BMCH2017-031678-495 CALLE TAMPICO
q LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0316
Property Address: 43790 W W PARKWAY ESPLANADE
APN: 609590028
Application Description: PIPER / CHANGE OUT (1)14SEER/80AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation: $9,500.00
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: 17-011--1 Contractor � 5;=
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
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.
'> 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 Polity 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.
11 Applican T� t
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.
t
Date: 7L 11 Signature (Applicant or Agent)Ci
Date: 7/20/2017
Owner:
LOU PIPER
43790 PARKWAY ESPLANADE
LA QUINTA, CA 92253
o
c
z
o n
Contractor:'
C
HARRISON ENTERPRISES
INC DBA G'ENEB61- AIR
;
31170 RESERVE DRIVE
�m
THOUSAND PALMS, CA 9227fi
—+ C=; ti i c:—=
(760)343-7488
v
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.
'> 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 Polity 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.
11 Applican T� t
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.
t
Date: 7L 11 Signature (Applicant or Agent)Ci
r•,
Date: 7/20/2017
Application Number: BMCH2O17-0316 Owner: .
Property Address: 43790 W W PARKWAY ESPLANADE LOU PIPER
APN: 609590028 43790 PARKWAY ESPLANADE
Application Description: PIPER / CHANGE OUT (1)14SEER/80AFUE SPLIT SYSTEM LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $9,500.00
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- 14SEER/80AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
•-.;'` i DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502.-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: .$5.00
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC)
Project Name:
LOU PIPER I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3).
2017-07-19
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
CF111-ALT-02 document for each dwelling unit.
01
Project Name
LOU PIPER
02
Date Prepared
2017-07-19
03
Project Location
43790 PARKWAY ESPLANADE WEST
04
Building Type
Single family
05
CA City
La Quinta°
06
Dwelling Unit Name
HOME
SC System
SC System
CFA served
Is the SC
systemary
Installing_a
ref�igerant
Inst,ll ng�new SCS
Installing
Installing
Installing
Dwelling Unit Conditioned
Location or Area
07
Zip Code
92253 1 ,
`08
Floor Area (ftp)
2737
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
Number of Space
Alteration Type
09
Climate Zone
15
10 �
Conditioning (SC) Systems in
1
Altered space
this Dwelling Unit:
WHOLE HOME
B. Space Conditioning (SC) System Information i l'
01
02
03'
04 '�=#
1-i Ij OS (---�
U6\�
07
08
09
10
SC System
SC System
CFA served
Is the SC
systemary
Installing_a
ref�igerant
Inst,ll ng�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
Altered space
SYSTEM 1
WHOLE HOME
2737
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020104134A-000-000-0000000-0000
Registration Date/Time: 2017-07-19 14:18:49
HERS Provider: CHEERS
CA Buildi ng Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-19 14:18:50
Bin`rr
Permit ,'
Project Address: -12)790
"
�tt of La Qui tto
Building 8F Safety Division
78-495 Calle Tampico
La Quinea, CA 92253 (760) 777-7012
Building Permit Application and Tracking Sheet.
e�•.�e5� Owner'sNamc: L
A. P. Number:
Address: L} 3.79D by r�<wa l—S I
Legal Description:
City, ST, Zip: CA 9z -z53
a -
ontr ct r
C o. �n r A �
al r d�
�%%
Telephone: fa O —
e ho e.
Tel -
5 � o`I0 S. loin=
P 8
\
Address: 31110 etve �c
Project Description: a�Q 3, 5 (yp"
City, ST, Zip: 9Zzi
_..__..._._ 'arnhG� YY1S CA
C qD B. t�
h c -
Teleon .7 8$
P �3
State Lic. # : (0%631 O
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
=
Occupancy:
tructi n Type: an cY
Lic. #-
dd'n Alter Repair r
Demo
Project (circle one), A
Name of Contact Person: Sd e�,e y� 5�1;
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Zk g- 722)5- 78 7Ce
Estimated Value of Project: Cj "5-0 0, CO
APPLICANT: DO NOT WRITE BELOW THIS LINE
t/
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact person
Plan Check Balance.
Tit!e 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrcctions/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.T.
Ii.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
''d Reyieiv, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
nate of permit issue
School Fees,
Total Permit Fees
•