BMCH2017-005778-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
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DESIGN &'DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O17-0057
Property Address:
81148 DESERT SAGE CT
APN:
764430041
Application Description:
WEST/ CHAGNE OUT (2) HVAC SPLIT SYSTEMS
Property Zoning:
Application Valuation:
$29,724.00
Applicant:
aQ
IE INC
®
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
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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
�y _ 1
[ 0 " LS 1 1 Contractor: Syvu _
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, after, 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 town 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.).
( 11, 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 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
(760)343-7488 Z
C3
Llc. No.: 686310 W
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificat: 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.
Q 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: INSURANCE COMPANY OF THE WEST Policy Number: WSDS0316S8
I certify that in the performance of :he 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 3 700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 't LS Applicant: r a
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 FORON 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 stat 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 representati-es of this city to enter upon the
above-mentioned property for inspection purposes.
e
Signature (Applicant os Agenb :-
Date: 3/15/2017
Owner:
12
JAMES WEST -
tJJ
2531 NW 16TH AVE
�
CAMAS, WA 92253
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Contractor:
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HARRISON ENTERPRISES INC D 9® NERAI�R
31170 RESERVE Q
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:)RIVE
THOUSAND PALMS, CA 92276
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(760)343-7488 Z
C3
Llc. No.: 686310 W
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificat: 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.
Q 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: INSURANCE COMPANY OF THE WEST Policy Number: WSDS0316S8
I certify that in the performance of :he 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 3 700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 't LS Applicant: r a
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 FORON 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 stat 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 representati-es of this city to enter upon the
above-mentioned property for inspection purposes.
e
Signature (Applicant os Agenb :-
Application Number: BMCH2017-0057
Property Address: 81148 DESERT SAGE CT
APN: 764430041
Application Description: WEST/ CHAGNE OUT (2) HVAC SPLIT SYSTEMS
Property Zoning:
Application Valuation: $29,724.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
Date: 3/15/2017
Owner:
JAMES WEST
2531 NW 16TH AVE
CAMAS, WA 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(760)343-7488
Llc. No.: 686310
---------------------------------------------------------------------------------------------
Detail: HVAC CHANGE OUT - (1)18SEER/80AFUE SPLIT SYSTEM AND (1)19SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED
PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
' HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$76.00
Total Paid for CHANGEOUT: $228.00,
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 ENHANCEMEMT FEE: $5.00
3+4ZI-11Sy -Aes,
STATE�OF CAL'FORNIA
AL'TERAYIONS - HVAC
!, - "o-1 il
CEC-CFI1R-ALT-04-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION 1iti/
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (Page 1 of 1)
Site Address:
Enforcement Agency:
Da, Prepared:
Permit#:
&'l148 l es@r S C'r.
G Lo. c�,, %A a-
3 ►5 1i
Equipment Type
Equipment Efficiency
New Ducting or Lineset:
Required R -value
Ccnditioned 2
Floor Area (ft )
Thermostat
❑ Packaged
1$' Evaporator Coil
80 AFUE
COP
❑ R-6 (CZ 1-10, 12&13) Ducts
Swed by system
0 Setback
System
X Condensing Unit
❑ R-8' (CZ 11, 14-16) Duds
;—,Co ft2
(if not already
)( Split System
❑ Compressor
J SEER
HSPF
❑ Z R=2.8 Lineset°
present must
❑ Mini Split
❑ Lineset
be installed)
fil!�Furnace
❑ TXV
EER
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-MCH-01-E, MCH -20-H, MCH -(23 or 24)2-H, MCH -25-H2
Compressor, TXV, Lineset, CF3R-MCH-20-H, MCH -(23 or 24)-H2, MCH -25-H2
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/tc n, 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 ....... I
❑ 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-MCH-01-E, MCH -20-H, MCH -22-H, MCH -(23 -or 24)-H2, MCF= -25-112
CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H2, MCH -25-1-12
Mini Splits require CFIR-ALT-02-E, CF2R-MCH=01-E, and (CF2R-CF3R) MCH -25-H
Installer Requirement: Duct leakage < 5%, Fan Efficacy (0.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Duds 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-MCH-01-E, MCH -20-H, MCH -(23 or 24)-H, MCH -25-H
Compressor, TXV, Lineset, Furnace CF311-MCH-20-1-1, MCH -(23 or 24)-H, MCH -25-H
Installer Requirement: Duct leakage < 5%, 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 asbestc-s
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Duds' CFIR-ALT-02-E, CF2R-MCH-20-H, CF3R-MCH-20-H
Installer Required to: Duct leakage L15% or, <_10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
'All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10, 12 &13, and R-6 insulation 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 MCH -(23 or 24), or Refrigerant Charge verification MCH -25
' All New Ducts is when 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)
.° R-2.8 (1" thick insulation) for linesets 1" and less.
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 Complia.qce 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.
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 Desi ner Name:
Res onsible Designer Signature:
Dat Sig
ed:
License:
ey 111'r-
3
Company:
n c(�l
Address:State/Zip:
3�11a 7
Ci soar. Q2Z-1
-hone:
'7bD - 3L•i3--P#W
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
4-Vcv,
STATEOF CAYLORNIA
ALTERATIONS - HVAC
"T-110
CEC-CFIR-ALT-04-E (Revised 01/16) CALIFOFNIA ENERGY COMMISSION Q
CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (Page 1 of 1)
Site Address:
Enforcement Agency:
Da:e Prepared:
Permit#:
811 W 4 l�es�r k Q
C; C -
. •
3115)1-7
Equipment Type Equipment Efficiency
New ucting or Lineset:
Required R -value
Conditioned
FIOor Area (ft)Thermostat
❑ Packaged
Evaporator Coi b'/ AFUE
COP
❑ R-6 (CZ 1-10, 12&13) Ducts
Served by system
X Setback
System
(Split System
Nrcondensing Unit
❑Compressor
❑ R-8' (CZ 11, 14-16J Ducts
2300 ft
(If not already
SEER
HSPF
❑ > R-2.8 Lineset'
present, must
❑ Mini Split
❑ Lineset
be installed)
�Furnace Jf
❑ TXV EER
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-MCH-01-E, MCH -20-1-1, MCH -(23 or 24)'-H, MCH -25-H'
Compressor, TXV, Lineset, CF3R-MCH-20-H, MCH -(23 or 24)-H', MCH -25-H2
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (< 15%, or 510% 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 dud in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building ...... I
❑ 2. New HVAC System
Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts3
CF1R-ALT-02-E
including Mini Split
CF2R-MCH-01-E, MCH -20-H, MCH -22-1-1, MCH -(23 or 24)-H2, MCH; -25-H'
CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H', MCH -25-H'
Mini Splits require CFIR-ALT-02-E, CF2R-MCH-01-E, and (CF2R-CF3R) MCH -25-H
Installer Requirement: Duct leakage < 5%, Fan Efficacy (0.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
1:13. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New Ducts3 and one or more of the following CF1R-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R-MCH-01-E, MCH -20-1-1, MCH -(23 or 24)-H, MCH -25-H
Compressor, TXV, Lineset, Furnace' CF3R-MCH-20-H, MCH -(23 or 24)-H, MCH -25-H
Installer Requirement: Duct leakage < 5%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbest06
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3 CF1R-ALT-02-E, CF2R-MCH-20-H, CF3R-MCH-20-H
Installer Required to: Duct leakage (5 15% or, 510% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting requires R-8 insulation when more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10, 12 &13, and R-6 insulation 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 MCH -(23 or 24), or Refrigerant Charge verification MCH -25
3 All New Ducts is when at least 75%of the duct system is new duct material, and up to 25%may consist of reused pa -ts from the dwelling unit's
existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-2.8 (1" thick insulation) for linesets 1" and less.
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. I 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 fow 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 Desi��werpName:
Re nsible Design signature:
Dat Sig d:
License:
e,Veh Jc hri�ecec
t
3 %S 1i
Company: /� 1
C �r 1.i-N41iOr"i`r�
Address:
X1170 des .ra�
C' /State/Zip:
4�ovso..d arnsg2z�l�
hone:
%Z>- 3-7'-)88
ror assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300
Bin #
City of Ta Q uin to
Building a Safety Division.
Permit u 78 -495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sleet
Project Address: 811 $ �,��� Sa G. Owner's Name: Tyyl
A. P. Number:
Address: W p
Legal Description:
City, ST, Zip:
Z6
A(
Contractor:G�Er a �
Teleho n O a - 3 q (o
Address: 3 l70ei set,i
Project Description:
City, ST, zip: 1S
CA o12 z-7c�
Vlam yor. ao CM TU C 'VAC
e e•
T le h n
P o . O-�i
3 y
% 3
State Lic. # : (p $�p31 t�
City Lic. #;
Arch.,'Engr., Designer:
�� 1aee 3}or
")p G1Gb�L�i V �Jrrl �e �%AC
Address:
City, ST, Zip:
TelePh one:
Con tructi n Type: O ecu .•aneY
a
St te Lic. #:
Project tYPa circle one), New Add'n Alter Repair.air Demo.
Name of Contact Person:
Sq. Ft.:
# Stories:
T# Units:
Telephone # of Contact Person:
Estimated Value of Project: 4z -q,-7 2--t Lb
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
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
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! 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,
I
Total Permit Fee;