BMCH2015-029852224 Avenida Madero
BMCH2015-0298
1
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
}a
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BMCH2O15-0298
52224 AVENIDA MADERO
773242001
HVAC CHANGE OUT
$6,000.00
Applicant:
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT, CA 92261
r 4 kQ rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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: C20se No.: 619091
Date -) 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 Name: -
Lender's Address:
k
VOICE (760) 777-7125
r FAX (760) 777-7011
INSPECTIONS (760)•777-7153
Date: 7/31/2015
Owner: r
MARK FLOREK
PO BOX 7062
LA QUINTA, CA 92253
Contractor:
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT, CA 92261
(760)347-1212
Llc. No.: 619091
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjuryone 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:— Policy Number: _
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 p o` sioAj,
Dat Applies — cant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 sentatives of this city to enter upon the above•
mentioned propeYfongpelo purposes.
amt-il®'.-- Signature (Applicant or "Agent,:'.
r
FINANCIAL INFORMATION
s 3;43DESCRIPTION, i;ACCOUNTFAMOUNT -" rig °a PAID"' ` PAID -.DATE;
E x 4
BSAS SB1473 FEE
101-0000-20306 0. $1.00 $1.00 7/31/15
PAID,_BY M
t. .' METHOD s ` . RECEIPT # r ' CHECK # ', E CLTD BY
` . I
PALOMA AIR CONDITIONING
CHECK R8143 0025142 EVA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
-tDESCRIP,TION a
u ACCOUNT' M `r
AMOUNT ';yry
PAID, r
PAID DATE
!'QTY'
4
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$72.52
$72.52
7/31/15
` PAID'$Y'a 'r
, . TMETHOD 4
E RE CEIPT#'rs
a . '
CHECK #
CLTD BY
a .
,-
PALOMA AIR CONDITIONING
CHECK
R8143
0025142
EVA
' : DESCRIPTION
tACCOUNT,h `
QTYdAMOUNT
'PAID #
"PAID DATE;
r
n j
;,.°<
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$36.26
$36.26
7/31/15
ix '.
PAID"BY "-E. s .
e METH°OD m
iRECEIPT #CFI
?
CHECK #,-
CLTD BY
a k
, _ E. , .
s_
PALOMA AIR CONDITIONING
CHECK
R8143
0025142
EVA
Total Paid forCHANGEOUT: $108.78 $108.78
DESCRIPTIONkaACCOIJNTxi
3
`r AMOUNTS
" PAID,'
'PAID DATE
r,
yQTYx
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
7/31/15
PAID BY '
x r `METHOD
y ' RECEIPT #
CHECK #x`.
CLTD BY
PALOMA AIR CONDITIONING
CHECK
R8143
0025142
EVA
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
TOTALS:
µl
pl
u
csnr0F..7a 'v v.
6.
Description -.'HVAC CHANGE OUT
Type: MECHANICAL Subtype:
Status: UNDER REVIEW
Applied: 7/31/2015 EVA
Approved:
Parcel No: 773242001 Site Address: 52224 AVENIDA MADERO LA QUINTA,CA 92253 —
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 41
Lot: 1 r
Issued:
UNIT 3
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $6,000.00- Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
CONTACTS
Details: HVAC CHANGE OUT - 13 SEER / 78 AFUE SPLIT SYSTEM [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES:
N AME TYPE
NAME` - '
}
Printed: Friday, July 31, 2015 11:04:07 AM 1 of 2
- srsreMs
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
N AME TYPE
NAME` - '
ADDRES51
CITY=x STATE
• ZIP " ti 'PHONE FAXu' EMAIL
:
2 F
,...
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o.
APPLICANT
PALOMA AIR CONDITIONING
P 0 BOX 3501
PALM DESERT
CA
92261
CONTRACTOR
PALOMA AIR CONDITIONING
P O BOX 3501
PALM DESERT
CA
92261
OWNER
MARK FLOREK
PO BOX 7062
LA QUINTA
CA
92253
Printed: Friday, July 31, 2015 11:04:07 AM 1 of 2
- srsreMs
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P,; DESCRIPTION, c, 0
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.,QTY
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*T AMOUNT
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PAID ."
a .w.
PAID DAT
.'
RECEIPT#`
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e`CHECK#+;'
µlr
METHOD
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PAIDBYFx',
.; yr.
.. ,, ' .tee
•
(: s::
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$72.52
7/31/15
R8143
0025142
CHECK
PALOMA AIR
-EVA
SPLIT -SYSTEM
CONDITIONING
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$36.26
7/31/15
R8143
0025142
CHECK
PALOMA AIR
EVA
SPLIT -SYSTEM PC
CONDITIONING
Total Paid forCHANGEOUT:
$108.78
$108.78
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
7/31/15
R8143
0025142
CHECK
PALOMA AIR
EVA
CONDITIONING
Total Paid for PERMIT ISSUANCE:
$91.85
$91.85
SEQID INSPECTION TYPE INSPECTOR'. -
SCHEDULED .COMPLETED RESULT }
a'REMARKS
NOTES
r _
u.
DATE_
DATE
w _
MECHANICAL FINAL" BLD
PARENT PROJECTS
BOND
INFORMATION
ATTACHMENTS
,Printed: Friday, July 31, 2015 11:04:07 AM 2 of 2 `
SYSTEMS
CERTIFICATE OF COMPLIANCE
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Florik Joe Date Prepared: 2015-07-30
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
Florik Joe
02
Date Prepared
2015-07-30
03
Project Location
52-224 Ave. Madero
04
Building Type
Single family
05
CA City
La Quinta
06
Dwelling Unit Name
Florik Joe
07
Zip Code
92253
U8
Dwelling Unit Conditioned
1600
Installing new SC
' Instilling I
installig
'Installing
Floor Area (ft2)
Identification or
Location or Area
by this SC
ducted
containing
Number of space conditioning
more than 40
09
Climate Zone
15
10
(SC) systems in this dwelling
1-
system?
component?
components?
feet of ducts?
unit.
SC system?
B. Space Conditioning (SQ System Information
-r7,
01
02
03 `
04'z
!i ^, 05 f y
r 06; —
t , 07-J .
? ° 08
09
10
' Is the SC'Installing
a"
"
'-
SC System
SC System
CFA served
`%,system a}-,-,;
r frige'rant
Installing new SC
' Instilling I
installig
'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
Entirely new or
System 1
Whole House
1600
No
Yes
Yes
No
No
Yes
complete
replacement 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: 215-A0211164A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-07-30 15:13:32
Report Version: 2014-03-31
Schema Version: 0.S55SDD
HERS Provider: CalCERTS
Report Generated: 2015-07-30 15:13:38
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)
This section does not apply to this project.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 1S0.2(b)iC)
01
02
03
04
05
06
07
08
09
10
11
Heating
Yf
'Cooling
r
System
Heating
Minimum
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
'Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Duct
Name
Type
Component
Type
Value
_System Type
Component
Type
Value
Type
R -Value
`split
This field
System 1
Central gas
furnace
All new heating
1
AFUE
E:
t 0.78
1 €>
Central
LAC
Allhewcooling;
'
SEER y
ti . 13.
SetbackTher
or section
cpm onents
p
.: ,
w.
?_..
E cpm onente r`
p r
x
-s
--,
mostat
is not
,. A
t' 11-7
Y 171 11—r
t
f "+ ! f
1:7,
applicable
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R & MR -MCH -20-H Duct Leakage Verification required.
-Leakage rate compliance: s 6%.
CF2R & CF3R-MCH-22 Fan Efficacy Verification
CF2R & CF3R-MCH-23 System Air Flow Rate Verification
-Compliance: Fan Efficacys; 0.58 W/cfm and System Airflow ? 350 cfm/ton.
- Alternative Compliance: CF211 & CF3R-MCH-28 Return Duct Design Verification is an alternative to MCH -22 and MCH -23 verification.
CF2R & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
Exceptions:
Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements.
No e:
An "entirely new or replacement duct system" means at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused
parts from the dwelling unit's existing duct system (e.g.,
registers, grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to'prevent leakage
Registration Number: 215-A0211164A-000000000-0000
CA Building Energy Efficiency Standards - 2013 Residential Compliance
Registration Date/Time: 2015-07-30 15:13:32
Report Version: 2014-03-31
Schema Version: 0.555SDD
HERS Provider: CalCERTS
Report Generated: 2015-07-30 15:13:38
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:
Paredes, Herman
Documentation Author Signature:
Company:
Signature Date:
PALOMA AIR CONDITIONING
2015-07-30 15:13:32
Address:
CEA/ HERS Certification Identification (if applicable):
P 0 BOX 3501
City/State/Zip:
ne:
PALM DESERT CA 92261
r(760)347-1212
Responsible Person's Declaration statement
1 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 approval 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 permits) 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 Compliance is required to be included with the documentation the builderp pro--vidi es to the building owner occupancy.
Responsible Designer Name: f I j
Paredes, Herman
-at
Responsible Designer Signature: it 7 1 %L1fLlLX/ / 1iG`(TiN
Company:
Date Signed:
PALOMA AIR CONDITIONING
2015-07-30 15:13:32
Address:
License:
P 0 BOX 3501
619091
City/State/Zip:
Phone:
PALM DESERT CA 92261
(760) 347-1212
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 215-A0211164A-000000000-0000 Registration Date/Time: 2015-07-30 15:13:32 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-30 15:13:38
Schema Version: 0.555SDD
Bin # .0ty of ,La Quin ta.
Building 8i: Safety Division
Permit # P.O. Box 1504, 78-495 Calle-Tampico
La Quinta, CA 92253 - (760) 777-7012.
2 Building Permit Application and Tracking Sheet
Project Address: Ula Ql (' Owner's Name: IAL1.
A. P. Number:
Address:<577 -- 11
Legal Description:
City, ST, Zip: C 0 1Z 3
'I,
Contractor: '
d'
N
N C. c
Telephone: 3
Address: O
( `
Project Description: -0toC
City, ST, Zip: 7z •( C fI
r /
Telephone: 11
State Lic. #: 6 1,000"City
Lie. #:
Lam_
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: one:
P
'.
Con
C sOccupancy:
n TYP
State to Lic. #
r JeP ct nPa (circle one):: New Add'n Alter Repair. r. Demo
0
Name of Contact Person:
Sq. Ft.: -
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
MOM
APPLICANT:•DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING
PERMIT 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 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2wd Revicw,.ready for'corrections/issue
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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P:
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees