BMCH2017-0096W
78-495 CALLE TAMPICO Ct 0 D �NNNCl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
W1DING PERMIT
D Q �
Application Number: BMCH2O17-0096
Property Address: 78062 CALLE NORTE MAR 31 2017
APN: 770012035
Application Description: DELANEY / HVAC CHANGE OUT 1 SE
Property Zoning: COI
Application Valuation: $4,015.00
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 i Contractor:
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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: 3/27/2017
Owner: ,
RON DELANEY
78062 CALLE NORTE
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.
1 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 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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Applicant:tryt
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 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 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 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.
Date: Signature (Applicant orAgent
I
Application Number:
BMCH2O17-0096
Property Address:
78062 CALLE NORTE
APN:
770012035
Application Description:
DELANEY / HVAC CHANGE OUT 14 SEER
Property Zoning:
Application Valuation:
$4,015.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
Date: 3/27/2017
Owner:
RON DELANEY
78062 CALLE NORTE
LA QUINTA, CA 977253
Contractor:
HARRISON ENTER?RISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALIVE, CA 92276
(760)343-7488
Uc. 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
$76.00
DESCRIPTION
ACCOUNT
IQTY
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
S02-0000-43611
0
$S.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
RON DELANEY I Date Prepared:
CFSR-ALT-02-E
(Page 1 of 3)
2017-03-23
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF111-ALT 02 document for each dwelling unit.
01
Project Name
RON DELANEY
02
Date Prepared
2017-03-23
03
Project Location
78062 CALLE NORTE
04
Building Type
Single family
OS
CA City
LA QUINTA
.06
Dwelling Unit Name
RON DELANEY
07
Zip Code
92253
'
Dwelling Unit Conditioned
2412
more than 40
entirely new
entirely new
Floor Area (ftp)
Served
System (ft2)
system?
component?
components?
Number of Space
duct system?
09
Climate Zone
15
10
Conditioning (SC) Systems In
1
Yes
Yes
No
No
this Dwelling Unit:
Altered space
B. Space Conditioning (SC) System Information
03
02
03
04
05
06
07
08
09
10
SC System
SC System
CFA served
Is the SC
system a "`'
InstallIng a'
refrigerant
,.
Installing new SCS
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLEHOUSE
2412
Yes
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: 417-A020086890A-000-000-0000000-0000
Registration Date/Time: 2017-03-23 15:11:09
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-23 15:11:11
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-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
0S
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
RequiredNew
or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat['�
eplaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type
Value
Type
uct Length
R -Value
Central gas
No heating
This fleld or
This field or
Central split
This field or
This field or
SYSTEM i
furnace
component
section is not
section is not
AC
Fancoil AHU
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
applicable
applicable
Reouired Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- 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 CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed Iniiucted 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.
CUR 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.
Excentions.
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Test)ng requirements.
Heating -only systems and Air Handier Furnace changes do not require vert lcation 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 Dud System, with or twithou�t
Equipment Changeout (Sections 150.2(b)iDita and 150.2(b)lE, F)
Thls'section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)X)
This section does not apply to this project.
Registration Number: 417-A020086890A-000-000-0000000-0000
Registration Date/Time: 2017-03-23 15:11:09
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-23 15:11:11
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
1.1 certify that this Certificate of Compliance documentation Is accurate and rnmplete,
Documentation Author Name:
Documentation Author Signature:
Patrick Somers
Patrick Somers
Company:
Signature Date:
General Air Conditioning
2017-03-23
Address:
CEA/ HERS Certification Identification (if applicable):
31170 Reserve Drive
City/State/Zip: 3rtr''
Phone:
Thousand Palms CA 92276 y
760=343-7488
Responsible Person's Declaration statement
1 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. 5`
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 agencyfor approval with this building permit application.
S. I will ensure that a registered copy of this Certificate of Compliance shall be m8'de ava fable with the bulldin'' 1rmit(s) Issued for the building, and made available to the enforcement agency for all applicable
Inspections. l understand that a registered copy of this Certificate of CompliP ce Is requlredto be'incl`uded with�the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
t),1i`' y tz '' f` ''Patrick'Siim'ers
Responsible Designer Signature:
Patrick Somers
Company :
Date Signed:
General Air Conditioning
2017-03-23
Address:
License:
31170 Reserve Drive
686310
City/State/Zlp:
Phone:
Thousand Palms CA 92276 1760-343-7488
Digitally slgred 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-A020086890A-000-000-0000000-0000 - Registration Date/Time: 2017-03-23 15:11:09 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-03-23 15:11:11
Schema Version: rev 10/16
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