BMCH2017-017678-495 CALLE TAMPICO
LA'QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0176
Property Address: 54315 AFFIRMED CT
APN: 767780073
Application Description: MATERICK / CHANGE OUT (1)14SEER/81AFUE DUCTLESS SPLIT SYSTEM
Property Zoning:
Application Valuation: .$7,250.00
Applicant:
HARRISON ENTERPRISES INC DBA GENERAL AIR MAY 1 Y 2017
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276 CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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: 11 1-1 Contractor:�.HMi�_-
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).:
( ) 1, 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 Address:
• VOICE (760) 777-7125
FAX'(760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/11/2017
Owner:
RON MATERICK
54315 AFFIRMED CT
LA QUINTA, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
WORKER'S COMPENSATION DECLARATION
1 -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.
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: INSURANCE COMPANY OF THE WEST Polity Number: WSD5031658
_ 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: S it 1—1 Applicant: c_,:)V:ZZ 7
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:'5 I t t 1 Signature (Applicant or Agent):
Date: 5/11/2017
Application Number: BMCH2017-0176
Owner:
Property Address: 54315 AFFIRMED CT
RON MATERICK
APN: 767780073
54315 AFFIRMED CT
Application Description: MATERICK / CHANGE OUT (1)14SEER/81AFUE DUCTLESS SPLIT SYSTEM
LA QUINTA, CA 92253
Property.2oning:
Application Valuation: $7,250.00
Applicant:
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
Detail: HVAC CHANGE OUT - (1)14SEER/81AFUE DUCTLESS SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid.for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT. ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
' Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin. #
C►ty. 0 La Qurnta
Building 8r Safety Division
P.Q. Box 1504,78-495 Calle Tampico
la.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Perini #
Project Address: 54315 Affirmed Court
Owner's Name: Ron Materick
A P. Number.
Address: 54315 Affirmed Court
Legal Description:
City, ST, Zip: La Quinta, CA' 92253
Contractor: General Air Conditioning
Telephone: 630-267-6333 WWI
Address: 31170 Reserve Drive
Project Description: 2.5 ton ductless mini split heat pump & .
City, ST, Zip: Thousand Palms, CA 92276
220 volt circuit
r
Telephone: 760-343-74880- —Afflpll
State Lic. # : 686310 City Lie. #;
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone: v •r ' `�� ,• ;
State Lic. #: :,.,.
Name of Contact Person: Steven Schnierer
Construction Type: . Occupancy:
'
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft:
#Stories: #Univ:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project: $7,250.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections.
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted .
Mechanical
Grading plan
2ad Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.-
3a Review; ready for corrections/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
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3)
Project Name: RON MATERICK I Date Prepared: 2017-05-09
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
RON MATERICK
02
Date Prepared
2017-05-09
03
Project Location
54315 AFFIRMED COURT
04
Building Type
Single family
05
CA City •
La Quinta t""
06
Dwelling Unit Name
HOUSE
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Dwelling Unit Conditioned
Name.
07
Zip Code
92253 :
_.
- 08 i
Floor Area ft2
( )
825
duct system?
SC system?
Alteration Type
Number of Space
09
Climate Zone
15 ' F
10z
Conditioning (SC) Systems in
1
this Dwelling Unit:
SYSTEM 1
B. Space Conditioning (SC) System Information 3
i _ .fl ,. 17 F l , (74
Ol
02
03
04
U 05 i
� i 06`� i �
' 07
08
09
10
SC System
SC System
CFA served
Is the SC
.t7iP°f
systema
Installing_a.
c rVi
refrigerant
' W .ire
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name.
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Entirely new or
complete
SYSTEM 1
WHOLE HOUSE
825
No
No
Yes
No
No
Yes
replacement 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: 417-A020093044A-000-000-0000000-0000
Registration Date/Time: 2017-05-09 21:54:59
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-09 21:55:00
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)
This section does not apply to this project.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(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)
01
02
03
04
r 05' k�"11
)r��
fa
07
08
09
10
11
Heating'
Cooling
System
Heating
Minimum,,.,-/fs
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
N ; Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Duct
Name
Type
Component
Type
Value;,.
System Type
Component
Type
Value
Type
R -Value
Annual Fuel
This field
SYSTEM 1
Ductless split HP
All new heating
Utilization
I
0;81
Ductless split
HP:
All new cooling
SEER
14
SetbackTher
or section
is
components
P
Efflclenc
UE)
I
com onents
p
mostat
not
(AF
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Uniwitc ied S?nl*V V jntoo tv
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6'(CZ 1-10, 12 and 13) and R8 (CZ'11 and 14-16),
CF2R and CF311WCH-20-11 Duct Leakage Test required
- Leakage rate compliance: <= 5%.
CF2R and CF3R-MCH-22 Fan Efficacy
CF2R and CF3R-MCH-23 Airflow Rate Verification
Compliance: Fan Efficacy <= 0.58 W per cfm and System Airflow >= 350 cfm per ton.
Alternative Compliance: CF2R and CF3R-MCH-28 Return Duct Design verification is an alternative to MCH -22 and MCH -23 verification.
CF211 and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
Exceptions:
Heating -only systems are exempt from the 0.58 W per cfm and 350 cfm per ton requirements.
Note: An "entirely new or replacement duct system" means at least 75% of the duct system is new duct material, and up to 25% may consist of reused parts from the dwelling
unit's existing duct system.(e.g., registers,
grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage
Registration Number: 417-A020093044A-000-000-0000000-0000
Registration Date/Time: 2017-05-09 21:54:59
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-09 21:55:00
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: .
Patrick Somers .
�atY%ck.SCwv�,v�-
Company:.
Signature Date:
General Air Conditioning
2017-05-09
Address:
CEA/ HERS Certification Identification (if applicable):
31170 Reserve Drive
City/State/Zip:, .•c$.'
Phone:
Thousand Palms CA 92276 (i ,
760: 343-7488
f
Responsible Person's Declaration statement'
Yj
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 manfactu ed 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 of Regulations. ~ �`
4. 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.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building purnit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
�f 1y
edMo
Responsible Designer Signature:
ne.
Patrick Somers
Company:
Date Signed:
General Air Conditioning
2017-05-09
Address:
License:
31170 Reserve Drive
686310
City/State/Zip:
Phone:
Thousand Palms CA 92276
760-343-7488
Digitally signed by CHEERS"". This digital signature is provided in order to secure the content of this registered
document, and in no way implies Registration Pro.vider.responsibility for the accuracy of the information.
Registration Number: 417-A020093044A-000-000-0000000-0000
Registration Date/Time: 2017-05-09 21:54:59
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-09 21:55:00