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BMCH2017-043878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 C& 4 Xi� QuIAZ DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: MECHANICAL/ Application Number: BMCH2O17-0438 Property Address: 78765 NOLAN CIR APN: 604233022 Application Description: HERTZBERG RESIDENCE / HVAC Property Zoning: Application Valuation: $9,868.00 Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 QCT 0 3 2017 CfrY OF LAQUINTA 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: C20. C36 . License No.: 686310 LDate: 101.3 1'7 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: 10/3/2017 Owner: ALEX HERTZBERG 78765 NOLAN CIF LA QUINTA, 922E3 Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 Llc. No.: 686310 WORKER'S COMPENSATAN DECLARATION I hereby affirm under penalty of perjury one ofthe 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 perfornance 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 thac, if I should become subject to the workers' compensation provisions of Section 3-00 of the Labor Code, I shall forthwith comply with those provisions., Date: )� '-� I� 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 ACKNOV7LEDGEMENT 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 Quints, its officers, agents, and : employees for any act or omission related to th? 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 stare that the above information is correct. I agree to comply with all city and county ordin antes and state laws relating to building construction, and hereby authorize representat ves of this city to enter upon the above-mentioned property for inspection purposes. r Date: �� Signature (Applicant cir Agent): �� Date: 10/3/2017 Application Number: BMCH2O17-0438 Owner: Property Address: 78765 NOLAN CIR ALEX HERTZBERG APN: 604233022 78765 NOLAN CIF Application Description: HERTZBERG RESIDENCE / HVAC CHANGEOUT LA QUINTA, 92253 Property Zoning: Application Valuation: $9,868.00 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/80 AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TG FINAL INSPECTION. PER 2016 CALIFORNIA BUILDING CODES. FORMATION DESCRIPTION ACCOUNT tQTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATIOV 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 QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $98.83 Total Paid for PERMIT ISSUANCE:. $98.83 DESCRIPTION ACCOUNT D.TY 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 ENHANCEMENTFEE: $5.00 Bin. # Cliy, Of La Qu(nta Building 8T Safety Division � 1-31e P.O. Box 1504, 78-495 Calie Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and.Tracking Street Permit # Project Address: 78765 Nolan Circle Owner'sName:.Alex Hertzberg A. P. Number. Address: 78765 Nolan Circle Legal Description: City, ST, Zip: La Quinta, CA 92253 Contractor. General Air Conditioning sx. gam' :�::s? ' Telephone: Address: 31170 Reserve Drive Project Description: Replace 3.5 ton A/C; coil, & 90,000 City, ST, Zip: Thousand Palms, CA 92276. BTU furnace Telephone: 760-343-7488 City Lia i/,: State Lic. # : 686310 Arch., Engr., Designer. Address: City., ST, Zip: Telephone:v Construction Type:. Occz_pancy: State Lic. #:�;� Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Steven Schnierer Sq. Ft : # Stories: #Units: Telephone # of Contact Person: 818-7354876 Estimated Value of project: $9,868.00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG ?ERMIT FEES Plan Sets Plan Check submitted Item Amount. Structnrai Cates. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Pian Check Stance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2i° Review, ready for correctiousrissue Electrical Subcontactor List Called Contact Person Plumbing Grout Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading . IN SOUSE:- ''d Review; ready for corrections/issue Developer Impaet Fee Planning Approval, Called Contact Person Ad.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit lees CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC) (Pagel of 3) Project Name: ALEX HERTZBERG I Date Prepared: 2017-09-29 A. General Information CF1R-ALT-02 is applicable to multiple space conditioning Systems contained within a singlp dwplling unit VVhpn mnitirle dwelling Units must be documented, use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name ALEX HERTZBERG 02 Date Prepared 2017-09-29 03 Project Location 78765 NOLAN CIRCLE 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name HOME 07 Zip Code 92253" systema Dwelling Unit Conditioned 1626 Installing Installing T< r, i X08 Z Floor Area (ft ) Location or Area. by this SC ducted ".) system Number of Space entirely new 09 Climate Zone 15 10' Conditioning (SC) Systems in 1 component? components? feet of ducts? ° this Dwelling Unit: Alteration Type B. Space Conditioning (SC) System Information E " R7 17 1 C' 01 02 03 04 ' 05y ; U6 07 08 09 10 Is the SCnn o�lnstal ing a„ $ : j At'ii�j SC System . SC System CFA served systema refrigerant Installin g 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 (ft) system? component? components? feet of ducts? duct system? SC system? Alteration Type SYSTEM 1 WHOLE HOME 1626 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-A020119315A-000-000-0000000-0000 Registration Date/Time: 2017-09-29 09:56:10 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006. Report Generated: 2017-09-29 09:56:11 Schema Version: rev 10/16 c. CERTIFICATE OF COMPLIANCE CF1R-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)1E and F) 01 02 03 04 05 06 07 08 09 10 it 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 14 Setback section is not section is not components components applicable applicable Required Documentation: CF2R-MCH-03-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 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 (• I - CF2R 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. 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. t(__' I If"..,1a.` E. EntirelyNew or Complete Replacement Duct System, with or E' ui i ent Chan a ut Sections 150.2 b 1Diia and 150.2 b 1E F) P P Y q P g ( () () , t.-ilr_►raU'h *0 `;;Arvin' -A .i<% lftlorit�" 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: 417-A020119315A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time: 2017-09-29 09:56:10 Report Version: 2016.1.006 Schema Version: rev 10/16 HERS Provider: CHEERS Report Generated: 2017-09-29 09:56:11 CERTIFICATE OF COMPLIANCE MR -ALT -024 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 stephawue.shryoclo Company: Signature Date: I Permit E Raters 2017-09-29 Address: CEA/ HERS Certification Identification (if applicable): . 31225 La,Baya Drive City/State/Zip:y r'` : Phone: Westlake Village CA 91362$ti 818735-7876 Responsible Person's Declaration statement t 1 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 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 a gency forr`app�roval:with this building permit application. S. I will ensure that a registered copy of this Certificate of Compliance shall be;made;available with the�building p r'mit(s ued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is regwred'to be included with'the documentation the builder provides to the building owner at occupancy. Responsible Designer Name:Responsible,Designer Unm=had S i tr Patrick Somerss Signature: i ha u?v SyuyAock, (autYwr v eci) Company: Date Signed: General Air Conditioning 2017-09-29 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: 4177A020119315A-000-000-0000000-0000 Registration Date/Time: 2017-09-29 09:56:10 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-29 09:56:11 Schema Version: rev 10/16