BMCH2017-042478-495 CALLE TAMPICO Ct 0 U �NMUCl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: MECHANICAL/
Application Number:
BMCH2O17-0424
Property Address:
79328 ROSE DAWN
APN:
600420021
Application Description:
HALL/ HVAC CHANGEOUT 14SEER/ .8 AFUE SPLIT SYSTEM
Property Zoning:
Application Valuation:
$9,973.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
1N3Jt'1dHddG�\^cf-c'0�32'QAl- INGI�f��;00
btR i`1C' "1 d0 an
11010 9 d3S
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter -9
(commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: License No.: 686310
Da-te'. 91 2-0 i1 Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for thefollowing 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).:
(1 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 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 Na
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/20/2017
Owner:
FRED HALL
, 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276,
(760)343-7485
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 certifiote of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
o e work for which this permit is issued.
I have and will maintain workers%ompensation insurance, as required by
Section 3700 of the Labor Code, for the perbrmance of the work for which this permit is
issued. My workers' compensation. insurance carrier and policy number are:
Carrier: INSURANCE COMPANY OF THE WEFT 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 :o as to become subject to the workers'
compensation laws of California, and agree :hat, if I should become subject to the
workers' compensation provisions of Sectio 13700 of the Labor Code, I shall forthwith
comply with those provisions.
�_..a r '
Date: 7-0 1 `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 tothe 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 perfo-med under or pursuant to any permit issued
as a result of this application, the owner, arrd the applicant, each agrees to, and shall
defend, indemnify and hold harmless the Citi( of La Quinta, its officers, agents, and
employees for any act or omission related tc the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this app'ication 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 cancellatbn.
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 represertatives of this city to enter upon the above-
mentioned property for inspection purposes .�
Date`: -, t Signature (Applicant or Agent)-. _C —�
Date, 9/20/2017
Application Number: BMCH2017-0424
Owner:
Property Address: 79328 ROSE DAWN
FRED HALL
APN: 600420021
Application Description: HALL/ HVAC CHANGEOUT 14SEER/ .8 AFUE SPLIT SYSTEM
92253
Property Zoning:
Application -Valuation: $9,973.00
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=7483
------------------ ------------------------------------------------------------------------
Llc. No.:.686310
Detail: HVAC CHANGE OUT - 14SEER/.8AFUE SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
FINANCIAL
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 IgSUANCE: $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
t
Bin .#
City. of La Quints
Building & SafetyDivision
P.O. Box 15Q4,'78-495 Calle Tampico
1.4.Quinta, CA 92253 -:(760) 777-7012
�yBuilding Permit'Application'and Tracking Sheet
Permit #
Project Address: 79328 Rose Dawn
Owner's Name:. Fred Hall
A P. Number.
Address: 79328 Rose Dawn
Legal Description:
City, ST, Zip: La Quints, CA 92253
Contractor:1st
General Air Conditioning
"
Telephone: 760-972-4444
Address: 31170 Reserve Drive
Project Description: Replace 3 ton A/C, coil, & 70,000 BTU
City, ST, Zip: Thousand Palms, CA 92276
furnace
Telephone: 760-343-7488
State Lie. # : 686310
City Lie. 9.,
Arch., Engr., Designer
Address:
City, ST, zip:
Telephone:
State Lia #:
Name of Contact Person: Steve n Sc hnierer
Construction Type: . O=pancy:
Pro1ect type a ( cucle one): New Add'n Alter Repair Demo
) p
Sq.'FL:
#Stories: #Unit:'
Telephone # of Contact Person: 818-73577876
Estimated Value of Project: $9,973.00 .
APPLICANT: DO NOT WRITE BELOW THIS LINE
it
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Cheek Deposit. .
Truss Cates.
Called Contact Person
Plan Check 3alance
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.-.
Mechanical
Grading plan
r' Review, ready for correctionsrissue
Electrical
Subcoatactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"` Review; ready for correetionslissue
Developer hapset Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr '
Date of permit Issue
School Fees
Total Perndt Fees
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
FRED HALL I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3)'
2017-09-19
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
CF1R-ALT-02 document for each dwelling unit.
01
Project Name
FRED HALL
02
Date Prepared
2017-09-19
03
Project Location
79328 ROSE DAWN
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
y _`�
92253
'08�
Dwelling Unit Conditioned
1523
by this SC
ducted
j r
system
Floor Area (ft)
entirely new
entirely new
[W
Served
Number of Space
system?
09'
Climate Zone
15
10
Conditioning (SC) Systems in
1
SYSTEM 1
WHOLE HOME
1523
Yes
this Dwelling Unit:
Yes
B. Space Conditioning (SC) System Information
01
02
03
04 '`
� 05 j.!--�
x..
i� I U6"� :'�
07
08
09
10
CFA
Is the SC
Q rt
Installing.a
at� -i 4�u - r Vi
r'ra With lnte tri? j
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 (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
I Alteration Type
SYSTEM 1
WHOLE HOME
1523
Yes
Yes
Yes
No
. No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020117059A-000-000-0000000-0000 Registration Date/Time: 2017-09-19 11:32:23 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-19 11:32:24
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CF111-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
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
14
Setback
section is not
section is not
components
components
applicable
applicable.
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems
- Duct insulation for the ducts i26{CZ 1 10, STand.13) R8 11 14-16)
requirement new portions of supply -air and return -air or plenums and (CZ and
CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed in.ducted.rystems, 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...';
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing c'omponents,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. it
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, o� Refrigerant Charge MCH -25.
-Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements.
ir�err i
E. Entirely New or Complete Replacement Duct System, with or without'Equipment Changeout (Sections 150.2(b)lDiia and 150.2(b)lE, F)
Thissec section doesn ap ly to this -project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)!C)
This section does not apply to this project.
Registration Number: 417-A0201170S9A-000-000-0000000-0000 Registration Date/Time: 2017-09-19 11:32:23 HERS Provider: CHEERS
CA Building Energy Efficiency Standards = 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09=19 11:32:24
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 complete.
Documentation Author Name:.
Documentation Author Signature:
Stephanie Shryock
stepha*,u Shryoci,
Company:
Signature Date:
I Permit E Raters
2017-09-19
Address: -
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip: j�
Phone:
Westlake Village CA 91362 1
818735-7876
Responsible Person's Declaration statement, cs
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 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-appmal,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'permit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections: I understand that a registered co of this Certificate of Compliance is're required to be included with�the documentation mentation the builder provides to the building owner at occupancy.
P g PY P q P g
Responsible Designer Name: UnmuResponsible
`�''1' 7l'StejTia'rue�Shryock
Patrick Somers
Designer Signature:
(atiu�+orvaeci)
Company:
Date Signed:
General Air Conditioning
2017-09-19
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-A020117059A-000-000-0000000-0000 Registration'Date/Time: 2017-09-19 11:32:23 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-19 11:32:24
Schema Version: rev 10/16