BMCH2017-037278-495 CALLE TAMPICO Ct 0 D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0372 D' Q fJ
Property Address: 53480 AVENIDA MADERO tJ 11
TA
APN: 774034012 rr
Application Description: HARTSON RESIDENCE / HVAC CHAN Q TAUU 2 5 2017 .
Property Zoning: L— ---.
Application Valuation: $18,844.00 OF COMMUNITY EVE Lop
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.: 6863`10
Date: ? S i CA[ ontractor: `�ci..��s-t�
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. C.).
Lender's
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/25/2017
Owner:
CAROL HARTSON
53480 AVENIDA MADERO
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 COMPENSA-ION DECLARATION
I hereby affirm under penalty of perjury one ct the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 370) 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:
Carrier: INSURANCE COMPANY OF THE WEST Policy 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 soas 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 =700 of the Labor Code, I shall forthwith
comply with those provisions.
_ � e
Datoe-} § 1-7 A p can es
WARNING: FAILURE TO SECURE WORKERS' CCIMPENSATION 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 thi: application.
1. Each person upon whose behalf this appltation 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 tie 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 cance_lation.
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 ordiiances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mgntioned property for inspection purposes.
Date: 8/25/2017
Application Number: BMCH2O17-0372
Owner:
Property Address: 53480 AVENIDA MADERO
CAROL HARTSON
APN: 774034012
S3480 AVENIDA MADERO
Application Description: HARTSON RESIDENCE/ HVAC CHANGE OUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $18,844.00
Applicant:
Contractor:
IE INC
HARRISON ENTEPPRISES INC DBA GENERAL AIR
31225 LA BAYA
31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362
THOUSAND PALMS, CA 92276
(760)343-7488
-----------------------------------------------------------------------------------------------
LIc. No.: 686310
Detail: HVAC CHANGE OUT -.21 SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TC 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
TOTALS: $216.27
r
#
Qty o� Q uin to
Building 8L 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: 53480 Avenida Madero
Owner's Name: Carol Hartson
A: P. Number
Address: 53480 Avenida Madero
Legal Description:
Contractor. General Air Conditioning
City, ST, Zip: La Quinta, CA 92253
Telephone: 760-399-0110
Address: 31170 Reserve Drive
ProjectDescription: Replace 3 ton hea: pump and air handler
City, ST, Zip: Thousand Palms, CA 92276 .
Tele hone.
P • 760-343-7488
State Lie. # : 666310City
Lia #,
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
P
`� .
- `�
Construction Type: , Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Steven Schnierer
Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: 818-735-7876.
Estimated Value of Project: $18,844.00
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check !Balance
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
r' Review, ready for correctiousfissue
Electrical
Subcostattor List
i
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^` Review; ready for correctionsfissne
Developer :cmpact Fee
Planning Approval
Called Contact Person
AXP.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: CAROUHARTSON Date Prepared: 2017-08-24
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
CAROL HARTSON
02
Date Prepared
2017-08-24
03
Project Location
53480 AVENIDA MADERO
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
HOME
SC System
SC System
served
system a
refrigerant
Installing new SC
07
Zip Code
92253`
";+
08
Dwelling Unit Conditioned
1348
by this SC
ducted
containing
system
Floor Area (W)
entirely new
entirely new
Name
S
Number of Space
system?
09
Climate Zone
15 ;'� "
duct system?
Conditioning (SC) Systems in
1
SYSTEM 1
WHOLE HOME
1348
X10'
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information
01
02
03
04
05
i i 06
07
08
09
10
CFA
Is the SCtif t
aJnstalling r ti
` "ate .I rlt
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 (W)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOME
1348
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-A020112017A-000-000-0000000-0000 Registration Date/Time: 2017-08-24 14:57:19
J'
CA Building Energy Efficiency Standards- 2016 Residential Compliance
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-08-24 14:57:19
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
Central gas
All new
Central split
All new
This field or
This field or
SYSTEM 1
furnace
heating
AFUE
0.8
AC
cooling
SEER
21
Setback
section is not
section is not
components
components
applicable
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums:A6 (CZ 1 10,•12 an i3) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are instalie'd 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 4'+ L-
CF2R and CF311-MCH-25-H Refrigerant Charge verification required when refrigerant containing components'are 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
Exce fio ons:
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.
:V — 1:_Ji '(--. ate: , IC -n tS
'+,�' I'c 14 lk -' 'fE ... r ir""(v
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F)
t`IThis section doesn+ot a p y to h s p oject.
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-A020112017A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-08-24 14:57:19
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-08-24 14:57:19
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.
Dnnimentatinn Authnr Name:
nnnin,Qnt3t nn n i.othnr
Stephanie Shryock
Stepha-t P Shryocl,
Company:
Signature Date:
I Permit E Raters
2017-08-24
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
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:
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 respons6lity.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.
i 4 *1 A4 0e 4 ')f - , f.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be madei with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable
�avaiIable
inspections. I understand that a registered copy of this Certificate of Compliarice it required to beIcn uded vwiththe documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
¢t Erl"stall''Stepkia"uetSlyock�(a�tithorv�ed�)
Responsible Designer Signature:
Patrick Somers
Company:
Date Signed:
General Air Conditioning
2017-08-24
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-A020112017A-000-000-0000000-0000
Registration Date/Time: 2017-08-24 14:57:19
HERS Provide r:,CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-24 14:57:19
Schema Version: rev 10/16