BMCH2017-046178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Twr46�4"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
MECHANICAL/
Application Number:
BMCH2O17-0461
Property Address:
60959 FIRE BARREL DR
APN:
764520026
Application Description:
LARSON RESIDENCE / HVAC
Property Zoning:
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Application Valuation:
$1000.00
Applicant:
IE INC
C�
Date: � 1-7 _Applicant:
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
D �--J
(�('T v U
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CITY OF LA QUINTA
COMMUNITY DEIIELOPMENTDEPARTMENT
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 °
ItDate:l lg C�ontractor271Z.,ry
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/30/2017
Owner:
JAY LARSON
60959 FIRE BARREL DR
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
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:
OWNER -BUILDER DECLARATION
Carrier: INSURANCE COMPANY OF THE WEST Policy Number: WSD5031658
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,
I certify that in the performance of the work for which this permit is issued, I
city or county that requires a permit to construct, alter, improve, demolish, or repair
shall not employ any person in any manner so as to become subject to the workers'
any structure, prior to its issuance, also requires the applicant for the permit to file a
compensation laws of California, and agree that, if I should become subject to the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
comply with those provisions.
3 of the Business and Professions Code) or that he or she is exempt therefrom and the,^I"�_
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a'Z
C�
Date: � 1-7 _Applicant:
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, .
(_) I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that
IMPORTANT: Application is hereby made to the Building Official for a permit subject to '
he or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(_) I, as owner of the property, am exclusively contracting with licensed contractors
1. Each person upon whose behalf this application is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to ar)y permit
State License Law does not apply to an owner of property who builds orimprovesissued
as a result of this application , the owner, and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
the Contractors' State License Law.).
employees for any act or omission related to the work being performed under or
(_) I am exempt under Sec. . B.&P.C. for this reason
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
Date: Owner:
work for. 180 days will subject permit to cancellation.
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 Na
Lender's
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.
Signature (Applicant or Agent)::7 — --�
Date: 10/30/2017
Application Number: BMCH2O17-0461
Owner:
Property Address: 60959 FIRE BARREL DR
JAY LARSON
APN: 764520026
60959 FIRE BARR =L DR
Application Description: LARSON RESIDENCE / HVAC CHANGE OUT
LA QUINTA, CA 9253
Property Zoning:
Application Valuation: $10,000.00
Applicant:
Contractor:
IE INC
HARRISON ENTERPRISES INC DBA GENERAL AIR
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/80AFUE 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
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$78.02
Total Paid for CHANGEOUT: $117.03
DESCRIPTION
ACCOUNT
IQTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$98.83
Total Paid for PERMIT ISSUANCE: $98.83 .
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $231.86
r
r ,
Bin. #
City of La Quinta
Building 8T Safety Division
P.O. Box 1504,78-495 Calle Tampico
14.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking S,ieet
Permit #
Project Address: 60959 Fire Barrel Drive
Owner's Name:. Camille Larson
A. P. Number.
Address: 60959 Fire Barrel Drive
Legal. Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. General Air Conditioning
Telephone:
. > ;�'":
Address: 31170 Reserve Drive
Project Description: Replace 5 ton A/C, coil, & 110,000 BTU
City, ST, Zip: Thousand Palms, CA 92276.
furnace
Telephone: 760-343-7488
State Lic. # : 686310
City Lic. #;
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone: Y. '
State Lia #:
,!C
Name of Contact Person:
Construction Type: , Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project: $10,000.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
M
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check E•eposit. .
Truss Cates.
Called Contact Person
Pian Check Ealanee
Tide 24 Calcs.
Plans picked up
Constructlom
Flood plain plan
Plans resubmitted.. '
Mechanical
Grading plan
2`! Review, ready for correctionslissue
Electrical
Subcontattor 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 correetionsliissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total PermR Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly. CF -1R -ALT -HVAC)
Project Name:
CAMILLE LARSON I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)
2017-10-27
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.
03
Project Name
CAMILLE LARSON
02
Date Prepared
2017-10-27
03
Project Location
60959 FIRE BARREL DRIVE
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
HOME
SC System
SC System
.
system a
refrigerant
07
Zip Code
i`
92253 �` <
'4081
Dwelling Unit Conditioned
2
2359
Location or Area
by this SC
ducted
%' -
Floor Area (ft )
more than 40
entirely new
entirely new
�1
Number of Space
System (ftz)
09
Climate Zone
15
10
Conditioning (SC) Systems in
1
Alteration Type
SYSTEM 1
WHOLE HOME
2359
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information
01
02
03
04 ``0
OS
06
07'-
08
09
10
{FA
Is the SC
Installinga
a(� jiPsa w ,r,
' '? nQnn jPY t1t ii �j:
SC System
SC System
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 (ftz)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOME
2359
Yes
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020124958A-000-000-0000000-0000 Registration Date/Time: 2017-10-27 13:22:39 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-10-27 13:22:40
Schema Version: rev 10/16
T,
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
O1
02
03
04
05
06
01
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
'Setback
This field or
This field or
SYSTEM 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
14
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems ; i
-Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and;13) and RS (CZ 11 and 14-16)
,i
CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced .
-Leakage rate compliance: 2= 15% or <= 10% leakage to outside, or seal all accessible leaks.-
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing corn ponents-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.
Exceptions: r
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 Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F)
This section do snci a ply toth pr ject.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 417-A020124958A-000-000-0000000-0000 Registration Date/Time: 2017-10-27 13:22:39 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016, Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-10-27 13:22:40
Schema Version: rev 10/16
t
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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:
Stephanie Shryock
Stepha#tLe.ShryccJ,
Company:
Signature Date:
I Permit E Raters
2017-10-27
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip:
Phone:
Westlake Village CA 91362- `
818735-7876
Responsible Person's Declaration statement J
I certify the following under penalty of perjury, under the laws of the State of California: ' F
1. The information provided on this Certificate of Compliance is true and correct. s
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 i 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::permit(s)) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered co of this Certificate of Com liance is"required-to be `in included With the documentation the builder provides to the building owner at occupancy.
P g PY PP g P cY•
Responsible Designer Name:
Pti"i"s "Il *I'�7X c
Responsible Designer.Signature:
!Stirp '`ha"'
s
Patrick Somers
&-Shi5Y&c (a—th—Cp&)
Company:
Date Signed:
General Air Conditioning
2017-10-27
Address:
License:
31170 Reserve Drive
686310
City/State/Zip:
Phone:
Thousand Palms CA 92276
760-343-7488
Digitally signed by CHEERSTM. 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-A020124958A-000-000-0000000-0000
Registration Date/Time: 2017-10-27 13:22:39
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-10-27 13:22:40
Schema Version: rev 10/16