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BMCH2017-0140j 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:. 1 1 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: (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: �' 1$ 1'T Applicant: " 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. r 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. -- 6 Date: 4 11? 1-1 Signature (Applicant or Agent): �� VOICE (760) 777-7125 78-495 CALLE TAMPICO U FAX (760) 777-7011 LA QUINTA; CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT s Date: 4/18/2017 Application Number: BMCH2O17-0140 Owner: Property Address: 78101 CALLE NORTE C IRENE FRUEHAUF' APN: 770011049 78101 CALLE NIORTE Application Description: FRUEHAUF / LAST NAME Property Zoning: / HVAC CHANGE OUT - 16SEER/80AFUE SPL LA QUINTA, CA 92253 A ( ! Ill Application Valuation: $11,389.00 \ Applicant: Contractor: j._, ..a o IE INC HARRISON ENTERPRISNC NERAL AIR FIVES 31225 LA BAYA 31170 RES'D WESTLAKE VILLAGE, CA 91362 IBA THOUSAND ALMS, j 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:. 1 1 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: (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: �' 1$ 1'T Applicant: " 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. r 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. -- 6 Date: 4 11? 1-1 Signature (Applicant or Agent): �� Date: 4/18/2017 Application. Number: BMCH2017-0140 Owner: Property Address:y 78101 CALLE NORTE IRENE FRUEHAUF APN: 770011049 78101 CALLE NORTE Application Description: FRUEHAUF / LAST NAME / HVAC CHANGE OUT - 16SEER/80AFUE SPL LA QUINTA, CA 92253 " Property Zoning: Application Valuation:- $11,389.00 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-.16SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARMS) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES. FINANCIAL .• ai 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 0 Bin.# Cray of La Quinta Bonding 8L Safety Division P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit #' Project Address: 78101 Calle Norte Owner'sName:.lrene Fruehauf A. P. Number. Address: 7$101 Calle Norte Legal Description: City, ST, Zip: La Quinta, CA' 92253 Contractor. General Air Conditioning Telephone: 760-771-4667 ;, ;g {w Address: 31170 Reserve Drive Project Description: Replace 2 ton A/C, coil, & 70,000 City, ST, Zip: Thousand Palms, CA 92276 BTU furnace Telephone: 760-343-7488 �s� ., '' State Lie. # : 686310 City Lic, #; Arch., Engr., Designer. j Address: City., ST, Zip: Telephone: P jy 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: 8.18-735.-7876 Estimated Value of Project: $11,389,00. APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd 'Reed TRACMG PERMIT FEES Plan Sets Plan Cheek submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Tide 24 Calci. Pians picked up Construction Flood plain plan Plans resubmitted ' ✓ Mechanical Grading plan V Review, ready for correctionsfissue Electrical Subcostactor List Called Contact Person Plumbing Great Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading ~ IM HOUSE:- '^' Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person Ad-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: IRENE FRUEHAUF I Date Prepared: 2017-04-17 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 IRENE FRUEHAUF 02 Date Prepared 2017-04-17 03 Project Location 78101 CALLE NORTE 04 Building Type Single family 05 CA City LA QUINTA ,,, ;.06 Dwelling Unit Name MARC GREEN SC SC System SC System CFA served u systema z i refrigerant 07 Zip Code 92253 : 08 t Dwelling Unit Conditioned 2793 Location or Area by this SC w containing Floor Area (ft2) more than 40 entirely new entirely new Name Number of Space System (ft2) 09 Climate Zone 15 _ ` 10 Conditioning (SC) Systems in 1 Alteration Type SYSTEM 1 WHOLE HOUSE 2793 this Dwelling Unit: Yes B. Space Conditioning (SC) System Information 01 02 03 04 \%-0 )? 05 Ll— i 06 ' 07 08 09 10 Is the SC C� Installing a, ,ati:j �P V; :A-tt I SC SC System SC System CFA served u systema z i 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 (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type SYSTEM 1 WHOLE HOUSE 2793 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-A020089967A-000-000-0000000-0000 Registration Date/Time: 2017-04-17 10:15:34 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-17 10:15:36 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CFiR-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 o r SYSTEM 1 furnace heating AFUE 80 AC cooling SEER 16 Setback section is not section is not components components applicable applicable Required Documentation:_ CF2R-MCH-01-E - Space Conditioning Systems Vl�111'0, Duct insulation requirement for the new portionsofsupply-airand return -air ducts or plenums R6 ( 12 andi13) and R8 (CZ 11 and 14-16) 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: <=15% or <= 10% leakage to outside, or seal all accessible leaks. > I '11CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components a e, 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: 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. f E. EntirelyNew or Complete Replacement Duct System, with orwithouEqTuiPent Changed t (Sections 150.2 b 1Diia and 150.2 b 1E F) ` This se tioonn do s not appy to the pro ect. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)iC) This section does not apply to this project. Registration Number: 417-A020089967A-000-000-0000000-0000 Registration Date/Time: 2017-04-17 10:15:34 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016. 1.005 Report Generated: 2017-04-17 10:15:36 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CFlR-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. Documentation Author Name: Documentation Author Signature: Patrick Somers PoL&6Ck1S0-wte k Company: Signature Date: General Air Conditioning 2017-04-17 Address: CEA/ HERS Certification Identification (if applicable): 31170 Reserve Drive City/State/Zip: Thousand Palms -Phone: 760,-343-7488 CA 92276p� ' J -tib Responsible Person's Declaration statement 1 . I certify the following under penalty of perjury, under the laws of the State of California: ` r -, y� 1. S 1. The information provided on this Certificate of Compliance is true and correct. A L, ; /. 11 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 manufactu ed 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 Mi "1 available for S. I will ensure that a registered copy of this Certificate of Compliance shall be made avaiIable with the-building:permit(s) slued for the building, and made to the enforcement agency all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Urr C It � C`?PUVCi Responsible Designer Signature: `onEA?Wk Pat -rick Somers k��S�� Company: Date Signed: General Air Conditioning 2017-04-17 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-A020089967A-000-000-0000000-0000 Registration Date/Time: 2017-04-17 10:15:34 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-17 10:15:36 Schema Version: rev 10/16