BMCH2018-002878-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application -Description
Property Zoning:
Application Valuation:
4 Qeuil
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
MECHANICAL/
BMCH2O18-0028
48123 STILLWATER DR
623530002
ROSE /[2] HVAC CHANGE OUT-14SEER SPLIT SYSTEM CONDENSOR
ONLY
$13,914.00
Applicant:
IE INC
31225 LA BAYA
WESTLAKE VILLAGE, CA 91362
u FEB 0 6 20J
C'TYOFUINTA
COMMUNIIYDEVE MQNTDEPAR7MEN
r
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: 2 19 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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/6/2018
Owner:
ROSE ROSS G TRUST
P 0 BOX 462810
ESCONDIDO, CA 92253
Contractor:
HARRISON ENTERPRISES INC DBA GENERAL AIR
31170 RESERVE DRIVE
THOUSAND PALMS, CA 92276
(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;bWork 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 Policy Number: WSD503165802
_ 1 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.
Z s
Date: b 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 FOA 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.
Date: Z Ig Signature(ApplicanYorAgent): �
5,
r,
Date: 2/6/2018
Application Number: BMCH2O18-0028
Owner:
Property Address: • -4B123 STILLWATER DR
ROSE ROSS G TRUST
APN: 623530002
P 0 BOX 462810
Application Description: ROSE /[2] HVAC CHANGE OUT-14SEER SPLIT SYSTEM CONDENSOR ONLY
ESCONDIDO, CA 92253
Property Zoning:
Application Valuation: $13,914.00
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 - [2] 5.TON SPLIT SYSTEM CON DEN SORS ONLY. CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
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 - CONDENSER ONLY
101-0000-42402
0
$78.02
DESCRIPTION
ACCOUNT
QTY,
AMOUNT
HVAC CHANGEOUT - CONDENSER ONLY PC
101-0000-42600
0
$52.02
Total Paid for CHANGEOUT: $130.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
F $98.83
Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
QTY
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 ENHANCEMENT FEE: . $5.00
stn .#
City. Of La QUIf1ta
Bullding 8L Safety Divtslon
P.O. Box 1504,78-495 Calle Tampico
La.Qulnta, CA 92253-:(760) 777-7012 ,
j Building Permit Application and Tracking Sheet
Permit #
&AcA6 %r -ao
Project Address: 48123 Stillwater Drive
Owner's Name:. Ross Rose
A. P. Number.
Address: 48123 Stillwater Drive
Legal Description:
Contactor. General Air Conditioning
City, ST, Zip: La Quinta, CA 92253
Telephone:760-777-9701
Project Description: Replace (2) 5 ton A/C's
Address: 31170 Reserve Drive
City, ST, Zip: Thousand Palms, CA 92276
Telephone: 760-343-7488
State Lie. # : 686310. City Lie, 9:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:1`
• .1 '
State Lie. #:
Construction Type:. Occupancy:
Project type circle one New Add' n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Name of Contact Person: Steven Schnierer
Telephone # of Contact Person:, 818-735-7876
Estimated Value of Project: $13,914.00
APPLICANT: DO. NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMfT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plana picked up
Construction
Flood plain plan
Pians resubmitted.'.Mechanical
Grading plan
r' Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-_
'^' Review;. ready for correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.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 -IR -ALT -HVAC) (Page 1 of 3)
Project Name: ROSS ROSE Date Prepared: 2018-02-05
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
ROSS ROSE
02
Date Prepared
2018-02-05
03
Project Location
48123 STILLWATER DRIVE
04.
Building Type
Single family
05
CA City
La Quinta
•06
Dwelling Unit Name
HOUSE J
07
Zip Code
1,}
92253
system a
'Dwelling Unit Conditioned
Installing new SC
Installing
Installing
_,
f
SUB.
€
Floor Area (ft)3000
Location or Area
by this SC
ducted
1. ` [
system
Number of Space
entirely new
09
Climate Zone
15
10'
Conditioning (SC) Systems in
1
component?
components?
feet of ducts?
duct system?
this Dwelling Unit:
Alteration Type
B. Space Conditioning (SC) System Information }}
01
02
03
04.'
05
+ 06 4
07
08
09
10
Is the SC
Installing a
SC System
SC System
CFA 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?
Alteration Type
Altered space
SYSTEM 1
LOCATION 1
1500
Yes
Yes'
Yes
No
No
No
conditioning system
Altered space
SYSTEM 2
LOCATION 2
1500
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: 418-A020007063A-000-000-0000000-0000 Registration Date/Time: 2018-02-05 11:42:55 HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018 -02 -OS 11:42:57
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CFiR-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
No heating
This field or
This field or
Central split
All new
This field or
This field or
SYSTEM 1
furnace
component
tion it
secs no
section no
tiit
AC
cooling
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
components
applicable
applicable
Central gas
No heating
This field or
This field or ,
Ce tral split
All new
This field or
This field or
SYSTEM 2
furnace
component
section is not
section is not
QAC i
poling
SEER
14
Setback
section is not
section is not
altered
applicable
applicable
`components
applicable
applicable
,
Required Documentation:
ell
CF2R-MCH-01-E - Space Conditioning Systems. iQ
- Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6°(CZ`1-10,, 1l 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 ftof 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 components are installed or altered (applicable in CZ 2, 8-15).
CF2R and CF311-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 fr6 CH -20 Duct Leakaagge Testingreq�uireemmee�nts.
Heating -only systems and Air Handler Furnace changes do not require verificationW Air Flow MCHs23Tbr 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)lDiia and.150.2(b)lE, F)
This section does not'apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC)
This section does not apply to this project.
Registration Number: 418-A020007063A-000-000-0000000-0000
CA Building Energy Efficiency Standards - 2016 Residential Compliance
Registration Date/Time: 2018-02-05 11:42:55
Report Version: 2016.1.006
Schema Version: rev 10/16
HERS Provider: CHEERS
Report Generated: 2018-02-05 11:42:57
CERTIFICATE OF COMPLIANCE CF111-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:
Patty Hernandez
Patty i~ "wwLdek
Company:
Signature Date:
I Permit E Raters
2018-02-05
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive
City/State/Zip:
Phone:
818y7,,735-7876
Westlake Village CA 91362
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
L 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 enforcementagenty.for-appy oval,with this bbwlding permit application.
wc,
for
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be.made available with the building'permlt(s)-i'sued for the building,and made available to the enforcement. agency all applicable
-�.
inspections. I understand that a registered copy of this Certificate of Compliancere isi requirredato be included w'ith h' the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Patrick Somers
Patty i!ie'"---de'k�a,
Company:
Date Signed:
General Air Conditioning
2018-02-05
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: 418-A020007063A-000-000-0000000-0000
Registration Date/Time: 2018-02-05 11:42:55
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2018-02-05 ' 11:42:57
Schema Version: rev 10/16