BMCH2017-0418h-n
78-495 CALLE TAMPICO C` D VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153_
BUILDING PERMIT
Date: - 9/18/2017
Application Number: BMCH2O17-0418 Owner:
Property Address: S365S AVENIDA RUBIO JAN ENGELBRECHT
APN: 774112017 53655 AVENIDA RUBIO
Application Description: ENGELBRECHT RESIDENCE / HVAC CHANGE LtIT n QUINTA, CA 922S3
Property Zoning: u Lam`.
Application Valuation: $11,585.00
SEP 18 2017
Applicant: —J ontractor:
INTA
IE INC CITY0FLAQUARRISON ENTERPRISES INC DBA GENERAL AIR
COMMUNITY DtVELOFMENTDEPARTMENT 1170 RESERVE DRIVE
31225 LA BAYA --
WESTLAKE VILLAGE, CA 91362 THOUSAND PALMS, CA 92276
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
Dr'qiU12k2___Contractorat;"'e:��--�
0j
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
orthe performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's
(760)343-7488
Llc. No.: 686310
WORKER'S COMPENSA-ION DECLARATION
I hereby affirm under penalty of perjury one clf 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' c)mpensation 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 ofrthe 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 th at, if I should become subject to the
workers' compensation provisions of Section _700 of the Labor Code, I. shall forthwith
comply with those provisions.
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 FOE 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 thi:, application.
1. Each person upon whose behalf this appli:ation is made, each person at whose
request and for whose benefit work is perforrred under or pursuant to any permit
issued as a result of this application , the owns, 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 ssuance 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 purpDses.
�l 1ir l Signature (Applicant or Agent): ��
Date: 9/18/2017
Application Number: 6MCH2017-0418
Owner:
Property Address: 53655 AVENIDA RUBIO
JAN ENGELBRECAT
APN: 774112017
53655 AVENIDA RUBIO
Application Description: ENGELBRECHT RESIDENCE / HVAC CHANGE OUT
LA QUINTA, CA 52253
Property Zoning:
Application Valuation: $11,585.00
Applicant:
Contractor.
IE INC
HARRISON ENTERPRISES INC DBA GENERAL AIR
31225 LA BAYA
31170 RESERVE DRIVE
WESTLAKE VILLAGE, CA 91362
THOUSAND PALLAS, CA 92276
(760)343-7488
--------------------------------7--------------------------------=---------------------------
Llc. No.: 686310
Detail: REPLACE HEAT PUMP AND9 DUCTS - 14 SEER/80AFUE SPLIT SYSTEM [2016 ENERGY] CARBON MONOXIDE ALARrA(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2016 CALIFORNIA BUILDING CODES.
f
FINANCIAL ,1,
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATICN BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
CITY,
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - REPAIR/ALTERATION PC
101-0000-42600
0
$5.07
Total Paid for CHANCEOUT: $81.07
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
Bin#
'
City of La Quinta
Building & Safety Division
78-495, Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Shi et
Permit#
Project Address:
S3b5 vcr.
\
l�v��o
Owner's Name: --
o,r� �r el
A.P. Number
Address:
Legal Description:
City, ST, Zip:
Contractor:
Ge-c-1 sA�- Co,_ on
Telephone:
ZcoO. 902-7byc�
Address: 31\70 _�)1esegVo
Project Description: t
,' ,
City, ST, Zip: � �ovsciv.a >o•�un
A nzz��
c=t . \ vL�
Telephone:
State Lic. #: t�b�J l l7
City Lic #:
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type:
Proj. Type I New Add'n
Occupancy:
Alter Repair Demo
State Lic. #:
Name of Contact:
SgFt:
#Stories
# Units:
Telephone of Contact:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Calcs
Reviewed, ready for corrections
Plan Check Deposit:
Truss Calcs
Called Contact Person
Plan Check Balance:
Title 24 Calcs
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrica.:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact.Person
A.I.P.P.
Pub. Wks. Apps
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: JAN ENGELBRECHT Date Prepared: 2017-09-18
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
JAN ENGELBRECHT
02
Date Prepared
2017-09-18
03
Project Location
53655 AVENIDA RUBIO
04
Building Type
Single family
05
CA City
La Ctuinta
06
Dwelling Unit Name
HOME
SC System
SC System
CFA served
systema
refrigerant
Installing new SC'
Installing
Installing
Installing
Dwelling Unit Conditioned
Location or Area
07
Zip Code
92253. '
08
2
Floor Area (ft )
1150
entirely new
Name
:?
System (ft)
system?
component?
components?
,y
y ?,
Number of Space
Alteration Type
09
Climate Zone
15
10
Conditioning (SC) Systems in
1
Yes
No
No
Altered space
conditioning system
this Dwelling Unit:
B. Space Conditioning (SC) System Information .
01
02
03
04
05
06
07
08
09
10
Is th6 SC
Installing -a,
:wz�a''u�i
? with la tepi`ri'p,
SC System
SC System
CFA served
systema
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 (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
SYSTEM 1
WHOLE HOME
1150
Yes
Yes
Yes
Yes
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-A020116833A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2017-09-18 11:49:29
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2017-09-18 11:49:31
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)lE and F)
01
02
03
04
05
06
07
08
09
30
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 split
All new
Central split
All new
Greater than
SYSTEM 1
HP
heating
AFUE
0.8
HP
cooling
SEER
14
Setback
40 feet
R 8
components '
components.
Required 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 (CZ1' 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 n 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. t }' (- 1-11 , (',
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. —'
Exceotions:.,�
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.
E. Entirely New or Complete Replacement Duct System, with or without Equipment ChangeoUt (Sections 150.2(b)1Diia and 150.2(b)lE, F)
Ur-rn; .'raho-d WiT irte-nri��
This section does not apply to this -project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 417-A020116833A-000-000-0000000-0000 Registration Date/Time: 2017-09-18 11:49:29 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-18 11:49:31
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
StPPha^6&Shry0a7v
Company:
Signature Date:
I Permit E Raters
2017-09-18
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip: r
Phone:
Westlake Village CA 91362 ,
818=735-7876
Responsible Person's Declaration statement �.
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 i 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.
., 1 -it 0e__ Ii ) I ?.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building.permit(s.,sued 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 required to be includd w
included the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
i�:^tr7lE3l:i11F"ViK�.?5haau°sh)oc7�(authored)
Responsible Designer Signature:
Patrick Somers
Company:
Date Signed:
General Air Conditioning
2017-09-18
Address:
License: .
31170 Reserve Drive
686310
City/State/Zip:
Phone:
I hOUSand 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-A020116833A-000-000-0000000-0000
Registration Date/Time: 2017-09-18 11:49:29
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-09-18 11:49:31
Schema Version: rev 10/16