BMCH2015-036878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0368
Property Address:
-.79879.INDEPENDENCE WAY
APN:
604503002
Application Description:
NEWTON RESIDENCE/ HVAC CHAN
Property Zoning:
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Application Valuation:
$6,009.00
Applicant:
Date:, ` \ —Applicant;
--
IE INC.
32115 LA BAYA
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UN WFUL,
WESTLAKE VILLAGE, CA 91362
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES TO -
l
FTSE.
t?2 oCTY OF QUINTA
COMMUNITY 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: CC20 C36 License No.: 686310
Da e'�'� V ` �� Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/24/2015
Owner:
GLORIA NEWTON]
79879 INDEPENCENCE WY
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 certifica-.e of consent to self -insure for workers'
compensation, as provided for by Section 37CD 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: _ Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
_ I certify that in the performance o- the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
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
comply with thos provisions.
Q \
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
Date:, ` \ —Applicant;
--
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UN WFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES TO -
(_) 1, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,0D0). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on tins application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this app ication is made, each person at whose
(1 I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application, the owrer, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(_) I am exempt under Sec. . B.&P.C. for this reason
2. Any permit issued as a result of this appl cation becomes null and void if work is
not commenced within 180 days from date cf issuance of such permit, or cessation of
work for 180 days will subject permit to cant=Ilation.
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
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 represen=atives of this city to enter upon the
above -m ntio d property for inspection pu poses.
Date �► �� Signa(Applicar t_or Agent):
FINANCIAL INFORMATION
°O�3C{tlP�lOPI raq ACCOUNT e' QTY.'' " AMOUNT' ;' PAID }' :.: IPAID DATE'
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY �`r� r RECEIPT # _ CHECK # CLTD BY,
METHOD
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
' } • t='GDESCRIPTION`
ACCOUNT
QTY;
AMOUNT
PAID
PAID DATE
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$0.00
s w
",,,PAID BY
"`. ' µ z y:METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION# ,
" ` R ACCOUNT,
QTY'
AMOUNT "
PAID 4r
PAID DATE'
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$0.00
. PAID BY `,`'
METHOD`
RECEIPT#
°CHECK # �_'�CLTD
BY,
Total Paid for CHANGEOUT: $108.78 $0.00 -
a DESCRIPTION � y
t p'ACCOUNT. ,
QTY'
AMOUNT r
PAID ; ;
.PAID DATE'
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
A PAID BY{ `` ';
:.£METHOD' <=
,RECEIPT #
CHECKW, s
CLTD BY '
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Description: NEWTON RESIDENCE / HVAC CHANGE OUT
type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 9/24/2015 MFA
Approved: 9/24/2015 MFA
Parcel No: 604503002 Site Address: 79879 INDEPENDENCE WAY LA QUINTA,CA 92253
Subdivision: TR 24197-3 Block: Lot: 47
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $6,009.00 Occupancy Type: Construction Type:.
Expired:
No. Buildings: 0 No. Stories: 0 . No. Unites: 0
Details: HVAC CHANGE OUT - 18 SEER MINI SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Thursday, September 24, 2015 1:35:03 PM 1 of 2
sysrrnns
CONDITIONS
CONTACTS
NAME TYPE
" ° NAME EADDRESS'1
_
CITY .
STATE
- ZIP
xr
PHONE FAX" Al
APPLICANT
IE INC.
32115 LA BAYA
WESTLAKE
CA
91362
(760)200-3603
-
VILLAGE
CONTRACTOR
HARRISON ENTERPRISES INC DBA
31170 RESERVE DRIVE
THOUSAND
CA
92276
(760)200-3603
GENERAL AIR
PALMS
OWNER
GLORIA NEWTON
79879 INDEPENDENCE
LA QUINTA
CA
92253
(760)200-3603
WY
Printed: Thursday, September 24, 2015 1:35:03 PM 1 of 2
sysrrnns
ON
ACCOUNT-
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #`
^ CHECK # "
METHOD '
} - -PAID,BY' 7'
L QA
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
- $72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid for CHANGEOUT: $108.78 $0.00 v
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
Printed: Thursday, September 24, 2015 1:35:03 PM 2 of 2
SYSTEMS
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name:
RICHARD & GLORIA NEWTON l Date Prepared:
2015-09-22
A. General Information
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling iinit WhPn multiple riwellinE units must be documented,
use one CFIR-ALT-02 document for each dwelling unit.
01
Project Name
RICHARD & GLORIA NEWTON
02
Date Prepared
2015-09-22
03
Project Location
79879 INDEPENDENCE WAY
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
RICHARD & GLORIA NEWTON
a.i h-« i=h
''+�,..:-. '
SC System
Dwelling Unit Conditioned
CFA served
07
Zip Code
92253
08
Floor Area (ft2)
2018
Identification or
Location or Area
by this SC
Number of space conditioning
containing
09
Climate Zone
15
10
(SC) systems in this dwelling
1
Served
System (ft2)
system?
component?
unit.
feet of ducts?
B. Space Conditioning (SC) System Information!
01
02
03
04�
rr 05I �.
If—U6 F)"
07') vy
.08 1
t 09
10
"'`�'��_
FIs the SC�'-'
x ? --st L "'r
Installing a
-„,-,rt 8 -.,,.gid 9.,;i a�.q
as °...w».�•!^'
a.i h-« i=h
''+�,..:-. '
SC System
SC System
CFA served
t
'*. system a
C�
il"�'. 'ran
refrigerant t
°” ar-�r�,
kInstalling-new3C
e �
i installing
�+^we- «mow
ilnsfalling°
installing
Identification or
Location or Area
by this SC
"ducted
containing
system
more than 40
enV..-
ely a
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
2018
No
Yes
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)iDiib)
This section does not apply to this project.
Registration Number: 215-A633414SA-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-09-22 13:28:21 HERS Provider: CaICERTS
Report Version: 2013-1.006 Report Generated: 2015-09-22 13:27:26
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)1E 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
Ductless split
All new
Ductless split
This field or
This field or
System 1
HP
heating
AFUE
0.8
HP
Fancoil AHU
SEER
18
Setback
section is not
section is not
components
applicable
applicable
Reauired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing 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: s 15%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow z 300 CFM/ton required when MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct LeakageTesting requirements. � �„
-Heating-only systems and Air Handler/Furnace changes do not require verification`of Air Flow MCH -23; or'Reftigeranf"Charge NIECH=25.7—
-Existing duct systems constructed, insulated or sealed with asbestos -are exemptFfrom MCH 20 Duct;Leakage Testing -requirements
f f .F ! I: f k" _. % f........ I c k I .i -11 .n 1. � t' I
E. Entirely New or Complete Replacement Duct�System, with or without,Equipment Changeout (Sections 150.2(b)1Diia,and 150.2(b)1E, F)
� f r it.It A 4 31
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC)
This section does not apply to this project.
Registration Number: 215-A6334145A-000000000-0000 Registration Date/Time: 2015-09-22 13:28:21 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-22 13:27:26
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-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. -
Documontation Author PI2mo:
Dncumpritation Author Signature: i
Jan
Jacoby, Ian
�acobJr
Company:
Signature Date:
i PERMIT E RATERS
2015-09-22 13:27:23
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
Responsible Person'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 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 Reg laf ons. I
I
e * w"" a, �« as
4. The building design features or system design features identified on this Certificate of Compliance are consistentwithtne information provided on other applicable compliance documents, worksheets,
t e ,rpp4 a h ' i -..E„ 9i
z � � � �
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit appbcation. � nal
S. I will ensure that a registered copy of this Certificate of Compliance shall'be,rri available with;the bwlding;permit(s); ssued for the building, and,made available totfi enforcement agency for all applicable
A
inspections. I understand that a registered copy of thisCertificate of Compliance is required to be,included with the documentation,tthe builder provides to.the building owner at occupancy.
-- .,.
Responsible Designer Name: k" X -
Responsible Designer Signature:
Shanley, Barbara
Company:
Date Signed:
HARRISON ENTERPRISES INC dba GENERAL AIR CONDITIONING
2015-09-22 13:28:21
Address:
License:
31-170 RESERVE DRIVE STE A
686310
City/State/Zip:
Phone:
THOUSAND PALMS CA 92276
(760) 343-7488
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A6334145A-000000000-0000 Registration Date/Time: 2015-09-22 13:28:21 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-22 13:27:26
Schema Version: 0.555SDD
Permit #
Project.Addmw.
A P. Number
City ' QUinta
at Safety Div[ m
P.O Box 1504,'78-49S Cde Tampko
4-QWr4 CA 92253 -.-(760) 777-7012
Building Permit APPlicatlon'and Tracking Sheat
Ll� Owner's Now.
Ad&=: KYR
City, ST, Zip: LA QUINTA, CA
Contaactor. GENERAL A/C & HEATING
Tdephoae -
Add=: 31170 RESERVE DRIVE
Ptojea Description:
City- $T• Z* THOUSAND PALMS, CA 92276
iYl kAl -s '
Tc]ePhew- 760-343-7488
— Z
State Lia N : 686310 . COY Lia &
i -
I 44-e I. S
ArciL' EW.. "adgm" ..
• •
. C'Y)
•
� • I�lr dl,e,>Z.
oc�o $-rus
Addrew.
City. ST, zip:
Telephone:
.
Con*uctioa Type- pccupaac,.
State Lia !l:
P''01ca OW (dtde ono): New AWn After Repair Demo
Name of Contact Person: IC K
-
Sq. Ft.;
Stoner.
N unitx
;PATRICK
T��e �' of Qmw P«�+: 760-343-7488
listimated• Valiu of Project , 00
APPLICANT: DO NOT WRITE SHAW THIS UNE
N
Sobmitbl
'd
&—ed
To A........
Plan Seb
Structural CdcL
'rtes: ata.
Mde 24 ales.
Flood plata plan
Grading pin
Sabeontactor Litt
Great Deed
ILO.A. Approval
IN HOUSE,
running Approval
Feb. Wan. Appr
School Feer
Pias Geek $Kmdtted
Rc kwek ready for conecdow
Called Coaaet Person
Peart ekid up
Plant resubmitted
21! Rtvlew, ready for oerr'ectionwitaue
Caged Contact Pcrsos
Plans pteked up
Plant rMbmttted
RcAew, ready for c*"wAostlksne
cow Contact Peasos
Date of permit Esme
PERWr FEES -
item Amount
Plan Check Deposit.
Plan Check Balance
contraction
Mecliadeal
Electrical
Plwbtag .
& LL
Gradlug
Developer fmpdet Fee
Ad.P.P.
Total Permit bees