 48F
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