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('bi{'� d City of Arcadia, CA .. Permit NO. Meeh-19-1263 \ \ Development Services Department D'i„....:.--,-)- `` '-^✓'-'�r` It p Permit Type:Mechanical f 240 West Huntington Drive,Post Office Box 60021 x 1 ; I I!Ef � ,__1-. Arcadia,CA 91066-6021 1 ! -J U 1 f V Ii ill Work Classification:HVAC Repair/Replace -�' `J l (626)574-5416 - - - Permit Status:'Issued •rt z. ARCADIA Issue Date:07/02/2019 I Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1112 La Cadena AVE 2 Arcadia,CA 5778009101 Contacts GRIEST,WILBUR JR AND MARY TRS Owner BRYANT HEATING&AIR Contractor GRIEST FAMILY TRUST CONDITIONING' 1112 LA CADENA AVE 1350 Las Tunas DR,San Gabriel,CA 917761706 (626)286-1141 948151 Description:REPLACE EXISTING HVAC,SAME LOCATION Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Compressor<3 Ton(up to 3 hp) $19.86 Total Fees $87.73 Furnace or Burner<=100,000 BTU $19.86 Cash/Receipt#REC-01713-19 $87.73 Mechanical Permit Issuance Fee $47.01 Solid Waste Management Fee 2 $1.00 Amount Due: CO $0.00 Total: g-Z 69 $87.73, o OM L T D PAete-, ?Fere-e'en-0 44 E. i.. S. jfPoxr 1 .,.. CALLS FOR INSPECTIONS Macs P 1d0a. rO0 t . Request for inspection by telephone at 626-574-5450. Leave a message / , requesting the address,timeframe and what inspection item is needed. This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. 1 July 02,2019 Issued By: Date July 02,2019 Page 1 of 1 AR iov R PERMIT/PLAN REVIEW APPLICATION • -444 tts• Z' Development Services Department,240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416, Fax(626)447-9173 City of - k Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION a I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C 42 Cs St; ense No. _ �/s 1 Exp. Date 6`16-z45 compensation, as provided for by Section 3700 of the Labor Code, for the /1�/cperformance of the work for which this permit is issued. Signature of Contractor V nag, OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued. workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier el't7C11YI14411,� demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number a i50(Sd 73 for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): 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 ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with hose provisions. 71 compensation,will do the work and the structure is not intended or offered for 7—2_t G� sale(Section 7044,Business and Professions Code:The Contractors License Date Signam ��afr Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING:Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. _ 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909) 396-2000 kr-' further information.�J� Name ( ,USS `t t S t2-0C) Title PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above- 'oned property for inspection purposes. p Signature ,......"--9C-44.,......"--9C-44.-44,..0�, Date 7-2— t / 1112•La Cadena Ave , ,;:_c? r •tal .y t r- d 1 ..e.'4, ;-c.' _ • a rr• I. G �q ' I 0 , moo,_ "atm, t;_ 2 t. . w, 11 !!' v;` , , �' c r, ., y4: ,; �l i1 b 4 'R ` l.,''r, tA�.' A ..r a F�..#�?Y't >$ n ,..,:rt i'� -' •, G S_`, -I '! I a_ 8 G ,c I j5-1 'c5� '# � ^ �:r� � t 9998 ( A7.�m t ♦ . •a4vT•(" rr� y, i t .ia , l I - a.t .SC.. ..r SJ`� 'V"r tee,) . �� \ `ran¢ 1 �` .. r _ - - - —L•_.—Se. 1 ,�...e ` ) G. y z. • ->- Baa . Google= .T„ r_~ r _ Imagery©2019 Google,Map data©2019 Google 20 ft, ` ® FU \\\ j i Litt:tett s=3.5. AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND ,CARBON MONOXIDE, / ALARMS Property Address: ///Z 2,4 [_�9Ate0Ag,g'L't, #3, l � 'e //� al 9/D7 Permit Number:/*€4c l- 47---/26- Brief f�/4 -Brief Job Description: /7/7/9g- ,/&,oft r Number of smoke alarms installed: Number of carbon monoxide alarms installed: When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. http://osfm.fire.ca.qov/licensinglistings/licenselistinq bml searchcotest.php As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) 4l11'O5tj'?, 29,19 at Arcadia, California. Owner's Name (printed/ted): //ixiSe lie' 72*:.- 67,2/6:67- s,rz'AK Ce/3. - Signature of Owner:'°""` � ' This affidavit must be returned to the City of Arcadia inspector prior to final inspection SMOKE ALARM AND CARBON MONOXIDE ALARM LOCATIONS Guest Room .61"c IDSatin•ou Storage Family Room •Garage FIRST FLOOR PLAN 110= SMOKE ALARM , = CARBON MONOXIDE ALARM I I IMI r Mstr L � Bath Pi Master Bedroom Dining Room Kitchen Bath C3 Hall 2 Q Closet _ I Closet Closet Family Room C — — Bedroom- I3cdroom SECOND FLOOR PLAN 110=SMOKE ALARM I = CARBON MONOXIDE ALARM 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 I 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 All new All new This field or This field or System 1 Central gas heating '' AFUE 0.8 Central split cooling SEER 14 - Setback section is not section is not furnace components AC components applicable applicable Required Documentation: -,:%'' , rrl I1It CF2R-MCH-01-E-Space Conditioning Systems I r k\-F!'1 ' - s1.=_ Z1- Jam:. -Duct Insulation requirement for the new portions of supply-air and return-air ducts or plenums:R6.(C21-10;_12iand 13)and R8(CZ 11 and 14-16) CF2R and CF3R-MCH-20-H-Duct Leakage Test required when heating or cooling components are(nstalle l.in ducted systems,or when more than 40 ft of duct length is replaced - -Leakage rate compliance:<=15 percent or<=10 percent leakage to outside,or seal all accessibleilealWiV iii ��ti 11• CF2R and cF3R-MCH-25-H Refrigerant charge verification required when refrigerant containing componentsiarre 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. `1,1‘.144'�` !j Exceptions: ,k�• : /,/,`"r . -Duct systems registered with HERS provider as previously sealed are exempt from MCH-20 Duct Leaka4 ge: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. , 11-AV - %. .. I II li I 14, L fL-- I it d I e-�i E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1Diia and 150.2(b)1E,F) • • 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:419-A020067613A-000-000-0000000-0000 Registration Date/Time:2019-07-01 10:52:28 HERS Provider:CHEERS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2019-07-01 10:52:28 Schema Version:rev 20180426 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: Griest,Wilbur Date Prepared: 2019-07.01 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 documeht for each dwelling unit: - - - - - - - 01 Project Name Griest,Wilbur 02- Date Prepared 2019-07-01 - - 03 Project Location- . "- 1112 La Cadena Ave#2 -04- Building Type Multi-family - - OS CA City Arcadia '- -06 Dwelling Unit Name Griest,Wilbur -- - - -- C lir n... . _ - - II Y�'%S Dwelling Unit Conditioned • 07 Zip Code 91007 Il `�^-: 08 .p Z ... 1599 - - illy. fnr_ i Floor Area(ft ) -- - ?,,C iji {r 1114 Number of Space 09 Climate Zone 9 10.. Conditioning(Sc)Systems in 1 ,f; ;r this Dwelling Unit: • E.Space Conditioning(SC)System Information /� t� TJ e i 5 n 11..._ 11 I n I 4 01 02 03 • • 04' a G o5 a— I L I O6', •l --,'- 07 08 09 10 Is the SC Installinga 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_ - System 1 Location 1 1599 Yes • 'Yes ' . Yes " • No No ' No Altered space " - 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:419-A020067613A-000-000-0000000-0000 Registration Date/Time:2019-07-01 10:52:28 HERS Provider:CHEERS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2019-07-01 10:52:28 Schema Version:rev 20180426 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1. I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Margie Pisano Ma gie-Piaano- Company: Signature Date: Middleridge Concepts Inc.dba Bryant Heating&Air Conditioning 2019-07-01 Address: CEA/HERS Certification Identification(If applicable): 1350 East Las Tunas Drive City/State/Zip: Phone: San Gabriel CA 91776 ?i "Ei 626=286-1141 Responsible Person's Declaration statement (G�% � fir I certify the following under penalty of perjury,under the laws of the State of California: �i 1 1. The information provided on this Certificate of Compliance is true and correct. �y.,\ Li19 2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility.for therebuilding 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. --=f 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 agencyifoe)appiroval with this building pint application. S. I will ensure that a registered copy of this Certificate of Compliance shalllbemadeJava, re`d- ilable-With the building p`rmit(s)issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a registered copy of this Certificate of Cbmpiiande isirequito bei eluded with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Margie Pisano Matgte'PGsano- Company: Date Signed: Middleridge Concepts Inc.dba Bryant Heating&Air Conditioning 2019-07-01 Address: License: 1350 East Las Tunas Drive 948151 City/State/Zip: Phone: San Gabriel CA 91776 626-286-1141 ' Digitally signed by CHEERS'TM. 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:419-A020067613A-000-000-0000000-0000 Registration Date/Time:2019-07-01 10:52:28 HERS Provider:CHEERS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2018.0.001 Report Generated:2019-07-01 10:52:28 Schema Version:rev 20180426