BMCH2017-038778-495 CALLE TAMPICO Ci 0 D �iIM1A�il/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0387 D W
Property Address: 53920 AVENIDA DIAZ
APN: 774152009 AUG I 1
Application Description: ULRICH RESIDENCE / HVAC CHANGE OUT Z��1 7
J
Property Zoning: CIT! OF LA QUINTA
Application Valuation: $10,852.00 COMMUNITY DEVELOPMENT DEPARTMENT
Applicant:
IE INC
31225 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 31 ` Contractor: �i.sg..�►��—�
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. Q.
Lender's Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 01/2017
DAVID ULRICH
53920 AVENIDA DIAZ
LA QU INTA, CA 92253
Contractor: -
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALPAS, CA 92276
(760)343-7488
Llc. No.: 686310
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one cf the following declarations:
I have and will maintain a certifica-.e of consent to self -insure for workers'
compensation, as provided for by Section 37C0 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, a3 required by
Section 3700 of the Labor Code, for the perfo-mance of the work for which this permit
is issued. My workers' compensation insuran--e carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031658 '
I certify that in the performance oz the work for which this permit is issued, I
shall not employ any person in any manner sc as to become subject to the workers'
compensation laws of California, and agree tl-at, 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: FS3l n Applicant: zu.irL Y"
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 FCR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNC WLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official fora permit subject to
the conditions and restrictions set forth on the application.
1. Each person upon whose behalf this app'ication 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 :he 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 o- 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.
n
Date: Signature (Applicant or Agent): —T�
i
Date: 8/31/2017
Application Number: BMCH2017-0387.
Owner:
Property Address: 53920 AVENIDA DIAZ
DAVID ULRICH
APN: 774152009
53920 AVEN IDA DIAZ
Application Description: ULRICH RESIDENCE / HVAC CHANGE OUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: ,$10,852.00
Applicant:
Contractor:
IE INC
HARRISON ENTERPRISES INC DBAGENERALAIR
• 31225 LA BAYA
31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362
THOUSAND PALMS, CA 92276
(760)343-7488
---------------------------------------------------------------------------------------------
Llc. No.: 686310
Detail: HVAC CHANGE OUT - 14 SEER/80 AFUE PACKAGED SYSTEM. CARBON MONOXIDE
ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER
2016 CALIFORNIA BUILDING CODES.
FINANCIAL •R •
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 - PACKAGED UNIT
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - PACKAGED UNIT PC
101-0000-42600
0
$25.33
Total Paid for CHANCEOUT: $63.33
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
TOTALS:.0
i
f
Bin. #
CQty. of La Quin td
Buiiding 8T 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: 53920 Avenida Diaz
Owner'sName:.David Ulrich
A. P. Number.
Address: 53920 Avenida Diaz
Legal Description:
Contractor. General Air Conditioning
City, ST, Zip: La Quinta, CA 92253
Telephone: 949-412-9100
Address: 31170 Reserve Drive
Project Description: Replace 4 ton pacPage unit
City, ST, Zip: Thousand Palms, CA 92276
Telephone: 7.60-343-7488
'
State Lic. # : 686310
City Lie. 9.
Arch, Engr., Designer.
Address:
City., ST, Zip:
Telephone: `
State Lia #:- '
-=.w3j ", y. ~
Name of Contact Person: Steven Schnierer
Construction Type: Oc::upancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#Stories:
#Units:
Telephone # of Contact Person: 818-735-7876
Estimat6d Value of Project: $10,852.00 .
APPLICANT:.DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check beposit. .
Truss Calcs.
Called Contact Person
Pian Check Balance
Titre 24 Calcs.
Plans picked up
Construction "
Flood plain plan
Plans resubmitted." .
Mechanical _
Grading plan
tad Review, ready for correctionstissue
Electrical
Subcontactor List
Called ContactPerson
Plumbing
" Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
1Di SOUSE.-
'^' Review; ready for corrections/issue
Developer rtpact 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 -1R -ALT -HVAC) (Page 1 of 3)
Project Name:
DAVID ULRICH I Date Prepared:
2017-08-30
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
DAVID ULRICH
02
Date Prepared
2017-08-30
03
Project Location
53920 AVENIDA DIAZ
04
Building Type
Single family
05 .
CA City
La Quinta06
Dwelling Unit,Name
HOME
SC System
SC System
�
system a
refrigerant
07 .
Zip\Code
92253
US
Dwelling Unit Conditioned
Identification or
Location or Area
by this SC
ducted
containing
Floor Area (ft)1522
more than 40
entirely new
entirely new
'Name
Number of Space
System (ft)
09
Climate Zone
15
-10
Conditioning (SC) Systems in
1
I Alteration Type
SYSTEM 1
WHOLE HOME
I ,
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information
1"A_J'! 37 Tt ____ _ Ff:�i F711
01
02
03
04
V 005 L
` 06
07
08
09
10
Is the SC
t,. nrl
Installing.a, ,
3 M" 4 r; }
tf . s ctrtl j
SC System
SC System
CFA served
system a
refrigerant
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?
I Alteration Type
SYSTEM 1
WHOLE HOME
1522
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System; Greater Than 40 Feet (Section 150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 417-A020113150A-000-000-0000000-0000 Registration Date/Time: 2017-08-30 12:43:00 HERS Provider: CHEERS.
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-30 12:43:00
Schema Version: rev 10/16 1
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)lE 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
All new
Central
All new
This field or
This field or
SYSTEM 1
packaged HP
heating
AFUE
0.8
packaged HP
cooling
SEER
14
Setback
section isnot
section is not
.components
components
applicable
applicable
Required Documentation:, t .7
CF2R-MCH-01-E -Space Conditioning Systems4'
- 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 CF311-MCH-20-H - Duct Leakage Test required when heating or cooling components are -installed inducted systems, or when more than 40 ft of duct length is replaced
-Leakage rate compliance: <=15% or <= 10% leakage to outside, or seal all accessible leaks.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow.Rate >= 300 CFM per ton required when MCH -25 is required. - .r
Exceptions:,
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 MCH -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 Changei�oat (Sections 150.2(b)lDiia and 150.2(b)1E, F)
t #This section does no apply to th s project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 417-A020113150A-000-000-0000000-0000 Registration Date/Time: 2017-08-30 12:43:00 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-30 12:43:00
Schema Version: rev 10/16.
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. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Salvador Correa
salvadorcorrea
Company:
Signature bate:
I Permit E Raters
2017-08-30
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
RCN13245
City/State/Zip: �Phone:
Westlake Village CA 91362 {'l
818.735-7876
Responsible Person's Declaration statement./'
certify the following under penalty of perjury, under the laws of the State of California: k dl
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 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.
rl r� _0 .,I,,(—n )s k•
5. 1 will ensure that a registered copy of this Certificate of Compliance shall beimadepavailablle_ with the b ilding:perm€t(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 €srequired to be €nclude'd with'the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: { YY�Y4� y
#, �k l3 i s'G�k�i #�'.^a�.z.TL��'es€s..i
Patrick Somers
Responsible Designer Signature:
1 "'c'"a+1. K€x^i:"YP•st ke•RM
Sa7vadarCorrew{ata-i
Company:
Date Signed:
General Air Conditioning
2017-08-30
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 Provider responsibility for the accuracy of the information.
Registration Number: 417-A020113150A-000-000-0000000-0000 ' Registration Date/Time: 2017-08-30 12:43:00
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006
Schema Version: rev 10/16
HERS.Provider: CHEERS
Report Generated: 2017-08-30 12:43:00